Synthesis, characterization and biological evaluation of some 5-methylpyrazine carbohydrazide based hydrazones

Pyrazine carbohydrazide based hydrazones were synthesized starting from 5-methylpyrazine-2-carboxylic acid. The acid was first converted to its methyl ester, which on further treatment with hydrazine hydrate transformed to carbohydrazide. The carbohydrazide was treated with differently substituted aromatic carbonyl compounds giving hydrazones. Characterization of the synthesized compounds was carried out using modern spectroscopic techniques and unambiguously confirmed through X-ray crystallographic studies of compound 3d. The purity of the compounds was verified using elemental analysis. The target molecules were evaluated for urease inhibition, antioxidant and antimicrobial activity

Short and long term follow up results of [the versatile] reverse sural artery flap

This study was designed to see the long and short term outcome of the reverse sural artery flap.Case series. From January 2009 to December 2011, data was collected and analyzed for this study. Eighty nine patients with wounds on the ankle, heel, sole, distal leg, and foot were included in the study.they were followed up at 01 week, 02 weeks, and then 4 weekly for 06 months and at one year time from operation. They were examined for necrosis, congestion, surgical site infection, dehiscence of suture line, epidermolysis, donor site infection and functional outcome. Most of the flaps healed nicely but two [2.25%] failed completely. Six flaps were delayed. However early follow up [within 04 weeks] revealed that there was partial loss of the distal 1-1.5 cm of flap in 04 patients [4.50%]. Two patients [2.25%] developed superficial surgical site infection. Six patients [6.74%] developed venous congestion of the flaps which recovered within two weeks. Other minor complications included dehiscence of suture line in 3 patients [3.37%], and superficial Epidermolysis in four [4.50%] [Table-2]. Twenty two patients [24.72%] returned to their work in 12-16 weeks, 31 [34.83%] in 16-20 weeks and 36 [40.45%] in 20-24 weeks. Long term follow-up to 06 months revealed hypertrophic scars at the donor site in three patients [4.91%] and recurrence of ulcer in 2 patients [3.27%]. The sural fasciocutaneous flap provides reliable supple and durable most single-stage coverage of wounds of the distal third of the leg, heel, and foot with the results comparable to free-tissue transfer

Reconstruction of non-melanotic facial tumours with local flaps; replacing like with like

To assess the outcome of early skin tumour excision and reconstruction with regards to tumour margin clearance, recurrence and aesthetic results of reconstruction. Quasi experimental. This study was carried in the department of Plastic and Reconstructive Surgery Combined Military Hospital [CMH] Rawalpindi, Pakistan from January 2010 to December 2012. All patients having tumours of the cheek, upper and lower lips, nose and forehead, who underwent primary surgical excision and reconstruction with local flaps, were included in the study. Patients with nodal or distant metastasis were excluded. Tumours were excised with safe margins and defects reconstructed with local facial flaps. Patients were regularly followed up as per protocol for basal cell carcinoma [BCC] and squamous cell carcinoma [SCC]. Eighty nine patients aged between 37-86 years with a mean age of 59.4 years [SD +/- 9.24] were included in the study. There were 58 [65%] cases of basal cell carcinoma [BCC] and 31 [35%] of squamous cell carcinoma [SCC]. Recurrence was seen in 3 [5.2%] cases of BCC and 2 [6.4%] cases of SCC. There was 1 [1.1%] complete and 4 [4.5%] partial flap losses. The follow-up period ranged from 4 months to 3 years with average of 16 months. Local flaps give a simple option for facial reconstruction for postoncological resection defects giving good aesthetic match due to local tissue

Relationship of serum uric acid level and angiographic severity of coronary artery disease in male patients with acute coronary syndrome

Background and objective: The association between serum uric acid and ischemic heart disease remains controversial and it has not yet been established as cardiovascular risk factor. Our objective was to study the association of serum uric acid level with angiographic severity of coronary artery disease in men with acute coronary syndrome [ACS]

