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Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2016
Pakistan Armed Forces Medical Journal, 2016
Objective: To assess the rate and causes of conversion of laparoscopic to open cholecystectomy (O... more Objective: To assess the rate and causes of conversion of laparoscopic to open cholecystectomy (OC) in 450 patients who underwent laparoscopic cholecystectomy (LC) by the same surgeon in tertiary care teaching hospitals. Study Design: Descriptive study. Place and Duration of Study: The study was conducted initially at Pakistan Navalship (PNS) Shifa, Karachi and later at Combined Military Hospital, Lahore from November 2009 to June 2013. Material and Methods: All the patients of both genders and of any age group, undergoing LC for gall bladder pathology whether acute or chronic, acalculous or calculous were included in this study by convenient sampling. The exclusion criteria were choledocholithiasis, malignancy, and patients who willingly opted for open cholecystectomy. All the patients were operated by the same experienced laparoscopic surgeon. The number and sizes of the ports varied from patient to patient and was on the choice of the operating surgeon. A detailed proforma was fi...
Objective: To determine the validity of Modified Alvarado Scoring System (MASS) in the diagnosis ... more Objective: To determine the validity of Modified Alvarado Scoring System (MASS) in the diagnosis of acute appendicitis. Study Design: Cross sectional validation study. Place and Duration of Study: Department of Surgery Combined Military Hospital (CMH) Kohat Pakistan, from Nov 2013 to Oct 2014. Material and Methods: A total of 248 patients fulfilling the inclusion criteria were enrolled in the study after getting the informed written consent. Modified Alvarado Score of all patients was calculated on a proforma which included migratory right iliac fossa pain, anorexia, nausea/vomiting, tenderness in right iliac fossa, rebound tenderness, elevated temperature and leucocytosis (>10 x 109/L). Surgeries were performed by residents and consultant surgeons. Decision to operate upon was not only on the MASS of the patients rather it was on overall clinical condition of the patients using different scoring systems. Where required aid of different laboratory investigations, ultrasonography,...
Objective: To compare the incidence of post dural puncture headache with pencil point 25 gauge Wh... more Objective: To compare the incidence of post dural puncture headache with pencil point 25 gauge Whitacre verse cutting 25 gauge Quincke spinal needle in patients for C section under spinal anaesthesia. Study Design: Randomized controlled trial. Place and Duration of Study: Operation Theatre, Department of Anaesthesia, Combined Military Hospital Lahore, from Nov 2015 to May 2016. Methodology: All patients with ASA status-I or II, undergoing elective C section surgeries were included in the study. Patients assigned to Group W was administered spinal anesthesia by using 25 gauge Whitacre pencil point needle at the level of L3,L4 space while patients assigned to Group Q was administered spinal anesthesia by using 25 gauge Quincke needle at the level of L3, L4 space. Patients were observed for PDPH in the recoveryroom and then in the ward 6 hourly till 72 hours. All the data was entered and analyzed on SPSS version 10. Results: In our study the mean age of the patients was 24.29 ± 3.78 ye...
PAFMJ, 2021
Chordee is a condition in which the penile head has a curvature. It can be towards ventral or dor... more Chordee is a condition in which the penile head has a curvature. It can be towards ventral or dorsal aspect. Dorsal chordee is very rare. In many normal males mild degrees of curvature can exist. Causes of dorsal chordee can be diverse but urethral duplication as its etiology is even rarer. We report a case of six year old boy who presented with severe dorsal chordee with associated double urethra and cleft of the glans dorsally without hypospadia.
OBJECTIVE To assess the safety of direct trocar insertion (DTI) before creating pneumoperitoneum ... more OBJECTIVE To assess the safety of direct trocar insertion (DTI) before creating pneumoperitoneum in laparoscopic procedures. STUDY DESIGN An observational study. PLACE AND DURATION OF STUDY Combined Military Hospital (CMH) Kohat, Pakistan from November 2013 to January 2015. METHODOLOGY All the cases undergoing laparoscopy at the study centre in the above duration were included in the study after approval from the Hospital Ethical Committee and informed written consent. Out of the 200 cases, DTI was successfully used to establish peritoneal access in 190 cases, while open Hassen's technique (OL) was used in ten cases. Body mass index (BMI) of all the patients was calculated before surgery. All the cases were performed under general anaesthesia with adequate relaxation. A 10 mm permanent re-useable sharp metallic trocar was inserted through umbilical scar after lifting the abdominal wall using towel clamps. Studied variables included age, gender, BMI, operations, history of previo...
