Sessile Pelvic Osteochondroma: A Rare Case That Required Abdominal Wall Reconstruction After Excision.

Osteochondroma are the most common benign tumours of the bone presenting in the young age group. Commonly found at the metaphysis of the long bones and mostly pedunculated; atypical locations and sessile appearances have also been described in literature. Due to the risk of conversion to malignant chondrosarcoma, the recommended treatment of these lesions is complete excision. We encountered a similar sessile growth in the pelvic region of a 21-year-old male with complaints of pain and swelling. After thorough investigation, excisional biopsy was performed and abdominal wall repair was reinforced with a polypropylene mesh. Careful evaluation, adequate investigations and meticulous surgical treatment can avoid potential problems in managing these tumours.

Ball tipped guide wire for broken nail removal: a case report.

A broken intramedullary nail is a well-known complication of non-union of femur shaft fractures. Numerous surgical techniques have been presented before in patients with non-union of long bone fractures. We report the surgical technique used to perform removal of the broken distal segment of a nail in a patient who achieved uneventful union after intramedullary nailing of closed femur shaft fracture. A ball-tipped guidewire was inserted through the broken segment of the femur nail. A pre-bend plain wire was then inserted. With the help of a vise-grip, both wires were twisted in order to make a secure handle between guidewires and a broken implant. With the help of a mallet upward-directed blows were applied to extract a broken segment of the nail. We found ball-tipped guidewire technique a useful and effective technique in removing the broken distal portion of the nail.

Trend over time; a structural review of articles published in Journal of Pakistan Medical Association from 1953-2009.

OBJECTIVE: To review the articles published in the Journal of Pakistan Medical Association from 1953 to 2009 and to assess the components of each article by a pretested proforma containing a checklist of items based on modified 'Strengthening the Reporting of Observational Studies in Epidemiology' statement. METHODS: The retrospective study was conducted at the office of the Journal of Pakistan Medical Association, Karachi, from February to November 2010. A checklist of items in the modified 'Strengthening the Reporting of Observational Studies in Epidemiology' statement was made after discussion among the authors of the study to finally include a revised checklist of 45 items instead of the checklist of 22 items of the statement. A total sample size of 370 was calculated. Simple randomisation was done for selection of articles from each year. For each article, major and minor items were documented. Data was fed into SPSS version 15. RESULTS: The scientific quality of reporting of most of the components of Introduction, Results and Discussion sections have improved progressively with time (p < 0.001) whereas most components of Methodology have remained consistent. CONCLUSION: A change in trend over time was observed over the study period in major and minor items of the articles in the Journal, showing improved reporting of various sub-components of articles.The modified 'Strengthening the Reporting of Observational Studies in Epidemiology' statement provides a checklist that may be used to improve the quality of articles.

Methods of disposal of used syringes by hepatitis B and C patients at an urban and rural setting.

OBJECTIVE: To evaluate the methods of disposal of used syringes employed by patients with hepatitis B and hepatitis C. METHODS: This cross sectional study was conducted at a tertiary care hospital of Karachi and a clinic at Khairpur, Sindh. Diagnosed cases of Hepatitis B and C currently receiving treatment in the form of Interferon alpha injection were included by convenient sampling. The study instrument was a well structured questionnaire meant to ascertain the disposal methods of used syringes once they had been employed for treatment purpose. Open-epi sample size calculator (Multi-purpose statistical software for calculation of the sample size) and SPSS 15.0 was used for data entry and analysis. RESULTS: A total of 203 patients were interviewed, 147 from Karachi and 56 from interior. The majority i.e. 164 were suffering from Hepatitis C, 27 from Hepatitis B and 2 were co-infected with Hepatitis B and D. The mean age of patients was 35.8 +/- 11.5 years. Regarding disposal of injections, the most frequent mode was disposal of used syringes in house trash i.e. 71 (37.4%), patients 46 (24.2%) responded that they utilized a needle cutter, 37 (19.5%) safety box (disposal method in tertiary hospitals where the needle is disposed off safely in a box), 12 (6.3%) disposed in sewage, 3 (1.6%) disposal in water, 3 (1.6%) buried the used syringes, while 2 (1.1%) reused the syringe and needle once they had been used for therapeutic purposes. CONCLUSIONS: The study suggests that the injection practices by the majority of patients suffering from viral hepatitis were unsafe. Majority of the patients were disposing the used syringes and needles in the house trash.

Gastroesophageal reflux disease (GERD) in students of a government medical college at Karachi.

OBJECTIVE: To assess the frequency of symptoms suggestive of Gastroesophageal reflux disease (GERD) in students of a government medical college at Karachi. METHODS: This is a cross sectional study conducted at Dow Medical College (from September to December 2008) through a well structured questionnaire meant to assess the typical and atypical manifestations of GERD in terms of frequency, consultation with physician and life style changes adopted to reduce the severity of symptoms. RESULTS: Out of 595 students interviewed, 444 (74.6%) were female. Majority of them were aged between 17-25 years. Abdominal discomfort ever developed in 288/595 (48.4%) students out of which 132/595 (22.18%) students complained of heartburn. Weekly episodes of heartburn were present in 35/444 (7.88%) female students and 10/151 (6.62%) male students. Dysphagia was present in 88/595 (14.8%) students, 9/88 (10.22%) of which also suffered weekly from heart burn. Overall 109/595 (18.3%) students, comprising of 82/444 (18.5%) female and 27/151 (17.9%) male, exhibited breathing problems. Weekly presentation of heartburn was also prevalent in 13/109 (11.92%) students who suffered from breathing problems. CONCLUSION: The study concludes that the percentage of students having weekly episodes of heart burn is significantly higher than that in general Asian population. The atypical symptoms of GERD are also found to be more prevalent among medical students.