Methods: This cross-sectional study was conducted on 100 consecutive male patients presenting with ACS at Punjab Institute of Cardiology. Hyperuricemia was defined as serum uric acid level >/= 6.5 mg/dl. Severity of ischemic heart disease was assessed on the basis of Gensini score, number of diseased vessels, critical lesions and total occlusions on coronary angiogram

Results: Mean age of normouricemic group [n=59] was 52.62 +/- 9.46 years and mean age of hyperuricemic group [n=41] was 50.52 +/- 9.40 years [p=0.273]. Mean uric acid level; normouricemic group [4.75 +/- 1.05], hyperuricemic group [7.61 +/- 1.24], p < 0.001. Mean Gensini score; normouricemic group [22.15 +/- 21.52], hyperuricemic group [35.69 +/- 26.80]. Mann Whitney U test was applied to compare the Gensini score of two groups and it showed statistically significant difference [p value <0.006]. Critical lesions, total occlusions and multi-vessel disease were more frequent in hyperuricemic group but statistically significant difference was found only for total occlusions [p=0.013] and critical lesions [p=0.046]

Conclusions: Hyeruricemia is associated with higher Gensini score and more frequent total occlusions and critical lesions in men presenting with acute coronary syndrome

Management of war injuries - experience at CMH Rawalpindi during 2008 - 2010

To see the changing mode of injury from firearm to blast, pattern of injury with modern body armor and improved surgical options with results of different procedures done. Descriptive study. Department of Plastic Surgery Combined Military Hospital Rawalpindi between Jan 2008 and Dec 2010. All victims of low intensity conflict whether civilian or military personnel from all age groups without sex discrimination were included. Data was collected from history, transferring notes from the forward medical facility to this hospital, case record documents in this hospital and `patients follow up proforma. All these cases were managed in collaboration with other concerned specialties including orthopedic surgery, general surgery, otolaryngyology, maxillofacial surgery and vascular surgery. Plastic surgery department managed 212 patients over last three years i.e. 2008-2010. Age range was 14-58 years and male to female ratio was 71:1. Primary surgical wound management was done at field military hospitals in majority of cases and few were air evacuated directly to CMH Rawalpindi. Majority of injuries were caused by explosions followed by firearms. Simultaneous injuries were 68.9% and isolated injuries were 31.1%. Decision of wound closure was usually dependent on level of tissue damage, contamination and infection. Concept of reconstructive ladder was followed. Majority of wounds were closed in delayed primary setting. Infection was the most common complication followed by partial or complete graft or flap loss. Minimum complication rate was encountered in the wounds which were closed in delayed primary setting. All war wounds are primarily contaminated. If these wounds are closed in delayed primary setting after 2-3 debridements, best results can be achieved. Although infected wounds, wounds with severely damaged structures and injuries associated with tendon or nerve injuries or bone loss will require secondary reconstructive procedures.

Patient satisfaction and merging of small hospital

The first merging of small hospitals into a large one came into existence in January 2005 in county Louth. As a result the surgical departments of Louth county hospital Dundalk and Our lady of Lourdes hospital Drogheda Ireland were combined. Two hospitals are at less than half an hour drive and situated North-eastern region of Ireland. To assess the impact of joining two departments of surgery in two different hospitals along with the patient's reaction after such arrangements were made. review of literature. Louth County Hospital Dundalk Ireland. One year Following review of literature it was decided to explore the experience of patients who were treated in Louth County Hospital Dundalk one year after merging of two departments of surgery. Randomly 20% of patients treated in Louth County Hospital were included in a telephone survey. These patients were under care of all consultant surgeons. The patients were asked about their experience in Louth hospital. Also impact of joining surgical departments on waiting list was explored. Out of 1310 patients, 20% of patients treated in Louth Hospitals were included in the survey. The age of the patients varied from 15 to 67 years. 57% of the patients were female and the remainders were males. It was found that 93.5% of patients were happy to travel to Dundalk and 96.5% were satisfied with the facilities there as well. Furthermore 96% said that they would be happy to have surgery in Dundalk if they ever needed it in the future. 6% of patients were dissatisfied with services in Louth County Hospital, Dundalk. The improvement of quality processes in healthcare is of constant concern to communities throughout the world. The results have clearly demonstrated that restructuring of services can work well and be acceptable to patients once hospitals are prepared with relevant resources in place

