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Aim: To evaluate the feasibility, safety and outcome of day case laparoscopic cholecystectomy in patients with symptomatic gallstones. Materials and methods: This prospective cross-sectional study was conducted at Department of Surgery, Northern Medical Tower, in the Northern Border region of Saudi Arabia from Jan 2018 to Dec 2019. Two hundred forty six patients with uncomplicated symptomatic gallstones were selected according to inclusion and exclusion criteria. They were admitted electively on the same day and operated on in the morning hours and discharged by the surgeon 6-8 hours later in the evening. The variables of this study were overnight stay, rate of conversion to open surgery and perioperative complications. Results: Out of 246 patients, 221 (90%) were female and 25 (10%) were male with a ratio of 9:1. The age of the patients ranged from 20-50 years with a mean age of 35 years. In this series 209 patients (85%) were discharged successfully after observation of 6-8 hours in the day surgery unit (DSU) whereas 37 patients (15%) stayed overnight. Factors responsible for overnight stay included excessive postoperative nausea and vomiting in 5 cases (2%), drain placement in 27 cases (11%) and three patients (>1%) refused to discharged. Two patients (<1%) required conversion to open laparoscopic cholecystectomy. Umbilical port site infection was noted in 4 cases (2%). Conclusion: Day-case laparoscopic cholecystectomy is safe and feasible with high success rate in carefully selected patients with uncomplicated symptomatic gallstones.
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Introduction: Urinary bladder Cancer [UC] is second most common cancer among patients with genitourinary malignancies. Because of high recurrence rate the patients with Non-muscle-invasive bladder cancer [NMIBC] requires a lifelong surveillance. Doxorubicin has been shown to decrease recurrence rate on long term follow up. However, evidence on its efficacy on short term follow-up is limited. The purpose of the current study was to find out early recurrence rate after Doxorubicin treatment. If found low, this study will reduce the costs and hospital burden for patients needing Re-TURBT
Objective: The study objective was to compare the frequency of recurrence in patients with low risk superficial bladder cancer receiving a single dose intravesical Doxorubicin instillation with placebo
Study Design: Randomized Controlled Trial
Setting: Department of Urology, Khawaja M Safdar Medical College, Sialkot
Duration: One year from 10-03-16 to 09-03-2017
Methodology: 70 patients with Non-muscle-invasive bladder cancer were randomly allocated into 2 groups. Group-A received Doxorubicin treatment while Group-B received Placebo. Patients were followed after 3 months on cystoscopy. All the patients were informed about the procedure
Results: The mean age of the patients was 56.84+/-7.28 years and majority [n=58, 82.85%] of the patients were male and only 12 [17.14%] patients were female giving a male to female ratio of 4.38:1. The mean age of the patients in Group-A was 56.44+/-7.10 years while in Group-B it was 57.23+/-7.50 years. Among Group-A 80% patients were male and 20% were female while in Group-B 82.9% were male and 17.1% were female. However, the difference in term of age and gender was not significant statistically. On follow up at 3 months, 19 [27.14%] patients had recurrence while 51[72.85%] patients were clear of disease. The rate of recurrence was similar across different age groups and gender. Doxorubicin treatment was associated with decreased frequency of recurrence [18.6% vs. 35.7%; p=.023] as compared to Placebo
Conclusion: This comparative randomized control trial showed that intravesical Doxorubicin instillation within 6 hours of TURBT is effective in reducing recurrence in patients with NMIBC
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Background: Different phenomenon such as loss or accumulation of various substances and dysregulation or alteration in number of metabolic pathways are responsible for aetiology and pathogenesis of chronic changes in chronic kidney disease [CKD]. Haemodialysis or renal replacement therapy [RRT] does not correct the dyslipidemia of uraemia but may modify it. The objective of this study was to see the effects of haemodialysis and frequency of dialysis sessions on dyslipidemia and various biochemical markers in patients with CKD
