Vol. 7, Issue 2, APR – JUN 2013

EDITORIAL

Right to Life and Safe Motherhood

 *PROF. DR. MARIAM MALIK, **PROF. DR. MUNIR AKHTAR SALEEMI

*Head of Department of Obstetrics & Gynecology, **Head of Department of Social & Preventive Pediatrics, Fatima Jinnah Medical College/Sir Ganga Ram Hospital, Lahore

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Screening of Microvascular Complications of Type-1 Diabetes Mellitus In A Tertiary Care Hospital

 1DURDANA MASOOD, 2SHAMEEM AHMAD SIDDIQUI, 3KASHAF JEHANGIR

1,3Department of Opthalmology, Fatima Jinnah Medical College,

2Biochemistry Senior Research Officer PMRC Research Centre, Fatima Jinnah Medical College, Lahore

*Corresponding Author and reprint request to Dr. Shameem Ahmad Siddiqui Senior Research Officer, Tel: 92-42-99203725 Fax: 92-42-99203726 E-mail: drshameem12@hotmail.com.

ABSTRACT

Objectives: To study the biochemical status and screening of microvascular complications of type-1 diabetic patients.

Study design and settings: It was a descriptive study carried out at Diabetic Clinic of PMRC Research Centre, FJMC, Lahore.

Patients and Methods: Eight years case records of type-1 diabetic patients seen at the PMRC Research Centre FJMC Lahore from 1999-2006 were reviewed Out of 1265 diabetic patients sixty five were known type-1 diabetic. A 12 hours fasting blood sample was collected from each patient for serum total cholesterol , triglycerides , low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, urea, creatinine, uric acid and glucose as well as glycosylated hemoglobin (HbA1c) by using standard methods performed at Biochemistry laboratory of the research centre. Body mass index (BMI) was calculated. HbA1c<6.1 was considered as poor glycemic control. Relevant information of all patients was recorded with the help of a pre-designed proforma. They were also investigated for type-1 diabetic complications. Data was analyzed by using statistical software SPSS-15.

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Role of Surgery in Diagnosis of Medaistinal Masses

 GHULAM SHABBIR, SAIMA SULTAN, FARMAN ALI LAGHARI

1Head of Thoracic Surgery, 2UHS/Gulab Devi Chest Hospital, Lahore

3Department of Paediatric Surgeon, Gulab Devi Chest Hospital, Lahore

 ABSTRACT

Introduction: Mediastinum is a wide space containing a lot of vital structures. Medaistinal masses represent a wide diversity of disease states. The location and composition of a mass is critical to narrowing the differential diagnosis. Distribution of mediastinum in to 3 compartments and presence of masses therein has been documented; however a tissue diagnosis is always essential to initiate the treatment. CT scan is successful in giving a diagnosis in many cases through a biopsy. Still many more require an aggressive measure like surgical intervention.

Material & Methods: From January 2009 to December 2011, 110 cases of Medaistinal mass were referred to our department and in all cases CT guided biopsy was not possible or fruitless. Results: 77 cases had anterior-superior Medaistinal mass, 23 cases had posterior Medaistinal mass and 10 had middle Medaistinal mass. Respiratory symptoms were present in 73 of cases while 37 cases were asymptomatic. Major surgical procedures for obtaining tissue were Medianostomy42, VATS 34, Sternotomy 14, Anterolateral thoracotomy 8 and Posterolateral thoracotomy 12. Major diagnostic outcome were Granulomatous involvement 36, thymic masses and Primary/secondary carcinoma 21 each. No mortality was reported. 95 cases went eventless. Conclusion: We conclude that Surgery is safest and most accurate tool in diagnosis of Medaistinal mass.

 

Key words: Mediastinum; thymic, Medaistinal mass, Granulomatous.