Bleeding in patients undergoing percutaneous coronary intervention [PCI]

To study the frequency of bleeding and associated risk factors among patients undergoing Percutaneous Coronary Intervention [PCI]. This cross-sectional study was conducted on 500 consecutive patients, who underwent PCI at Punjab Institute of Cardiology, Lahore. Bleeding was defined according to REPLACE - 2 criteria. There were 82 females [16.4%] and 418 males [83.6%]; mean age 53.4 [ +/- 9.6 years]. Bleeding complications occurred in 6.2% [n=31] of patients; major bleed 0.8% [n= 4] and minor bleed 5.6% [n= 27]. One patient with major bleed [retroperitoneal] died in hospital. The frequency of bleeding complications was 8.5% among females and 5.7% among males [P=0.24]. Radial route was used in majority [88.6%]. The risk factors found to be significantly associated with the development of post-PCI bleeding were diabetes [OR: 6.4; P < 0.0001], hypertension [OR: 13.2; P < 0.0001], smoking [OR:8.31; P<0.0001] and BMI > 40 [OR: 6.8; P < 0.002], use of streptokinase [OR: 3.1; P < 0.0005], femoral approach [OR:4.2; P < 0.02], anaemia [OR: 44.8; P < 0.0001] and ACT >/- 350 [OR: 3.73; P < 0.0005]. In our study, female gender, procedure time >/-60 minutes, use of Glycoproteins IIb/IIIa inhibitors [GPI], and patient's age >/-50 years did not show significant association with post PCI bleeding. Major bleeding complications during Percutaneous Coronary Intervention [PCI] though occur rarely, are an important cause of patient morbidity and mortality

Free anterolateral thigh flap raised on musculocutaneous perforators of rectus femoris muscle

The anterolateral thigh flap [ALTF] has been in wide clinical use for the last two decades, its major disadvantage has been its variable anatomy. We are presenting a case in which no substantial perforators were found to be arising from either the lateral septum of thigh or Vastus Laterlis muscle. In this case, instead of raising another flap, we used the same skin paddle raised on the musculocutaneous perforators of rectus femoris muscle

Development and validation of a screening instrument for bipolar spectrum disorder: the URDU version of SIMS screening instrument for bipolar spectrum disorders [SIBD]

To develop and validate a new screening instrument in Urdu language for bipolar spectrum disorders in patients presenting to tertiary care center. This instrument is called the Services Institute Medical Sciences screening instruments for bipolar spectrum disorders [SIBD]. It was quasi-experimental study. Department of Psychiatry, Services Institute of Medical Sciences and Services hospital, Lahore. January 2006 to November 2006. A total of 200 patients attending outpatient and in-patient facilities of Psychiatry Department, Services hospital, Lahore suffering from mood disorders completed the SIBD. A research professional, blind to the SIBD results, conducted a semi structured interview using DSM - IV diagnostic criteria for the diagnosis of bipolar disorder. SIBD with a screening score of 30 or positive responses to at least 7 items yielded good sensitivity [0.73] and very good specificity [0.90]. The SIBD is a useful screening instrument for bipolar spectrum disorder to be used in clinical practice in tertiary care centers initially

