Journal of Islamabad Medical & Dental College
Not a member yet
636 research outputs found
Sort by
Management of Fistula-In-Ano: A local Experience
Get PDFObjective: To evaluate short and long-term outcomes of complex fistula surgery. Patients and Methods: This cross-sectional study was conducted on all patients, both male and female admitted to General Surgery Department of PIMS, Islamabad who underwent surgery for fistula-in-ano from 1st January 2010 to 31st December 2015. A total of 65 patients, who underwent surgery for fistula-in-ano in the hospital were included in this study. They were assessed by case review supplemented by OPD follow up and telephonic interview when necessary. Results: A total of 65 cases of fistula-in-ano were operated in the surgical unit of the hospital. Out of the total patients, 27 patients were operated once, 29 patients were operated twice and 9 patients had surgery three times. Almost about half of the patients (45 %) had trans sphincteric complex fistula with secondary tract identified in 40% cases, 16 % cases with intra sphincteric, 36% cases with extra sphincteric, 3% case with horseshoe shaped and 5% with a combination of two. In 45 % of the cases, excision of primary and secondary tracts were done with loose seton placement while preserving the sphincter complex. About 36 % cases had excision of the tract while in horseshoe cases fistulotomy was done. In 4 % of cases primary excision of the tract and repair of the sphincter complex was performed. In two patients, drainage and curettage of presacral abscess was done. We made colostomy in one patient after 4th recurrence while one patient was having colostomy before operation that was operated 6 times for fistula. No incontinence was reported for solid and liquid, while 12.3 % cases had transient flatus incontinence, 9.2 % cases presented post-operative bleeding in which 4 % of patients settled with pressure dressing while 5.2 % required control of bleeding under GA. Conclusion: Majority of the complex fistula in-ano treated by primary fistulotomy or stage fistulotomy with a loose seton are followed by good clinical and functional result
Outcome of Chipping Method in Complex Non-Union of Long Bones
Get PDFObjective: To determine the outcome of chipping method in the treatment of long bones complex non-union with autologous bone graft. Patients and Methods: This interventional study was conducted in orthopedics and trauma department Khyber teaching hospital, Peshawar. Duration of this study was January 2015 to January 2016. The consecutive nonprobability technique was used to collect the samples and twenty-one patients were managed with chipping method for complex non-union of long bones. All the patients were treated by appropriate fracture fixation, including revision of implants. and followed for at least 06 months postoperatively. Results: A total of 21 patients were included in the study among which 14(66.67%) were males and 7(33.33 %) were females. Mean age of the patients was 44 years (Range 20 to 80 years). Among them 13 patients had femoral shaft fracture non-union,5 patients had tibial shaft fracture non-union, 2 patients had humerus fracture non-union and one had radius/ulna fracture non-unions. Mean duration from trauma to non-union was 15 months (Range 6 months to two years). All the patients were treated with this method, using an autologous bone graft from the iliac crest and followed for at least six months postoperatively. Twenty patients obtained bony union successfully. One patient failed to get a union, requiring the second operation, three patients got ipsilateral knee stiffness and three patients got limb length discrepancy less than 2cm. Conclusion: Chipping method with autologous bone grafting is easy to perform and is an encouraging approach for enhancing bone healing in long bones complex non-union
Comparison of Mean Lipid Profile in Calcific Aortic Stenosis Cases and Controls
Get PDFObjective: This study was aimed to compare the mean lipid profile in calcific aortic stenosis patients and control group. Patients and Methods: Total 202 individuals, 101 cases and 101 controls visiting National Institute of Cardiovascular Disease and various tertiary care hospitals of Karachi from January 2012 to December 2012 were included in this study. Calcific AS patients having the age of ≥60 years fulfilling the inclusion criteria were selected from echocardiography department and OPD from NICVD. Age and gender match controls were selected from OPD. Lipid profile was done in DDRRL, Ojha Campus. Lipid profile estimates were carried out on HITACHI 902 analyzer using photometry technique. Results: Nonparametric Mann-Whitney test showed increase level of Triglyceride in calcific AS patients. Conclusion: Calcific AS patients showed altered lipid profile as compare to control group so dyslipidemia may be involved in its pathogenesis
Association between Raised Serum C-Reactive Protein and Arteriovenous Fistula Failure
Get PDFObjectives: To study the association between serum Creactive protein (CRP) and arteriovenous fistula (AVF) failure rate. Patients and Methods: This case control study Department of Vascular Surgery Combined Military Hospital Lahore and Peshawar between January 2015 and March 2016. Total 126 consecutive patients who had serum CRP checked preoperatively and underwent AVF procedure were included. Patients were divided into Case (with raised CRP) and Control (Normal CRP) groups. Data regarding serum CRP level were recorded and analysed to evaluate the impact of preoperative CRP levels on AVF failure rates. Results: The AVF failure rate was significantly high (53.2%) in case group as compared to control group (14.5%). Age, gender, diabetes and hypertension did not show statistically significant difference between the two groups. Conclusion: Raised level of CRP is related to significantly higher AVF maturation failure rate. Therefore, it is recommended to check CRP levels preoperatively to identify those patients who can be at higher risk of fistula failure. 