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Analysis of Medicolegal Deaths in Sandeman Civil Hospital Quetta, Balochistan

MURAD ZAFAR MARRI1, M. ZAHID BAHIR2, MARIAM ARIF 3, MUHAMMAD MAQSOOD4

Department of Forensic Medicine & Toxicology, Associate Professor Liaquat National Medical College, Karachi 1, Professor Shalamar Medical & Dental College,Lahore2, Assistant Professor FMH College of Medicine & Dentistry Lahore3 , Associate Professor Shalamar Medical & Dental College,Lahore4

 ABSTRACT

A retrospective study was done on the cases brought for postmortem examination in the medicolegal section of Sandeman Civil Hospital Quetta during 2009. It is a teaching Hospital of Bolan Medical College Quetta. All the cases from Quetta city, suburbs and rural area were included in the study and results were analyzed.

Objectives: The aim of the study was to know manners of death and modalities in medicolegal deaths presented in medicolegal section of Sandeman Civil Hospital Quetta Balochistan.

Study Design: Retrospective study.

Place and Duration of Study: This study was conducted from 1st January, 2009 to 31st December, 2009 in Medicolegal section Casualty Department at Sandeman Civil Hospital Quetta, a teaching Hospital of Bolan Medical College, Quetta.

Subjects and Methods: Materials for this study have been collected from Sandeman Civil Hospital Quetta Casualty Medicolegal Section including police reports, postmortem reports and clinical notes. During one year study period, a total of 329 medicolegal deaths were presented for postmortem examination in Civil Hospital, Quetta. Males (91.49%) were more commonly involved as compared to females (8.51%). All these cases were grouped according to age and gender, manners and modalities of medicolegal deaths (unnatural). The data thus collected is analyzed on Microsoft program.

We have taken permission from Police Surgeon Sandeman Civil Hospital Quetta for entire study.

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The Histopathological Diagnosis of Ulcerative Colitis on Non-Neoplastic Colorectal Biopsies – An Audit

1AMAN UR REHMAN, 2FAIQA YASIR, 3KHALID JAVAID

1Department of Histopathology, Shaikh Zayed Postgraduate Medical Institute, Lahore

2Department of Oral Pathology, CMH Medical &Dental College, Lahore

3Department of Histopathology, Women Medical College, Peshawar

Correspondence: – Dr Aman-ur-Rehman. Email- rehmanaman@hotmail.com

 ABSTRACT

Background: The gastroenterologists along with histopathologists are carrying out early diagnosis and surveillance of patients presenting with ulcerative colitis. A long term treatment and follow up by a gastrointestinal unit is needed in diagnosed cases of ulcerative colitis. As a part of quality assurance, this audit was done to analyze the consistency of diagnosis of ulcerative colitis on non-neoplastic colorectal biopsies and to compare audited results with originally diagnosed reports in cases of ulcerative colitis.

Material and Methods: The study was conducted in Histopathology department of Shaikh Zayed Hospital Lahore Pakistan. H & E stained slides of 500 diagnosed cases of ulcerative colitis were retrieved from the record in time period between February 2012 to June 2013. The cases were reviewed for three histological parameters i.e., architecture of epithelium, chronic and acute inflammation. The new observations were recorded in a specially designed proforma and compared with original reports.

Results: A definite diagnosis of ulcerative colitis in our study was proved correct in 100% of cases. Where the biopsy which was reported as suggestive of ulcerative colitis, 97.9% proved to have ulcerative colitis.

Conclusion: This audit concluded that diagnosis of colorectal biopsies with high suspicion of ulcerative colitis should be carried out on a proforma which clearly depicts all the relevant histological features that may be important to the histopathologists for diagnosis and to the gastroenterologist for clinical treatment. The clinical findings given by the physician was another area of improvement.

 Key words: ulcerative colitis (UC), colorectal biopsies, architecture, inflammation.

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Hernial SAC Ligation in Hernioplasty of Indirect Hernia – A Needless Step

BALAKH SHER ZAMAN, MUHAMMAD FAHEEM ANWER, MUHAMMAD USMAN ASLAM, AHSEN NAZIR AHMED, ABUL FAZAL ALI KHAN, SALMAN ARIF

ABSTRACT

Objectives. To evaluate the effect of high sac ligation in Lichtenstein Indirect inguinal hernia repair on post operative pain.