Role of neo-adjuvant chemoradiation in locally advanced rectal cancers

To determine the radiologic downstaging and histological response after neo-adjuvant concurrent chemoradiation in locally advanced rectal cancers. Case series. Radiation Oncology department of Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from December 2004 to November 2005. Thirty patients with histopathologically confirmed locally advanced carcinoma rectum who had not received any treatment [chemotherapy, radiotherapy or surgery] prior to presentation were enrolled. Radiation therapy was delivered with a three-field technique to a dose of 50.4 Gy over 5 weeks at the rate of 1.8 Gy/day. Two cycles of chemotherapy were given synchronously, which comprised of 5-fluorouracil 350 mg/m[2] and folinic acid 20 mg/m[2] continuous intravenous infusion over first five days and last five days of radiotherapy. Surgery was planned 4-6 weeks later to chemoradiation after radiologic post therapy staging. Viable specimens were identified and toxicity was observed. All patients completed treatment without modification. Radiologic downstaging was found in 56.7%, stable disease was seen in 30.0% and progressive disease was present in 13.3% of the patients. Radiologically complete resolution of tumour was not observed. Pathological complete resolution of tumour was achieved in 3.3% and near complete resolution was observed in 13.3% of the patients. In 86.6% cases, a total gross tumour resection with no macroscopic residual disease was possible. All the patients tolerated the treatment well. Neo-adjuvant chemoradiation for locally advanced rectal cancers is associated with high resectability rate and is relatively safe with acceptable morbidity which favours its use in future

comparative study of three brands of biosynthetic human insulin

To compare the activity of three brands of regular biosynthetic human insulin [BHI] in healthy normal subjects with the glucose clamp technique. A comparative study. CMH Lahore from May 2007 to July 2007. Thirty healthy normal male volunteers who met the inclusion criteria were tested. Each insulin preparation was sequentially infused through intravenous route at 0.02 U/kg/h for 2 hour, 0.032 U/kg/h for 2 hour and finally at 0.05 U/kg/h for 2 hours. A simultaneous 25% glucose infusion was maintained and the amount the glucose consumed was calculated. All subjects were studied on three different occasions with the three brands' of insulin. Blood glucose was monitored at regular intervals and its level was kept constant [clamped] at a baseline. The amount of glucose infused was calculated for each insulin dose for the three brands of BHI. Mean values of glucose administered during the six hour infusion period for the three brands ranged between 162 to 190g. The mean glucose consumed with 0.02 units/kg/hr of Zansulin, Actrapid and Humulin were 26.7gm, 30.6gm and 31.2gm respectively Similarly the mean glucose consumed with 0.032 units/kg/hr of Zansulin, Actrapid and Humulin were 53gm, 59.7gm and 62.1gm respectively and a similar pattern of glucose consumption was observed for insulin dose of 0.05 units/kg/hr. Glucose administered during the 6 hour infusion differed significantly among the three brands of insulin, [p<0.05]. Post hoc test for multiple comparison showed significantly more glucose consumption with Humulin R and Actrapid as compared to Zansulin R [p value <0.05].There was no significant difference in biological activity of Humulin R and Actrapid [p value >0.05] Humulin R and Actrapid had greater biological activity as compared to Zansulin R when glucose consumption was measured for each using glucose clamp technique

Comparison between effectiveness of topical 1% lindane cream and oral ivermectin in the management of scabies

To compare the efficacy of lindane 1% cream with oral ivermectin in the management of scabies. Interventional quasi-experimental study. This study was conducted in Dermatology Department of Nishter Hospital Multan, from 1[st] November 2005 to 31[st] April 2006. One hundred Patients; diagndsed for scabies by history [nocturnal itch], dermatological examination [papules, vesicles, burrows] and parasitological examination under microscope, selected by convenient sampling, were randomly assigned into two groups. Group-A was given 1% lindane cream and to Group B was given ivermectin. Both groups were treated with 2 doses after interval of 1 week, 11 out of these were dropped later on, so 89 patients, 45 in ivermectin group and 44 in lindane group were accessed for final results. Cure criteria for comparison of two treatments was absence of nocturnal itch, papules, vesicles, burrows and mite/ova under M/S. At day 8, 69% in group-B were completely cured as compared to 57% in group-A. P value was 0.00. At day 15, in group-B 91% were completely cured as compared to 86% in group-A. [P = 0.00]. At day 30, 100% in group-B were cured as compared to 89% in group-A. P=. 0.00. Oral ivermectin was significantly more effective than lindane 1% cream in treatment of scabies