Methods: This was a hospital based cross-sectional observational study conducted in Dialysis Unit of Ayub Teaching Hospital, Abbottabad. In our study renal functions and lipid profile of 30 healthy subjects as control group were compared with 56 cases of CKD undergoing haemodialysis with a frequency of 1, 4, 8, or 12 per moth. Serum lipid profile, renal function tests, serum and urinary albumin was estimated for both the groups. They were further analysed for serum markers before dialysis [pre-HD] and post dialysis, six months [post-HD]. Statistical analysis was performed using SPSS-17
Results: Thirty [54%] subjects were males and 26 [46%] were females. The mean age of the patients was 45.48+/-14.78 years as against mean age of controls [46.78+/-13.95 years]. Urea and creatinine were raised, and anaemia, hypocalcemia, hypoalbuminemia, hyponatremia, and hyperkalemia were observed. A significant elevation in serum total cholesterol, triglycerides, LDL and VLDL-C was seen. There was a reduction in HDL-C in pre-dialysis patients compared to controls. The difference between pre-HD and post-HD groups was unremarkable except for the serum potassium, chloride, urea, creatinine, total cholesterol, triglycerides and HDL-C. The effect of frequency of dialysis sessions was also not statistically significant
Conclusion: Regular treatment with dialysis may partially compensate for loss of renal function and decrease the accumulation of toxic metabolites, but cannot revert the overall physiological deficit
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Background: Visceral adipose tissues secrete several adipocytokines that modulate on their own way the extreme obesity, diabetes, dyslipidemia, atherosclerosis and inflammation. Visfatin is newly identified adipocytokine that is released by visceral adipose tissue. Its levels markedly increase during development of obesity. The aim of this study was to determine the levels of visfatin and its association with dyslipidemia in obese albino mice
Methods: It was a quasi experimental study. Sixty [60] Balb/c strain albino mice were divided into two groups of 30 each. Group I was taken as control non obese mice while Group II animals were fed high fat/high carbohydrate diet. Blood samples were collected to measure Total Cholesterol [TC], Triglycerides [TG], High Density Lipoprotein [HDL-C], Low Density Lipoprotein [LDL-C], Very Low Density Lipoprotein [VLDL-C] and visfatin levels
Results: There was significant correlation among different classes of lipids with increasing visfatin levels in diet induced obese mice [p<0.05]. TC, TG, LDL and VLDL showed significant elevation in serum levels [5.94+/-1.18 mmol/L, 2.92+/-0.15 mmol/L, 3.91+/-0.56 mmol/L, 1.56+/-0.31 mmol/L respectively] against controls [3.1+/-0.40 mmol/L, 1.62+/-0.01 mmol/L, 1.82+/-0.432 mmol/L, 0.60+/-0.13 mmol/L correspondingly]. Pearson's correlation coefficient between rising serum visfatin and various classes of lipids showed strong positive correlation between visfatin and TC, TG, LDL, and VLDL, while negative correlation with serum HDL levels [p<0.05]
Conclusion: Increased serum visfatin levels are strongly associated with obesity and dyslipidemia
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Background: Hypospadias is a congenital abnormality characterized by opening of external urethral meatus on ventral aspect of the penis with an overall incidence of 1:300. Different treatment modalities have been employed in the treatment of distal penile hypospadias with varying degrees of success and complications. A number of studies have compared Mathieu and Snodgrass Techniques but the existing evidence is doubtful owing to small sample size and great variation in their results
Objective: To compare the outcome of Mathieu repair with that of tubularized incised Plate Urethroplasty [Snodgrass] in distal penile hypospadias
Methodology: 90 patients meeting the inclusion and exclusion criteria's were selected and divided into two equal groups randomly using lottery method. Group-A was treated by Mathieu technique and Group-B underwent Snodgrass repair. Operative time was noted in minutes from the start of procedure till the end. Patients were followed post-operatively at 15[th] day, 1 Month and 2 Months and functional recovery and complications were evaluated
Results: The age of the patient ranged from 1 to 25 years in both groups with mean age of 6.67+/-5.74 years in Group-A and 6.65+/-6.06 years in Group-B [p=0.982]. Snodgrass was better in terms of mean operative time [67.37+/-8.85 minutes versus 87.86+/-8.22; p=0.00] as compared to Mathieu technique. The functional outcome in terms of meatal location at tip was better in Snodgrass [93.7% versus 80.2%; p=0.003] with a lower fistula rate [5.4% versus 21.6%; p=0.00] as compared to Mathieu technique
Conclusion: Tubularized Incised Plate Urethroplasty [Snodgrass] is better than Mathieu technique for the treatment of distal penile hypospadias in terms of operative time, success and complication rate
