Urethral catheterization

[1] To assess the theoretical and practical knowledge of young doctors about urethral catheterization. [2] To evaluate the experience and level of confidence of young doctors regarding the urethral catheterization in various tertiary care centers of Rawalpindi and Islamabad. Sep 2009 to Feb 2010. Tertiary Care Centre, Fauji Foundation Hospital, Rawalpindi. A questionnaire was distributed among 400 young doctors working as interns in various tertiary care teaching hospitals of Rawalpindi and Islamabad. We obtained the information about observation, assistance, performance and knowledge of young doctors about urethral catheterization. Questionnaire was distributed to about 400 young doctors working as interns in different teaching hospitals of Rawalpindi and Islamabad. Among the 400 doctors, 20 [5%] doctors never observed the male urethral catheterization and 35 [8.75%] doctors never observed female urethral catheterization. While among these 400 doctors 159 [38.75%] doctors never assisted male urethral catheterization and 175 [43.75%] doctors never assisted female urethral catheterization. Moreover 205 [51.25%] doctors never performed the male urethral catheterization and 185 [46.25%] doctors never performed female urethral catheterization. Training of young doctors about UC is not adequate. There is a need to train the young interns properly on this aspect. A senior resident or registrar of department should demonstrate the procedure in front of young interns before they are allowed to practice and first few catheterizations should be supervised by senior residents. Other alternate is the use of manikens for training of house officers

Complications of thyroid surgery

To determine the percentage of complications in thyroid surgery and compare these complications with the other national and international studies, Study Design: A descriptive study, The study was conducted in the department of Surgery, Foundation University Medical College and Fauji Foundation Hospital Rawalpindi from 1 [st] January 2009 to 31[st] December 2009. Patients and Methods: 192 patients above the age of 14 who consented were included in the study. General physical ansd loco regional examination was done in OPD. Thyroid function tests [T3, T4, and TSH] were done in all the patients besides other routine investigations. FNAC and thyroid scan was done in only selected patients. Anemia, hypertension and other comorbid condition, if present, were corrected and assessed by anesthetist in the pre admission clinic. Only euthyroid patients, both clinically and biochemically and fit for general anesthesia were admitted for operation. Subsequently all the patients were subjected for surgery and the specimens were sent for histopathology after visual examination. Pre as well as per operative findings were recorded on a specially designed proforma. The data were then entered in the computer for analysis and conclusions were drawn. Total of 192 patients operated for benign thyroid disease in year 2009. Age ranges between 14 to 80 with 120 patients below the age of 40. Out of 192 patients, only 6 were males.90 patients were operated for pressure symptoms, 78 for cosmetic reasons and 24 for toxic symptoms. Subtotal thyroidectomy was done in 132 patients while 24 patients ended up with near total and 36 were candidates for lobectomy. 6 patients had symptoms of RLN damage while 24 develop parathyroid insufficiency post operatively. All these patients managed conservatively and discharge on 2[nd] or 3[rd] post op day. They regain normal voice and normal serum calcium levels by the end of 3 months. Subtotal thyroidectomy is one of the commonest procedure done by the surgeons of Rawalpindi Islamabad region. Maximum effort should be done to optimize the patients preoperatively. If patients are euthyroid and assessed carefully for anesthesia fitness before operation, chances of per or post- operative complications are negligible

Causes of mechanical intestinal obstruction in adults

To investigate the causes of mechanical intestinal obstruction in adults at surgical C unit Lady Reading Hospital Peshawar. This case series study was conducted at surgical C unit, of Lady Reading Hospital Peshawar, Pakistan from July 2006 to June 2007. In this study a total of 93 patients were included; who underwent exploratory laprotomy. These patients were diagnosed on the basis of clinical history, examination and radiological findings. After resuscitation, exploratory laprotomy was performed to confirm the diagnosis and relieve the obstruction. Laprotomy findings were recorded and where necessary specimen was sent for histopathology for definitive diagnosis. In this study of 93 cases, 100% patients presented with pain and abdominal distension. Other symptoms were less frequent. Males were 50 [53.76%] and females 43 [46.24%] with a male to female ratio of 2:1. 72. Tuberculosis [36.55%] was the leading cause of mechanical intestinal obstruction followed by carcinoma of the large gut [22.58%] and postoperative adhesions [21.51%]. Five [5.37%] patients had obstructed herniae and four [4.31%] had malignancy of the small gut. Three [3.22%] patients were with Meckle's diverticulum while 2 [2.15%] each had appendicular adhesions, intussusception and sigmoid volvulus. The causes of intestinal obstruction are variable in different parts of the world. Tuberculosis was the leading cause of dynamic intestinal obstruction in this study