Cutaneus manifestations of diabetes in diabetic patient presenting in outdoor

The aim of our study was to evaluate the frequency of skin manifestations in diabetic patients. Cross sectional study. Outpatient Department of Nishter Hospital Multan during the period from 1-6-2006 to 1-6-2007. One hundred and fifty-one type-2 diabetic patients [106 women and 45 men] attending an outpatient clinic were included in this study. All patients were then asked about any skin problems they might have and subsequently all were examined, regardless of their response. A total of 36 dermatologic disease entities were categorized. Information regarding age, sex, and the presenting disorders was recorded. The overall prevalence of one or more identifiable/apparent skin conditions was 85.4%. The most common skin conditions were infections [31.7%] [mostly mycoses], non-Candidal intertrigo [20.5%], eczemas [15.2%] [mostly neurodermatitis], psoriasis [11.2%], diabetic dermopathy [11.2%], and prurigo [9.9%]. According to sex, there was no significant difference in the prevalence of skin disorders. This study shows that skin cenditions are common in patients with type-2 diabetes mellitus. Therefore, frequent dermatologic evaluation of these diabetic patients is warranted

Cardiac mortality trends in the emergency department of a tertiary care cardiac centre

Limited information is available on trends in mortality from cardiovascular diseases in Pakistan. The objective of this study was to examine the various cardiac causes of early deaths and asses the treatment strategies in emergency department of a tertiary care cardiac centre. We conducted a prospective observational study of early deaths over an eight months period. Data of emergency admissions from June 2006 to January 2007 was analyzed. There were 357 early deaths; median age 60 years, and median survival time 1.55 hours. There were 6221 emergency admissions, with 4.6% of men and 9.4% of women having early mortality in emergency department. Only 14 were non-cardiac deaths and 314 [88%] were cardiac related deaths. Valvular heart disease comprised 6% of cardiac deaths. There were 373 cases received dead in emergency and assumed to be sudden cardiac deaths. Cardiogenic shock [CS] was the leading cause [265, 74%] of cardiac deaths and ST elevation myocardial infarction [STEMI] comprised nearly half of those deaths [130, 49%]. Only 39% [51/130] of STEMI patients were thrombolysed and there was only marginal difference in the survival time of patients with or without lytic therapy. ST depression was seen in 17% of CS patients. Ventricular fibrillation and ventricular tachycardia constituted only 20% of cardiac deaths. Complete heart block [CHB] was seen in a quarter of CS patients and emergency transvenous pacing was successful in 67% [42/63]. The survival time was shorter in patients with failure to pace acutely; men [0.50 vs. 1.30 hrs], women [1.00 vs. 2.15 hrs]. A very large number of early deaths were cardiac and cardiogenic shock was the major cause. Only half of cardiogenic shock patients had diagnostic ECG changes of ST segment elevation and less than half of these were thrombolysed

Frequency of post-traumatic stress disorder and its association with types of physical injuries and depression in earthquake victims

