Frequency of disordered eating and menstrual dysfunctions in female athletes

Objectives: To determine the frequency of disordered eating and menstrual dysfunctions in female athletes

Material and Method: This was a cross sectional study. A Total of 66 female athletes from different colleges of Lahore participated in the study. Disordered eating was assessed using eating disorder examination questionnaire [EDE-Q] and menstrual dysfunctions were determined using standardized questionnaire

Results: Disordered eating was present in 15.2% while menstrual dysfunctions were present in 4.5% of the female athletes

Conclusion: It is concluded that frequency of disordered eating is high in female athletes while menstrual dysfunctions are not common in female athletes of major teaching institutions of Lahore

Exclusive breast feeding; duration at northern areas of Pakistan; a hospital based study

To study the duration and factors influencing exclusive breastfeeding practice. Across sectional descriptive. A primary care hospital Gilgit, northern area of Pakistan. Ten months from March 2007 to December 2007. This study include 125 mothers with mean age of 24.3 years [SD 4.8],37% were illiterate while only 14% were matriculate or above among 125 babies [male 61%: female 39%]. Out of total 125, eighty one [64.8%] babies were exclusively breast fed [EBF] for first six months of life and only five [4%] infants were not given breast milk at all. among 76 male infants, 52 [68.4%] were EBF for six months in comparison to 29 female [59.2%] out of 49. among 36 first born infants only 15 [41.7%] were EBF for six months in comparison to 66 [74.2%] out of 89 not first born [p<0.05]. Exclusive breast feeding for complete 6 months is still not routinely practised by most of mothers and first born are deprived of this right in majority lower socioeconomic group and illiterate mothers are more likelyto breast feed, gender bias was also observed as a significantly high percentage of male babies were observed to be breast fed as compared to females. More efforts are required by health depart. And NGO's to promote good breast feeding practices in our setup

Association of aetiology, presentation and post-operative complications of post-traumatic peripheral artery pseudoaneurysm

To describe post traumatic pseudoaneurysms and its association to causes, presentation and conventional surgical treatment modalities. This Descriptive study carried out in the Department of Cardiovascular Surgery, Lady Reading Hospital, Peshawar from January 2003 to December 2007. Patients with associated arteriovenous fistula were excluded from this study. All the demographics including age, sex, type of injury, site, associated complications operative details, pen operative morbidity and mortality were prospectively recorded in a data base. The total number of patients was seventy five. All the patients underwent conventional surgical procedures. Reverse saphenous graft was received by 34%, 24% had end to end anastomosis, 12% had interposition synthetic graft, 8% had rent repair while 21.33% had primary ligation of the involved artery. There was no pen operative mortality. Six patients had post operative complication in the form of graft, thrombosis and or infection. Three patients had amputation, two in lower limb and one in the upper limb. Majority of them were male 90.66%. Age ranged from 7 years to 75 years. Most of the patients [77.3%] were in second to fourth decade of life. The most common cause of injury was gunshot wound [56%] followed by stab wounds [13.33%] and road traffic accidents [12%]. Few cases of bomb blast [6.66%], Post cardiac catheterization [4%], glass injury [4%] and intravenous drug abusers [2.66%] were also reported. The commonest site of injury was fern oral artery [37.33%].In this study majority of patients were male with gunshot wound as commonest cause. Reverse saphenous vein graft was treatment of choice. Infection and thrombosis were the commonest postoperative complications

Partial inferior turbinectomy; a better management option for hypertrophied inferior turbinates

To assess the effectiveness of partial inferior turbinectomy in relieving the symptoms of nasal obstruction in cases of inferior turbinate hypertrophy and to compare the results in terms of relief from nasal obstruction in response to total inferior turbinectomy. Department of Otorhinolaryngology and Head and neck surgery, CMH Rawalpindi, From January 2004 to November 2004. A total of 60 patients with inferior turbinate hypertrophy were selected by convenient sampling. 30 patients were treated by partial inferior turbinectomy and 30 by total inferior turbinectomy and result in terms of relief of nasal obstruction based on VAS [Visual Analogue Score] was observed with follow up carried out at interval of one week and then two months. All cases of both the groups showed complete relief of nasal obstruction after 02 months, showing 100% out of 30 cases managed by total inferior turbinectomy 4 cases [13%] developed atrophic rhinitis. Partial inferior turbinectomy is as good as total inferior turbinectomy in relieving nasal obstruction with an edge of avoiding complications like atrophic rhinitis

DDS- syndrome: a rare side effect of dapsone in leprosy patients

A 35-year-old male suffering from mid-borderline leprosy was put on multidrug therapy. Six weeks after the commencement of therapy he developed features of DDS- syndrome. Dapsone was immediately stopped, he was put on oral steroids. The patient gradually improved and the liver functions became normal within few weeks. The steroids were gradually tapered off. Dapsone was replaced with quinolones

