Vesicovaginal fistula has remained a scourge and of public health importance, causing significant morbidity, and psychological and social problems to the patient. Continuous wetness, odor and discomfort cause serious social issues. The diagnosis has been traditionally based on clinical evaluation, dye testing, cystoscopic examination and contrast studies. A successful repair of such fistulas requires an accurate diagnosis and timely surgical intervention using techniques that are based on basic surgical principles with or without the use of interpositional flaps. The method of repair depends on the type and location of the fistula, and the surgeon's training and expertise. The main complications are recurrence and stress/urge incontinence. Prevention must include universal education, improvement in the social and nutritional status of women, discouraging early marriages, and the provision of improved accessible healthcare services.

Objective: The objective of this study is to see the current breast feeding and weaning practices in our rural areas and its impact on the growth of children less than one year of age. Design: It is an observational descriptive study. Place and duration of study: Madinah Teaching Hospital University Medical and Dental College Faisalabad from June to September 2015. Patients and Methods: A total of 300 children belonging to rural areas were included in the study. The address was noted from the CNIC of father/mother/caregiver. Only children < 1 year of age belonging to rural areas were included in the study. Infants having chronic illnesses like congenital heart disease, Asthma, Tuberculosis, cystic fibrosis, immunodeficiency or congenital defects like cleft palate and lip were excluded from the study. The weight of each infant was recorded and Classified according to gomezs classification for malnutrition on a predesigned proforma. The data was assessed by using SPSS version 19. Results: Out of 300 infants 121 were on exclusive breast feeding, 81 were on predominant breast feeding and 98 were not being given breast milk. Early ablactation was also observed, at the age of>8-12 months 36 children were not being given breast milk. Weaning foods were started in 152 infants only. The infants who were not being given breast milk were the worst affected group by malnutrition, 37 infants had 3rd degree malnutrition similarly the infants who were not given weaning foods were also affected adversely by malnutrition , 40 infants had 3rd degree malnutrition as compared to 17 who were being given weaning foods. Conclusion: The breast feeding practices in our rural areas are not optimal, the timing and quality of weaning foods are also not appropriate. There is a significant association between breast feeding and weaning patterns with malnutrition in infants less than 12 months of age.

Objectives: This study was performed to establish role of CT Brain in establishing frequency of different type and subtypes of stroke in Pakistani population and to correlate CT findings with risk factors and duration of onset of symptoms that lead patient to take admission in hospital and outcome of different types of stroke. Methodology: A sample of hundred patients was taken from SOCIAL SECURITY HOSPITAL MULTAN ROAD LAHORE over a period of nine months starting from October 2014 to June 2015.A prospective study with convenient sampling technique was performed. Equipment used was 64 slice TOSHIBA CT scanner machine. Patients with incomplete data, pediatric age group to age 14 years, stroke due to trauma, infections or tumours were excluded from this study. A detailed questionnaire was used to collect data from the patients that included age, sex, type of stroke, time of onset of symptoms, location of lesion on CT brain, odema of cerebral tissues, midline shift predisposing risk factors like HTN, DM, oldage, high cholesterol levels, CLDetc and outcome of stroke and time of death in some cases was recorded.The collected data was analyzed by SPSS-20. Results: Shows that infarctive stroke was more prevalent type of stroke in Pakistani population and the frequency increases with increasing age and stroke was more prevalent in men than in women.It shows that subdural hematomas were more prevalent out of hemorrhagic strokes than other subtypes of extraaxial type of hemorrhagic strokes.Complications like odema of cerebral tissues,midline shift and disabilities were more common in hemorrhagic strokes than in infarctive strokes.Also the cases of stroke due to rupture of a blood vessel presented earlier to hospital because of early onset of symptoms as compared to cases of stroke due to blockade of a blood vessel.

Inguinal bladder hernia is a rare condition usually diagnosed per-operatively. Patients may present with inguinal swelling, dysuria, hematuria,or urinary urgency. Obesity, advancing age and poor musculature are risk factors. We hereby present a case of inguinal bladder hernia in a 47-year-old obese male presented to outpatient department with history of inguino-scrotal, partially reducible swelling, lower urinary tract symptoms, off and on haematuria and dysuria. Scrotal ultrasound showed clear fluid present in the scrotum which was communicating with bladder. This was confirmed by cystography showing “dog ear”sign. Hernia containing bladder was reduced and hernioplasty was performed.