Surgical outcome of spelenectomy in Thalassemia major in children

Objective: To determine the surgical outcome of splenectomy in children with thalassemia major

Methods: It is an observational and descriptive study conducted in Department of Paediatric Surgery in collaboration with hematology, radiology, anesthesia and paediatric intensive care department at The Children's Hospital and the Institute of Child Health, Multan during the period of September 2007 to September 2013. A total of 50 patients suffering from thalassemia major already diagnosed and under management reffered from haematology department for splenectomy were included in this study. After admission, patients were assessed on the basis of history, clinical examination, and necessary investigations before surgery and later on follow-up. Investigations carried were CBC, PT, APTT, Viral markers, ECG, X-ray Chest, abdominal ultrasonography and ECHO if necessary. Splenectomy was performed after prophylactic vaccination against post splenectomy infections. Follow up was performed for at least two years. Blood transfusion requirements and number of hospital visits per annum before and after splenectomy were calculated and results analyzed statistically using SPSS-20

Results: Fifty patients were included in this study. Out of these fifty, 43 [86%] male and 7[14%] were female with a mean age of 9 years. Average blood transfusion requirement was 250 ml/kg/year, interval of blood transfusion was two weeks and twenty five visits per year before splenectomy. After splenectomy, requirement of blood transfusion reduced to 125ml/kg/year, interval between transfusion increased to one month and hospital visits reduced up to twelve per year

Conclusion: Blood transfusion requirement and number of hospital visits per year are decreased and interval between transfusions is increased after splenectomy. Splenectomy should not be delayed when indicated. Preoperative vaccination decreases the chance of post splenectomy infection

Frequency of early atrial fibrillation in post mitral valve replacement surgery

Objective: To determine the frequency of atrial fibrillation after mitral valve replacement surgery

Methodology: This study was performed in cardiac surgery ward of Lady reading Hospital [LRH] Peshawar. It was a descriptive cross sectional study. Data was collected from 1.3.2014 to 28.02.2015. Statistical analyses were performed using SPPS version 14. Mean +/- SD were used for quantitative and Frequencies and percentages were used for categorical variables

Results: Total 120 patients undergone through mitral valve replacement. Male patients were 48 [40%], Mean age of the study population was 46.20 years +/- 9.14SD. Atrial fibrillation [AF] was observed in 45 [37.5%] patients. Post operative AF was similar between both gender and all ages

Conclusion: Atrial fibrillation is common finding in patients undergoing Mitral valve replacement surgery and is not affected by age and sex

Frequency of acute kidney injury in patients undergoing coronory artery bypass grafting

Objective: To find the frequency of acute kidney injury in patients undergoing coronary artery bypass grafting

Methodology: The study was conducted in cardiovascular unit Lady Read-ing Hospital Peshawar. It was cross sectional study. Sampling technique was non probability convenient sampling. Data was collected from 20.2.2013 to 20.8.2013. Total 179 patients included in the study. All patients with known coronary artery disease were included in the study whom were planned for revascularization in the form of coronary artery bypass grafting [CABG]. Post-operatively all patients' serum creatinine till 48th post op hour was observed to detect acute kidney injury. Acute Kidney Injury [AKI] was defined as more than 50% or elevation of 0.3 mg/dl of creatinine level from base line

Results: A total of 179 patients undergoing coronary artery bypass grafting were included in the study. Average age of the patients was 46.88 years +/- 9.91 with range 20-60 years. Patients were divided into four groups according to age. The acute kidney injury after coronary artery bypass grafting was observed in 14 [7.82%] patients. Acute kidney injury was more common in old age and it was non significantly more common in male gender

Conclusion: In spite of current highly advance cardiac surgery techniques and post operative care still there is high incidence of acute kidney injury following revascularization and subsequent worst outcomes

Left atrium volume as a surrogate marker of left ventricular diastolic dysfunction

Objective: To determine correlation between left atrial volume and left ventricular diastolic dysfunction

Methodology: This was a single center observational study conducted at Lady Reading Hospital, Peshawar. Patients above 18 years of both genders, who were in sinus rhythm and having no significant systolic dysfunction or significant mitral insufficiency on echocardiography, were included in the study, using purposive non-probability sampling technique. A total 339 patients underwent transthoracic echocardiography from July 2013 to June 2014. Detailed cardiac echocardiography was performed to determine left atrial volume, ejection fraction, E and A velocities, deceleration time and e've-locity, E/e

