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Objective: To determine the frequency of acute renal failure in patients presented with Blackstone poisoning in a tertiary care Hospital. Study Design: Cross sectional study. Setting: Medical wards and ICU at Peoples Medical College Hospital, Nawabshah. Period: September 2017 to March 2018. Material & Methods: All the patients of age 20 to 50 years having Paraphenylenediamine (PPD) poisoning (kala-patthar) during ≥6 hours after ingestion and either of gender were included. AKI was labelled as positive if either of any stage was present on the basses of urine output measurement for 24 hours through urine beg r urine output (UO) criteria. All the data was documented in self-made proforma. Results: The mean age for patients was 24.9±8.9 years, 46(19.08%) subjects were male and 195(80.91%) were female. 18(7.5%) study subjects had acute renal failure, out of them 6 study subjects had ARF of stage I, 5 patients had stage II and 7 study subjects had acute renal failure stage III. Conclusion: Acute renal injury is a common complication following PPD ingestion 7.5%. Paraphenylenediamine toxicity is a threat to the region of Asia and is evolving as a substitute to the poisoning of organophosphorus due to its easy accessibility and low cost.

Objectives: The objective of this study is to evaluate visual outcome afterphacoemulsification in diabetic patients. Study Design: Prospective study. Setting:Ophthalmology department of Shaheed Mohtarma Benazir Bhutto Medical University Larkana.Period: January 2017 to April 2018. Method: Over a period of 15 months, all diabetic patientshaving cataracts were part of the study. All these patients would undergo phacoemulsificationfor cataract removal by a single ophthalmologist. A total of 76 participants were includedand their consent was taken. Visual acuity and progression of diabetic retinopathy would beassessed 12 months post-operatively. Results: The data included 76 patients, among which32 were females (43%) and 44 males (57%). The mean age of females were 58 + 6.8 yearsand that of males were 62.5 + 9.3. Mean hbA1c of 76 patients were 9.2. At the end of firstpost-operative year of the 76 operated eyes, 46 eyes (60.52%) indicated no progression ofdiabetic retinopathy, whereas 30 eyes (39.47%) showed no progression of retinopathy. Therewas no significant discrepancy in progression of retinopathy in the number of operated andun-operated eyes post-operatively. Retinopathy progression was related to higher mean hbA1cOE p= 0.001 NOE p=0.015). Conclusion: The number of people having diabetes mellitus isincreasing exponentially. Early diagnosis and good diabetic control is associated with slowdevelopment of cataract. Uncomplicated phacoemulsification leads to good visual outcomeand better quality of life.

Objectives: The objective of this study is to compare the surgical outcome between modified trabeculotomy v/s combined modified trebeculotomy & trebeculectomy in primary congenital glaucoma. Study Design: Interventional case series. Setting: Paediatric Ophthalmology Department, Chandka Medical College. Period: June 2016 to June 2017. Method: This is a comparative study done to compare the outcomes of trabeculectomy and combined trabeculotomy and trabeculectomy. For comparison a prospective interventional study conducted in paediatric ophthalmology, Chandka Medical College during the duration of August 2014 to August 2016 was chosen. After examination by slit lamp and under anaesthesia, combined modified trabeculotomy and trabeculectomy was performed. Results: A total of 45 eyes of 29 patients with primary congenital glaucoma underwent modified trabeculotomy, 15 (51.72%) were males and 14 (48.28%) were females. Mean age of patients was 2.29 ± 3.70 years. On the other hand, combined modified trabeculotomy and trabeculectomy was performed in 22 eyes of 17 patients out of which 08 (47.06%) were males and 09 (52.94%) were females. Mean age ± standard deviation was 3.37 ± 4.40 years. Statistically significant reduction in IOP, corneal diameter and axial length were found. Conclusion: Combined trabeculotomy-trabeculectomy has better outcomes than trabeculotomy alone. It requires greater surgical expertise and time. Higher success rates are reported in previous studies due to dual outflow of aqueous humour.

Objective: To make an audit of laparotomies carried out at Combined Military Hospital Pano Aqil over a three year period.Study design: Cross sectional, retrospective study. Place and duration of study: Study was carried out at surgical department ofcombined military hospital Panno Aqil over a period of three years from Jan 2009 to Dec 2011. Patients and methods: Patients withsignificant intra-abdominal pathology presenting as acute abdomen and who underwent laparotomy were included in study. Patientswere either electively admitted via outpatient department or through Accident and Emergency (A&E) department. Patient charts andrecords were used to collect data. Results: All 174 patients underwent laparotomy. In (27.6%) cases, intestinal perforation was theunderlying cause; gynaecological pathology was found in (21.2%) patients. In 19.5% cases blunt and penetrating abdominal trauma wasthe cause of acute abdomen. Acute intestinal obstruction was found in (21.3%), tumors were found in (7.9%) and miscellaneous causeswere identified in (2.3%) cases. Conclusions: Laparotomies carried out at Combined Military Hospital Pano Aqil fulfilled the evidencebased medicine criteria.

sak1958@hotmail.com. Peripartum cardiomyopathy is a relatively rare but life threatening disease. The etiology and pathogenesis of peripartum cardiomyopathy remains largely theoretical and is generally centered upon viral and autoimmune mechanism. This case report describe the anaesthetic management of a patient suffering from dilated peripartum cardiomyopathy, successfully managed with epidural anaesthesia.