Penetrating colonic injuries: primary repair versus colostomy

To compare the primary repair with colostomy in colonic injuries at tertiary care hospital in terms of morbidity and hospital stay. Quasi experimental study. This study was conducted in the Department of Surgery, Unit II BVH Bahawalpur from 27-01-2010 to 31-8-2010. A total of sixty patients fulfilling the inclusion criteria were selected for this study. Patients were randomly allocated in two groups. Group A [Primary Repair] and Group B [Colostomy], 30 patients in each group. Follow up in group A patients was done twice after 2 weeks and after one month. The follow up in group B was done for multiple times. Initially the visit was advised after every two weeks until the patient was called back for colostomy closure. The mean age in group A was 28.9 +/- 8.1 years and in group B was 30.1 +/- 14.0 years. The mean hospital stay in group A was 8.9 +/- 3.65 days and in group B was 11.0 +/- 4.7 days. At two weeks follow up, in group A, there was one [3.3%] patient of abscess, one [3.3%] of suture repair leak, one [3.3%] patient of sepsis and 2 [6.7%] patients of wound infection. In group B, there were 2 [6.7%] patients of abscess, one [3.3%] patient of suture repair leak, 3 [10%] patients of sepsis and 4 [13.3%] patients of wound infection. This is concluded from our study that primary repair was safe and effective treatment modality in the management of colonic injuries as compared to colostomy

Vaginal delivery versus cesarean section; birth outcome in primi gravdae breech

It is to compare neonatal morbidity in terms of birth trauma, respiratory distress syndrome, APGAR score in Primigravida with breech presentation delivered vaginally and emergency cesarean section. Cross-sectional comparative study. Obstetrics and Gynaecology Unit-l, Bahawal Victoria Hospital, Bahawalpur from 1-5-2007 to 30-4-2008. The study was carried out on all Primigravida with breech presentation reported through emergency in labour delivered vaginally and by emergency cesarean section. The variable analyzed were birth trauma, respiratory distress syndrome and APGAR score at 1 and 5 minutes. Students-t test was used for comparison between means and chi square test for comparison between percentages. Significance was taken at P<0.05. It was found that mean APGAR score at 1 and 5 minutes is 7.31 and 9.066 in vaginal and 8.533 and 9.644 in cesarean group. Respiratory distress syndrome is more in cesarean [4.4%] than vaginal group [2.2%]. Observed neonatal trauma is more in vaginal group [6.7%] than cesarean section [2.2%]. Neonatal morbidity appears to be more in vaginal breech delivery than I cesarean section for Primigravida with breech presentation at term