To examine the frequency of Post Traumatic Stress Disorder [PTSD] in victims of October 2005 earthquake in Pakistan and to evaluate its association with type of physical injuries and depressive disorder. 210 victims were assessed for PTSD and depression by using semi-structured clinical interview and HADS respectively. These subjects were selected at random. Victims, both with or without physical injuries, were assessed. Of the two hundred ten victims, 141 had sustained physical injuries. Among those, 51% had soft tissue injuries, 36% had bony injuries and 13% had spinal injuries. Among physically injured victims 87 [62%] developed PTSD and 54 [38%] did not. Sixty nine victims who did not sustain physical injuries, 32 [46%] developed PTSD while 37 [54%] did not. The results indicate significant relationship between PTSD and physical injury [Chi square=4.43, df=1, p<0.05]. Frequency of PTSD was markedly increased in people suffered from physical injuries as compared to those who did not sustained injuries

Experience with lateral cheek rotation flap for the reconstruction of medial cheek soft tissue defects

To analyze the results of reconstruction in terms of complications, functional restoration and cosmetic restoration of lateral cheek rotation flap. A cross sectional study was conducted between April 2004 and January 2005. Patient's particulars and history were documented. The cause, whether trauma or tumor resection, and dimensions of the defects were recorded. All the patients underwent a "cheek rotation flap" procedure to reconstruct the defect. Post-operative complications like haematoma formation, infection and flap necrosis were noted. Results were assessed in terms of functional as well as aesthetic restoration. A total of 30 patients were included with a male to female ratio of 3:1 and an average age of 46 + 14.7. The majority of the defects [76%] were post tumour excision, while the rest [24%] followed trauma. The average defect diameter was 7.5 cms. There was no peri-operative mortality or total flap loss. There were three cases [10%] of transient facial nerve palsy who recovered spontaneously. The final reconstruction was deemed satisfactory in terms of functional and cosmetic restoration in the majority of cases [93%]. Our results with the lateral cheek rotation flap to reconstruct the defects involving medial cheek have prompted us to recommend it as a first line reconstructive option for many varieties of defects in this area

Frequency of hepatitis-C virus infection in patients on maintenance haemodialysis in Nishtar Hospital Multan

To determine the frequency of hepatitis-C virus infection in patients on maintenance haemodialysis in Nishtar Hospital Multan. Simple descriptive cross sectional. Thirty patients of maintenance haemodialysis for atleast six months twice daily haemodialysis were included. From April 2003 to March 2004. Thirty patients out of whom 20 were male and 10 were female. Patients between the age of 16 to 60 were included in the study. All the patients were on haemodialysis for more than six months and were receiving dialysis therapy twice week. Diagnosis of HCV infection was made by detection of HCV antibody with the help of kit. Name of the kit used was ACON hepatitis C Virus Rapid Test Strip [Serum]. This was a qualitative membrane based immunoassay for the detection of antibody to HCV in serum. Frequency of anti HCV among patients of maintenance haemodialysis was found to be 26.7% [8/30]. Role of different risk factors for the transmission of HCV during haemodialysis were quite conclusive. History of blood transfusion and duration of haemodialysis were the main factors in transmission of anti HCV to the patients of maintenance haemodialysis. The Frequency of anti HCV among patients on maintenance haemodialysis was 36.7%

Frequency of microalbuminuria in newly diagnosed type 2 diabetics at Nishtar hospital, Multan

Objectives: to describe frequency of microalbuminuria in newly diagnosed Type 2 Diabetics

Study Design: Descriptive and cross-sectional study. 50 indoor and outdoor newly diagnosed type 2 diabetics were screened for microalbuminuria

Study Setting: Medical Unit III of Nishtar Hospital Multan

Materials and Methods: Both males and females with newly diagnosed type 2 diabetics were included in the study while Presence of overt proteinuria on routine urine analysis, Patients with evidence of congestive cardiac failure, urinary tract infection, and chronic obstructive pulmonary disease and Pregnant diabetics were excluded from the study. A detailed history was taken from every patient and meticulous clinical examination performed on each of them. Diabetes mellitus was confirmed by fasting and random hyperglycemia. Routine investigations like complete blood examination, complete urine examination serum urea, creatinine, X-ray chest, ECG, were obtained for each patient. Micral test [Boehringer Manhhem] was used for detection of microalbuminuria

