Irritable bowel syndrome in two different socioecnomic groups in Pakistan

Irritable bowel syndrome [IBS] in outpatient department in Social Security teaching hospital and Surgimed hospital Lahore and the comparison of the two groups along with their comparison with the western data. 163 patients in social security hospital [group I] and 44 patients at Surgimed hospital [group II] were studied for irritable bowel syndrome from October 2005 to January 2007. The patients presented with abdominal distension, pain abdomen along with diarrhea / constipation were included in this study and used Rome II criteria. Diagnosis confirmed by using exclusion criteria with specific history. Data from group II patients was similar as western data while in group- I patients data differed from western data. This was due to repeated coexisting gut infections along with IBS due to contaminated water and poor compliance

Assessment of diastolic dysfunction in hypertensive patients and its association with left ventricular mass index

Early detection of diastolic dysfunction in hypertensive patients to reduce complications and improve outcome. East Medical and Cardiology wards of Mayo Hospital Lahore. Study A descriptive cross-sectional study. 51 hypertensive patients between 50 - 80 years of either sex enrolled through out patient department of Mayo Hospital Lahore underwent Doppler Echocardigraphy and data was analyzed by using Chi-square and Students 't' tests. The percentage of left ventricular hypertrophy [LVH] was 66.66%. On comparing hypertensive patients with and without LVH, E and A wave velocities, E:A ratio, deceleration time and isovolumic relaxation time were similar. 33.33% of patients had no LVH in the presence of diastolic dysfunction so LVH was not an independent factor associated with abnormal flow patterns in hypertensive patients with normal systolic contractility. Impaired relaxation was the predominant pattern of diastolic dysfunction an d increased further with age

Lichtenstien repair of inguinal hernia under local anaesthesia - day case surgery

This prospective study was carried on 250 patients to study the complication and recurrence rate associated with Lichtenstien repair of inguinal hernia in our clinical and socioeconomic settings. The cost effectiveness and return to work after surgery were the other outcome measures. Two hundred and fifty patients underwent mesh repair of inguinal hernia at two different centers over a period of two years. All the patients were operated under local anesthesia. A bolus dose of preoperative antibiotic was given intravenously. The patients were followed up for two years and their post operative course was assessed according to a prescribed proforma. The rate of minor complications was in the range of 11.8%. The recurrence rate was 1.2%.There was minimal pain and the procedure was cost effective in terms of operative cost and less economic loss due to early return to work. It is concluded that Lichtenstien repair as a day case is safe and effective procedure to be performed by a trained general surgeon under local anesthesia. The infection rate and the recurrence rate are low. The compliance and acceptability of the patient and ease of carrying out the procedure under local anesthesia by surgeon is acceptable. In our view this type of hernial repair is an appropriate method in district hospital and tehsial headquarter hospitals where provision of anaesthesia facilities are yet to be fully developed and hospitals cater a major hernial load due to elderly patients with background of farming professions being admitted. The patient can be sent home on same day after surgery

Selective expolratory protocol, a possibility in penetrating neck trauma

A four year [1993-96] prospective study of penetrating neck trauma was carried out at a surgical unit of a major teaching hospital. The study comprises of 48 patients. Age ranged from 16-72 years with a male to female ratio of 9:1. Thirty two [66.6%] merited early exploration while 16 [33.3%] were initially treated conservatively. Two of the later group underwent delayed exploration for infected hematoma. Firearm was the commonest mode of injury [43.7%] and cervical vasculature was the most commonly injured[25.4%]. Exsanguination and respiratory paralysis following cord damage were responsible for the mortality in 5 cases