ABSTRACT
Background: Various methods have been used to detect the colonization status of near term pregnant females but there is lack of consensus on the most appropriate method. In this study we have evaluated three different techniques in terms of their reliability and easiness to perform
Objective: The objective of our study was to determine the validity of 3 laboratory methods namely direct culture on selective blood agar, direct culture on Islam agar and subculture after enrichment with Lim broth on Islam agar in diagnosis of group B streptococcus [Streptococcus agalactiae] [GBS] in near term pregnant females
Materials and Methods: This prospective study was conducted at microbiology section of department of the Pathology, King Edward Medical University and outpatient department of Lady Atchison and Lady Willington Hospital, Lahore. 200 near term, pregnant women of all ages between 35 to 37 weeks of gestation were included in the study. Swabs from the vaginal introitus were subjected to analysis by culture on 4 medias and sensitivity and specificity were calculated for each media against the gold standard
Results: On gold standard media 32 cases were found to be positive for GBS. The prevalence was 16%. The calculated sensitivity and specificity for different techniques were; Blood agar [93.3%, 98%], Islam Agar [93.3%, 98%] and LIM enriched Islam Agar [100%, 100%]
Conclusion: Subculture on Islam Agar after LIM enrichment is superior to other techniques in terms of its performance and cost related issues
ABSTRACT
Background: Various methods have been used to detect the colonization status of near term pregnant females but there is lack of consensus on the most appropriate method. In this study we have evaluated three different techniques in terms of their reliability and easiness to perform
Objective: The objective of our study was to determine the validity of 3 laboratory methods namely direct culture on selective blood agar, direct culture on Islam agar and subculture after enrichment with Lim broth on Islam agar in diagnosis of group B streptococcus [Streptococcus agalactiae] [GBS] in near term pregnant females
Materials and Methods: This prospective study was conducted at microbiology section of department of the Pathology, King Edward Medical University and outpatient department of Lady Atchison and Lady Willington Hospital, Lahore. 200 near term, pregnant women of all ages between 35 to 37 weeks of gestation were included in the study. Swabs from the vaginal introitus were subjected to analysis by culture on 4 medias and sensitivity and specificity were calculated for each media against the gold standard
Results: On gold standard media 32 cases were found to be positive for GBS. The prevalence was 16 %. The calculated sensitivity and specificity for different techniques were; Blood agar [93.3%, 98%], Islam Agar [93.3%, 98%] and LIM enriched Islam Agar [100%, 100%]
Conclusion: Subculture on Islam Agar after LIM enrichment is superior to other techniques in terms of its performance and cost related issues
ABSTRACT
Patients with trivial blunt abdominal trauma may present with isolated jejunal blow out [IJBO]. A high index of suspicion is required as delayed presentation or delayed diagnosis may increase morbidity. Presentation with frank perforation peritonitis can be diagnosed by abdominal X-rays. We report the case of a patient who presented with features of peritonitis 10 days after being injured by a knee kick trauma. An erect abdominal X-ray showed extraluminal air-fluid levels, suggesting a hollow viscous injury which on exploration was found to be IJBO
ABSTRACT
Background: A vesicovaginal fistula [VVF] is a surgical problem and is associated with many social consequences. Multiple techniques including different approaches and different tissues as interposition grafts have been proposed for the repair of the VVF. We are reporting our experience of VVF repair with free omental graft through transperitoneal transvesical approach
Objective: The objective of present study was to assess the outcome of supratrigonal vesicovaginal fistula repair by modified 0, connors' technique
Patients and Methods: This descriptive study was based on case series of nine patients of supratrigonal VVF admitted in surgical unit-1, between 1[st] December 2010 and 31[st] August 2011. After a detailed medical history, physical examination, per vaginal assessment, cystoscopy and radiological and laboratory work up these patients underwent VVF repair. Post operatively these were assessed for recovery, failure of fistula and development of any complications. Patients were re examined before discharge from hospital. Follow up visits were planned after 2 weeks and then after 3 months in order to assess success of repair