Methodology: This study consisting of 100 patients of clinically diagnosed right or left indirect inguinal hernia with age ranging from 16-80 yrs, was conducted in the department of surgical unit II, Jinnah Hospital, Lahore. Patients were divided randomly in two equal groups. Group A included patients undergoing high sac ligation while group B included patients of sac reduction. The main outcome measure was mean postoperative pain score using visual analog scale on 1st, 7th and 10th post operative days.

Results: 78% of the patients were between 20 to 50 yrs of age with male to female ratio 99:1. 60% of the patients had presented with right inguinal hernia and 40% with left inguinal hernia. Postoperatively mean pain scores in patients who underwent sac reduction were 3.30 + 0.70 on 1st post op day, 2.22 + 0.58 on 7th and 0.32 + 0.47 on 10th post op day, while mean pain scores in patients who underwent high sac ligation were 4.34 + 0.82 on 1st post op day, 3.34 + 0.64 on 7th and 2.40 + 0.53 on 10th post op day.

Conclusion: Ligation of the hernial sac in inguinal hernia surgery is not only unnecessary and time consuming but also leads to increased post-operative pain.

Key Words. High sac ligation, sac reduction, hernioplsty.

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Cheiloscopy as an Aid To Personal Identification and Its Variation According To Gender

MARIAM ARIF1, M. KHALID CHAUDHARY2, M. MAQSOOD3

Department of Forensic Medicine & Toxicology , Assistant Professor FMH College of Medicine and Dentistry, Lahore1; Professor FMH College of Medicine and Dentistry, Lahore 2; Associate Professor Shalamar Medical & Dental College,Lahore3

Corresponding Author: Dr. Mariam Arif, Assistant Professor, Forensic Medicine & Toxicology Department

FMH College of Medicine & Dentistry, E-mail: kemc51@yahoo.com

ABSTRACT

Cheiloscopy is a forensic investigation technique which deals with the study of grooves and furrows forming a characteristic pattern on the external surface of the lips. This is unique for every individual just like finger prints. Therefore, lip prints found at the scene of crime on drinking glass, cigarette ends, etc can be used to convict a suspect of crime. The aim of the study was to evaluate the depth of lip prints in identification, their uniqueness, consistency for a period of time and variation in males and females. Lip prints of 100 students, 50 males and 50 females of FMH College of Medicine and Dentistry, Lahore of the age group 18-23 years were collected and classified according to classification proposed by Suzuki. According to our study, Type I (40%) was the commonest pattern and Type I’ (6%) the least. This study revealed that lip print patterns are different in both sexes. Type I (56%) was commonest in females whereas Type V (1%) was the rarest. On the contrary, Type IV was predominant and Type I’ (2%) had the least frequency in males. This study showed that lip prints have a role in establishing personal identity as they are unique, permanent, show gender variation and remain unchanged during the life of an individual.

 Key words: Lip prints, Cheiloscopy, Suzuki classification, Identification, Gender

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Attitude of Self-Employed General Practitioners Towards Medical Research

1RANA AAMIR DIWAN, 2MUHAMMAD SAIF UL MALOOK, 3SUMAIR ANWAR

1Department of Community Medicine, DG Khan Medical College, DG Khan, 2Civil Hospital, Bahawalpur, 3Department of Community Medicine, Shalamar Medical and Dental College, Lahore

Correspondence: Dr Rana Aamir Diwan, House No: 32 Officers Colony, DHQ Hospital, Dera Ghazi Khan, Phone no 03219153389, Email: aamirdiwan@yahoo.com

 ABSTRACT

Background: In Pakistan general practitioners (GPs) are self-employed medical doctors, who work independently and establish their own clinics usually in their hometowns. Compared to other clinical disciplines, however, general practice has produced significantly less published research in terms of both researchers and subjects. Our objective was to assess the attitude of self-employed GPs towards medical research.