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Background: Medical education has undergone a paradigm shift from traditional disciplinary teaching to 'outcome based integrated medical education system'. AJK Medical College, since its inception, made an effort to bring the basic, clinical and social sciences into one course by adopting an indigenously designed 'system based vertically and horizontally integrated modular curriculum' to meet the local needs and global demands at undergraduate level. This study aimed to assess 'the Renal Module' by evaluation of the processes of module designing, content delivery, students learning and academic environment
Methods: The renal module program was evaluated by using level 1 [reaction] and level 2 [learning] of the Kirkpatrick Model. The student performance was assessed in the integrated practical examination where basic science knowledge was linked with real life clinical tasks
Results: A large number of students and faculty involved in module delivery and assessment showed satisfaction over implementation of the module. Many gave feedback responses with suggestions to improve the organization, delivery and/or assessment of the module that identified the weakness and challenges in design, delivery and assessment of the module. Eleven problem areas were identified by 22 respondents, which were conveyed to the module team for evaluation and recommendation of the required corrective measures in design, delivery and assessment
Conclusion: Integrated modular medical curriculum can be implemented at any medical college to replace the traditional system and the evidence based practices are possible, even in resource constraint environment
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Background: For first and second degree haemorrhoids, the preferred outpatient treatments are injection sclerotherapy or rubber band ligation of the haemorrhoids. The aims of this study were to compare postoperative pain, postoperative and delayed bleeding after injection sclerotherapy and rubber band ligation of first and second degree haemorrhoids
Methods: From January 2016 to January 2017, 60 patients were alternately allocated to undergo either injection sclerotherapy [group A] or rubber band ligation of the haemorrhoids [group B]. Pain sores, and frequency of early and delayed per-rectal bleeding were compared between the two groups
Results: Postoperative pain was present in 9 patients [30%] in sclerotherapy group and 15 patients [50%] in rubber band ligation group. Per-rectal bleeding was more common in rubber band ligation group [56% vs 26%; p=0.018]. Delayed bleeding was more common in rubber band ligation group [30% vs. 3%; p=0.0006]
Conclusion: Injection sclerotherapy of first and second degree haemorrhoids is associated with fewer complaints of pain and per-rectal bleeding, both early and delayed
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Background: Preeclampsia is a common obstetrical problem affecting 5-10% of pregnant females. The objective of this study was to determine and compare liver function tests in primigravidas in second and third trimesters of normal pregnancy and preeclampsia
Methods: A cross-sectional comparative study was conducted that included 100 subjects aged 15-40 years with normal pregnancy, and preeclamptic primigravidas of second and third trimester. Their liver function tests were carried out and compared among the study groups
Results: The mean age of the subjects was 25.92+/-5.56 years, mean systolic BP was 136.3+/-24.623 mmHg, mean diastolic blood pressure was 87.8+/-15.736 mmHg. There were statistically significant differences in AST, ALT, ALP, and serum albumin among cases and controls of both 2[nd] and 3[rd] trimester [p<0.05]. However, serum total bilirubin among preeclamptics of 2[nd] and 3[rd] trimesters, and also between controls and preeclamptics of 3[rd] trimester was significantly increased [p<0.05]. Serum AST and ALT were significantly decreased among controls of 3[rd] trimesters compared to 2[nd] trimester while ALP was significantly increased in 3[rd] trimester controls compared to 2[nd] trimester controls. Serum albumin was significantly decreased in both 2[nd] and 3[rd] trimester preeclamptics compared to controls
Conclusion: Serum AST, ALP, and bilirubin was significantly increased in 3[rd] trimester preeclamptics compared to 2[nd] trimester preeclamptics
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Background: The significance of research cannot be neglected in medical science; it is very essential part of current medical education system especially in modular or Problem-Based Learning [PBL] when junk of information is available on internet. The purpose of this study was to analyze the impact of short session of introducing the research module among medical students
