Agriculture related injuries; Spectrum and management outcome in General Surgical unit

Traumatic injuries related to agricultural related profession can lead to serious disability and even mortality. To study the spectrum of agricultural production related injuries and their management outcome in General Surgical unit. RetrospectiveDescriptive, Interventional. January 2012 to December 2013. Surgical Department Aziz Bhatti Shaheed Teaching Hospital Gujrat and Surgical department Islam Medical and Dental College Sialkot. Data of 33 patients involved in an accident and sustained injury while operating agriculture machine/ equipment is being presented with reference to age, gender, nature of injury, type of equipment /machine involved and management outcome. Record of total 33 patients with agriculture related injuries was analysed retrospectively. Male population is more involved in agriculture related accidents seen in 20 out of 33 patients [60.6%], female involvement in such accidents is not uncommon seen in 13 patients [39.9%]. Fodder Cutter [TOKA] was the commonest agricultural equipment found involved in 17 [51.5%] cases. Traumatic amputation both minor or major type of upper limb was most frequent injury seen in 19 [57.7%] cases and infection was the commonest complication occurred in 13 cases. Fournier's gangrene and tetanus was the most dreadful complication with 100% mortality. Overall mortality was 03.03%. Agriculture machinery related accidents cause serious injuries that lead to disability, morbidity and often mortality. Victims are usually young. Awareness campaigns regarding hazards and safety measures in using agriculture machinery should be launched with the help of media. Re-implantation / re-vascularization surgery must be considered in case of limb amputations in selected cases

Faith healing; modern health care

To observe the frequency and various modes of faith / spiritual healing adopted by patients admitted with surgical diseases and their effects on course of disease. Prospective, observational. Surgical Department Aziz Bhatti Shaheed [Teaching] Hospital Gujrat, and Surgical department Islam Medicaland Dental College Sialkot. Duration of study: January 2013 to June 2013. Patients of both sex and all age groups admitted surgical wards of in both study setting during the study period were included in the study. Unattended/non cooperative and patients with trauma were excluded. Their surgical problems were evaluated and recorded. Various techniques of spiritual/ faith healing being adopted by the patients either as primary or /and an adjuvant modality were noted and resulted formulated. A total of 953 patients with surgical problems were admitted in both study settings. 788 patients [82.68%] were found to be using one or another technique of faith /spiritual healing as a primary or/ and an adjuvant to medical treatment. Out of total 788 patients 414 [52.53%] were female, no much difference of adaptation of various spiritual/faith healing was found in literate and illiterate population. This practice of adopting spiritual/faith healing was more common in rural population [n=493 62.56%]. Trust on faith/ spiritual healing techniques is a common phenomenon in society, but it is a commonest known reason of late presentation, diagnosis, treatment of the diseases leading to poor outcome. One must trust Allah, and it is consistent to apply every remedy that comes with in the range of one's knowledge, and then to ask Allah to sanctify that application to the healing of ailment. Religious scholars, electronic as well as print media can play a vital role in making people aware of this fact that will eventually lead to early diagnosis, treatment and better outcome of various body ailmentsand treatment by faith healers is independent predictors of death in case of snake bite. This may provide important evidence to formulate preventive strategies especially health education

Carcinoma breast; late presentation facts and factors

To evaluate the factors responsible for the late presentation of carcinoma of breast in Pakistani women. Prospective, Cross sectional, Interventional. Women Medical Complex Sialkot and Surgical Unit II. Aziz Bhatti Shaheed [Teaching] Hospital. Nawaz Sharif medical College, University of the Gujrat. Study. January 2009 to June 2012. A total of 87 patients of all age groups with carcinoma of breast were enrolled in this study. Mean age of presentation with breast cancer was 43 years. Stage III carcinoma breast was the most common presenting stage seen in 56 [64.36%] women. Socio economic status, delay in presentation and diagnosis, fear of mastectomy and its social consequences found to be major factors in the late presentation of carcinoma of breast. There is need to launch cancer public health campaign mechanisms, should include teaching of Breast Self Examination [BSE] to patients, Clinical Breast Examination [CBE] to health workers. Strenuous efforts should be made to break the vicious cycle of late presentation, poor treatment outcome and reluctance of patients to present to health facilities because of social mindset

Scierotherapy versus rubber band libation. comparative study of efficacy and compliance in the treatment of uncomplicated second degree haemorrhoids

To compare the outcome of two different procedures of non operative treatment of uncomplicated second degree hemorrhoids in terms of efficacy and patients compliance. Prospective interventional. Controlled Phase II clinical trial. Surgical Unit DHQ [Teaching] Hospital Rawalpindi from 10th September 2004 to 20th May 2006. Regardless of age and sex, first hundred patients attending the out patients department of surgical unit, DHQ [Teaching] Hospital, Rawalpindi with uncomplicated second degree hemorrhoids after informed consent were enrolled in the trial. Patients were divided into two treatment groups A and B with 50 patients in each by random draw sampling. Patients in Group A were subjected to injection sclerotherapy [SCL] whereas of Group B, Rubber band ligation [RBL]was performed. One hundred patients of mean age of 42.24 years with uncomplicated second degree hemorrhoids with standard deviation of +13.63 years were enrolled in this study. Out of total one hundred patients, 62 were male and 38 were female. The major indications of treatment were bleeding per rectum and prolapse. Patients in Group A were subjected to Injection sclerotherapy [SCL] and of Group B, Rubber band ligation [RBL] was performed. In Group A, 28 patients [56%] were symptoms free after 4-6 weeks with single session of SCL, 16 patients [32%] required additional second session at eight week and 6 patients [12%] required third session at 12 weeks respectively due to persistence of symptoms. In Group B, 44 patients [88%] were symptom free after four weeks with single session of RBL, while 6 patients [12%] required second session at 10 weeks to become symptom free. At 12 month follow-up 46 patients [92%] remain symptomfree and 4 patients [8%] had recurrence of symptoms in Group A and rubber band ligation was performed. All the patients of Group B [RBL] remained symptom free. [P value=0.041]. Rubber band ligation is a safe, effective, economical non operative treatment option for second degree uncomplicated hemorrhoids with good patients compliance

Non-traumatic lower extremity amputations in diabetics

The purpose of this study was to estimate the prevalence of non -traumatic lower extremity amputations in diabetic in peripheral teaching hospital catchment area. Prospective, Cross sectional, Interventional. Surgical Unit II. Aziz Bhatti Shaheed [Teaching] Hospital. Nawaz Sharif medical College, University of the Gujrat. February 1, 2011 to January 31, 2012. A total of 132 patient were subjected to non traumatic lower extremity amputation were enrolled in this study out of which 89 [67.42%] were diabetic, followed by non specific infections n=39 [23.48] Out of 89 total diabetic patients 53 [40.15%] patients were female whereas 36 [27.27%] were male. Both major and minor non traumatic lower extremity amputation rate was more in female diabetic patients than male diabetics. The prevalence of non -traumatic below knee amputations at an early age is high in our diabetic patients, especially in female population. By improving primary health care service regarding foot care awareness in diabetics appears to be the main way to reduce the amputation rate