Materials and methods:

Cross-sectional survey was conducted in the districts of Lodhran and Bahawalpur in Punjab from May to Oct, 2012. Convenience sampling technique was used to select these GPs. Data was recorded on the questionnaires, collected through personal interviews with every GP.

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Unlimited Benefits of Muscle-Sparing Limited Thoracotomy in Management of Empyema Thoracis

 GHULAM SHABBIR PERVEZ, SAIMA SULTAN, FARMAN ALI

Department of Thoracic Surgery, Gulab Devi Chest Hospital, Lahore

 ABSTRACT

Introduction: Pleural empyema has got a very old history which dates back to the times of Hippocrates. The modern era of broad spectrum antibiotics has reduced the threat in developed countries but the danger persists in developing world. Early surgical intervention is what is recommended in great majority of cases. Closed aspiration / fibrinolysis, Tube Thoracostomy, Video Assisted Thoracoscopic Decortication and Open Lung Decortication are the measures in practice for the last many years. Open Lung Decortication (OLD) has been thought to be the most successful modality but its longer incision reserved its use in specific cases only. Limited Thoracotomy and Video Assisted Thoracoscopic Decortication however, have encouraged use of aggressive modalities in cases of Empyema.

Material & Methods: From 1st July 2011-31st December 2011, 152 OLD (open lung decortications) were done using limited thoracotomy and collected data will be presented in the study. Informed consent taken from all patients and only those were included who opted for thoracotomy.

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Laparoscopic Cholecystectomy in a Day Case Setting: A Ganga Ram Hospital Experience

SHAHZAD ALAM SHAH; MUHAMMAD ARSHAD; HINA KHAN; ASLAM JAVED; MUHAMMAD TANVEER

Corespondence: Shahzad Alam Shah, Department of Surgery, Sir Ganga Ram Hospital, Lahore.

e-mail:shahzadalamshah@gmail.com; Cell: +92 300 4269681

 ABSTRACT

Because of the early recovery after Laparoscopic Cholecystectomy, this procedure is now being performed in day care settings. This study was conducted to determine the feasibility, rate and type of complications associated with laparoscopic cholecystectomy as a day case procedure without compromising the health of the patients.

Material and Methods: This study was conducted in the Department of General Surgery Sir Ganga Ram Hospital, Lahore from December, 2010 till December, 2012. Seventy five patients of mixed gender were included in the study.

Sampling Technique: Convenience sampling technique was employed

Study Design: It was a cross sectional descriptive study conducted from December 2010 to December, 2012.

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To Compare the Efficacy and Safety Profile of Total thyroidectomy with Near Total Thyroidectomy for Benign Multinodular Goiter: A District Headquarter Hospital Experience

 MOHAMMAD NASIR, WASEEM MUHAMMAD, ARSHAD FARZOOQ, FAREEHA HUMAYOUN, RAFIULLAH KHAN, MUSTAFA ABBAS, SOHAIL AZIZ PARACHA

 ABSTRACT

Background: The objective of this study is to compare Total Thyroidectomy with Near Total Thyroidectomy in terms of efficacy and safety. Total thyroidectomy is currently the preferred treatment for thyroid Cancer and benign multinodular goiter. However, many surgeons do not perform total thyroidectomy to treat benign thyroid diseases owing to the associated risk of postoperative hypoparathyroidism and recurrent laryngeal nerve damage. In our research we compared total thyroidectomies performed for benign thyroid diseases with near total thyroidectomy in order to assess whether the results support the hypothesis that total thyroidectomy is safe and can be considered as the optimal surgical approach for treating benign thyroid diseases.