Results: A total of 339 patients were studied. Male were 61.9%. Mean age of study population was 58.42 +/- 10.48 years. Baseline characteristics of patients having some degree of diastolic dysfunction were; mean age 65.5 +/- 12.3, mean body mass index 25.2 +/- 2.5 kg/m2, mean ejection fraction 55.1 +/- 7.5%, hypertension 48.6%, diabetes mellitus 10.1% and left ventricular hypertrophy 38.6%. Echocardiographic findings in diastolic dysfunction patients were as follow: mean left atrial volume was 65.3 +/-10.1 ml, E/A 1.4 +/- 0.6, TDI e' was 6.7 +/-1.3 m/sec and TDI E/e' was 12.7 +/- 2.1. Increasing left atrial volume was well correlated with increasing severity of left ventricular diastolic dysfunction [y = +0.8, Spearman rank correlation]

Conclusion: Increase in left atrial volume is directly correlated with severity of diastolic dysfunction. Severity of diastolic dysfunction increases with increased left atrial volume

Frequency of complete heart block after surgical closure of perimembranous ventricular septal defect

Objective: to find the frequency of complete heart block [CHB] in patients undergoing surgical perimembranous Ventricular septal defect [VSD] closure

Methodology: this was a Descriptive cross sectional study performed in Cardiovascular Department Lady Reading Hospital Peshawar. Data was collected from 28 January 2013 to 28 July 2013 with sample size of 103.Sampling technique was non probability consecutive. All patients with perimembranous ventricular septal defect, aged 5 years to 25 years with any gender were included in the study

Results:-mean age was 12.63 years +/- 6.63. Patients were divided in four categories according to their age. Over all complete heart block in the perimembranous ventricular septal defect after surgical closure was 10[9.71%]. Age wise distribution of complete heart block shows that majority of the complete heart block 6[12.8%] were found in age less than or equal to 10 years

Conclusion:-VSD closure is less often associated with CHB but there should be arrangements for pace maker to timely pace the patient in case of any emergency

Predictive value of neutrophil/lymphocyte ratio in predicting complications after non st elevation myocardial infraction

A Cross sectional study conducted in Cardiology Unit, Hayatabad Medical Complex from August 2011 to February 2012. In a total of 250 patients with non ST elevation MI were enrolled in study. Neutrophil to lymphocyte ratio [NLR] was determined. Those with high NLR were followed over two week period to detect in hospital mortality; Atrial Fibrillation and ST segment Deviation. Association of cellular response with the incidence of post-MI mortality/complications was assessed by multiple logistic regression analyses. There were 250 patients comprising of 154 [61.60%] males and 96 [38.40%] females. The overall mean age was 51.57 +/- 12.5 years. The frequency of high neutrophil to lymphocyte ratio was present in 78 [31.20%] patients. The In hospital mortality and atrial fibrillation rate was in 10.26% and 11.54% cases respectively while ST segment deviation was in 57.69% patients. Patients with Non ST Segment elevation Myocardial Infarction with high Neutrophil to lymphocyte ratio, is a good predictor of In hospital mortality, atrial fibrillation and ST segment deviation. Thus a single CBC analysis may help to identify Non- STEMI patients at risk for mortality and complications.

Clinical profile of patients with normal coronary angiogram

To observe the clinical and bio-chemical profile of patients having normal coronary angiogram following an abnormal stress test. This was a single center retrospective, descriptive study. Coronary angiograms done from July 2009 to December 2011 were retrieved and reviewed for normal coronary arteries. Clinical and bio-chemical profile of the patients having normal coronary angiogram was retrieved from hospital record. Patients, whose computerized data could not be retrieved from department database, were excluded from the study. Out of 8425 angiograms reviewed, 816[9.7%] were having normal coronary arteries. Mean age was 4 +/- 27.4 years. Females were 66.7%. Clinical and biochemical profile for normal coronary angiograms was as follows: smokers 59%, family history of premature coronary artery disease 41%, hyperlipidemia18.5% and hypertension 14%. Diabetes was present only in 2.1%. Among females: 11% were current users of oral contraceptives pills, 3.4% were post menopausal and 0.87% pregnant. Mean BMI was 25.4 +/- 5.2 and total cholesterol and triglyceride were 278 +/- 31mg/dl and 180 +/- 28mg/dl respectively. Normal coronary angiogram is infrequently observed in catheterization laboratories and mostly found in younger to middle aged females. Smoking is very common in such patients. Hyperlipidemia, hypertension, diabetes mellitus are not frequently present in these patients.

