Journal of Islamabad Medical & Dental College
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Ectopic Mediastinal Parathyroid Adenoma Excision via Video Assisted Thoracoscopic Approach: A Case Report
Get PDFEctopic parathyroid adenomas can be a cause of recurrent and refractory hyperparathyroidism. Majority of parathyroid adenomas are located in the neck region, however in very few cases they are located within the mediastinum. In such cases excision via cervical approach is not possible and it becomes a diagnostic as well as surgical challenge. Excision via thoracoscopic approach is a preferred approach in this regard. Here we represent a case of ectopic parathyroid adenoma embedded within thymus gland which underwent surgical excision via thoracoscopic approach.
Key words: Ectopic, Parathyroid adenoma, Thoracoscop
Phenotypic Profile of Kidd Blood Group System in Northern Pakistani Population
Get PDFOBJECTIVETo investigate the phenotypic profile of Kidd blood group system in Northern Pakistani population.STUDY DESIGN: Descriptive cross-sectional PLACE AND DURATION OF STUDY: The research was conducted at department of immunohaematology, Armed Forces Institute of Transfusion (AFIT) Rawalpindi, Pakistan, from Dec 2022 to Jun 2023.METHODOLOGY: The study included 280 donors of all ages and both genders fulfilling the WHO Healthy Volunteer Donor criteria for blood donation. Individuals were included in this study while individuals not fulfilling the criteria were excluded from this study.. Blood grouping was performed by tube agglutination method and for data analysis version 23.0 of Statistical Package for Social Sciences (SPSS) was used.
RESULTS: The frequencies of A, B, AB, and O antigens were (23.9%), (33.6%), (10.0%), and (32.5%), respectively among all the 280 participants while the frequencies of Kidd Jka and Jkb were 73.2% and 75.4% respectively. The expression of phenotypic profile was Jk ( a+b+) in 49.6%, Jk (a-b+) in 25.7%, Jk (a+b-) in 23.6%, and Jk (a-b-) in 1.1%.
CONCLUSION: Kidd antigen was found in a significant proportion of our donor population which arises the need for undertaking extended antigen typing for this minor blood group as a routine in our blood banks to be able to provide antigen free blood units to chronically transfused, pregnant and anaemic individuals for prevention of delayed haemolytic transfusion reactions
Actinomycosis, A Rare Cause of Perianal Fistula
Get PDFPerianal fistula (fistula-in-ano) is one of the most common anorectal diseases. It is an abnormal connection between the anal canal and the perianal skin and is lined with granulation tissue. Although benign, the condition can cause significant distress and embarrassment to the patient. Major causes of an anal fistula are clogged anal glands forming anal abscesses. Other, much less common, conditions are infections, trauma and tumors. The treatment of an anal fistula depends on the etiology and location of the fistula. Most fistulas are treated surgically, through a variety of different procedures. Actinomycosis which is a gram positive bacteria can rarely cause perianal fistulas which is difficult to diagnose clinically so can result in mismanagement and recurrences leading to repeated surgeries.
Key words: Actinomycosis, Fistula in ano, Gram positive bacteria
Impact of Obesity on Lumbar Disc Herniation
Get PDFBackground: Prevalence of obesity is increasing worldwide and obese patients constitute a major portion of the spinal surgeon s practice. The patients with lumbar disc herniation present the most in the outpatient department of neurosurgery. Obesity not only leads to the disc herniation but also causes a surgeon a difficult ordeal while operating as it leads to more peri operative complications than normal weight patients. This cross-sectional study was planned to see the impact of obesity on lumbar disc herniation and its association with disease outcome.
Methodology This study was conducted in the department of neurosurgery at Sir Ganga Ram Hospital/ Fatima Jinnah Medical University (N=604; Males: n=368 Females: n=236) from December 15th 2021 to July 31st 2022. From the prospective registry, patients undergoing unilateral fenestration and discectomy, bilateral partial laminectomy and discectomy, and endoscopic discectomy were identified with complete BMI data.