Materials and Methods: 250 patients with multinodular goiter were selected for the study from August 2008 to August 2013 at District Headquarter Hospital Kohat KPK, Pakistan. Patients were divided equally in two groups Group A and B (125 patients each). All patients were euthyroid. Group A patients underwent Near Total Thyroidectomy whereas Group B patients Total Thyroidectomy. Results were analyzed in terms of efficacy and in both group using SPSS program.

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Experience of Pilonidal Sinus Excision with Off Midline Closure Over A Drain

 FAZAL AHMED, WASEEM MUHAMMAD, FAREEHA HUMAYOUN, ANOOSHA NASEEM

 ABSTRACT

Objective: Despite different research studies available advocating various methods of treatment for Pilonidal sinus, recurrence rate and complications are marked. The aim of our study was to evaluate the efficacy of pilondal sinus excision with off midline closure over a suction drain and establish it as a standard treatment protocol.

Methods: This prospective study was conducted over a period of six years from March 2005 to April 2011 in Kohat, KPK, Pakistan. A total of 125 patients were included in the study. All the patients were male between 25 to 40 year of age and had chronic pilonidal sinus diagnosed on history and physical examination alone. Extensive shaving of back hair from nape of neck to natal cleft pre- and post operatively at regular intervals for six months was performed. Excision of the chronic pilonidal sinus along with all tracks and recesses with off midline closure over suction drain was done under general anesthesia.

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The Frequency of Cervical Lymph Node Metastasis in Multifocal Papillary Thyroid Carcinoma

 ASHFAQ AHMAD, FAIZA SIDDIQUE, TOOBA MAHMUD GAUHAR, NAVEED AHSAN, KHWAJA MOHAMMAD AZIM

Correspondence to: Dr Ashfaq Ahmed, Associate Professor, East Surgical Ward, Mayo Hospital, Lahore. Email: ashfaq156@hotmail.com

ABSTRACT

Objective: To determine the frequency of metastatic cervical lymphadenopathy among cases presented with multifocal papillary thyroid carcinoma (PTC) planned to undergo total thyroidectomy (TT) with or without neck dissection.

Materials and Methods: A retrospective study was conducted based on data of 35 patients who presented with PTC and had been managed at East Surgical ward, Mayo Hospital ,Lahore from August 2010 to April 2011. Data of 35 patients of PTC was collected from inpatient department of East Surgical ward. Confidentiality of information was ensured. All the patients underwent total thyroidectomy with or without cervical lymph node dissection.

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Cross-Sectional Study to Determine the Most Common Cause of Breathing Difficulty in Children from 1 Month to 12 Years of Age

 USMAN JAVED IQBAL1, ZAHEER AKHTAR, ASIF HANIF3, M. UMER AFTAB4

1B.Sc (Hons) Cardiac Perfusion, 2Assistant Professor, Gulab Devi PGMI Lahore, 3Assistant Professor, HOD Biostatistics, Gulab Devi PGMI Lahore, 4B.Sc (Hons) Emergency & Intensive Care Technology

ABSTRACT

Background: Breathing difficulties are most commonly encountered in children and potentially life threatening emergency presenting to a hospital. Having significant mortality and morbidity among children the causes of breathing difficulties are on the rise in Pakistan.

Objective: Objective of the study was to determine the most common cause of breathing difficulty in children from 1 month and 12 years of age. So as to guide our planning for primary and secondary prevention of those causes to prevent disease in our community

Methodology: This was a cross sectional study. 100 patients presented in Children Hospital Lahore emergency with breathing difficulty were selected on the basis of non-probability (purposive) sampling. Study was completed in 3 months. Questionnaire was made to collect data and their detailed history was then taken including symptoms at presentation

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Presentation of Carcinoma Breast in Female Population of Northern Half of Pakistan

MUHAMMAD ATTIQUE SADIQ, SHAHID MAHMOOD

ABSTRACT

Objective: The objectives of this study were to determine the most common presentation of carcinoma breast in female population of northern areas of Pakistan.

