JPMA. The Journal of the Pakistan Medical Association
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To review the clinical experience in diagnosis, management and outcome of elderly patients presenting with acute appendicitis at the Pakistan Ordnance Factories Hospital, Wah Cantt. ⋯ Acute appendicitis needs to be considered in the differential diagnosis of all patients with abdominal pain. A high index of suspicion is necessary to guard against mis-diagnosis, especially in the elderly. Delays in presentation and diagnosis are associated with higher rates of perforation and, hence, higher morbidity. Repeated clinical examination, a high index of suspicion and urgent investigations are necessary for a correct and rapid diagnosis.
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To assess the efficacy of reverse flow posterior interosseous artery flap for the coverage of large variety of hand/wrist defects. ⋯ Reverse flow posterior interosseous artery flap in experienced hands is safe, versatile and reliable for the coverage of hand/wrist defects.
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Randomized Controlled Trial Comparative Study
Spinal anaesthesia for caesarean section: plain vs hyperbaric bupivacaine.
To compare the clinical characteristics of sensory and motor block as well as haemodynamic stability using plain and hyperbaric bupivacaine in spinal anaesthesia for caesarean section. ⋯ In obstetric population, both plain and hyperbaric bupivacaine 10 mg, with fentanyl produced adequate anaesthesia for caesarean section without any differences in the time of onset, extent of the block and haemodynamic parameters. However, sensory level regression was delayed in the plain group which may have caused prolonged duration of block.
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To analyse inter-observer variation between a neuroradiologist and neurosurgeon in the MRI diagnosis of lumbar nerve root compression. Although lumbar MFI is primarily analyzed and reported by a radiologist, neurosurgeons often analyse it independently as they have sufficient clinical background as well as radiological expertise to diagnose most spinal pathologies on Magnetic Resonance Imaging (MRI). ⋯ Inter-observer agreement between neuroradiologist and neurosurgeon in diagnosing nerve root compression due to lumbar disc disease was excellent. Agreement regarding disc bulge and herniation was fair.