Results: In total 604 patients, 368 were males and 236 were females, with age range 25-55 years with ± 4.9 SD. Among these 187 (30.9%) were managed surgically while 417 (69.1%) patients were managed conservatively, which were assessed on VAS (Visual Analogue Score) and Sciatica Bothersomeness Index (SBI). Among them 87 patients (20.8%) patients were of normal weight, 145 (34.77%) were overweight and 185 (44.36%) were obese. Among187 patients who underwent surgery; 74 (39.5%) underwent unilateral fenestration and discectomy, 113 (60.4%) underwent bilateral partial laminectomy and discectomy whereas 16 patients (8.5%) underwent endoscopic discectomy. Lumber Disc Herniation (LDH) was more frequent in obese and overweight individuals than in normal-weight patients.
Conclusion It was observed that in obese and overweight patients, the severity of pain was more as compared to normal patients. Higher the BMI more the excruciating pain and more neurological were seen with increasing trend of numbness and radiculopathy. Hence, obesity may have a robust impact on lumbar disc herniation apart from other pathologies involved.
Key words: Discectomy, Disc herniation, Laminectomy, Lumbar region, Obesity
A Case Report on Abdominal Cocoon Syndrome: Cocoon Syndrome
No full textAbdominal cocoon syndrome (ACS) is encapsulation of the abdominal organs by thick fibro-collagenous material forming cocoons. On the basis of the part of abdominal organ encapsulated, ACS is classified into three types. Patients with this condition usually present with intestinal obstruction. We present a case who presented to us with features of intestinal obstruction and was diagnosed as a rare case of abdominal cocoon syndrome on CT scan. He was managed operatively where adhenolysis was performed and patient had uneventful recovery. CT scan is found to be the investigation of choice. Laparotomy with excision of membrane overlying bowel loops is the treatment most commonly adopted by surgeons and it has satisfactory results.
Key words: Cocoon syndrome, Computed tomography, Intestinal obstruction
Medicolegal Aspect Analysis of Burn Cases in Liaquat University Hospital, Hyderabad
Get PDFBackground: Owing to the high potential of physical injuries, disabilities and even deaths resulting from burn-related injuries, these are considered as injuries of medico-legal importance. The study aims to investigate the medico-legal aspects of selective cases of burn victims admitted to the Burn unit of Liaquat University Hospital, Hyderabad.
Methodology: This study was conducted at the Burn unit of Liaquat University Hospital, Hyderabad. The information on burn patients was collected retrospectively from the record for the period of three years from January 2018 to December 2020 from the Burn unit. The data related to socio-demographic details, site, cause, severity and outcome of burn cases was recorded.
Results: Total 418 victims record was evaluated; the highest prevalence of cases was in the age group of 0-10 years (60.6%). Majority; 58.8% of the victims were males. In more than half (52.6%) of the victims, 20% or less body area was burnt. In 34.2% cases, 21-40% area was burnt. About 48.1% of cases were of wet scalds and 40.2% dry flame burns. About 7.6% were cases of electrocution. Male and female burn victims demonstrated statistically significant difference (p<0.05) regarding site of burn, side, source, manner and survival from burn injuries.
Conclusion: Males are more affected by burns than their counterpart while children ≤ 10 years are most commonly reported with burn injuries. Wet scald is the most common type of burn while most victims present with ≤20% burnt body area.
Key Words: Accidental injuries, Burns, Suicid
A Descriptive Correlational Study of Vascular Foramina in Adult Human Femora in Cadavers in Pakistan
Get PDFBackground: This study was conducted to study the variations in the number and location of nutrient and epiphyseal vascular foramina of the femur in the Pakistani population
Methodology: This descriptive cross-sectional study was conducted from April -June '2022 after getting ethical approval. Data collection tool: 24-gauge hypodermic needles & measuring tapes.