Material and methods: This prospective study was conducted in the Department of Surgery, Fauji Foundation Hospital Rawalpindi from 1st March 2009 to 28th February 2010. 120 patients were included by non-probability convenience sampling. Only female patients with histological proof of carcinoma breast were included in the study. Male patients, patients with recurrent disease and those who refused to give consent were excluded from the study.

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Histological and Radiological Correlation in the Diagnosis of Bone Tumors

 *ASIMA NAZ, ZERTAJ KASHIF, IJAZ WARIS, BILQUES SULEMAN

Address for correspondence: Dr. Asima Naz, Assistant Professor, University of Lahore

 ABSTRACT

Objective: To Determine the sensitivity, specificity, positive predictive value and negative predictive value of radiological results of bone tumors, taking histological findings as the gold standard.

Study design: Descriptive case series

Subjects & methodology: Thirty cases of clinically suspected and with radiological evidence of bone tumors were included in this study. The specimens were sent to the Histopathology Department, fixed in 10% formaline.

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Study of Effect of Chest Physical Therapy in Patients with Chronic Obstructive & Acute Suppurative Lung Diseases

ZAHEER AKHTAR*, HAMID HASSSAN**, GHULAM SHABBIR PERVAIZ***, ASIF HANIF****

* Assistant Prof Pulmonolgy Gulab Devi PGMI Lahore, ** Cardiothoracic Surgeon & MS Gulab Devi Chest Hospital, *** Thoracic Surgeon Gulab Devi Chest Hospital, **** Head of Biostatic Department Gulab Devi PGMI Lahore

ABSTRACT

Background: In airway diseases, decline in pulmonary functions, mucus hypersecretion and airway clearance always remain a big problem. Manual chest physiotherapy techniques involving chest percussion, vibration and shaking have long been used in the treatment of respiratory conditions. There is limited study of CPT effectiveness in these diseases. We applied different CPT techniques in different respiratory conditions to understand its effectiveness.

Objective: The goal of this study is to know the effectiveness of different chest physical therapy techniques in patients with chronic obstructive , acute suppurative lung diseases and also to educate these patients about the benefits of bronchial hygiene therapy, breathing exercises and other protocols of chest physical therapy along with conventional treatment

Settings: This study was done in chest physiotherapy department of Gulab devi chest hospital from june 2012-dec 2012. .

Method: This study includes 51 subjects(n=51) with mean age 45 years, out of which 18 patients were with COPD and 15 with br.asthma and they were diagnosed on the basis of clinical & spirometric findings PEFR, FEV1, FVC &FEV1/FVC ratio. Bronchiectasis, pneumonia and lung abscess diagnosed in 11, 4 and 3 patient respectively on the basis of clinical judgementct, CXRs PA & CT scan chest. CPT techniques like aerosol therapy,bronchial hygiene therapy( BHT), postural drainage purcussion vibration(PDPV), active cycle breathing(ACB), and different cuff & huff techniques were applied for 1week and observe the effect after 7days.

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Significance of Transrectal Ultrasonography in Infertile Patients with Persistently Elevated Bacteriospermia

 MUHAMMAD AMIR, SOHAIL HASSAN, ZAHID SIDDIQUE, ADIL KHUURSHID

ABSTRACT

Objective: To establish the significance of transrectal ultrasound to identify and define prostate and seminal vesicle abnormalities in patients with chronic male accessory gland infection (MAGI) who failed to respond to antibacterial treatment.

Methods: We selected 50 consecutive patients with MAGI and persistently elevated bacteriospermia (≥ 106 colony forming units [CFU]/mL) after three antibiotic courses. All patients underwent transrectal ultrasonography (TRUS) scans and semen analysis.

Results: TRUS revealed hyperechogenicity with areas of calcifications in 90% (n=45) of patients with MAGI.

Conclusion: Although antibiotic therapy is considered suitable when microbial MAGI is suspected, it is impossible to account for a poor response to antibiotics merely on the basis of conventional criteria (clinical history, physical and ejaculate signs). Thus, TRUS may be helpful in the follow-up of these patients.

