Aetiological considerations of acquired aplastic anaemia

Acquired aplastic anaemia is one of the important causes of pancytopenia. This study was conducted to observe the mode of presentation of acquired aplastic anaemia and to find out its possible etiological factors. It is a hospital based descriptive study of 100 patients of acquired aplastic anaemia. Out of 100 patients 60 were male and 40 female. Majority [44%] of the patients were between 12-20 years of age. Patient presented with variable symptoms majority [40%] with fever. Most of the patients had haemoglobin levels between 4-6 gm/dl. [53%. Seventy percent of the cases had no obvious cause, while in 30% some known causative factors were found. Chloramphenicol was found to be the most common causative drug. Mortality was 35%. Thirty patients were partially treated and 15 were lost to follow up. Twenty patients showed improvement with treatment. Acquired aplastic anaemia is common among males and more prevalent in younger age group. It is idiopathic in 70% cases while 30% had some cause. It has very high mortality. Doctors need to keep in mind this fatal condition in patients presenting with anaemia and should properly investigate before prescribing antibiotics and haematinics

Lichtenstein's repair with polyester [mersilene] mesh for inguinal hernia

Lichtenstein's repair using polypropylene [proline] mesh for inguinal hernia is now well established method of dealing inguinal hernia with minimal postoperative complications. We have used mersilene mesh instead of proline mesh in this study. One mersilene mesh of 30x30 cm was used in 12 patients, thereby decreasing the overall expenses of the patient. A prospective study of 100 patients with inguinal hernia, who underwent mesh repair was carried out at Sindh Govt. Qatar Hospital Orangi Town Karachi, from February 1995 to June 1998. We present our results of Lichtenstein repair with mersilene mesh

Laparoscopy in the management of impalpable undescended testes

Management of impalpable testes poses a diagnostic and therapeutic challenge. A case of impalpable testes is reported, which was managed successfully by staged laparoscopic Fowler-Stephens orchidopexy

Effects cimetidine ranitidine and tiotidine on plasma testosterone and luteinizing hormone level in rats

The investigation was carried out to study the comparative effects of cimetidine, ranitidine and tiotidine on the plasma levels of testosterone and luteinizing hormone under local environmental conditions. The three H2- blocking drugs were injected to the adult male albino rats twice daily at the recommended therapeutic dose levels for six weeks. The data obtained showed that only tiotidine caused a significant [P< 0.05] increase in the level of testosterone. However, all the three drugs caused a significant rise in the levels of luteinizing hormone and maximum with ranitidine

Modified posterior sagittal anorectal pull-through for imperforate anus

A total of 100 children with ano-rectal malformations were admitted to the Department of Paediatric Surgery, Civil Hospital, Karachi during 1988 to 1992; 40 patients were male and 60 were female; 84 patients had high or intermediate variety of ano-rectal malformations. Amongst them, 59 had fistulae [rectovaginal 29, rectovestibular 18, rectourethral 10 and rectovesical 2]. They were subjected to staged procedures [colostomy, modified posterior sagittal anorectal pull [PSARP] through and colostomy closure]. All three stages were completed in 34 patients. postoperative complications in treated patients were seen in 10 patients. we feel that our procedure of PSARP is a safe, effective method of dealing with anorectal malformations of high and intermediate type with minimal post-operative complications

Abdominal tuberculosis a 20 years experience [1971-1990]

During 1971-1991, 133 patients of abdominal tuberculosis were operated upon and diagnosis was confirmed by histopathology. Maximum incidence was seen between 2nd to 4th decade of life with female preponderance. Majority of them had symptoms of 2 years or more duration. 48% patients presented as emergency. 18% patients had uncommon presentation with initial clinical diagnosis of other than abdominal tuberculosis. Associated pulmonary tuberculosis was seen in 13%. 52 patient had strictures while 38% had hypertrophic ileocecal tuberculosis. Resection was performed in 79 patients, bypass in 26, strictureplasty in 10 while 32 had biopsy only. We feel that the diagnosis of abdominal tuberculosis is difficult. Laparotomy and biopsy are the safest and quickest method of obtaining immediate diagnosis. Surgery has a definite role in treatment and is mandatory in presence of obstructive episodes