Hemorrhoidal endoscopic band ligation; present pattern and management outcome at Isra university hospital

To determine the management outcome of the endoscopic band ligation in the patients with internal haemorrhoids at isra university Hospital Hyderabad Sindh. Pakistan. All the patients were under went sigmoidoscopy and colonoscopy for the complete diagnosis and the patients were excluded, if polyps or evidence of malignancy was found at colonoscopy. Haemorrhoids were sucked with the tip of endoscope from the anal canal and elastic bands were applied. After first treatment session, patients were asked to complete a questionnaire to evaluate the subjective satisfaction, which was classified as poor, good and best. Patients who had with multiple haemorrhoids were recalled for the ligation on remaining haemorrhoids after 2 weeks, if indicated. Total 100 patients were included in the study. In complications, intensive pain was found in the 55% of the cases while other complications were seen in very few patients and many patients were seen without any complication. Hospital stay was only one day was noted in the very few patients and mostly patients were discharged after few hours of the procedure. Outcome of the endoscopic band ligation was found excellent in 40% of the cases, good results found in the 45% of the cases and poor results were seen only in the 15% of the cases. Re-endoscopic band ligation was done in the 20% of the cases and recurrence of hemorrhoids was noted in the 30% of the cases. We concluded that the endoscopic band ligation is very good management for haemorrhoids without typical complications, with very short hospital stay and recurrences rate

Current pattern and diagnosis of small bowel obstruction in the patients of rural areas

Objective of this study to determine the clinical presenting factors including diagnosis and risk factors of the patients those admitted with small bowel obstruction. Observational study. This study was carried out at the Departments of General Surgery, Peoples Medical University and Health Science Nawabshah and Isra University Hospital Hyderabad from March 2013 to Aug 2013. After admission detailed history, physical examination, ultrasound, X-ray abdomen erect and supine and all routine baseline laboratory investigations were carried out. CT scan was done in the selected patients. Final diagnosis was done by laparotomy which was attempted after thorough initial assessment and investigations. Total 50 patients were included in the study of the rural areas of the Sindh, from all of them male were in majority. On the clinical presenting features Nausea, Constipation and Abdominal pain were most common with the percentage of 92%, 80% and 78% while other presenting features as; Vomiting, Abdominal tenderness, Abdominal distension, Fever, Epigastrium pain, Rectal bleeding and Rebound tenderness were with the percentage of 40%, 42%, 22%, 38%, 30%, 16%, 10% and 26% respectively. On the diagnosis adhesion was found as most common. In the conclusion of this study adhesion found as most common and leading cause of small bowel obstruction