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Aim: To evaluate the outcome of a fibular nail in the treatment of open and closed unstable ankle fractures in a non-designer centre. Methods: In a retrospective cohort study, a total of 39 ankle fractures (14 open and 25 closed) treated with a locking fibular nail were evaluated between 2012 and 2015 in a non-designer level I major trauma centre. Post-operative radiographs were analysed to assess the quality of reduction (McLennan and Ungersma marking system), fracture union and complications. Three patient reported outcome scores (Olerud and Molander score (OMAS), American Association of Orthopaedic Surgeons (AAOS) foot and ankle score and 12-Item Short Form Survey (SF-12)) were collected to obtain an overall measure of the patient’s physical and mental outcome. Results: The adequacy of reduction data was available for 38 of 39 cases; 33 (87%) achieved good, 3 (8%) fair and 2 (5%) poor ratings, based on the McLennan and Ungersma marking system. Thirty-five (12 open and 23 closed) patients were available for initial follow-up. Five (14.3%) of 35 had documented complications (2 of 12 in the open cohort and 3 of 23 in the closed cohort). All fibular fractures treated with the fibular nail went on to unite. Twenty-three (66%) of 35 patients were available at 1-year follow-up for measurement of objective outcome. The combined mean OMAS for both groups was 53.7 (0–85) with statistically better results (59.5 (25–85) vs. 37.3 (0–75)) in favour of the closed versus open injuries, respectively. The mean AAOS score was also statistically better for the closed group than the open, 70.3 (30–95) versus 46.6 (20–77), respectively. The mean SF-12 score (physical component) was 40 (21.6–52.4) in the closed group versus 36.1 (19.4–51.5) in the open group; the mean mental component was 42.5 (26.6–54.3) in the closed group versus 38.8 (28.4–60.5) in the open group, these however were not statistically different. Conclusion: Fibular nails are an effective alternative for the treatment for both closed and open unstable ankle fractures with soft tissue compromise.

Gas in portal veins is a rare phenomenon observed secondary to bowel ischaemia and necrosis. A young girl with history of pica ingestion presented with acute abdomen with huge distension. Investigation revealed air in hepatic portal veins, air within stomach wall, and massive distension of stomach secondary to acute pancreatitis. Successful conservative treatment confirmed the current concept that all cases of hepatic portal venous gas do not warrant immediate surgical intervention.

Background: Duodenal carcinoids (neuroendocrine tumour) are rare tumour, but recently, increase in incidence has been noted. Various techniques for excision of tumour have been described in literature, but very few case reports and case series have mentioned about laparoscopic management of carcinoid tumour. We describe a case series of seven cases of duodenal non-periampullary carcinoids which was managed by laparoscopic method. Aims: The aim of the study was to check feasibility of laparoscopic management of duodenal carcinoid and technique of surgery. Settings and Design: This study design was a case series and prospective data were retrospectively collected. Materials and Methods: A total of 7 patients were operated for carcinoid tumour of duodenum mainly involving first part by laparoscopic method from February 2016 to January 2017. All patients were followed up for minimum 1-year period and various pre-operative, intra-operative findings and post-operative outcome were noted. Results: Out of seven patients, 6 patient were managed by laparoscopic duodenotomy and transduodenal excision whereas one patient required duodenectomy of first part. Mean operative time was 99 min, mean intraoperative blood loss was 55.7, mean hospital stay was 99.7 and no recurrence in a 1-year follow-up. Conclusions: Laparoscopic excision of carcinoid tumour is safe, technically reproducible and feasible method.

Diverticular disease of the jejunum is a rare entity. Most patients with small bowel diverticula are asymptomatic. Patients who develop symptoms generally report symptoms that reflect associated complications. The most common are non specific epigastric pain or flatulent dyspepsia, mainly postprandial. Complications including haemorrhage, intestinal obstruction, diverticulitis and perforation may be life threatening and warrants early surgical intervention. We report a case of a 68-year-old male admitted with jejunal diverticulosis complicated by sealed off perforation and phlegmon formation who has been admitted and treated for abdominal pain previously with different diagnosis in two occasions, once with a diagnosis of symptomatic cholelithiasis and second time with mild pancreatitis which could be the manifestation of jejunal diverticulitis. On admission CT abdomen confirmed the diagnosis of diverticulitis and he underwent laparoscopic assisted resection of involved segment of jejunum and jejuno-jejunal anastomosis. On one year follow-up patient was pain free and symptom free throughout the period. The purpose of presenting this case is to evaluate a presentation of diverticulitis which can delay the diagnosis and contribute to diagnostic dilemma.

