Solitary rectal ulcer mimicking rectal carcinoma on imaging

A 37-year lady presented with pain, per rectal bleeding and altered bowel habits. She was suspected to have a rectal growth on colonoscopy , contrast enhanced CT scan and MRI. However the CEA levels were normal and histopathology showed a solitary rectal ulcer. The report highlights the importance of this benign condition as confounding for rectal malignancy

Knowledge and beliefs regarding breastfeeding in college students of Karachi

BackgroundBreast feeding has been shown to decrease infant mortality rates. However, the increasing number of neonatal deaths and decline in breastfeeding reflect a lack in knowledge about its importance and benefits.AimsTo assess the knowledge and beliefs of college students regarding breastfeeding and to determine the factors affecting the knowledge scores regarding breastfeeding in studentsMethodsA cross-sectional study was carried out with a convenience sample of 1500 undergraduate college students via self-administered questionnaires. Structured questionnaires were distributed in six well known universities of Karachi. Data analysis of socio-demographics, beliefs and knowledge of students regarding breastfeeding was done using SPSS (V20) software.ResultsThe response rate of the survey was 93.3 per cent. The difference in overall knowledge between medical and non-medical students was significant (p < 0.001) with 61.1 per cent of medical and only 14.4 per cent of non-medical students having adequate knowledge. Results regarding the basic knowledge about breastfeeding reflected that 49 per cent of non-medical participants had a poor knowledge compared to the 19.6 per cent of medical students. 39.4 per cent of medical and 64.5 per cent of non-medical participants considered their knowledge of breastfeeding to be inadequate. On multivariate analysis, non-medical participants were 6.85 times more likely to score in the inadequate range for knowledge compared to medical participants.ConclusionThe results indicated that medical students had a better knowledge regarding the advantages of breastfeeding as compared to non-medical students. However, the overall knowledge among undergraduates from both groups was low. Therefore, in order to improve this inadequacy, it is important that public campaigns targeting the advantages and significance of breastfeeding be conducted in Pakistan

Gastric volvulus through Morgagni hernia and intestinal diverticulosis in an adult patient: a case report

Abstract Background Morgagni’s hernia (MH) is a rare type of congenital diaphragmatic hernia with limited available literature. Late presentations are infrequent and the ones complicated due to gastric volvulus are even rarer. Another uncommon association of MH is with small bowel diverticulosis. We herein discussed a case of gastric volvulus as the content of MH, and small bowel diverticulosis present in a patient concomitantly. Case presentation A 30 year old woman, who presented with a one year history of epigastric burning and indigestion, occasionally associated with pain and vomiting. On clinical examination, no clue to the diagnosis could be ascertained. Her chest and abdominal x-ray indicated an abnormal air-fluid level at right hemithorax, which prompted a Computed Tomography (CT) scan, showing organo-axial gastric volvulus. MH with gastric volvulus was observed during laparotomy and trans-thoracic reduction of the contents was performed, along with repair of the defect. Multiple intestinal diverticuli were also found and the largest diverticulum was excised. Conclusions Gastric volvulus through MH is a rare but potentially life-threatening condition. Non-specific symptoms like epigastric pain and vomiting can delay the diagnosis and management, however, advanced imaging techniques like CT scan can speed up this process. After the diagnosis is made, surgical repair should be attempted regardless of symptoms

A prospective randomized trial to compare the effectiveness of zero calorie carbonated drink and water as a solvent in sodium phosphate for colonoscopy

Abstract Objective: To compare the effectiveness of zero-calorie soft drink and plain water as a solvent for sodium phosphate in terms of good palatability and better patient tolerance. Methods: The randomised controlled trial was conducted from May to December 2019 at the Dowites Operation Theatre Endoscopy Suite, Surgical Unit 3, Civil Hospital Karachi, and comprised patients aged >18 years of either gender undergoing colonoscopy for screening and non-emergency/non-urgent colorectal diseases. The patients were randomised into group A, which was assigned to take sodium phosphate in water, and group B, which was assigned to take sodium phosphate in zero-calorie soft drink. Bowel preparation was assessed by the consultant during endoscopy. Outcome variables, such as bowel cleanliness, palatability, tolerance of solution, adverse effects, and willingness to repeat the preparation, were evaluated in both groups. Data was analysed using SPSS 21. Results: Of the 162 patients, there were 81(50%) in each of the two groups. There were 124(76.5%) males and the overall mean age was 43±8.66 years. The palatability score was significant (p=0.01) for group B compared to group A. Due to better palatability and tolerance, 64(79%) patients in group B took the preparation in <6 hours. Conclusion: Use of zero-calorie soft drink was found to be a better option for colonoscopic preparation compared to plain water. Key Words: Zero calorie coke, Sodium phosphate