Acute cholecystitis: immediate versus interval cholecystectomy

To compare the outcome of acute cholecystitis treated by early surgery with acute cholecystitis treated initially by conservative management and later on surgery after 6 weeks. Material and This prospective, comparative study was conducted in the surgical B unit PGMI, L.R.H Peshawar from June 1997 to-June1998. A total of 100 cases of acute cholecystitis were selected and divided into two groups. Half of the cases were selected for conservative treatment and half were treated with immediate surgery i.e. the next available list. of the two protocols were compared. Chi Square and student-t test was applied and level of significance was checked. Out of 100 cases, 50 were treated conservatively [Group B] and 50 were given the option of early surgery [Group A]. The results showed that patients of group "A" benefited more as regards early definitive treatment, less hospital stay and comparatively decreased cost of treatment. The patients of group [B] had to suffer two hospital admissions, frequent visits to hospital, double expenses and were on a constant risk of developing complications during their wait for surgery. There was no postoperative mortality and complications were few. It is concluded that patients received with acute cholecystitis at any time during the first 02 weeks should be treated by surgery as soon as possible

Complete androgen blockade in advanced prostate cancer: a clinical experience

To evaluate the clinical and biochemical outcome of patients with advanced prostate cancer treated by complete androgen blockage [CAB]. A total number of thirty patients with histologically confirmed advance prostate cancer and serum PSA level of more than 30ng/ml were subjected to bilateral subcapsular orchidectomy, supplemented with oral antiandrogens. These patients were followed for a period of two years by recording their symptoms and serum PSA level at twelve weeks intervals. Only 16[53.33%] patients complied with the protocol of the study and observed two years followup. 12[75%] patients showed complete response to CAB while 4[25%] patients showed rising PSA levels and became symptomatic after one year of treatment. CAB is still the treatment of choice for patients with advanced prostate cancer

Management of pilonidal sinus

A prospective study was conducted in 'Surgical A' Lady Reading Hospital, Peshawar from December 2000 to May 2001 to evaluate the results of different methods of treatment of pilonidal sinus. Twenty patients who were fit for general anaesthesia were selected for operative treatment and were included in the study. Acute infection was treated first. Twelve patients were treated by Karydaki's procedure and eight were treated by open method. The mean hospital stay was 4-5 days in Karydaki's but multiple admissions were required for open procedure patients. There was two recurrence in the open procedure. The technique of asymmetric cleft closure is the best method of treatment for the management of pilonidal sinus