Femoral neck fracture; outcome of unipolar hemiarthoplasty in elderly patients

Objective of this study determines the outcome of unipolar hemiarthoplasty in elderly patients with femoral neck fracture at Liaquat University Hospital Hyderabad/ Jamshoro. Total 50 elderly patients were included in the study with femoral neck fracture and all the cases were selected from accident, emergency and OPD. All the patients with the history of pregnancy, those patients who were unfit for anesthesia, malignancy, neurological deficits of lower extremity, rheumatoid arthritis and Parkinson's disease regarding with systemically disease were excluded from the study. All the patients under went surgical hemiarthoplasty treatment with Austin moor-femoral head prosthesia. In the last all postoperative complications, functional outcome and mortality were noted on proforma. Total 50 patients were included in the study. Mean age of this study was mean +/- SD 64.98 +/- 4.13. Females were found in majority with male/ female ratio 1:1.27. Post operative pain was noted in the 50% of the cases and out of them severe pain was noted only in 4% of the cases. Superficial infection was seen in 4% of the cases and deep infection was not found in the cases and death was occurred in 10% of the patients. On the outcome, excellent results were found in the 44.44% of the study participants, good and fair results were seen in 26.66% and 20% respectively, while poor results were seen in 8.88% of the patients. It is concluded that unipolar hemiarthoplasty is of the reliable procedure by use of Austin-moor femoral head prosthesia for the treatment of femoral neck fracture in elderly

Outcome of the closed diaphyseal humeral fracture treated with dynamic compression plate

To determine the treatment outcome of the closed diaphyseal humeral fracture treated with dynamic compression plate at Liaquat university hospital Hyderabad. Total 30 patients having displaced diaphyseal humeral fracture were included in the study. All the patients having fracture of less than 10 days and between the ages 15 - 45 years were selected. All the patients selected after counseling and diagnosed as a case of closed diaphyseal humeral shaft fracture on the basis of clinical examination and X-rays. In this study dynamic compression plates [DCP] were used for stabilization of humeral shaft fracture as assessed by pre operative workup, operative findings and outcomes were recorded with postoperative complications. To avoid the radial nerve palsy it is isolated during operative procedure. Present study was comprises of 30 patients with humeral fracture with the mean age of 30.29 +/- 8.92 years and male/ female ratio of 7:3. On the radiological findings most common type of fracture was oblique in 54%. From the complications, postoperative pain was found in 6.6% of the cases along with postoperative Infections in 10%. 90% fractures united while 10% fractures found with non union. Excellent result were seen in 60% of the cases, while 30% cases were noted with satisfied results and very poor results were found in 10% of the cases. It is concluded that DCP is the good option for the fixation of diaphyseal humerus fracture. Radial nerve palsy is less likely if isolated during operation

Cirrhotic patients; incidence, of UGI bleeding factors and esophageal varices

To determine the frequency of upper GI bleeding and its predicting factors and esophageal varices in the patients with liver cirrhosis disease admitted at medicine ward of Isra university hospital. Prospective and observational study. Isra university hospital. March 2012 to August 2012 [six months]. Containing 100 patients, mean age was 45.8, and all the patients with cirrhosis disease were included in this study with liver cirrhosis disease. All patients were under went endoscopy and Frequency of upper GI bleeding and varices presentation and classification according to grade were noted. All the 100 patients were selected on the basis of presenting liver cirrhosis disease. Male were more found than the female with the mean age 45.8. Mostly cirrhotic patients were found with HCV positive and upper GI bleeding were noted in [40%] of the cases. With the endoscopic finding mostly patients were noted in II - III grad of esophageal varices and according to child pug classification majority of patients was noted in class "C" In addition, thrombocytopenia and red wale markings along with the presence of large sized varices were associated with the presence of esophageal varices. In the conclusion of this study we found majority of the cirrhotic patients with HCV, Esophageal varices and thrombocytopenia are the important factors of upper GI bleeding. Knowledge and etiology of this manuscript may helpful in the prevention of oesophageal varices and upper GI bleeding

Pattern of microbes associated to acute appendicitis at Liaquat University Hospital

To identify the most common of causative microbes associate to acute appendicitis and choice of different antibiotics according to sensitivity. Observational and Prospective Study. This was carried out in the Department of Surgery, Liaquat University Hospital, Hyderabad from January 2009 to January 2010. In this study patients various cultures obtained at the time of appendectomy was sent under sterile conditions for isolation of organisms and their sensitivity were sent to university hospital. the condition of the appendix regarding catarrhal inflammation, perforation and gangrene were noted on the preformed. Cultures were sent from the appendix wall and peri appendix peritoneal fluid for aerobics and anaerobic cultures. Total number of 100 culture reports of the patients who underwent open appendectomy was enrolled in this study irrespective of sex. The Pipracillin + Amikacin was the most effective [41.8%, n= 55] antibiotic followed by Ceftazidime + Amikacin, the second commonest effective antibiotic in 17 patients [30.9%]. We conclude that the most common isolated organisms of the aerobes were found sensitive against cephalosporins. Pipracillin tazobactum and Quinolones are the most sensitive antimicrobial to most of the pathogens isolated in our study