Frequency of coronary heart disease risk factors among nurses

To find out frequency of various risk factors for coronary heart diseases in nurses. This was a cross-sectional study. Nurses working in three shifts at Lady Reading Hospital, Khyber Teaching Hospital, Nursing school of Lady Reading Hospital Peshawar, were included in the study. All participants were interviewed in detail including their family history, past medical history, smoking and dietary history. Pulse, blood pressure, body mass index [BMI] and waist: hip ratio was determined. Their random blood sugar and total cholesterol was checked. Data was analyzed for cardiovascular risk factors using SPSS version 16. A total of 165 nurses were screened and interviewed. Mean age was 40.75 +/- 8.577 years. Mean BMI was 28.80 +/- 4.77. Mean systolic BP was 124.82 +/- 20.91 mm Hg, while mean diastolic BP was 82.45 +/- 13.07 mm Hg. Mean random blood sugar was 128.39 +/- 52.74 mg /dl. Diabetic nurses were 18[10.9%],hypertensive nurses were 31[18.8%], nurses having high cholesterol were 4[2.4%], nurses having documented CAD were2[1.2%], other than above risk factors or conditions were present in 34[20.6%] of the nurses, not having any of the mentioned risk factors or diseases were present in 76[46.1%]. Nurses not having any regular exercise schedule were 104 [63%]. We noticed that among modifiable risk factors hypercholesterolemia, diabetes and hypertension were less frequent in nurses while obesity, physical inactivity and sedentary life style with more duty hours and smoking were more prevalent

Head injury in paediatric population

To study the presentation and outcome of head injury in paediatric patients managed in Children Hospital and The institute of Child Health, Multan. Retrospective Descriptive Study. This study was conducted in the Deptt. of Paed. Surgery, CHandICH, Multan, during a period of five years from Jan 2006 to Dec 2010. A total of 1150 paediatric patients with head injury were managed in this unit. Data was collected on the basis of history, clinical examination, base line investigations, radiological findings including CT scan, diagnosis and management. Patients were divided into three groups according to the severity of injury based upon Glasgow Coma Scale [GCS]. Final analysis and comparison with literature was done. Seventy percent patients were male and 30% female. The age ranged from 1 week to 12 years. Commonest cause was history of fall from height found in 68% cases, followed by road traffic accident 25% and other causes 7%. 70 patients had associated injuries, 5 patients were already mentally handicapped. In 75% cases mild head injury with GCS 14 -15 was present. 35 patients required neurosurgical intervention. 15 patients required treatment for post traumatic seizures. 3 developed brain abscess. 15 patients died in the emergency ward without any surgical intervention within 2 days of admission and 2 died post operatively. Head injury remained a serious problem in paediatric age group with significant morbidity and mortality. Recognizing the pattern of head trauma in children help us to identify high risk groups and environment, which will then help us to design appropriate preventive measures

Congenital diaphragmatic hernia in children

To study the presentation, results and complications of management of congenital diaphragmatic hernia in children at our setup. Retrospective Descriptive Study. This study was conducted in the department of Paediatric Surgery, Children Hospital and The Institute of Child Health, Multan during a period of three years from January 2008 to December 2010. A total of 25 patients with congenital diaphragmatic hernia were managed. Data was collected on the basis of history, clinical examination, relevant investigations, operative results and complications. Final analysis was made at the completion of study. Study included 25 consecutive cases with ages ranging from 12 hours to 7 months. 19 [76%] were male and 6 [24%] female. 20 [80%] were neonates with predominant symptoms of respiratory distress since birth along with cyanosis and apnoeic spells. Five [20%] patients were beyond the age of one month with predominant symptoms of recurrent respiratory tract infection, vomiting and failure to thrive. Clinical signs included absence of breath sounds, presence of bowel sounds and impaired resonance on affected side of chest in all 25 [100%] patients. Flat abdomen in 18 [72%] and cachexia in 2[8%]. Left side involvement was in 22 [88%] and right side in 3 [12%]. All the patients were operated upon. Conventional mechanical ventilation [CMV] was given to 16[64%]. One [4%] patient died and rest of the 24[96%] survived. Best possible operative results can be obtained with the help of limited facilities present in our setup