Pattern of Dyslipidemias and their Association with Ischemic and Hemorrhagic Stroke
Get PDFObjective: To find out the association between dyslipidemias and ischemic and hemorrhagic stroke. Patients and Methods: This cross-sectional study was conducted in Medical Unit I, Jinnah Hospital Lahore (JHL) from 1st January 2015 to 30th Jun 2015. A total of 420 cases of stroke were included via Nonprobability consecutive sampling technique. The sample size was calculated with 95% confidence level, 2% margin of error. At the time of admission, every patient underwent CT scan in the radiology department of JHL, fasting blood samples were taken, on next day of admission. Every sample was processed for lipid profile in pathology department of Allama Iqbal Medical College, (AIMC) Lahore. Based on CT scan findings, patients were labelled as ischemic or hemorrhagic stroke. Demographic details, BMI, blood pressure and Diabetic status were also recorded. Results: Out of 420 study participants, 47.6% (n=200) were male and 52.4% (n=220) were females, the mean age was 39.29 + 11.82 years, mean BMI was 39.29 + 11.82 kg/m2. History of hypertension (HTN) was most frequent risk factor seen in 82.6% (n=347) followed by Diabetes mellitus (DM) 49.8% (n=209) and smoking found in 32.1% (n=135) cases. Frequency of Hypercholesterolemia (>200 mg/dl) was observed in 26.2% (n=110) and Hypertriglyceridemia (>150 mg/dl) in 7.9% (n=33) patients. High LDL (>130 mg/dl) levels were observed in 5.7% (n=24), high VLDL (>35 mg/dl) in 6.9% (n=29) patients, while low HDL (<35 mg/dl) was noticed in 17.1% (n=72) patients. There was significant association between type of stroke & hypercholesterolemia as well as low HDL levels (p-value<0.05). While insignificant association was found between type of stroke & hypertriglyceridemia and high VLDL (p-value>0.05). Effect modifiers i.e.; age, BMI, gender, history of smoking, HTN and DM were not significantly associated with type of stroke (p-value >0.05). Conclusion: Hypercholesterolemia & HDL levels are significantly associated with type of stroke, whereas serum hypertriglyceridemia, high LDL and high VLDL were not significantly associated with type of stroke
Comparison of Efficacy of Canal Wall up Mastoidectomy with Canal Wall Down Mastoidectomy in Surgical Management of Otitis Media with Cholesteatoma
Get PDFObjectives: To compare the efficacy of Canal Wall Up (CWU) Mastoidectomy with Canal Wall Down (CWD) Mastoidectomy in the surgical management of chronic otitis media with cholesteatoma in local population. Patients and Methods: A total of sixty patients with chronic otitis media, cholesteatoma and granulation tissue were enrolled. Patients were randomly divided into two groups; Group A patients underwent CWU Mastoidectomy while Group B patients underwent CWD Mastoidectomy. Both groups were followed for 6 months, for recurrence of the disease and associated complications. Chi-square test was applied as a test of significance, to compare the outcomes of CWU Mastoidectomy and CWD Mastoidectomy. a p-value <0.05 was considered as statistically significant Results: Disease recurrence rate was significantly higher in group A (CWU) while complications rates were higher in group B (CWD) patients. Persistent discharge, conductive deafness, and development of mastoid cutaneous fistula were reportedly higher in group B patients (P<0.05). Conclusion: CWD operations have a higher probability of permanently curing the patient of the cholesteatoma but with higher rates of post-surgical complications. CWU procedures have the advantage of maintaining a near normal anatomy but with a higher risk of residual or recurrent cholesteatomas. Choice of a particular surgical procedure depends on the preference of the surgeon, the nature, and extent of the pathology and the general health of the patien
Correlation between Glycated Hemoglobin and Dyslipidemia in Type-2 Diabetes Mellitus