Method: Using experimental research, quantitative research design was adopted. Before conducting a 3-hour short session with medical students an open-ended questionnaire was distributed among 80 students of 3[rd] year MBBS in order to know the extent of basic skills of doing research. Five open-ended questions were asked from students. The results were tabulated and analyzed on Microsoft Excel. Frequency and percentage were calculated for each item. Same questionnaire was distributed after the 3-hour lecture session
Results: Mostly medical students did not know about the type of research being practiced in medicine in the world. They also did not know about the relevant databases, appropriate referencing styles and the databases provided through HEC digital library
Conclusion: The course on information retrieval and management should be incorporated in the academic syllabi. Information literacy programmes should be conducted for all, especially the medical students
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Background: The course of chronic kidney disease [CKD] is complicated by dyslipidemia defined as changed plasma lipid levels and abnormalities of lipoproteins associated with early onset of atherosclerotic events. The altered pattern of lipid and lipoproteins metabolism results in rapid progression to end stage renal disease [ESRD] and atherosclerosis. The aim of this study was to see the pattern of dyslipidemia in CKD patients and to evaluate the effects of various sociodemographic variables on patterns of lipids and lipoproteins
Methods: This was a cross- sectional observational study conducted in Ayub Teaching Hospital, Abbottabad. In group-I, 313 patients of CKD were included in the study and 150 subjects with normal renal functions were taken as control. Serum lipid profile was evaluated for both groups. Effects of sociodemographic variables like age, sex, BMI, diabetes, hypertension and duration of renal failure was assessed. Data were analysed using SPSS-17 and p<0.05 was taken as significant
Results: Out of 313 subjects, 144 [46%] were female and 169 [54%] were male. The mean age of the patients was 48.48+/-14.78 years and it was 46.20+14.90 in controls. Most common type of dyslipidemia was hyperlipidemia of low density lipoprotein cholesterol [LDL-C] present in 90% patients. Hypertriglyceridemia was observed in 72% of patients. Low values for high density lipoprotein cholesterol [HDL-C] was observed in 28% of CKD group. Very low density lipoprotein cholesterol [VLDL-C] was found raised in 72% of CKD group. The most frequent dyslipidemia in combination was high LDL-C and high TG [201, 64%]. Eighty-two [26%] of patients had a combination of high triglycerides [TGs] and low HDL-C
Conclusion: Significant dyslipidemia does develop in vast majority of chronic renal failure [CRT] patients. This is an important risk factor associated with early onset of atherosclerosis
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Background: Visfatin is a novel adipocytokine, secreted by the visceral fat of humans and mice. Its level increases in plasma during progression of diabetes and development of obesity. The objective of study was to determine the levels of visfatin in obese and diabetic BALB/c strain of albino mice
Methods: It was a quasi experimental study. Ninety BALB/c strain albino mice were procured from NIH, Islamabad and divided into three groups. Animals in Group I [n=30] were grown obese by feeding high fat/high carbohydrate diet whereas Group II [n=30] were turned insulin dependent diabetic by injecting streptozotocin. Group III [n=30] served as control. Blood samples were collected to measure the blood glucose, lipid and visfatin levels. Visfatin levels were measured by enzyme-linked immunosorbent assay [ELIZA], and p
Results: Visfatin levels were significantly raised in obese and diabetic mice
Conclusion: Diabetes Mellitus and obesity are strongly associated with increased serum visfatin levels in BALB/c strain of albino mice
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Objective: The present study was undertaken to document the presentation of intestinal tuberculosis in patients with intestinal perforation that present to the emergency department of Nishtar Hospital Multan
Study Densign: Observational / Descriptive / cross sectional study
Place and Duration of Study: This study was conducted at Nishter Hospital, Multan. from 2007-2015
