Hamzullah Khan

Short-term complications of ventriculoperitoeal shunt in children suffering from hydrocephalus

To assess various complications in children with hydrocephalus after ventriculoperitoneal shunt surgery. This de- scriptive study was conducted in the Department of Neurosurgery, Lady Reading Hospital and Al-Ibrahimi Hospital, Peshawar, Pakistan, from September 2005 to April 2007. A total of 86 children, 48 male and 38 female patients, with male to female ratio of 1:1.3 were included. Age range of patients was from 2 months to 13 years with mean age of 4.3 years. Seventy-nine cases were operated electively while seven cases operated in emergency due to poor clinical condition. Shunt malfunctioning due to obstruction of upper end was noted eight cases (9.3%), shunt infection in seven (8.1%) cases, seizure four (4.7%) cases, paralytic ileus in five (5.8%) cases, shunt extrusion per rectum in two (2.3%) cases, bilateral subdural hematoma in three (3.5%) cases, hydrocele and shunt erosion in two (2.3%) cases each. Two (2.3%) deaths were recorded in the study, which was not related with the surgery or with shunt complication. It is concluded that various complications may develop during and after ventriculoperitoneal shunt surgery. Shunt malfunction and infection are main causes for its failure and poor prognosis, although a list of other rare possible complications can also be expected.

Abuse due to jealousy: A case study

This is a prospective study aimed to compare the results of stapled hemorrhoidopexy with LigaSure Haemorrhoidectomy. This study included 50 patients who were divided into 25 patients underwent stapled hemorrhoidopexy and 25 patients underwent LigaSure Haemorrhoidectomy. Operat ion t ime and postoperative progress was assessed. Postoperative pain was assessed using visual analogue scale. Patients were followed for six month. The majority of patients were males; 12 patients had grade III haemorhoids and 38 patients had grade IV haemorhoids. Mean age was 43 years. The average operating time was 45.5 minutes for stapled hemorrhoidopexy and 35.5 minutes for LigaSure haemorrhoidectomy. The average pain scores on postoperative day 1, day 2 and day 3 were 2.5 and 2 for stapled hemorrhoidopexy while for LigaSure haemorrhoidectomy were 5.5 and 5. Stapled hemorrhoidopexy offers much less pain when compared to LigaSure haemorrhoidectomy and allow early return to work.Uterine rupture is an obstetric catastrophe that is associated with high maternal and perinatal mortality rates. Its incidence is high in developing countries. Uterine rupture may be silent and obscure but requires immediate surgical intervention and its occurrence can result in severe maternal morbidity. We report a case of G4P3+0 with previous traumatic rupture uterus presented in labor at 32 weeks and found in caesarean section to be ruptured fundus of the uterus with active bleeding. Baby delivered alive, and uterus repaired. Most cases of ruptured uterus are preventable with good antenatal care, intra-partum care and proper identification of high risk cases. Thinning in the lower uterine segment measured by ultrasonography is a predictor of uterine rupture but, ideal thickness cut-off value could not be defined. We recommend; use of partogram as tool in recognising deviations from normal, prevention of unnecessary cesarean sections, facilitating early referral and continued education of staff in order to prevent uterine rupture.Bilateral ectopic pregnancy is a rare phenomenon. It has been 76 years since the first published report of a case of bilateral ectopic pregnancy. Since then about 200 cases have been reported in the literature; we report a case here.Lipomas are the most common type of nonepithelial benign tumors of the gastrointestinal tract. This is a report of a case of transverse colonic lipoma which presented with a misleading Gastroenteritis for which upper and lower endoscopies were done for recurrent and persistent symptoms and revealed tumor-like mass in the transverse colon for which transverse colectomy with primary anastamosis was done and histopathology came as the rare colonic lipoma. The gastrointestinal lipoma is a relatively rare disease, and originates from the submucosa of the gastrointestinal tract and occurs the most frequently in the cecum and ascending colon. One of the challenges in the management of colonic lipoma is to establish the diagnosis preoperatively. Three diagnostic tools can bring arguments in favor of the diagnosis: colonoscopy, barium enema and CTPerforated peptic ulcer is a common abdominal disease that is treated by surgery. Despite the use of proton pump inhibitors, perforated peptic ulcer remains a frequent surgical emergency with an average mortality rate of 5.8%. This is a report of a 77 year old Saudi diagnosed as acalculus cholecystitis and upon laparoscopic exploration it was found to be sealed duodenum perforation. Patient was treated conservatively and discharged in good condition.Intrathoracic goiters are usually located anteriorly, in the superior or anterior mediastinum, and are termed substernal or retrosternal goiters. Posterior mediastinal goiters are rare, about 10% of all intrathoracic goiters. Patients with retrosternal goiter usually have a visible or palpable cervical mass. In addition, tracheal deviation may be present with compression symptoms. Posterior mediastinal goiter with mediastinal compressive symptoms is an indication of surgery. Lateral thoracotomy is an alternative approach for intrathoracic goiter extending into the posterior mediastinum. We report a case of 75 years old gentleman, referred with right neck swelling, difficulty in swallowing and breathing and changes of voice. Total thyroidectomy was performed. Histopathology report showed multi nodular goiter with no evidence of malignancy. This patient had both types of extension. Both were delivered successfully through a classic neck incision without sternotomy or combined cervicothoracotomy. It would be reasonable to consider surgical management for such symptomatic goiters if there were no contraindications.Background: Youth have higher risk of sexual and reproductive health (SRH) problems, and consequently have a higher need for SRH counselling. In Egypt, reproductive health (RH) awareness is generally poor especially among young women attending high institutions that requires further attentions and research to explore the different barriers to access the RH services. Aim: The aim of this study is to investigate the barriers to access SRH services among young educated Egyptians. Materials and Methods: A cross-sectional, community-based survey was conducted in Minia Governorate, Egypt through a self-funded research project during the period from January 2019 till September 2019. The invited sample were 750 female university students. Approval by ethical committee of the Department of Obstetrics and Gynecology, Minia University Hospital was obtained. Descriptive and a cross-tabular descriptive statistical analysis of frequencies and percentages were performed. Comparing means with a significance level of 0.05 was performed to investigate the association between the different variables. Results: A total of 48.1% of participants reported an unmet need of sexual and reproductive health counselling. Ten different barriers were described by the participants. The first four barriers in the order of importance were health service provider’s attitudes (88.5%), misinformation in the communities (86.5%), cultural norms (86.5%) and health system barriers (73.1%) while the logistics and the distance was rated on the bottom. Conclusion: It is imperative to ensure efficient and adequate SRH counselling among the vulnerable groups. Improving the access to SRH can be achieved by correction of the community misconceptions with adequate training of the health service providers.