To compare sleep quality among basic sciences and clinical post graduates trainees working at Tertiary care teaching hospitals and allied college

Objective: Evaluation of single preoperative dose of pregabalin in terms of postoperative pain after laparoscopic cholecystectomy

Study Design: Randomized controlled trial [RCT]

Place and Duration of Study: Study was conducted in Surgical Department of Military Hospital Rawalpindi over a period of one year fromJan 2013 to Dec 2013

Material and Methods: One hundred patients [50 in each group] were included in this study. They were divided into two groups. Group-A was given pregabalin and group-B was given placeboafter laparoscopic cholecystectomy

Results: Mean age was 38.2 +/- 11.0 years in group A and 36.9 +/- 11.7 years in group B. Regarding distribution of gender, 14 patients [28.0 Percent] in group-A and 17 patients [34.0 Percent] in group-B were males while 36 patients [72.0 Percent] in group-A and 33 patients [66.0 Percent] in group-B were females. Mean visual analogue score at 24 hours was 4.98 +/- 1.87 and 6.58 +/- 2.03 in group-A and B, respectively. The difference between two group was statistically significant [p<0.001]. Analgesia was required in 17 patients [34.0 Percent] in group-A and 37 patients of group-B

Conclusion: A single preoperative oral dose of pregabalin 150 mg was found very effective method for reducing postoperative pain in patients undergoing laparoscopic cholecystectomy

Association between bone mineral density and low backache in postmenopausal women

Objective: To determine association between bone mineral density [BMD] and low backache in post menopausal women in general population of Lahore. Study Design: Descriptive study. Place and Duration of Study: Gynaecological outpatint department of Punjab Rangers Hospital Lahore during the period, from Feb 2015 to Feb 2016

Material and Methods: Screening for association between BMD and low backache in 481 post menopausal women was carried out. Low back pain was considered clinically relevant if the patient complained of moderate to severe pain, or if the patient needed any medical treatment. Their BMD was measured. The measurement site for BMD was the calcaneus of patient. The diagnosis was based on T score. Data was analyzed

Result: Osteoporosis was found in 303 [88.3%] of 50-60 years age group and 40 [11.7%] of 61-plus years age group

Conclusion: Bone mineral density was significantly lower in postmenopausal women and there was a strong association between low back ache and decreased BMD value

Frequency of syphilis among antenatal clinic attendee in combined military hospital Abbottabad

Frequency of syphilis among pregnant women attending Combined Military Hospital Abbottabad Descriptive study. A screening for syphilis of 500 married pregnant women presenting to antenatal clinics was carried out using the qualitative Rapid Plasma Regent [RPR] test/ Venereal Disease Research Laboratory [VDRL] test. The Treponema Palladium Haem-Agglutination Assay [TPHA] test was used as confirmatory test for all Venereal Disease Research Laboratory [VDRL] test positive cases. A total of 8 women [1.6%] were positive for Venereal Disease Research Laboratory [VDRL] test. Out of these 4 [0.8%] were positive for Treponema Palladium Haem-Agglutination Assay [TPHA] test. All of these cases have bad obstetrical history. The sero-positivity of Venereal Disease Research Laboratory [VDRL] test is [1.6%], considered high among pregnant women reporting in obstetrics clinics of Combined Military Hospital Abbottabad. Similarly sero-positivity of Treponema Palladium Haem-Agglutination Assay [TPHA] test is [0.8%] considered high among the Venereal Disease Research Laboratory [VDRL] test population. Therefore Screening of syphilis in pregnancy especially in patients having bad obstetrical history [BOH] should be incorporated into the study

