ABSTRACT
Objective: To document the demographical evaluation of laparoscopic versus open appendectomy at tertiary care teaching hospital
Patients and methods: This is comparative study was carried out in Surgical Unit-II, Liaquat University Hospital Jamshoro, Sindh, Pakistan from 21[st] November 2012 to 3[rd] February 2016 after the approval from Ethical review committee. During period of the study sixty patients admitted through the outpatient department, as well as from casualty department of Liaquat University Hospital Jamshoro / Hyderabad were enrolled. Results were prepared with the help of tables and graphs. Data was analyzed through SPSS software
Results: Out of 60 patients, 40 were males [66.66%] and 20 females [33.33%]; with male to female ratio of 2:1. The mean age for both groups was 26.78 years, ranging from 10 to 70 years. Symptoms of patients in both groups were almost identical comprising of pain in right iliac fossa in 59 [98.33%], pain starting around umbilicus in 45 [75%], nausea in 50[83.33%], vomiting 35[58.33%], anorexia in 25 [41.66%], fever in 22[36.66%] and altered bowel habits in 20[33.33%]
Conclusion: The laparoscopic appendectomy has significant advantages over open appendectomy with respect to length of hospital stay, discharge from hospital, and postoperative in-hospital complications and morbidity
ABSTRACT
INTRODUCTION: Xanthogranulomatous cholecystitis [XGC] is an unusual form of chronic cholecystitis characterised by marked thickening of the gallbladder wall and accumulation of lipid laden macrophages. It is frequently misdiagnosed preoperatively with gallbladder carcinoma. The aim of this study was to assess the preoperative clinical and radiological characteristics, operative findings and histological features of patients with XGC based on the experience of a single institution. In addition a literature search was performed to identify previously reported cases
PATIENTS AND METHODS: This retrospective study was conducted from January 2009 to December 2014. 1,989 consecutive patients who underwent elective cholecystectomy at the Surgical Unit-I, Liaquat University Hospital, Jamshoro, Pakistan were included in this study. Seventeen patients were identified to have XGC on histopathology
RESULTS: Seventeen [0.8%] cases of XGC were identified in 1,989 cholecystectomy specimens performed. The female to male ratio was 7.5:1. The average age in our series was 51.6 [range from 18 to 77 years]. Two [11.7%] cases, suspected of malignancy during preoperative work-up, were reported as XGC on histopathology
CONCLUSION: Preoperative differentiation between XGC and carcinoma of the gallbladder remains challenging due to similarities in clinical presentation, radiological and operative findings
In view of this there should be a low threshold for conversion from a laparoscopic to an open procedure
ABSTRACT
OBJECTIVE: To observe the effect of single dose antibiotic is it as efficient as a 24-hour regimen in preventing SSIs in adults undergoing clean, clean contaminated and contaminated elective surgical procedures
STUDY DESIGN: Random, prospective SETTING AND DURATION: Department of general Surgery, Liaquat University Hospital, Jamshoro, Pakistan from May 2011 to April 2012
PATIENTS AND METHODS: A total of 208 patients undergoing general surgical operations were included in the study. The patients were randomly divided into two groups
The single-dose group received 2 grams of ceftriaxone intravenously, whereas the 24-hour group received 2 grams of ceftriaxone intravenously at the time of induction of anaesthesia, followed by 1 g at 8 and 16 hours postoperatively
RESULTS: The administration of ceftriaxone in a single dose regimen was associated with higher rate of SSIs compared with rates for patients receiving the 24-hour regimen [9.6% vs. 6.7%]
CONCLUSION: Multiple doses of prophylactic antibiotics over 24 hours should be used instead of single doses in surgical prophylaxis in clean-contaminated and contaminated procedures
ABSTRACT
Objectives: to determine the prevalence of Helicobacter pylori infection in patients with perforated peptic ulcer
Patients and methods: this prospective study was conducted in the Department of Surgery, [Surgical Unit-II], Liquate University of Medical and Health Sciences, Jamshoro. All patients were evaluated by full history, clinical examination and relevant laboratory investigations including. X-ray chest and abdomen, ultrasound abdomen, serum anti H-Pylori, biopsy and histopathology for detection of helicobacter pylori infection and perforation. The data was collected through pre-designed proforma and analyzed by SPSS version 10.00
Results: during study period 75 patients were diagnosed as case of perforated peptic ulcer. Male [73%] outnumber female [27%]. Majority of patients were more than 30 years of age with mean age of 44.6 years SD +/- 9.89. The serological test for helicobacter pylori was positive in all 75 cases; however histopathology of biopsy yields H. pylori in 50 [66.6%] cases. On exploratory laparotomy perforated duodenal ulcer was found in 50 [67%] patients while 25[33%] patients had perforated gastric ulcer
Conclusion: the biopsy proven prevalence of perforated peptic ulcer, one of the life threatening complications of H. Pylori, was is 67% in this study
ABSTRACT
Objective: Acute appendicitis is one of the commonest surgical emergency. There are different scoring systems in use to diagnose the appendicitis. Aim of this study was to document the diagnostic accuracy by application of Alvarado Scoring System in clinical practice for acute appendicitis. Design: Descriptive case series. Setting: Surgical Unit-II, Liaquat University Hospital Hyderabad, Sindh - Pakistan; from January 2003 to September 2004
Methods: All the patients with suspected appendicitis were admitted in the ward. A profroma was designed and relevant findings were documented. These were observed regarding the increase or decrease in severity of symptoms and hence the change in the initial score according to Alvarado Scoring System was documented at the time of admission. Decision regarding surgical intervention was made on the basis of change in the score
Results: A total of 227 patients with clinical features suggesting acute appendicitis was admitted in the ward. Among them, 150 [66.07%] were males and 77 [33.92%] were females. Age ranged from 10-62 years. Main symptoms at presentation included pain in right iliac fossa 67.8%, fever 66.9% and nausea and vomiting 49.7%. Thirty two patients were received with Alvarado Score of 1-4 and three out of them required surgery. Thirty five patients were in the score of 5, twenty three out of them required surgery. One hundred sixty patients were in the score of 6 and above, all of them required surgery. Out of 185 patients who underwent surgery, 178 patients had appendicitis. The negative appendicectomy rate was 3.78%
Conclusion: It is concluded that according to Alvarado the patients with score up to 4 probably do not require surgery and among the patients with score up to 5, most of them need surgery while the patients with the score of 6 and above will require surgery