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2016
Pakistan Armed Forces Medical Journal, 2016
Objective: To assess the rate and causes of conversion of laparoscopic to open cholecystectomy (O... more Objective: To assess the rate and causes of conversion of laparoscopic to open cholecystectomy (OC) in 450 patients who underwent laparoscopic cholecystectomy (LC) by the same surgeon in tertiary care teaching hospitals. Study Design: Descriptive study. Place and Duration of Study: The study was conducted initially at Pakistan Navalship (PNS) Shifa, Karachi and later at Combined Military Hospital, Lahore from November 2009 to June 2013. Material and Methods: All the patients of both genders and of any age group, undergoing LC for gall bladder pathology whether acute or chronic, acalculous or calculous were included in this study by convenient sampling. The exclusion criteria were choledocholithiasis, malignancy, and patients who willingly opted for open cholecystectomy. All the patients were operated by the same experienced laparoscopic surgeon. The number and sizes of the ports varied from patient to patient and was on the choice of the operating surgeon. A detailed proforma was fi...
Objective: To determine the validity of Modified Alvarado Scoring System (MASS) in the diagnosis ... more Objective: To determine the validity of Modified Alvarado Scoring System (MASS) in the diagnosis of acute appendicitis. Study Design: Cross sectional validation study. Place and Duration of Study: Department of Surgery Combined Military Hospital (CMH) Kohat Pakistan, from Nov 2013 to Oct 2014. Material and Methods: A total of 248 patients fulfilling the inclusion criteria were enrolled in the study after getting the informed written consent. Modified Alvarado Score of all patients was calculated on a proforma which included migratory right iliac fossa pain, anorexia, nausea/vomiting, tenderness in right iliac fossa, rebound tenderness, elevated temperature and leucocytosis (>10 x 109/L). Surgeries were performed by residents and consultant surgeons. Decision to operate upon was not only on the MASS of the patients rather it was on overall clinical condition of the patients using different scoring systems. Where required aid of different laboratory investigations, ultrasonography,...
Objective: To compare the incidence of post dural puncture headache with pencil point 25 gauge Wh... more Objective: To compare the incidence of post dural puncture headache with pencil point 25 gauge Whitacre verse cutting 25 gauge Quincke spinal needle in patients for C section under spinal anaesthesia. Study Design: Randomized controlled trial. Place and Duration of Study: Operation Theatre, Department of Anaesthesia, Combined Military Hospital Lahore, from Nov 2015 to May 2016. Methodology: All patients with ASA status-I or II, undergoing elective C section surgeries were included in the study. Patients assigned to Group W was administered spinal anesthesia by using 25 gauge Whitacre pencil point needle at the level of L3,L4 space while patients assigned to Group Q was administered spinal anesthesia by using 25 gauge Quincke needle at the level of L3, L4 space. Patients were observed for PDPH in the recoveryroom and then in the ward 6 hourly till 72 hours. All the data was entered and analyzed on SPSS version 10. Results: In our study the mean age of the patients was 24.29 ± 3.78 ye...
PAFMJ, 2021
Chordee is a condition in which the penile head has a curvature. It can be towards ventral or dor... more Chordee is a condition in which the penile head has a curvature. It can be towards ventral or dorsal aspect. Dorsal chordee is very rare. In many normal males mild degrees of curvature can exist. Causes of dorsal chordee can be diverse but urethral duplication as its etiology is even rarer. We report a case of six year old boy who presented with severe dorsal chordee with associated double urethra and cleft of the glans dorsally without hypospadia.
OBJECTIVE To assess the safety of direct trocar insertion (DTI) before creating pneumoperitoneum ... more OBJECTIVE To assess the safety of direct trocar insertion (DTI) before creating pneumoperitoneum in laparoscopic procedures. STUDY DESIGN An observational study. PLACE AND DURATION OF STUDY Combined Military Hospital (CMH) Kohat, Pakistan from November 2013 to January 2015. METHODOLOGY All the cases undergoing laparoscopy at the study centre in the above duration were included in the study after approval from the Hospital Ethical Committee and informed written consent. Out of the 200 cases, DTI was successfully used to establish peritoneal access in 190 cases, while open Hassen's technique (OL) was used in ten cases. Body mass index (BMI) of all the patients was calculated before surgery. All the cases were performed under general anaesthesia with adequate relaxation. A 10 mm permanent re-useable sharp metallic trocar was inserted through umbilical scar after lifting the abdominal wall using towel clamps. Studied variables included age, gender, BMI, operations, history of previo...