Frequency of depression among fertile and infertile women

To compare the frequency of depression among fertile and infertile women reporting in CMH Abbottabad. A case control study. This study was conducted in combined military hospital abbottabad, over a period of six months from January 2013 to June 2013. The inclusion criteria were all those patients who were married. All the cases were selected from the women reporting in the obstetrics and gynecology department of CMH Abbottabad for investigation and treatment of infertility. A total of 200 patients, 100 fertile and 100 infertile women were included. Patients were given questionnaire form with their consent for research. Beck depression inventory [BDI] was used to assess depression among fertile and infertile women. Other factors such as age, education level, and duration of infertility, pressure from family members, miscarriages, and support from husband were studied. Depression was significantly higher in infertile women as compared to fertile women i.e. 95% vs. 63% [p<0.001]. It was higher among women with more than 1 year of duration of marriage as compared to those with infertility of one year duration or less. Infertility is associated with depression

Management of Guillian-Barre syndrome with respiratory failure: our experience

Up to 40% of cases of Guillian -Barre syndrome [GBS] require ICU admission and ventilatory support. The aim of this paper is to describe our experience with different modalities in managing GBS. 31 patients with GBS were enrolled in groups. Group A were managed by plasmaphoresis [11 patients], group B were managed by intravenous immunoglobulin [seven patients], group C patients were managed by plasmaphoreses and IVIG [six patients], and group D [six patients]were managed by classical old method [ventilatory support only].There were 17 male and 14 female,, the ages of them between 2-70 years. The use of new modalities significantly shorten the period of ICU admission [36 days with new methods, 59 days with classical methods], this decrement in period of staying in the ICU play an important role in preventing complication and improving the course of the disease. [Group B is the most superior one, while group D is in the bottom on the list]. The use of new methods in managing GBS shortened the period of ICU staying

Robotics and telepresence urologic surgery Where do we stand?

Minimally Invasive Surgery [MIS] is a revolutionary approach in surgery. In MIS, the operation is performed with instruments and viewing equipment inserted into the body through small incisions created the surgeon, in contrast to open surgery with large incisions. This minimizes surgical trauma and damage to healthy tissue, resulting in shorter patient recovery time. Open surgery requires precise movements by the surgeon, while laparoscopic surgery requires even more small and precise movements. The use of long, rigid laparoscopic instruments amplify the normal tremor of the human hand and produce a fulcrum effect because of the trocars. Unfortunately, these disadvantages reduce dexterity, workspace, and sensory input to the surgeon which is only available through a single video image. With the telesurgical workstation, the conventional surgical tools are replaced with robotic instruments which are under direct control of the surgeon through teleoperation. The goal is to restore the manipulation and sensation capabilities of the surgeon which were lost due to minimally invasive surgery. A 6 DOF slave manipulator, controlled through a spatially consistent and intuitive master will restore the dexterity, the force feedback to the master will increase the fidelity of the manipulation, and the tactile feedback will restore the lost tactile sensation

evaluation of not stenting after uncomplicated ureteroscopy: a Randomized prospective study

The aim of this study is to determine the morbidity associated with not placing a ureteral stent following uncomplicated ureteroscopy and to determine the safety of performing ureteroscopy as a day-case procedure. This is a prospective study. The study was done in the Day-case Unit, Salmaniya Medical Center, Bahrain. Sixty-one patients with symptomatic ureteric stones who underwent ureteroscopy as an outpatient procedure. The patients were followed up at days 1-4 and again at 4-6 weeks postoperatively to determine the morbidity associated with the procedure [i.e. analgesic use and length of time to return to normal activity]. Follow up consisted of urine analysis and radiological studies, which were done between 2-3 months postoperatively. Twenty one patients [34%] had no discomfort postoperatively. The remaining 40 patients [66%] had discomfort, 35 [57%] had pain that was relieved by the 2nd postoperative day. The main indication for admission was pain and hematuria. Five patients required admission. None of the patients had major immediate postoperative complications and all of them had follow up excretory urography or ultrasound done. None showed newly identified ureteric strictures or stone recurrence. Conclusions: Day-case ureteroscopic management of ureteric stones is a potentially safe procedure and can be performed in selected patients.We believe that routine placement of ureteric stents following uncomplicated ureteroscopy is not essential Gastrointestinal Bezoar - Case Reports and Literature Review