 Keywords: persistent bacteriospermia; male infertility, chronic prostatitis, transrectal ultrasound,

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The Prevalence of Polycystic Ovarian Syndrome in Students of Sir Syed Medical College for Girls, Karachi

ANISA KAMAL, SONIA NAQVI, EMAN KHALID, HASSAN FATIMA JAFFERY

Department of Gynae & Obs, Sir Syed Medical Karachi

Correspondence: Dr. Anisa Kamal, House # 63, Street # A, Phase V, D.H.A., Karachi. E-mail: anisakamal5@gmail.com, Cell # +92- 321-3820895

ABSTRACT

Objective: To assess the prevalence of Polycystic Ovarian Syndrome in students of Sir Syed Medical College for Girls.

Study Design: Descriptive, Cross-Sectional Study.

Place and Duration: Outpatient Department of Sir Syed Hospital from August 2012 – December 2012.

Methodology: One hundred and thirty eight students were enrolled in the study after informed consent. The information about study variables was collected by administering a predesigned questionnaire. The data was based on demographic, body mass index(BMI), relevant biochemical tests and abdominal ultrasound evaluation.

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Comparison of Clomiphene Citrate and Letrozole in Ovulation Induction and Pregnancy Rate in Polycystic Ovarian Disease

*H AKRAM, **A ABBAS, ***U ZAFAR

Department of Obstetrics & Gynaecology, Moula Bakhsh Teaching Hospital & Diagnostic Centre Sargodha

 ABSTRACT

Objectives: To compare the efficacy of letrozole versus clomiphene citrate in ovulation induction and pregnancy rate in patients with polycystic ovarian disease.

Design:Randomized controlled trial.

Place and duration of study: Moula Bakhsh Teaching Hospital And Diagnostic Centre Sargodha from January 2013 to June 2013.

Subject and Method: 200 patients with polycystic ovarian disease selected by non probability purposive sampling were included. Efficacy was determined in terms of ovulation induction when follicular size of more than or equal to 17mm is achieved on transvaginal ultrasound and pregnancy rate is checked by urine for pregnancy test in those patients with successful ovulation induction in the same cycle.

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Accuracy of Fournier’s Gangrene Severity Index in Predicting Mortality in Fournier’s Gangrene

FAZAL-UR-REHMAN KHAN, QAMAR SAEED, MUHAMMAD USMAN KHAN

Department of Urology, Shaikh Zayed Hospital Lahore.

Correspondence to: Dr. Fazal-ur-Rehman Khan, Email: drfazaln@gmail.com

 ABSTRACT

Objective: To determine the accuracy of Fournier’s gangrene severity index in predicting mortality of patients of Fournier’s Gangrene.

Patient and Methods: This is a cross sectional study and conducted from September 2011 to May 2012 at Shaikh Zayed Hospital, Lahore in the Department of Urology. A total of 30 patients were included in this study to find out the accuracy of Fournier’s gangrene severity index in predicting mortality in Fournier’s gangrene.

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Comparison of Delayed Versus Early Clamping of the Umbilical Cord in Preterm Neonates

TAYYABA MANZOOR, MUHAMMAD ARSHAD HUSSAIN, SUMAIRA SEHAR, UZMA YAQOOB

Department of Obstetrics & Gynaecology, Lady Willingdon Hospital, Lahore

Correspondence: Dr. Tayyaba Manzoor, e-mail: drtabi@live.com

ABSTRACT

Background: Umbilical cord after birth may be clamped early (<30 seconds) or late (30-120 seconds). Early clamping leads to deprivation of fetus from blood whereas later clamping may provide this extra blood to the fetus but may cause polycythemia and hyperbilirubinemia.

Objective: To compare the mean hematocrit in early versus delayed cord clamping in preterm neonates.