Echocardiographic findings in hypertrophic obstructive cardiomyopathy [hocm]

To find out various Echocardiographic findings in patients with HOCM. This was a retrospective cross-sectional study performed in Cardiology department Lady Reading Hospital, Peshawar. Data collected from the database computer section of echocardiography department from February 2009 to November 2011.The data was analyzed using SPSS version 14. Total study population was 28. Male were 14 [50%]. Mean age was 52.5_ 15.9 years. Mean left ventricular end diastolic dimension was 3.84cm; inter-ventricular septal thickness 2cm [1.1-3.1] and posterior wall thickness was 1.17cm [0.6-1.6]. Mean Left atrial [LA] diameter was 3.86cm [0.8-5.6]. Mean peak gradient across LVOT was 48.43 mmHg. Mitral regurgitation [MR] was found in 19 [67.9%] patients. MR was mild in 57.1%, moderate in 7.1% and severe in 3.6% of patients. Aortic regurgitation [AR] was found in 13 [46.4%] patients. AR was mild in 35.7%, moderate in 10.7% of patients. Left atrial size was increased in 14 [50%] patients. Mean LA diameter was 4.6cm, 5cm and 5.6cm in patients with mild, moderate, and severe MR respectively. So there was direct relation between severity of MR and LA diameter. The respective mean gradient across LVOT in patients mild, moderate and severe MR was 31mmHg, 43.5mmHg and 140mmHg. So higher the gradient across LVOT, more will be the MR and hence the LA size and the patient will be more symptomatic. HOCM is significantly associated with both MR and AR and there is direct relation between severity of MR with LA diameter and LVOT gradient

comparative analysis of frequency of in-hospital arrhythmias in patients with successful versus failed thrombolysis following acute myocardial infarction

To compare frequency of in-hospital arrhythmias in patients with successful and failed thrombolysis using streptokinase in patients presenting with acute myocardial infarction [AMI]. This was a comparative study conducted at department of Cardiology, Lady Reading Hospital,Peshawar from October 2006 to October 2007 .Two hundred patients with first AMI were divided into two groups: group A [successful thrombolysis] and group B [failed thrombolysis] using ECG criteria. A total of 200 patients were studied. Group A included 136 [68%] patients while group B included 64 [32%] patients. Among these 24 [12.0%] patients developed arrhythmias. Of these 8 patients were in group A and 16 patients were in group B [5.9% vs. 25.0%, p=0.003].Ventricular tachycardia was the most common arrhythmia. It was documented in 9 [4.5%] patients, with 2 patients in group A and 7 patients in group B [1.5% vs. 10.9%, p=0.003]. The other arrhythmias which included atrial fibrillation, ventricular fibrillation and supraventricular tachycardia were statistically insignificant between the two groups [p=0.174]. In hospital mortality was more common in patients with failed thrombolysis [6 [9.4%] vs. 3 [2.2%] [p=0.023]]. Failed thrombolysis is associated with complex arrhythmias and high in- hospital mortality

Response to treatment of cutaneous leishmaniasis with intralesional chloroquine vs intralesional meglumine antimoniate

In Pakistan, cutaneous leishmaniasis [CL] is mostly caused by Leishmania major. For simple lesions which are few in number and where there is no risk of disfigurement or joint mobility restriction, topical application or local treatment e.g. intralesional antimony compounds are valuable. To compare the effect of intralesional chloroquine with meglumine antimoniate in the treatment of CL. In this quasi experimental study, 60 patients of CL with 1 to 3 lesions and aged >3years were divided into 2 treatment groups to receive either intralesional chloroquine [treatment group] or meglumine antimoniate [control group]. Both drugs were used Ice per cm[2] of lesion, once weekly for 8 weeks [8 injections]. 8 more injections were given to those who showed partial response. Both treatments showed 100% response; however, greater number of injections was required with meglumine antimoniate [p<0.05]. Both drugs were well tolerated. Intralesional chloroquine appears to be an effective, safe and cheap alternative to meglumine antimoniate in the treatment of CL

