Journal of Ayub Medical College, Abbottabad : JAMC
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J Ayub Med Coll Abbottabad · Jan 2019
Emergency Laparoscopic Cholecystectomy: Is Dedicated Hot Gall Bladder List Cost Effective?
Acute presentation of gall stone disease is a common emergency. Resource limitation often results in unnecessary long waiting times and repeat hospital admissions. The aim of this study was to investigate if funding a dedicated hot gall bladder list is justified. ⋯ Emergency LC is cost effective and savings made for such a service is sufficient to fund a dedicated hot gall bladder list..
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J Ayub Med Coll Abbottabad · Oct 2018
Ultrasonographic optic nerve sheath diameter Measurement for raised intracranial pressure in a Tertiary care centre of a developing country.
Intracranial hypertension is not an uncommon life-threatening syndrome, caused by a variety of non-neurological and neurological illnesses, and quick diagnosis, timely treatment of Raised Intracranial Pressure (ICP) is associated with improved outcome. Our aim of study was to determine ultrasonographic measurement of Optic nerve sheath diameter (ONSD) for raised ICP. ⋯ We identified threshold of Ultrasonographic ONSD measurement in infants >4.0 mm, in children 1-10 yrs >4.71 mm, in adolescent >10 yrs >5.43 mm for raised ICP with sensitivity and specificity of 100% and 60-66.7% respectively. 85% of patients showed raised ICP with Ultrasonographic ONSD measurement with GCS ≤12.
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Ramadan, the ninth month of Islamic calendar brings alongwith it a sense of responsibility to fast among the Muslim adult population. Though patients with chronic illnesses like Diabetes mellitus are exempted from fasting during the month if their health does not allow, they still wish to fast. ⋯ Insulin sensitizers are a better option than drugs increasing secretion of insulin. Type 2 Diabetic patients can fast much safely as compare to Type 1 Diabetics.
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J Ayub Med Coll Abbottabad · Oct 2018
Coeliac Plexus Neurolysis For Pancreatic Cancer Patients; Retrospective Analysis Of Shaukat Khanum Memorial Cancer Hospital & Research Centre Experience.
Among all the abdominal cancers, pancreatic cancer is the second most common one. Majority of the patients present with an excruciating pain when they are diagnosed with the disease. Coeliac plexus neurolysis (CPN) is a procedure that can control the pain in pancreatic cancer while precluding further consumption of analgesics in higher doses and quantity. The procedure of neurolysis is performed by injecting phenol/alcohol into the coeliac plexus ganglionic neural network. There is a high proportion of pain relief with CPN in up to 80% of the patients. ⋯ It has been observed from the results that CPN works effectively for pancreatic cancer patients. There is a strong recommendation of neurolysis in patients with pancreatic cancer pain as it improves the pain scores, significant reduction in analgesia consumption with good patient satisfaction.
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Intracranial arteriovenous malformations (AVMs) consist of an abnormal nidus of blood vessels that shunt blood directly from an artery to a vein and thereby bypass an intervening capillary bed. AVMs may be found as an incidental finding. They may be associated with intracranial haemorrhage, seizures, headaches or neurological deficits. There are different treatment options for AVM. These include observation, microsurgery, Stereotactic radio surgery (SRS), endovascular embolization and intensity modulated radiotherapy (IMRT). ⋯ Stereotactic radiosurgery is the most suitable technique for AVMs considering the good prognosis and the risks associated with this procedure. However, large AVMs require multidisciplinary approach for better results.