Notes

Adding Energy Investigation and Impulse Acting with regard to Realistic Form of Pyrolytic Methods to Remediate Garden soil Contaminated using Weighty Oil.
Students of SVT group exposed to visual style of learning performed better.

SVT cannot totally replace traditional lecture, although it is a promising tool which can be introduced in the curriculum to enrich the learning experience of students. Key Words Traditional method, Sectra visualisation table, MCQs test, Feedback, Learning style.
SVT cannot totally replace traditional lecture, although it is a promising tool which can be introduced in the curriculum to enrich the learning experience of students. Key Words Traditional method, Sectra visualisation table, MCQs test, Feedback, Learning style.Parachute mitral valve is a rare congenital heart defect characterised by a distorted mitral geometry with a single papillary muscle for all mitral chords to attach. It may develop in isolation or as a constillation of Shone syndrome. By comprehensive retrieval of the pertinent articles published since 2000, 22 articles with 149 cases of parachute mitral valve were recruited into this study. The present article revealed that most patients with a parachute mitral valve had a stenotic or regurgitant mitral valve, which is often associated with left heart obstructions, thereby leading to haemodynamic compromise. Therefore, multiple surgical maneuvers are warranted for such patients. Mitral valve repair is preferred over mitral valve replacement for the mitral valve abnormalities so as to avoid the associated complications of valve replacement procedure. The patients' outcomes are satisfactory with a total event-free survival of surgical patients of 84.8%. read more Key Words Cardiac surgical procedures, Congenital heart defects, Mitral valve.
To determine the clinical presentation of Addison's disease in order to increase the awareness of presentation in Pakistani children.

Observational study.

Department of Diabetes and Endocrinology, National Institute of Child Health, Karachi, Pakistan, from 2015 to 2019.

Sixty-three children of Addison's disease were enrolled in the study, who have visited and facilitated from the services of National Institute of Child Health from urban and rural region of the Sindh province. Diagnosis were made through biochemical analysis and detailed examination of acute and chronic symptoms. Study was initiated after taking the approval from Institutional Review Board. Moreover, written informed consents were also taken from each of the study participant.

There were 36 boys and 27 girls with a mean age at diagnosis of 3.92 and 4.96 years, respectively. Twelve patients were presented with an adrenal crisis following an acute illness. All of them had hyponatraemia; however, 10 had a hyperkalaemia and 8 had been reloss, lethargy, and poor response in activities. Moreover 15 of them were identified with associated disorder (autoimmune polyendocrinopattay syndrome (APS), Allgrove or triple A syndrome, and adrenoleukodystrophy). Conclusion Typical and atypical presentations of Addison's disease in children of Pakistani population are defined in this study which may assist in better management of Addison's patients. Key Words Adrenal crisis, Hyponatremia, Hyperkalemia, APS, Allgrove, Adrenoleukodystrophy.
To evaluate the outcomes of videothoracoscopic and open surgeries for pulmonary hydatid cysts.

Descriptive study.

Department of Thoracic Surgery, Faculty of Medicine, Balıkesir University, Turkey, between May 2015 and March 2020.

Patients who underwent surgery for pulmonary hydatid cysts were evaluated retrospectively, for the age, gender, symptoms, cyst size and localisation, preferred surgery, duration of surgery, the extent of the intraoperative bleeding, duration of the chest drainage, hospitalisation time, and postoperative complications. The relationship between the categorical variables was examined with the Chi-square and Fisher's exact tests and the relationship between the non-parametric data and continuous variables with the Mann-Whitney U-test.

A total of 60 patients included in the study; 23 underwent videothoracoscopic surgery and 37 had thoracotomy. There were no statistically significant differences between groups as gender, age, location and size of cyst. The videothoracoscopic surgery has superiority to thoracotomy group in terms of lower duration of operation, less perioperative bleeding (p = 0.005), early chest tube removal and lower hospitalisation time (both p <0.001). But there were no statistical difference between groups in complication rates (p = 0.340).

Videothoracoscopic removal of pulmonary hydatid cyst is a safe and advantageous procedure comparing to thoracotomy. There is a need for prospective studies with a larger sample size. Key Words Hydatid cyst, Thoracoscopic surgery, Thoracotomy, VATS.
Videothoracoscopic removal of pulmonary hydatid cyst is a safe and advantageous procedure comparing to thoracotomy. There is a need for prospective studies with a larger sample size. Key Words Hydatid cyst, Thoracoscopic surgery, Thoracotomy, VATS.
To evaluate the efficacy and safety of the semi-rigid URS with pneumatic lithotripsy for the treatment of large (>10 mm) proximal ureteral calculi.

Cohort study.

Section of Urology, Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan, from January 2010 to December 2018.

All patients with single, radio-opaque unilateral proximal ureteral stones >10 mm were included in the study. Patients with urosepsis, pregnancy, solitary kidney, and indwelling JJ stent or prior percutaneous nephrostomy drainage were excluded. Patients without any visualisation of stone on abdominal X-Ray done at 4 weeks of the procedure were labelled as stone-free.

One hundred and three cases with stones >10 mm and fulfilling the selection criteria were included. The mean age was 40.83 + 14.92 years. The mean stones size was 13.33 + 4.64 mm. The mean procedure time was 41.50 + 15.60 minutes. Indwelling JJ stents were placed in 49 (47.6 %) cases. The stone-free rate was 83.5% at four weeks with calculated efficiency quotient (EQ) of 0.72, using a standard equation. The overall complication rate was 27% with the majority being minor (Clavian-Dindo grade 1). Only one patient had urosepsis (MCG IV). Ancillary procedures were performed in 17 (16.5%) cases, most commonly the extracorporeal shock wave lithotripsy (ESWL) in 14 (13.5%) cases, followed by the secondary URS in 3 (2.9%) cases.

Semi-rigid URS is an effective and safe procedure for the large proximal ureteral stones, with limited access to flexible instruments. Key Words Ureteroscopy, Semi-rigid, Stone, Proximal, Clearance, Safety.
Semi-rigid URS is an effective and safe procedure for the large proximal ureteral stones, with limited access to flexible instruments. Key Words Ureteroscopy, Semi-rigid, Stone, Proximal, Clearance, Safety.
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