Granuloma formation in discoid lupuserythematosus: a novel microscopic feature

Lupus erythematosus is an autoimmune disease with marked pleotropism. If several systems are involved then the disease is named as systemic lupus erythematosus [SLE] and if skin is exclusively involved the term discoid lupus erythematosus [DLE] is used. One of the several histopathological features of DLE includes periappendageal inflammation. This may at times ; completely wipe out sebaceous glands forming sebaceous granulomas. To determine the frequency of sebaceous granulomas formation in discoid lupus erythematosus. In this prospective observational study was conducted at the Departments of Dermatology and Pathology, Pakistan Institute of Medical Sciences, Islamabad. 100 cases of DLE spanning over two years and with the age range of 3 years to 70 years were examined for the presence of sebaceous granuloma. Other features of DLE like hyperkeratosis, follicular plugging, epidermal atrophy, basal layer vacuolization, basement membrane deposits, pigmentary incontinence, perivascular inflammation, periappendageal inflammation, and collagen damage were also noted., Out of these 100 cases, 8 cases contained sebaceous granulomas. These granulomas were,, . composed of epithelioid cells, foreign body giant cells containing partially digested sebaceous material and a few lymphoctytes. Sebaceous granulomas formation was seen in 8% cases of DLE cases. This feature must be recognized both by dermatologists and pathologist so that diagnosis of DLE may not be distracted and erroneous diagnosis due to presence of granulomas may not be rendered

Evaluation of lipopeptide [surfactin] production by bacillus subtilis

Lipopeptides are the bioactive peptides and some constituents of these compounds are surfactin, fengycin and Turing A, B and C, mycosubtilins and bacillomycins. Among these lipopeptides, surfactin is produced by Bacillus subtilis that has strong anti-microbial properties. Surfactin can be obtained by cultivation of bacteria and possesses various biological activities; anti-microbial, anti-viral, anti-tumour, haemolytic, blood anticoagulant and fibrinolytic activities. The present study was evaluated for optimisation of media components [Carbon source, N, P. and K] and environmental factors for the growth and production of lipopeptides by Bacillus subtilis. It was a quasi experimental study. Surfactin production was optimised with different factors including Mannitol, Phosphate, Nitrogen, Carbon, Potassium, and pH by inoculating B. subtilis on standard mineral salt [SMS] medium using fermentation technology. Showed that all the optimised factors have contributed their role in the production of lipopeptides by B. subtilis. The increasing concentrations of mannitol and nitrogen produced maximum lipopeptides with O.D 2.110 and 2.375 respectively. Production of surfactin by B. subtilis might be increased by using different factors optimised in medium and these compounds have potential applications both in medical and biotechnological fields

Phorbol myristate acetate [PMA] induced megakaryocytic differentiation of K562 cells from human chronic myelogenous leukaemia patient

To observe the K562 cell line derived from a patient of chronic myelogenous leukemia differentiated into megakaryocytes by growing in the presence of phorbol myristate acetate [PMA]. The differentiation process of K562 cells was monitored by the expression of a platelet cell marker, CD61 through immunocytochemistry using mouse alkaline phosphatase antialkaline phosphatase [APAAP] complex employing fast red TR as substrate, crystal violet and MTT assay used for cell growth analysis. The crystal in the presence of PMA, cells obtained were of large size and less in number as compared to cells incubated without PMA where they were of smaller size and more in number and immunochemical reaction used to detect the presence of CD61, a platelet cell marker that is expressed during differentiation of K562 cells to megakaryocytes. The results showed that the addition of PMA to the growing culture of K562 cell lines induced differentiation, observed through CD61 expression and increase in cell size and cessation of proliferation

Haloperidol induced neutropenia

Leukopenia, neutropenia and agranulocytosis [low white blood cells count] are rare but serious side effects of antipsychotics, notably clozapine. We here report a case of an Afro-Caribbean patient who developed neutropenia on haloperidol, which was reversed when he was switched to quetiapine. It is recommended that caution should be exercised when treating patients with antipsychotics and patients should be told to report high fevers and painful sore throats to their doctors as soon as possible