Results: Average age of the patients was 45 years. 41 patients were males and 9 were females. 30% of these patients were found to be microalbuminuric. Both fasting blood sugar and random blood sugar levels were impaired in microalbuminurics. 38% of the total patients were smokers and 24% were hypertensives. Ischemic heart disease was found in 14% of patients on ECG where as LVH [Left Ventricular Hypertrophy] was evident in 4% of the patients. Renal parameters and Chest X-rays of all the patients were normal. None of them had CVA [Cerebrovascular Accident]

Conclusion: This study has documented higher frequency rate of microalbuminuria in newly diagnosed type 2 diabetics in our society. Poor glycemic control and delay in the diagnosis of diabetes mellitus were factors in the development of early diabetic nephropathy. Screening for early detection of diabetes mellitus is recommended

Resectability rates in locally advanced esophageal carcinoma following neo-adjuvant chemo-radiotherapy

Purpose of this study was to assess the resectability rates in un-resectable [Stages III and IV] cancers of the esophagus, to assess the complete pathological response and to compare the efficacy between two chemotherapy regimens. From January 1999 to June 2002, medical records of the patients with un-resectable esophageal cancers were reviewed, who received radiation-therapy with concomitant chemotherapy using following regimens:- Arm A:- 5FU 500 mg/m2 intravenous push [IVP] on first 5 and last 5 days of radiation. Arm B:- 5FU 1 Gm/ m2/Day 96 hour continuous infusion [CIV] and Cisplatin 70 mg/ m2 on day one and twenty eight of radiation. At completion of neoadjuvant chemo-radiation patients were offered surgery after four to six weeks. 35 patients had un-resectable esophageal cancer. Twenty-six received arm A, and 9 arm B treatment. Of 26 patients in arm A, in 13 the disease was made resectable and two of them showed complete pathological response in surgical specimen, thirteen had progressive disease. On the other hand, of 9 patients receiving arm B treatment, in 7 the disease was made resectable and out of them 5 showed complete pathological response in surgical specimen and two had progressive disease. Resectability in patients receiving arm B treatment was better than the patients treated arm A. The data is not mature enough to assess the effect on disease free survival or overall survival, this will be seen and published later

Reconstruction of lip defects with the Karapandzic technique

To study the use and effects of Karapandzic technique of lip reconstruction by long-term assessment. Design: A descriptive study. Place and Duration of Study: CMH Rawalpindi from January 1994 to January 2002. Subjects and Thirty seven consecutive patients who underwent Karapandzic technique of lip reconstructon with a minimum follow-up period of two years have been included. The variables assessed were hemorrhage, wound infection, flap necrosis, microstomia, reconstruction time, hospital stay and dynamic lip functions. Results drawn were analyzed. A total of 37 patients were included in the study. Thirteen [35%] patients were outdoor cases while 24 [65%] were in-patients. Average time of reconstruction was 40 minutes, which was done under general anesthesia in 21[57%] patients and under local anesthesia in 16 [43%] cases. Mean hospital stay of the indoor cases was 26 hours. There was no flap loss except for marginal necrosis in 04 [11%] patients. Wound infection and wound dehiscence was observed in 03 [08%] patients. Sensations were completely intact in 29 [78%] patients and aesthetically 28 [76%] patients gave normal look at the end of two years [2Y]. Twenty-seven [74%] patients had no change in speech and only one [3%] patient had unsatisfactory speech after 2 years. Varying degree of microstomia was observed in all the cases at immediate postoperative stage of one month but 35 [95%] patients showed gradual improvement with active mouth opening and stretching by prosthetic splints over 2 years. The Karapandzic technique of lip reconstruction is strongly recommended over the other techniques as it is a single stage, quick and safe procedure which gives cosmetically and functionally excellent results. Microstomia, occuring in early postoperative stage, shows gradual improvement on long-term follow-up