Subjects and Methods: This randomized control trial study was carried out at Department of Obstetrics & gynecology, Unit-I, Lady Willingdon Hospital, Lahore between 21st May 2012 to 20th November, 2012. Total 100 cases were selected and divided into two groups; group A, early cord clamping technique was applied while in group B, delayed cord clamping technique was applied. Each group comprised 50 patients. After 24 hours of birth blood of neonates was drawn with the help of a trained staff nurse and sent to the laboratory of Lady Willingdon hospital for assessment of hematocrit level.

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Comparison of Side Effects of Intravenous Phloroglucinol Versus Intravenous Drotavarine in Primigradvidas Presenting in Active Phase of Labour

TAYYABA MANZOOR, MUHAMMAD ARSHAD HUSSAIN, SUMAIRA SEHAR, UZMA YAQOOB

Department of Obstetrics & Gynaecology, Lady Willingdon Hospital, Lahore

Correspondence: Dr. Tayyaba Manzoor, e-mail: drtabi@live.com

ABSTRACT

Background: The problems and hazards of prolonged labour, both for the mother and foetus have been recognized for many years. The mother is exposed to high risk of infection, ketosis and obstructed labour while the foetus faces the danger of infection, asphyxia and excessive cranial moulding. Spasmolytic drugs or smooth muscle relaxants help to relieve cervical spasm and facilitate cervical dilatation. Smooth muscle relaxants inhibit impulses in the form of spasm that impairs the effective cervical dilatation.

Objective: To compare the side effects of intravenous phloroglucinol and intravenous drotavarine in primigravidas presenting in active phase of labour.

Subjects and Methods: This randomized controlled trial study was carried out at Department of Obstetrics & Gynaecology, Lady Willingdon Hospital, Lahore between 8th April 2012 to 7th October 2012.

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Surgery for Pulmonary Mucormycosis in Multiorgan Transplant Patient: A Case Report and Review of Literature

 IKRAM UL HAQ CHAUDHRY, HADI MUTARI, WAJDAN MANAH, MUSSARAT AFZAL, MOUSA A. AL-ABBADI, EBRAHIM HASAN, IMTIAZ KHURSHID

Department of Thoracic Surgery, Pulmonary Medicine, Pathology, Radiology, and Anesthesiology, King Fahad Specialist Hospital (KFSH), Dammam, Saudi Arabia

Corresponding author: Dr. Ikram ul haq Chaudhry, KFSH, P.O.Box 15215, Dammam 33314, Saudi Arabia

dirhc@hotmail.co.uk, 00966-383-41111

ABSTRACT

Mucormycosis is an angioinvasive fungal infection caused by ubiquitous organism mucorales of Zygomyctes class. Herein we report a case of 31-year-old male who had undergone renal and pancreas transplant. Patient presented with complain of chest pain, cough, and shortness of breath. Chest computerized tomography (CT) scan revealed a large opacity in right lung. After a non-diagnostic bronchoscopy and bronchoalveolar lavage, it was decided to proceed with surgery.

Keywords: Transplant, Immunosuppression, Mucormycosis, Surgery, Amphetericin B.

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Giant Submandibular Salivary Gland Calculus-A Case Report Volume 1 Issue 1

MUHAMMAD FAHEEM ANWER, MUHAMMAD USMAN ASLAM, BALAKH SHER ZAMAN

ABDUL QUDOOS, FIZZA ANWAR, AHSEN NAZEER AHMED, ABUL FAZAL ALI KHAN

Correspondance: Muhammad Faheem Anwer drfaheem99@hotmail.com

ABSTRACT

Salivary gland calculi is the most common disease of the salivary glands. Commonly, sialoliths measure from 1mm to <1cm. Giant salivary gland stones (GSGS) are those stones measuring>15 mm and have been rarely reported in the medical literature. GSGS measuring over 3cm are extremely rare, with only scanty reported cases. A case of an unusual  large(4.2×1.4cm) sialolith completely encased  in the glandular substance is presented along with a review of the management of Giant salivary gland calculi.

Key words: submandibular salivary gland, Giant sialolith.

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