Missed abortion; misoprostol versus cervical catheter as cervical priming agent

To compare the effectiveness of extra-amniotic cervical catheter and vaginal misoprostol as a cervical priming agent prior to surgical evacuation in first trimester missed abortions. Randomized clinical trial. At lady Willingdon hospital gynecology unit 1 from 1 st March 2008 to 28th February 2009. 100 patients with diagnosis of missed abortions of up to 12 weeks + 6 days were studied. The primigravida were included. They were divided in two groups. In group. A [50] patients 400 microgram [2 tablet] misoprostol were placed high up in posterior vaginal fornix while in group B [50] patients extra-amniotic. Foleys catheter was placed aseptically 6 hour before surgical intervention as priming agent. All multigravida, patients sensitive to prostaglandin, and with disturbed coagulation were excluded. The main out comes are 1, cervical dilatation and effacement 2, complications like fever, pain lower abdomen, headache and vomiting 3, amount of bleeding in ml after application of agent. Cervical catheter proved to be good cervical priming agent comparable to misoprostol. Cervical dilatation was significantly better in misoprostol [> 10 mm 44%, > 8mm 30%, > 5mm 20%] as compared to Foleys group [>10 mm 24%, > 8mm 38%, > 5mm 20%] while in 3 [6%] dose of misoprostol was repeated and in 10 [20%] patient in Foleys group has no effect. The side effects occurred in both groups but systemic effects were more in misoprostol, pain lower abdomen 42% VS 46%, backache 18% VS 26%, fever 10% VS nil, headache 16% VS nil and no side effect 14% VS 28% as compared to Foleys catheter. Systemic effects were absent in Foleys catheter due to inert nature. Bleeding occurred in all patients with misoprostol while it was absent in 48% cases in Foleys group [>60ml 42% VS 8%, <40ml 32% VS 14% < 20ml 26% VS 30%]. 48% cases had no bleeding in Foleys group. Cervical catheter proved to be good priming agent due to lesser systemic side effects as compared to misoprostol

Sebaceous granulomas: a novel feature of discoid lupus erythematosus

To determine the frequency of sebaceous granulomas formation in discoid lupus erythematosus, Retrospective observational study. Departments of Dermatology and Pathology, Pakistan Institute of Medical Sciences, Islamabad. 100 cases of Discoid Lupus Erythematosus [DLE] spanning over two years and with the age range of 3 years to 70 years were examined for the presence of Sebaceous Granuloma. Other features of DLE like hyperkeratosis, follicular plugging, epidermal atrophy, basal layer vacuolization, basement membrane deposits, pigmentary incontinence, perivascular inflammation, periappendigeal inflammation, and collagen damage were also noted. Lupus erythematosus is an immune complex, type Ill hypersensitivity disease where antibodies are formed against native Deoxyribose Nucleic Acid [DNA]. The immune compexes are deposited in various organs and various sites causing marked pleotropism. If several systems are involved then the disease is named Systemic Lupus Erythematosus [SLE] and if skin is exclusively involve the term Discoid Lupus Erythematosus [DLE] is used. One of the several features of DLE includes periappengeal inflammation. This may at times completely wipe out sebaceous glands forming sebaceous granulomas. Out of these 100 cases 8 cases contained sebaceous granulomas. These granulomas were composed of epithelioid cells, foreign body giant cells containing partially digested sebaceous material and a few lymphoctytes. Sebaceous granulomas formation was seen in 8% cases of discoid lupus erythematosus. This feature must be recognized both by dermatologists and pathologist so that diagnosis of DLE may not be distracted and erroneous diagnosis due to presence of granulomas may not be rendered

Management of viable sigmoid volvulus by mesosigmoidoplasty

Mesosigmoidoplasty is a non-resective procedure for viable sigmoid volvulus. It corrects the main pathogenetic factor, the narrow but long mesosigmoid. This study was conducted to know the outcome of mesosigmoidoplasty in cases of viable sigmoid volvulus. This prospective study was conducted from July 2004 to June 2008 at District Headquarter Teaching Hospital D.I.Khan, on patients admitted with large gut obstruction due to viable sigmoid volvulus. After initial investigations and resuscitation, non-operative decompression was tried in all cases. Successfully decompressed patients underwent elective laparotomy and the rest had emergency laparotomy and mesosigmoidoplasty. After their discharge from hospital, patients were followed up for 6 months. Thirty-nine patients presented with viable sigmoid volvulus; 35 males and 4 females, with male to female ratio of 8.7:1. Age range was 48-70 years. Thirteen [33%] patients had successful decompression. Two patients refused surgery after successful non-operative decompression and were dropped from the study. Out of the remaining 37 patients 11[30%] patients had mesosigmoidoplasty on elective list and 26[70%] had emergency operation for mesosigmoidoplasty. Average hospital stay was 4 days [2-6 days]. Post-operative complications were wound infection in 1[2.7%] and paralytic ileus in 3[8%] cases. During 6 months follow-up, only 1[2.7%] patient had recurrence. Mesosigmoidoplasty is a definitive procedure for viable sigmoid volvulus with low rates of mortality, morbidity