Materials and Methods: A proforma was filled which was approved by hospital ethical committee. 1000 patients who were admitted in in A and E department Nishtar Hospital,Multan with intestinal perforation were included in this study
Histopatology specimen were sent. Results were labeled as either presence or absence of intestinal tuberculosis
Results: 1000 patients, complying with the inclusion criteria were included in the study. The mean age of the patients was 45 +/- 5 years. 289 [ 28.9%] were in the age group of 20-30 years of age.312[31.2%] were in the age group 31-40 years.243 [24.3] were in age group [24.3%]. 156 [15.6%] were from age group 51-60
Regarding age, majority of the patients 532 [53.2%] were females, and 468 [46.8%] were males
Duration of symptoms ranged from 1 day to >3 days. 312 [31.2%] had symptoms for 1-2 days. 432 [43.2%] had symptoms for 2-3 days and 256 patients had symptoms for more than 3 days. All had histological evaluation
Conclusion: 23% patients were found to have tuberculosis
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Objective: To study the incidence of infected diabetic foot among diabetic admissions on the surgical floor
Study Design: Quasi-experimental study
Place and Duration of Study: This study was conducted at the Surgical Unit-IV, Nishtar Hospital Multan from June 2013 to March 2016
Materials and methods: The study on diabetic foot management was carried out involving 100 patients with septic foot complications in diabetics
Results: Out of 100 patients, 59 [59%] were male, 41 [41%], were female, 76 [76%] patients were admitted through emergency, 18 [18%] through outpatient department and only 6 [6%] patients were referred from physicians. Family history of diabetes was found in 45% of the patients in both parents. As regards age, most of the patients i.e. 50 [50%] patients were in age group 61-70 years. In 25 [25%] patients left foot was involved, right foot was involved in 55 [55%] patients while in 20 [20%] patients both feet were involved. As regards management of patients, 15 [15%] patients were taking insulin, 30 [30%] were on OHA, 30 [30%] were controlled by diet and remaining 20% had no treatment. Planter infection and infection on dorsal aspect was seen in 30% patients respectively
Conclusion: No aspect of regimen of therapy for diabetics is more important than the proper care of his feet
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Background: This study aims to describe our surgical technique and results for endoscopic transnasal dacryocystorhinostomy for the blocked nasolacrimal passage in patients presented in the department of Otolaryngology and ophthalmology at a tertiary care center
Methods: A consecutively presenting case series of blocked nasolacrimal passage were selected for transnasal endoscopic dacryocystorhinostomy. Bone removal done by cold instruments and the drill was used to remove the bone over the superior aspect of the sac. Medial wall of the sac was removed to marsupialize the sac in the nasal cavity. Septoplasty was done in 13 patients [17.10 %]. The specific surgical approach with or without septoplasty and the use of endolight was discussed. Postoperative follow up including endoscopic examination and results are documented
Results: A total of 76 cases were included. Mean age was 37.32 [range 6-76]]. An endolight was used in all cases to localize the site of nasolacrimal sac72 cases [94.74 %] have successful outcome in terms of relief of symptoms, whereas 4[5.26 %] cases had persistent epiphora. Revision procedure were done and 3[3/4, 75 %] cases had successful outcome. The overall success rate in our series of primary and revision ETDCR is 98.68 %
Conclusion: Endoscopic transnasal dacryocystorhinostomy is an effective treatment for nasolacrimal duct obstruction. Use of the endolight to localize and the power drill to expose the sac and septoplasty; contribute to the ultimate surgical success
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To test the reliability and applicability of Urdu translation of the International personality disorder examination [IPDE] in a psychiatric outpatient population in Pakistan. This study was conducted at the outpatient department of Fatima Memorial Hospital Lahore from April 2012 to March 2013. Patients considered to have a personality disorder by a psychiatrist were initially screened by the IPDE screening questionnaire. Those who scored positive on screening were evaluated in a detailed interview using IPDE. Two interviewers conducted the interviews simultaneously, to ensure inter-rater reliability. For translation, permission was taken from World Health Organization. Linguistic equivalence was assessed through back- translation and conceptual equivalence through opinion of