Objective: To determine the frequency of gestational diabetes mellitus in pregnant women reporting to a public sector tertiary care hospital and find the association of gestational diabetes mellitus with age. Study Design: Comparative cross-sectional study. Place and Duration of Study: Pathology Department, Combined Military Hospital, Quetta Pakistan, from Jan 2016 to Mar2017. Methodology: Five hundred and thirty pregnant women who reported to the Pathology Department of the hospital for an Oral Glucose Tolerance Test at 24-28 weeks of gestation were included. The blood samples were taken after ten hours off fasting and one hour and two hours after loading with 75g of anhydrous glucose and analyzed using the enzymatic (Glucose Oxidase) method. Gestational diabetes mellitus was diagnosed using guidelines recommended by the International Association for Diabetes and Pregnancy Study Group /American Diabetic Association for a one-step diagnosis of gestational diabetes mellitus according to the new criteria. Results: The frequency of gestational diabetes mellitus was quite high 190(35.8%). Of these 530 pregnant women, 162(85.3%)women were diagnosed with Fasting Plasma Glucose, and 28 women were diagnosed with 1-hour or 2-hour after the glucose load test. Age-group of ≥ 30 years had the highest number of women with gestational diabetes mellitus. Conclusion: The frequency of gestational diabetes mellitus in our hospital-reported sample of pregnant women was 35.8%,associated with advanced age. The maximum number of women were diagnosed as having gestational diabetes mellitus based on the fasting Plasma Glucose cut-off value.
Introduction: Double J stent (DJS) is a basic and valuable tool in urological practice. A forgotten DJS is not uncommon and is associated with significant morbidity and mortality. The presenting complaints may range from UTI to renal failure. Therefore, this study has been carried out to assess the clinical spectrum of this entity in our setting. Objective: To describe the clinical presentation, complications and management of forgotten DJS. Methods: This retrospective descriptive study was done at the Department of Urology, Services Institute of Medical Sciences, Lahore (SIMS) from August 2015 to December 2016. Sixteen patients with forgotten DJS were included. Each patient was studied for age, gender, presenting complains, indication of DJS, duration of stent insertion and management performed. The data was recorded on a proforma and analyzed using SPSS version 20. Results: 16 patients 68.8% (n=11) male and 31.2% (n=5) female patients were included in study. The average age was 46.38 ± 13.58 (23-65 years). The mean indwelling time of DJS was 16.31 ± 32 months. 50% of patient's had obstructive uropathy due to stones. Most patients had UTI (37.5%) at presentation while mild encrustation was the major complication encountered (43.8%). Majority of patients were not compliant to the advice for DJS removal. Conclusion: Forgotten DJS leads to multiple complications, if not intervened timely. They can be successfully removed employing least invasive endourologic techniques. Proper counseling of patient/relatives is needed to get it removed in the due time period.
Objective: To compare open testicular biopsy and testicular fine needle aspiration (TEFNA) for spermatogenesis in terms of Johnsen’s scoring in patients with suspicion of obstructive azoospermia. Study Design: Comparative study. Place and Duration of Study: Department of Urology, Services Hospital, Lahore from 24th December 2018 to 23rd December 2019. Methodology: Forty males with primary infertility and azoospermia (in 3 consecutive reports) were enrolled. Males with normal testicular size and bilaterally palpable vas deference were investigated further regarding their hormone profile (serum FSH, LH, and Testosterone) and scrotal color Doppler ultrasound (CDUS). When hormones and scrotal ultrasound were found normal, appointment was given to patients for procedure, after complete discussion about their diagnosis and plan of management with possible complications. Both procedures; open testicular biopsy and testicular fine needle aspiration (TEFNA) were done simultaneously under local anesthesia. Specimen obtained from both procedures was sent for analysis of spermatogenesis in terms of Johnsen scoring. Patients were discharged after four hours with advice of daily dressing for five days and scrotal support for two weeks and oral Diclofenac Sodium 50mg twice daily after meals for three days. Results: The mean values of Johnsen scores were 7.7±2.8 in open biopsy while in TEFNA 9.9±0.95 and statistically significant (<0.05) results were found. Among 40 patients, 33(82.5%) patients showed spermatogenesis on open biopsy and 39(97.5%) on TEFNA. Sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and accuracy of TEFNA in diagnosing spermatogenesis was 100%, 14.2%, 84.6, 100.0% and 85.0% respectively. Conclusion: Testicular fine needle aspiration is found to be a simple, reliable, and least invasive mode of diagnosing and management of azoospermia in adult males with minimal complications. Keywords: Open testicular biopsy, TEFNA, Infertility, Johnsen score
Introduction: In otorhinolaryngology practice deviated nasal septum is a very common issue. Multiple theories demonstrated that deviated nasal septum started from birth moulding to the trauma to the nose. Sometimes surgery is performed to the approach of paranasal sinuses but the most common indication for septoplasty is nasal obstruction. Aim/Objectives: To compare the management of complications after septoplasty in different groups by using nasal splints, plastic splints and without a splint. Methodology: One hundred and fifty patients were selected randomly having deviated nasal septum (DNS) for septoplasty. We divided all patients into three different groups i.e., Group I (without splints), Group II (silicon splints), and Group III (plastic splints). Fifty patients were enrolled on each group. We measured the severity of pain by using a visual analogue scale, post operated bleeding, post-operated septal hematoma, post-operated nasal adhesion, saddle nose deformity, and septal perforations. Data was entered in SPSS software by using version 20. Results: Among 150 patients, ninety-five were male and 55 were female. Pain score (severe pain) in Group I was 0%, in Group II, it was 20% and in Group III, it was 30%, showing the severity of pain was less in Group I. Moderate pain was more (30%) in patients of Group III. Nasal bleeding was noted in 16% in Group I, 18% in Group II, and 80% in Group III. Nasal adhesions were more in Group I, i.e., 24 patients (48%), in Group II and in group III, it was 8%. The hematoma was more in Group III. Saddle nose deformity was seen in 2 patients in group III. Septal perforations were seen in 6 patients in Group I and 1 patient in group III. Conclusion: Silicon nasal splints are good and effective; patients were more comfortable and have fewer complications when compared to plastic splints and without splints.
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