We report a rare case of a 62-year-old male who presented to surgical emergency department with the complaints of sudden onset pain and swelled in the right inguinal region with nausea, vomiting and abdominal distension. There was a history of a reducible swelling in the right inguino-scrotal region for the last 1 year. Based on history, clinical examination and investigations a provisional diagnosis of right-sided strangulated inguinal hernia was made and patient was planned for an emergency surgery. On the exploration, the hernial sac revealed a gangrenous vermiform appendix and the diagnosis of Amyand′s hernia was made. Appendectomy was performed through the same incision, and hernial repair was done using a polypropylene mesh.

A study was conduced at Agronomic Research Institute, AARI, Faisalabad, Pakistan during 2003-04 and 2004-05. Fifteen wheat genotypes namely 99022, 00055, 00125, MAW-1, 00183, 01180, 91-BT-010-84, 91-BT-010-05, AS-2002, SH-2002, Ufaq-2002, Inqalab-91, SIS-12, SIS-13 ad SIS-32 were sown under mixed cropping system. Wheat seed of each genotype @ 100 kg per hectare was hand drilled in well prepared seed bed during first week of November. Data regarding different yield components and grain yield were recorded. Wheat genotype 00183 gave significantly higher grain yield during both years (4815 kg/ha during 2003-04 and 4255 kg/ha during 2004-05). This genotype depicted significantly more number of spikelets per spike (21.65) and grains per spike (64.75). However, spike length was comparatively more in variety MAW-1 on the basis of average of two years (12.80). [ABSTRACT FROM AUTHOR]

A study was conducted at Agronomic Research Institute, AARI, Faisalabad Pakistan during 2006-07 and 2007-08 to investigate the effect of integrated use of organic manures [farm yard manure (FYM) and sesbania (Sesbania rostrata) as green manure] and inorganic fertilizer on wheat yield. The treatments were; FYM @ 25 tons, green manure @ 4 tons, fertilizer @ 150-100-50 kg NPK, FYM @ 25 tons + 150-100-50 kg NPK, green manure @ 4 tons + 150-100-50 kg NPK, 75- 50-25 kg NPK, FYM @ 25 tons + 75-50-25 kg NPK, green manure @ 4 tons + 75- 50-25 kg NPK per hectare and control (no fertilizer). FYM and green manure were applied two months before sowing of wheat. Two years data revealed that treatment of green manure @ 4 tons + 150-100-50 kg NPK per hectare produced maximum spike bearing tillers dUring 2006-07 (474) and 2007-08 (478) followed by FYM @ 25 tons + 150-100-50 kg NPK (473 and 475). The same treatment also performed better during both years for grains per spike (53 and 56), 1000 grain weight (32.67 and 35.50 g) and grain yield (4561 and 5803 kg/ha). The lowest wheat grain yield was obtained where no fertilizer was applied. [ABSTRACT FROM AUTHOR]

Performance of six brown chickpea (Cicer arietinum L.) genotypes viz. 90261, 93127, 97086, 98004, 98154 and Bittal-98 was tested under four NP levels (0-0, 12- 30, 24-60, 30-90 kg/ha) at Agronomic Research Institute, AARI, Faisalabad, Pakistan during 2006-07 and 2007-08. Fertilizer levels had a significant but differential effect on seed yield of chickpea genotypes. Fertilizer @ 24-60 kg NP per hectare gave better results during both the years. There was a linear increase in yield of all genotypes from 0-0 to 24-60 kg NP level. The differences among varietal means were non-significant during first year but significant during second year. However, on the basis of average of two years, genotype 98004 expressed comparatively more plant height (90.23 cm) and pods per plant (77.58), whereas, chickpea genotype 97086 produced higher biological (7658 kg/ha) and economic yields (2222 kg/ha). Genotype 93127 excelled in 1000- grain weight (285.54 g). [ABSTRACT FROM AUTHOR]

A study was conducted during 2004-05 at Agronomic Research Institute AARI, Faisalabad, Pakistan. Screening of 25 wheat genotypes was carried out on the basis of photosynthetic efficiency, plant growth rate, total dry matter, 1000-grain weight and grain yield per plant under normal soil moisture and moisture stress conditions. In case of normal soil moisture conditions five irrigations were applied at critical growth stages viz. crown root development, tillering, booting, anthesis and milking, whereas in moisture stress treatment no irrigation was applied during whole plant growth and development period and only rainfall of 158.4 mm was the source of moisture supply. The results showed that moisture stress significantly decreased plant growth rate, total dry matter, 1000-grain weight and grain yield; whereas it increased chlorophyll content. Wheat genotype Blue Silver exhibited comparatively more drought tolerance with less decrease in growth rate (18.70%), total dry matter (22.94%), 1000-grain weight(21.31%) and grain yield (26.50%). Eventually wheat genotype Blue Silver expressed higher values of plant growth rate (1.13 cm/day), total dry matter (39.30 g/plant), 1000-grain weight (48.04g), grain yield (14.48g/plant) and chlorophyll content (1.46 mg/cm2) under moisture stress conditions followed by Bulbul and Baviacora M 92. [ABSTRACT FROM AUTHOR]