mental health experts. The final Urdu draft was obtained after incorporating modifications suggested by experts following a feasibility study. The analysis was carried out using SPSS v.20. Out of 30 enrolled patients, 25[83.3%] were females. The mean age of the sample was 28.5 +/- 6.08 years. Majority of patients had more than one personality disorder. Most prevalent personality disorder was emotionally unstable borderline type with a phi correlation of 0.831, followed by emotionally unstable impulsive type and anankastic personality disorder with phi correlations of 0.930 and 0.867, respectively, for definite cases. Correlation coefficient for dimensional scores between the two raters was 0.392 for paranoid personality disorder, 0.842 for anankastic and around 0.9 for the rest of the personality disorders, each. Urdu translation of IPDE is a reliable tool to screen and diagnose personality disorders in population of Pakistan
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Humanos , Masculino , Feminino , Transtornos da Personalidade , Reprodutibilidade dos Testes , Traduções , Inquéritos e QuestionáriosRESUMO
To determine the current pattern and outcome of the closed diaphyseal humeral fracture treated with intramedullary interlocking nail. Descriptive study. This study was carried out at Orthopedic Department of Liaquat University Hospital Hyderabad and PUMHS Benazirabad Nawabshah from March 2011 to February 2012. All the 40 patients with closed diaphyseal humeral shaft fracture between the ages 15-45 years were included in the study. All the patients after counseling and diagnosed as case with closed diaphyseal humeral shaft fracture on the basis of clinical examination and X-rays. Closed intramedullary nailing management procedure was used for closed diaphyseal humeral shaft fracture regarding with clinical presentation, preoperative findings and functional outcomes were documented including postoperative complications. Total 40 patients were selected in this study with humeral fracture. Male were found in majority. From types of fractures transverse fractures were most common 45% and road accidents were seen in majority. Most common complication was post operative pain in 40% of cases; Excellent results were found in the 55% of the cases while good in 20%, fair in 10% and 5% results were noted poor in the patients. In the conclusion of this study the closed intramedullary interlocking nailing procedure is the very good method for treatment of fracture shaft of humerus including with very good outcome
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Background: Adequate vascular access is of utmost importance for hemodialysis treatment. Upper arm fistulae, obesity and deep or tortuous veins may impair cannulation and can cause significant complications and inconvenience for the technicians and patients
Objective: We intended to present the technique of superficialization [transposition] of the brachiobasilic fistula [BBF] and its clinical outcome regarding patency and complications
Materials and Methods: Twenty two brachiobasilic fistulas were fashioned in 20 patients between October 2010 to November 2011.The second stage superficialization [transposition] was carried out at a median of 59.1 days [range: 40-90 days] after fistula formation and involved mobilizing the arterialized basilic vein through a curved longitudinal incision on the antero-medial aspect of the arm and transposing it beneath skin
Results: During the study period 20 brachiobasilic fistulas [BBF] were fashioned in 20 patients. There were 8 [40%] males and 12 [60%] females. The mean age was 53.45years + 12.34 years [range: 21-70years]. The patency rates were 90% at 6 months. Surgical complications of transposition were infection in 2 [10%] patients and lymphocoele in 4 [20%] patients
Conclusion: Transposition of brachiobasilic fistulas is technically feasible and relatively safe procedure. Patency rates at 6 months are excellent
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Objective of this study determines the outcome of unipolar hemiarthoplasty in elderly patients with femoral neck fracture at Liaquat University Hospital Hyderabad/ Jamshoro. Total 50 elderly patients were included in the study with femoral neck fracture and all the cases were selected from accident, emergency and OPD. All the patients with the history of pregnancy, those patients who were unfit for anesthesia, malignancy, neurological deficits of lower extremity, rheumatoid arthritis and Parkinson's disease regarding with systemically disease were excluded from the study. All the patients under went surgical hemiarthoplasty treatment with Austin moor-femoral head prosthesia. In the