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o reducing major outbreaks in the future.
Lupus nephritis and its induction therapies are understudied subjects in rheumatology especially in our population. The objective of this study is to compare the renal response to Mycophenolate mofetil (MMF) and Cyclophosphamide (CYC) as induction therapy in the Pakistani population with lupus nephritis.
This is a comparative retrospective study conducted at the department of rheumatology, Fauji Foundation Hospital (FFH), Rawalpindi, and the duration of the study was 1.5 years from July 2016 to December 2017. The study includes 28 patients, all females, ages between 18 to 50 years. All have biopsy proven lupus nephritis (LN). All 28 LN patients have either stage III, IV, V. They were investigated and analysed over 1.5 years. 14 patients were given MMF (2.5 gram/day) (MMF group) and 14 patients were given CYC (NIH protocol/monthly) (CYC group) for 24 weeks as induction therapy. Comparison of baseline characteristics, complete and partial renal responses to treatment was seen in the MMF and CYC groups.
Primary end point (complete response) is achieved in 6 (42.85%) in MMF group and 5 (35.71%) in the CYC group. The secondary end point (partial response) was achieved in 5 (35.71%) patients in the MMF group and 6(42.85%) in the CYC group. The difference in the cumulative probability of complete and partial response was not statistically significant between the two groups (P-0.470 for CR) and (p-value 0.132 for PR).
Mycophenolate mofetil is a new therapy for LN and it has equal efficacy as compared to CYC for LN induction.
Mycophenolate mofetil is a new therapy for LN and it has equal efficacy as compared to CYC for LN induction.
The objective of this study was to determine and compare the structural and functional outcome in eyes who underwent Pars Plana Vitrectomy (PPV) with Epiretinal Membrane (ERM) peeling alone verses combined Epiretinal membrane with Internal Limiting Membrane (ILM) peeling for Idiopathic Epiretinal Membrane along with the rate of recurrence.
It was an interventional randomized study, conducted at Al-Ibrahaim Eye Hospital, Malir, Karachi, for two-year period from 1st August 2016 to 1st August 2018. A total of forty-four eyes of 44 patients were divided into two groups equally. Group A contains 22 eyes of 22 patients who underwent PPV with ERM peeling alone. Group B also contains 22 eyes of 22 patients who underwent PPV with ERM and ILM peeling. The follow up period was 1 year. The patients having best corrected visual acuity (BCVA) less than 6/18 or symptom of metamorphopsia were included in our study. The best corrected visual acuity (BCVA) and central macular thickness (CMT) were recorded at 3, 6 and 12-moM, however, no significant difference and no recurrence of ERM was observed in either group.
Pars plana vitrectomy along with ERM peeling alone or combined with ILM peeling is a safe procedure. Both methods were effective functionally and structurally in the treatment of idiopathic ERM, however, no significant difference and no recurrence of ERM was observed in either group.
Despite numerous clinical studies regarding the management of unilateral impalpable testes by laparoscopy, there is a paucity of such studies regarding the management of bilateral 'non-palpable' testes. We shared the outcome of the laparoscopic management of bilateral 'non-palpable' testes in terms of successful orchiopexy and complications in children.
A total of 22 children underwent bilateral diagnostic laparoscopy for undescended testes who presented to our department from January 2010 till March 2018. anti-HER2 antibody We did chart review for variables such as the age of children, operative time, hospital stay, single-stage or 2 stage procedure, and operative complications. Preoperatively history and physical examination were done along with baseline investigations and Ultrasound abdomen and scrotum before surgery for general anaesthesia fitness. They were managed by single or two steps laparoscopic orchiopexy according to suitability for each case.
We performed bilateral laparoscopic orchidopexies in 22 children having a mean age of 4.1±1.98 years (49.2 months) Mean operative time for single setting bilateral single-stage orchiopexy was 136±32 minutes. Out of twenty-two children with bilateral impalpable testes, 12 boys (54.5%) were managed with a single-stage Bilateral Laparoscopic technique while the other 10 (45.45%) were managed in 2 staged laparoscopic intervention using Fowler-Stephens technique. Testicular atrophy was seen in 2/44 testes (4.54%). While 1 /44 (2.27%) testis had ascended to the inguinal region requiring redo surgery.
Laparoscopic management of bilateral 'non-palpable' testes in a single or double setting is a safe and effective method of bringing testes down to the scrotum. It has no major morbidities.
Laparoscopic management of bilateral 'non-palpable' testes in a single or double setting is a safe and effective method of bringing testes down to the scrotum. It has no major morbidities.
Distal radius fractures account for most of the injuries presenting in trauma centers. Colle's fractures are defined as fractures within 2.5 cm of the wrist with dorsal angulation of the distal fragment. The cornerstone of treatment remains immobilization of the wrist in a cast. The objective of the study was to determine the outcome of closed reduction and plaster cast immobilization of Colle's fractures in adults using Radiological parameters. It was a descriptive case series study, conducted at the Department of Orthopaedics Sheikh Khalifa Bin Zayed Al Nahyan /CMH Muzaffarabad Azad Kashmir from June 2018 to June 2019.
Patients with distal radius fractures fulfilling the criteria of Colle's fractures presenting in the Emergency Department were selected through non-probability consecutive sampling. They were managed as per stated protocols and followed up for 06 months.
A total of 106 patients of either gender were included in this study. The average age of patients was 30.36±4.12. Fall on an outstretched hand is the major cause of Colle's fracture. In the older age group, most of the fractures are caused by falls while trauma was responsible for the younger age group. Normal post reduction radial inclination was seen in 72% cases; dorsal angulation was normal in 75% while post reduction height was normal in 91% cases. Post reduction radiological parameters were excellent in 49% and good results were seen in 40%. Poor post reduction anatomical results were found in 11% of cases. Overall, the Stewart Anatomical score was 84/100 (p<0.01).
A large majority of Colle's fractures achieved excellent Radiological results after treatment by closed reduction and cast immobilization.
A large majority of Colle's fractures achieved excellent Radiological results after treatment by closed reduction and cast immobilization.
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