Should we say good bye to closed mitral commissurotomy in our setup

To study the short-term results of closed mitral commissurotomy in patients with rheumatic mitral stenosis. Material and This study was conducted at the department of cardiovascular surgery, Lady Reading Hospital, Peshawar from January 2003 to December 2003. Data was collected on a preformed proforma. Mitral valve characteristics were evaluated according to the scoring system devised by Wilkins and Associates. All those patients who had severe mitral stenosis and echo score of < 12, raised pulmonary hypertension or patients with atrial fibrillation were included in this study. Patients having echo score > 12, left atrial and left atrial appendage clot, moderate mitral regurgitation were excluded from the study. After operation patients were followed up for six months for haemodynamic stability. During this time period, 76 patients with rheumatic mitral stenosis underwent closed mitral commissurotomy. Total patients were 76 [male 18, female 58] with age range of 10 to 60 years. Pre-op 2 2 mitral valve area ranged from 0.6 to 01 cm a mean of 0.74 + 0.13 cm. Mean mitral valve gradient was 19.7 + 6.3 mm Hg. Pulmonary artery systolic pressure ranged from 35-110 mmHg. Five patients had associated severe tricuspid regurgitation. Twenty patients had controlled atrial fibrillation. At two weeks follow-up in the out patients department after closed mitral commissurotomy the mean mitral valve 2 gradient was 9.4 + 4.2 mmHg and mitral valve area was 1.6 +/- 0.7 cm. One patient developed severe mitral regurgitation and one had left hemperesis. Pulmonary artery systolic pressure assessed by Doppler, dropped to a mean of 40 mmHg. There was no death. At six months follow-up the improved haemodynamics were maintained. Cost of the whole procedure was less than the cost of the percutaneous transmitral commissurotomy catheter alone. Closed Mitral Commissurotomy is a safe procedure. It is cost effective in developing countries with limited health budget, closed mitral commissurotomy still has a role to play

Devega's tricuspid valve annuloplasty: Still a good alternative in our setup

To assess the durability of Devega's repair of tricuspid valve in severe tricuspid regurgitation [TR]. From January 2002 to December 2003. 22 Devega's surgical repairs of tricuspid valve in severe TR were done either with mitral valve replacement or with Atrial Septal Defect [Secundum Type] repair. Clinical data was retrieved from hospital records and analyzed post-operatively on the basis of NYHA status and echocardiographic findings at the interval of 6, 12 and 24 weeks. The durability of Devega's repair was assessed. Out of 22 Devega's repair, over 80% of the patients having severe TR+3 reverted to no TR and about 20% patients had mild TR postoperatively at the interval of 6 months and the repair was intact on echocardiography. Devega's repair of tricuspid valve in severe TR is a safe and economical procedure in our setup

Abdominal aortic aneurysm surgery - local experience

The aim of this study was to evaluate the outcome of AAA referred to our unit by general surgeons/physicians.This study was conducted from Jan 1996 to Dec 2001. 25 AAA were referred. Age range 18-75 years [mean 54 years] male 19, female 6. Eight out of 25 patients presented with dissecting leaking AAA while 16 presented with non-specific symptoms. Diagnoses were made only by doppler ultrasound. Out of 8 leaking AAA 2 patients were not operated because of low pressure and no response to resuscitative measures. Six patients underwent surgery but we lost 4 out of which 1 had table death, 2 patients died on 3rd and 5th post operation day because of Acute MI, 4th patient died on 4th post operative day because of graft thrombosis. Two patients survived the operation and went home on the 10th post operation day. Out of the non-dissected group of AAA all the patients survived surgery and discharged home on the average 10th post operation day. Non-specific abdominal pains radiating to back especially in the elderly should be thoroughly investigated keeping in mind the AAA and they may be referred to the respective center for proper management

Urethral discharge in men - risk assessment and evaluation of syndromic management

Sixty two patients presenting with urethral discharge were enrolled in the study. The high risk sexual behaviour in these individuals was assessed through standardized, anonymous, self completed questionnaire. The WHO algorithm for the syndromic management of urethral discharge in men was applied to these patients. The questionnaire was completed in full by 45[73%] and partly by 8[13%]. The high risk factors included paid sex or casual sex, and lack of condom use. According to the algorithm, 59 cases with clinically confirmed urethral discharge received the treatment, 55 individuals completed the follow up and 53 [96.3%] were clinically cured. The sensitivity of algorithm was 100% and its Positive Predictive Value was 97%. We conclude that high risk sexual behaviour exists in our population and syndromic approach in the management of men with urethral discharge is effective, acceptable and affordable. Its implementation particularly at the primary healthcare settings could have major impact in the control and prevention of sexually transmitted infections