Results: Mean age of the patients was 37.5 +/- 11.7 years. Most of the patients [8] were from low socioeconomic group. Six patients had primary fistulae while 3 had recurrent. One patient had right ureteric dilatation due to iatrogenic ureteric ligation. The size offistulae noted during the surgery was < 2 cm in 5 patients and >2cm in 4 patients. Average operative time was 72 +/- 15 minutes. Average hospital stay was 9.4 +/- 3 days. Success rate was 100% as none of the repair failed. Minor urinary leakage, minimal hematuria and laparotomy wound infection settled spontaneously
Conclusion: Free omental graft through transabdominal transvesical approach for VVF repair is associated with very low morbidity and carries a very high success rate
ABSTRACT
Background: Perforation of peptic ulcer is a life-threatening emergency and associated with marked post surgical morbidity
Objective: To enlist the predictors of the postoperative morbidity in surgically treated patients of perforated peptic ulcer
Methods: A cross sectional study was conducted at Surgical Departments of Allied and DHQ Hospital Faisalabad. Clinically and radiologically suggestive but surgically proven, 60 cases of the perforated peptic ulcer were included in the study. Possible predictors were recorded on admission as well as during surgery. Postoperatively, patients were taken care of and followed up for the development of complication till the time of discharge. Depending upon the presence/ absence of the post operative complications, patients were divided into two groups. Data was entered and analyzed by using SPSS version 11
Results: In our study, age ranged from 24-80 years. 26.7 percent of the cases had clinical features of shock at presentation. Smoking was noted in 47 percent of the cases. In 97% of the cases, the size of perforation was less than 1 cm while more than half of the cases had amount of peritoneal spillage more than 1 Litre. The most common complication was wound infection. Most of the patients were discharged home between the 7[th] and 10[th] postoperative days. Age more than 40 and male sex [p-value < 0.147] were not found to be associated with increased risk of development of the post operative complication. Complication rate was found to be quite high for the patients presenting after 72 hours of the development of the pain [p=0.006, OR=9.3]. Other factors which showed significant difference between the two groups for the development of complication included shock at presentation [p-value= 0.032], history of smoking [p-value= 0.002] and the presence of associated medical illness [p-value= 0.01]
Conclusions: Late presentation, history of smoking, presence of shock at the time of presentation and presence of the associated medical illness significantly influence the rate of development of post operative complications
ABSTRACT
Appendectomy is a common emergency procedure. Negative appendectomy rate is up to 33%. As it is associated with the risks of anesthesia like any operation, it should be avoided where possible. Modified Alvarado score is one of the probable ways to reduce this rate. Our objective of the study was to evaluate its value in reducing the percentage of the negative appendectomy. A non randomized controlled trial was conducted at Emergency Department of DHQ Hospital Faisalabad over the period of 6 months. 60 patients were divided into two groups. In group A, 1st consecutive 30 patients were included who had indication for appendectomy based on the choice of the surgeon while in group, B 30 patients having indication for appendectomy based on modified Alvarado score 7 or more were included. Surgically removed appendix was evaluated by histopathology for the presence or absence of inflammation. Both groups were compared for the percentage of the negative appendectomy. In group A, overall negative appendectomy rate was 20% while gender based negative appendectomy rate was 28.5% in Females and 12% in males. In group B overall negative appendectomy rate was 14% while gender based negative appendectomy rate was l7.6% in females and 7.6% in males. Over all reduction through modified Alvarado score was insignificant [chi-square 0.480, df 1, p value 0.488]. Similarly, statistically significant reduction could not be found both in female [chi-square 0.524, df 1, p value 0.469] and male [chi-square 0.179, df 1, p value 0.672] groups. Modified Alvarado score is not helpful in significant reduction of the over all percentage of the negative appendectomy. Similarly, statistically significant reduction could not be found both in female and male groups. Further methods of evaluation should be used especially in females