Complications of acute appendicitis: a review of 120 cases

To find out the frequency of complications of acute appendicitis. A retrospective study was conducted at surgical unit-I and III, Chandka Medical College Hospital, Larkana. Case records of patients who were admitted with complications of appendicitis from June 2004 to May 2007 were examined and data analysed. Most common complications of appendicitis were appendicular mass [38.3%] followed by appendicular perforation and peritonitis [37.5%], appendicular abscess [10%], gangrene of appendix [11.6%] and intestinal obstruction [2.5%]. Majority [66.6%] of the cases were operated while 33.3% were treated by conservative measures. Appendicular mass and perforation were the main complications of untreated acute appendicitis. Complications of appendicitis usually result due to delay in diagnosis and treatment

Management of ureterovaginal fistula

To evaluate the outcome of surgical management of uretero-vaginal fistula [UVF]. It was a descriptive study. Setting and Duration of study: The study was conducted at the Department of Urology, Chandka Medical College teaching Hospital and Almas Kidney and Lithotripsy Centre Larkana from February 1995 to November 2006. The criterion for selection of the patients and screening workup included complete history, clinical examination and investigations like complete blood count and biochemistry, ultrasound, intravenous urography and retrograde ureteric brash or ureterogram were performed to confirm the level of fistula and also to assess the function of affected kidney. The neo-ureterocystostomy was made with modified Lich Gregoir, Boari Ockeblade flap, Psoas hitch and endoscopic methods as deemed necessary. Our study included 20 cases. The ages of the patients ranged from 22 year to 45 years [average 36 years]. We used modified Lich George method, Boari Ockeblade flap, Psoas hitch method and internal stenting in 09[45%], 05[25%], 04[20%] and 02[10%] of cases respectively. The ureteric catheter or DJ stent were kept postoperatively in 06[30%] and 04[20%] cases respectively. Although all patients had no leakage after surgery; but 06[30%] cases developed transient urgency, frequency, dysuria and persistent pain. These were resolved with conservative treatment. The complications occurred in 4[20%] cases which were wound infection in 01[05%], recurrent urinary tract infection in 02[10%] cases and 01[5%] developed a small bladder capacity. There was no significant difference in outcome of different techniques, rather choice depends upon individual case and preference of surgeon. We conclude that modified Lich surgical procedure is simple, successful and quick method of treatment for repairing the cases of uretero-vaginal fistulae. We suggest bilateral ureteric catheterizations prior to difficult female pelvic and gynecological surgery to prevent such disaster

Basal cell carcinoma

The objective of the study is to document results of various modes of treatment in cases of basal cell carcinoma. This is a five year retrospective study conducted between January 1994 and December 1998 at Chandka Medical College and Larkana Institute of Nuclear Medicine and Radiotherapy [LINAR].The cases were collected from surgical wards and Larkana Institute of Nuclear Medicine and Radiotherapy, where cases were referred from Dermatology OPD directly. The total number of patients under study were 46. Surgery was done in 12 cases [2696] and Radiotherapy in 23 cases [50%], in remaining 11 cases [24.096] combination of surgery, radiotherapy and chemotherapy were given when one mode of treatment failed.The youngest patient was of 30 years, while the eldest was of 90 years. The male to female ratio was 1:1.The majority of patients were field workers. In surgery group only one recurrence out of 12 cases [8.33 96] occurred, while in radiotherapy group 11 recurrences occurred out of 23 [47.82%] cases. In our study, surgery had better results than radiotherapy

Ovarian carcinoma local experience at Shaikh Zayed Hospital for Women [CMCH] and LINAR Larkana

To study the frequency of Ovarian Carcinoma for early detection and appropriate management. DESIGN: Retrospective observational study. [One years study]. ShaiKhzayed Women Hospital [CMCH] Larkana. A tertiary care Hospital] and Larkana Institute of Nuclear Medicine and Radiotherapy. [LINAR]. The total number of carcinoma patients reported from January 2000 to December 2000, were analyzed. In our study total numbers of ovarian carcinoma presented was 29. Chronologically this was 2nd common gynaecological cancer in the women. Advanced cases [stage III and IV] were 58.5 percent. Surgery was performed in all cases. A complete course of postoperative chemotherapy as received by 7 patients only, remaining cases received incomplete chemotherapy course. Ovarian carcinoma is common health problem. Late presentation leads to poor prognosis