last all postoperative complications, functional outcome and mortality were noted on proforma. Total 50 patients were included in the study. Mean age of this study was mean +/- SD 64.98 +/- 4.13. Females were found in majority with male/ female ratio 1:1.27. Post operative pain was noted in the 50% of the cases and out of them severe pain was noted only in 4% of the cases. Superficial infection was seen in 4% of the cases and deep infection was not found in the cases and death was occurred in 10% of the patients. On the outcome, excellent results were found in the 44.44% of the study participants, good and fair results were seen in 26.66% and 20% respectively, while poor results were seen in 8.88% of the patients. It is concluded that unipolar hemiarthoplasty is of the reliable procedure by use of Austin-moor femoral head prosthesia for the treatment of femoral neck fracture in elderly
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Humanos , Masculino , Feminino , Hemiartroplastia/métodos , Idoso , Fraturas do Colo Femoral/diagnóstico , Resultado do TratamentoRESUMO
To determine the treatment outcome of the closed diaphyseal humeral fracture treated with dynamic compression plate at Liaquat university hospital Hyderabad. Total 30 patients having displaced diaphyseal humeral fracture were included in the study. All the patients having fracture of less than 10 days and between the ages 15 - 45 years were selected. All the patients selected after counseling and diagnosed as a case of closed diaphyseal humeral shaft fracture on the basis of clinical examination and X-rays. In this study dynamic compression plates [DCP] were used for stabilization of humeral shaft fracture as assessed by pre operative workup, operative findings and outcomes were recorded with postoperative complications. To avoid the radial nerve palsy it is isolated during operative procedure. Present study was comprises of 30 patients with humeral fracture with the mean age of 30.29 +/- 8.92 years and male/ female ratio of 7:3. On the radiological findings most common type of fracture was oblique in 54%. From the complications, postoperative pain was found in 6.6% of the cases along with postoperative Infections in 10%. 90% fractures united while 10% fractures found with non union. Excellent result were seen in 60% of the cases, while 30% cases were noted with satisfied results and very poor results were found in 10% of the cases. It is concluded that DCP is the good option for the fixation of diaphyseal humerus fracture. Radial nerve palsy is less likely if isolated during operation
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Humanos , Masculino , Feminino , Fraturas Fechadas/cirurgia , Resultado do Tratamento , Fixação Interna de Fraturas/métodos , Diáfises/lesõesRESUMO
The Objective of this study is to assess the anatomical correction, cosmetic and functional outcome of the Ponseti method in idiopathic congenital Talipes Equino Varus [CTEV]. Experimental and case series study. The study was carried out in the Department of Orthopaedic Surgery and Traumatology [DOST] Liaquat University of Medical and Health Sciences Jamshoro for a period of two years from 21-01-2009 to 20-01-2011. This study was contains 50 cases of congenital talipes equino varus "CTEV". In this study all the case were selected with age of one year from the birth with congenital "talipes Equino Varus". All the cases with Acquired "Talipes Equino Varus", atypical foot, "talipes Equino Varus' with Arthrogryposis Multiplex Congenital, "talipes Equino Varus previously treated by method other than ponseti technique were excluded from the study. Total 50 cases of congenital Telipase Equine, Varus [CTEV] having 77 feet were analyzed in this study with [male female ratio 1:7]. Out of 50 cases, 27 [54.0%, n = 50] had bilateral [54 feet] deformities and 23 [46.0%, n = 50] cases were unilateral deformities. Severity was assessed according to Pirani Scoring system. 48 [62.0%] had severe foot deformity while 29[37.60%, n = 77] patients had moderate foot deformity. Out of 77 feet, rocker bottom foot deformity developed in 03[18%] feet, increased stiffness of ligaments and joints occurred in 1[1.2%, n 77] foot while vascular complications like skin ulceration and necrosis was observed in 1[1.2%, n =77] feet. At the end of 2 to 3 years follow-up period, in 72 [94.0%, n = 77] patients congenital clubfoot deformities were corrected successfully by using Ponseti method while 05 [6.0%, n = 77] patients were not fully corrected due to other complications. The Ponseti method is a fast, safe and effective treatment for congenital idiopathic clubfoot and radically decreases the need for extensive corrective surgery