Data collection and Analysis: SPSS & Excel
Inclusion & exclusion criteria: Anatomically sound bones were included from the bone bank of RMU; pathological, deformed bones were excluded
Results: Out of 80 bones 66.6% had single nutrient foramina, whereas 31.3% had two on the shaft. 82.05% of foramina were type II, 16.67% were type I and 1.26% were type III. Only 2.5% had no foramina. Majorly the nutrient foramina were found on the medial surface, medial lips or between the lips of linea aspera. There was no significant difference bilaterally in the mean foraminal index, foraminal length, or several epiphyseal vascular foramina, which were 18.65 cm, 42.66 cm, and 16 cm respectively.
Conclusion: Most of the nutrient foramina in the femora were found in the middle third of the shaft, either on the medial lip of the Linea Aspera or on the shaft’s medial surface; however, variations in their location have been found. The mean epiphyseal vascular foramen ranged from 6 to 26.
The article finds its implications in orthopaedic surgery and osteogenesis.
Key words: Epiphyses, Diaphysis, Femur, long bones, Hip joint, Arteries, Pathology, Research, osteogenesis, Populatio
Patterns of Developmental Delay in Children with Autism Spectrum Disorder: A Perspective from a Developing Country: https://jimdc.org.pk/index.php/JIMDC/workflow/index/814/3#
No full textBackground: Autism Spectrum Disorder is a developmental disorder characterized by difficulties in social interaction, initiating conversations, delay in language skills, play skills and stereotypic behaviours. Children with severe developmental delay and those with global developmental delays are needed to be identified as they may have long term problems and disabilities.
Materials & Methods: All children below age of 5 years coming first time for assessment of ASD and diagnosed using ADI-R and ADOS-2 were included in the study. Total 334 children met the criterion. All children having performance deficit below 2SD on age appropriate mean were considered as having developmental delay. Those having delay in two or more than two domains were labelled as having global developmental delay. Detailed clinical and developmental assessment was performed. Data was entered and analysed via SPSS v26.
Results: Mean age of children at time of presentation was 3.6±1.10 years with male to female ratio of 3.5:1. According to developmental assessment using Schedule for growing Scales II, most affected area was speech and language (51.5%) followed by cognitive skills (50.7%), social interactive skills (49.9%), visual skills (46.9%), hearing and language skills, (38.3%), self-care social skills (26.2%), manipulative skills (13.5%) and gross motor skills (0.4%). Global Developmental Delay was found to be present in half of the children for which there was no other possible explanation.
Conclusion: Most of the children with Autism Spectrum Disorder from developmental delay of some sort. Therefore, every child with Autism Spectrum Disorder must be evaluated for Developmental Delay and supported
Relationship of Maxillary Sinus and Maxillary First Molar Root Using Cone Beam Computed Tomography
Get PDFBackground: Cone beam CT (CBCT) is an advancement of conventional CT that uses a divergent pyramidal or conical X-ray beam for imaging the craniofacial complex. Studies on the maxillary sinus and its relationship with the roots present within its close proximity are mostly based on computed tomography imaging and rarely being based on cone-beam computed tomography (CBCT). This study aims to determine the relationship of maxillary sinus and the mesiobuccal root of maxillary first molar using cone beam computed tomography (CBCT).
Methods: The study was conducted in Armed Forces Institute of Dentistry (AFID) from Sept, 2019 to Feb, 2020. 142 CBCTs were studied in the duration of six months. The distance between the maxillary mesiobuccal root and floor of maxillary sinus was measured using the built in software. The data collected was analyzed using SPSS 23. p-value of <0.005 was considered significant.
Results: The mean distance was -0.85 mm ± 2.56 on left side and -0.74mm ± 2.40 on right side. There was no significant difference between left and right side. The correlation between age and left and right-side measurements was statistically significant, p-value 0.000.
Conclusion: The relationship of maxillary sinus and the mesiobuccal root of maxillary first molar is significant. The study shows that in dentate healthy patients, the maxillary mesiobuccal molar root is nearly in contact with the sinus floor. These findings lead to the conclusion that performing surgical procedures in maxillary molar region may invariably lead to sinus perforation if one is not care full.
Keywords: Cone beam computerized tomography, Dental implant, Maxillary sinus, Mola