Objective: To determine the frequency of fractures among motor bike accidents presented in emergency department of Jinnah Postgraduate Medical Centre, Karachi. Methodology: A Cross-sectional study was conducted in Emergency department (ER) of Jinnah Postgraduate Medical Centre (JPMC) of Karachi. A validated questionnaire was used and study was carried out from February 2015 to October 2015. The interviews were carried out by trained data collectors. All motorcycle riders of any age presented in ER are included in this study. The study did not include those patients who had injuries other than fractures. Frequency and percentages were reported for categorical variables while mean and standard deviation for Original Research Article continuous variables. Data was analyzed using SPSS version 20 with 95% confidence interval, margin of error was taken as 5% and P-value 0.05 was considered significant. Results: Among the study sample of 366 patients, mean age was 29.86 ± 11.41. Most of those (61.2%) were in the age group of ≤30 years and single (53.8%). The greatest number of motor bike accidents (66.4%) were seen on working days. Distal portion of the lower limb (Tibia/Fibula) was most frequently involved in these accidents (40.43%). Among all fractures, 83.1% fractures were at single sites and 86.9% had close fractures. Maximum accidents occurred (48.4%) were in the areas with poor light and 74.6% of these incidents were on the main roads. During riding, 9% were smoking and 18.6% using their mobile phone. Positive association was found between occurrence of multiple fractures and speed, mirror status and inspection interval of motor bikes (p<0.05). Conclusion:Motor bike riders are very prone to road traffic accidents (RTA) leading to fractures and soft tissue injuries. Distal portion of the limb is the most common site involved. Preventive measures are important in avoiding these accidents.

Background: Low back pain (LBP) is one of the major factors impairing the quality of life and is the most frequent cause of disability. Inadequate water intake is believed to be the predisposing factor for LBP particularly in the younger population. It is commonly seen that the incidence of LBP has been on the rise in people between 20-40 years of age. Thus, the basic aim of this study is to find a potential relationship between dehydration and LBP among young adults. Methods: This cross-sectional study was conducted from the medical students and practicing doctors of 21-39 years from March-May 2019. Characteristics of pain along with the daily activities of patients were assessed. The severity was assessed by using the Graded Chronic pain scale (GCPS). Results: Out of a total of 426 participants, 84.74% had LBP. Of these, 44.3% complained of having it more than once a week, with duration usually between 1-7 days. More than half of the patients had their routines disturbed because of this pain. Most of the participants complained of an episodic increase in summers. The majority (75.9%, n=274) drank 5-9 glasses of water a day, 64.5% of them were of opinion that their daily water consumption was enough, while 61.5% felt an association between dehydration and LBP. According to the GCPS, one-third of the population had chronic pain of grade I and the other third had grade IV. Conclusion: It can be concluded that with the increase in the pace of life many individuals who belong to the above mentioned age group have a reduced intake of water, and due to a probable relationship between LBP and dehydration, this might be a reason of the increasing propensity of LBP in them. There is a need for further work in this regard.

Background Hemangiopericytomas (HPC) are vascular tumors and can be found at any place where vessels are present. These were previously known as ‘extrapleural Solitary Fibrous Tumour’. These tumors may reoccur and metastasize after surgical excision. We present herein a HPC of the greater omentum, diagnosed as left inguinal hernia preoperatively. Case presentation A 61-year-old male, presented with a huge painless mass in his left inguinoscrotal region secondary to weigh-lifting associated with malaise and vague abdominal pain. A well-defined, non-tender, and firm mass was found at the left lower abdomen extending to the left inguinoscrotal region. Based on the examination, a diagnosis of indirect inguinal hernia was made. Abdominal ultrasound showed a heterogeneous, hyporeflective, and vascularized mass. Contrast-enhanced computed tomography scan identified a localized, extraperitoneal, heterogeneously hypodense, well-defined, and lobulated mass, with marked contrast enhancement. On exploration, an encapsulated large mass originating from the omentum with enormously dilated blood vessels was excised. On histopathology, a neoplastic lesion, composed of spindle-shaped cells and moderate cytoplasm was identified. The blood vessels appeared thin-walled with a staghorn appearance in hemangiopericytic pattern. Omental sections showed fibro adipose tissue with dilated lymphatics and thick-walled blood vessels. Features were consistent with a malignant HPC of 20 × 14 × 10 cm. Conclusion We present an unusual presentation of primary omental malignant HPC as an inguinal hernia, treated by complete surgical resection. These tumors are rare therefore, timely diagnosis is important for proper evaluation, diagnosis, and treatment. It also requires long-term follow up for better survival.

Intussusception is an invagination of one segment of the bowel into its adjoining segment. In children, the cause is usually benign, while in adults it is secondary to a mass lesion. Here we present a case in which the preoperative diagnosis of intussusception secondary to colonic mass was made, but no definitive cause was identified by histopathology. A 30-year-old male presented with abdominal pain, altered bowel habits, weight loss, loose motions, bleeding per rectum, and vomiting. The abdomen was distended, firm, mildly tender, and guarded. A vague mass of 15 x 10 cm was palpated on the left upper quadrant. X-ray and ultrasound showed dilated small bowel. A computed tomography scan suggested ileoileal intussusception. Colonoscopy showed a growth at 15 cm of the anal verge. Exploratory laparotomy was performed, showing the presence of ileocolic intussusception with two large perforations. Subtotal colectomy with ileostomy was done. The histopathological examination showed signs of perforation.

Background: Low back pain (LBP) is one of the major factors impairing the quality of life and is the most frequent cause of disability. Inadequate water intake is believed to be the predisposing factor for LBP particularly in the younger population. It is commonly seen that the incidence of LBP has been on the rise in people between 20-40 years of age. Thus, the basic aim of this study is to find a potential relationship between dehydration and LBP among young adults. Methods: This cross-sectional study was conducted from medical students and practicing doctors of 21-39 years from March-May 2019. Characteristics of pain along with the daily activities of patients were assessed. The severity was assessed by using the Graded Chronic pain scale (GCPS). Results: Out of a total of 426 participants, 84.74% had LBP. Of these, 44.3% complained of having it more than once a week, with a duration usually between 1-7 days. More than half of the patients had their routines disturbed because of this pain. Most of the participants complained of an episodic increase in summers. The majority (75.9%, n=274) drank 5-9 glasses of water a day, 64.5% of them were of opinion that their daily water consumption was enough, while 61.5% felt an association between dehydration and LBP. According to the GCPS, one-third of the population had chronic pain of grade I, and the other third had grade IV. Conclusions: It can be concluded that with the increase in the pace of life, many of the young adults have a reduced intake of water, and due to a probable relationship between LBP and dehydration, this might be a reason for the increasing propensity of LBP in them. There is a need for further work in this regard.