Get PDFObjective: To evaluate correlation between glycated haemoglobin and dyslipidaemias in patients with type-2 Diabetes Mellitus (DM). Patients and Methods: Participants were selected from out-patient department of Sheikh Zayed Hospital, Lahore and Laboratory analysis was performed at department of chemical pathology, University of Health Sciences, Lahore. Total 60 patients of type-2 DM and 40 age and gender matched controls were included in study. Glycated haemoglobin (HbA1c), fasting blood glucose (FBG) and lipid profile was performed after overnight fasting. Control group was labelled as Group-A and patient group was labelled as Group-B. Mean of all parameters from both groups was compared and checked for significance by independent sample t-test and Pearson correlation. Results: There was no significant difference in mean values of all biochemical parameters between both genders, except total cholesterol, which was found higher in females (pvalue 0.047). Only 3.3% (n = 02) patients had normal lipid profile, 76.6% (n = 46) had one-abnormal parameter of lipid profile, 28.3% (n = 17) patients had two-abnormal parameter of lipid profile and 58.3% (n = 35) had mixed type of dyslipidemia. HbA1c was positively correlated with all parameters of lipid profile except HDL-C, which was negatively correlated. Conclusion: There is positive correlation between level of glycemic control (HbA1c) and severity of dyslipidemia in patients of type 2 DM
Endoscopic Diagnosis in Patients with Acute Upper Gastrointestinal Bleeding
Get PDFObjective: To determine the causes of acute upper gastrointestinal bleeding using upper gastrointestinal endoscopy. Patients and Method: This cross-sectional study was conducted at Peoples University of Medical and Health Sciences (PUMHS), Lakyari Endoscopic suit, Nawabshah from Jan 2015 to March 2016. Patients presenting with acute upper gastrointestinal bleeding were inducted in the study. After stabilizing the patients, upper gastrointestinal endoscopy was performed. Data was entered and analyzed by statistical software package SPSS version 10.0. Mean ± SD was calculated for quantitative variables and qualitative variables like gender and endoscopic findings were expressed as frequencies and percentages. Results: Out of 208 patients, 139 (67%) were males and 69 (33%) were females. Mean age of the patients was 52.77±14.5 SD years. Haematemesis was the main presenting complaint followed by melena. Bleeding related to portal hypertension was present in 112 (53.84%) patients, followed by peptic ulcer disease in 74 (35.57%) patients. Malignant lesions were present in 11(5.28%) patients while miscellaneous lesions were found in 11(5.28%) patients. Conclusion: Gastro esophageal variceal bleeding was the leading cause of upper GI bleeding followed by ulcerative disease
Association between Gly460Trp Polymorphism of αAdducin Gene and Risk Factors in Hypertensive Pakistani Population
Get PDFObjective: To determine possible association between αadducin gene G460W polymorphism and risk factors like age & BMI in hypertensive Pakistani population. Material & Methods: Deoxyribonucleic acid (DNA) samples from 200 patients with essential hypertension and 200 normotensive healthy individuals from Pakistani population were genotyped for G460W polymorphism by Polymerase Chain Reaction and Restriction Fragment Length Polymorphism. Logistic regression analysis was used to find association between ADD1 gene G640W polymorphism and risk factors like age and BMI (Body mass index) in hypertensive Pakistani population. Results: No significant association was found between G640W polymorphism and risk factors like age and obesity. Conclusion: This study showed that there is no significant association between ADD1 gene G640W polymorphism and risk factors in our selected samples from Pakistani population
Prevalence of Asymptomatic Bacteriuria in Pregnancy
No full textObjective: The present study aimed at estimating the prevalence of asymptomatic bacteriuria during pregnancy. Patients and Methods: This descriptive cross-sectional study was conducted in pregnant women coming for antenatal checkup to IYB Headquarter Hospital Attock during March-June 2017. After taking informed consent, urine samples of 180 pregnant females were collected and subjected for culture. Growth of>1x105 CFU/mL was considered as significant bacteriuria. Isolates were identified using standard microbiological methods. Results: Out of total 180 samples, 16-showed significant bacteriuria, thus prevalence was calculated to be 8.89%. Asymptomatic bacteriuria had no significant relationship with age, gravidity and trimester of pregnancy. Escherichia coli was the most common isolated bacteria (43.75%). Conclusion: Due to high prevalence of asymptomatic bacteriuria and its associated adverse complications, urine culture should be made essential part of antenatal investigation