Gynecomazia: a study of 46 cases

To study the presentation and outcome of cases operated for Gynecomazia. A retrospective study spread over four years i.e. June 2002 to May 2006. Different hospitals of Karachi including Civil Hospital. 46 males who were admitted for surgery of Gynecomazia. All patients included in this study were evaluated in detail clinically and by appropriate investigations. They were counselled about the condition, and operated via a peri-areolar or sub-mammary incision, and the outcome noted in terms of healing and complications. Out of the 46 cases, majority [71.74%] presented in the age group 11-20 years with peak incidence around 16 years of age. The main symptom was breast enlargement, though pain or discomfort was also seen in 12 [26.1%] patients. The size of the breasts varied between 4-8 cms, and 34 [73.9%] cases were bilateral. Surgery was done for macromastia in 7, long standing gynecomazia in 11 and cosmetic reasons in 28 cases. Wound infection and hypertrophic scar formation constituted the few complications noted. Gynecomazia is the commonest condition affecting male breasts. In majority of the cases counselling and observation is all that is required for management, as they subside spontaneously or on medication. Surgery is indicated in those cases that do not subside or on patient demand

Efficacy of needle aspiration as primary treatment of amoebic liver abscess

To describe the efficacy of needle aspiration of amoebic liver abscess and to assess its morbidity and mortality rates. A descriptive case series is designed. This study was conducted on 46 patients admitted to surgical ward 5 of Civil Hospital Karachi during a period of 2 years from December 2004 to November 2006. The success rate of percutaneous needle aspiraion was found to be 98%. Only one case came with recurrence. Four cases did not respond and were treated through laparotomic drainage. Reason of failure was found to be the more posterior location of the abscess. Treatment of amoebic liver abscess by aspiration with a wide bore needle is a very satisfactory method. It is accompanied by very low morbidity and mortality. In developing countries like Pakistan needle aspiration should be recommended as a standard procedure to treat amoebic liver abscess

Pattern of malignant tumours in general surgical practice

To study the pattern of malignant tumours in relation to various variables like age, sex, histology, anatomical involvement, etc. A retrospective study from June 2001 to May 2007. Surgical Unit V of Civil Hospital, Karachi. All patients who presented with malignant tumours were included. The data of all the patients was collected from case sheets and analyzed. A total of 217 patients, 96 males and 121 females were included in this study. The most common tumour was carcinoma of the oespophagus [23 males, 32 females], followed by carcinoma of the breast in 42 females. There were no case of male breast cancer. Malignant tumours are commonly seen in surgical units. It is important to increase public awareness about them so that patients can present at an early stage for a better outcome

Varicocele: treatment options

To study out come of current methodology of management of Varicocele with comparison between high and low ligation procedures. A retrospective study, from March 2001 to February 2005. Department of Surgery Surgical Unit IV, Civil Hospital Karachi, Ghafoor Medical Center and Imam Zainul Abideen Hospital Karachi. This study was done on 54 patients who were operated for this disease. The data of all these patients was entered in the Case files and used in this study. Majority of the patients had varicocele on the right side [95%]. Infertility was detected in 10% of cases. High ligation was better tolerated by patients and had lesser complications like Hydrocele and hematoma of scrotum. Results of surgery are rewarding and in doubtful casis abdominal tumors compressing testicular veins should be excluded

Management of hydatid disease of liver

To study the pattern of presentation, diagnosis and treatment of Hydatid disease of Liver. A retrospective study from April 2002 to March 2004. Setting: Department of Surgery, Civil Hospital, Karachi. All patients admitted with Hydatid disease of the Liver. The case sheets of all these patients were studied in detail to retrieve the relevant data. A total of 44 cases, 24 females and 20 males, presented during the study. Most cases were seen in the age group of 20 to 40 years. The scolicidal agents used included formalin, hypochlorite solution, hypertonic saline and silver nitrate; no major reactions to these were noted. The right lobe of the liver was involved in the majority of the cases. All cases underwent laparotomy; the hydatid fluid was aspirated, scolicidal agent injected into the cyst cavity, and hydatid cyst was removed in toto or piece meal. Hydatid cysts are common in our rural areas. Stray dogs should be eliminated from the society while there should be strict hygienic care of the pet dogs. All vegetables should be washed thoroughly before eating raw and the public made aware of the condition and its hazards

Carcinom Bladder: a study of 44 cases

Over a period of six year, 44 cases of bladder carcinoma were admitted in Surgical Unit IV of Civil Hospital, Karachi. Of these 31[70.45%] belonged to be transitional cell type, 9[20.45%] were anaplastic and 2[4.55%] squamous cell carcinoma, while two were secondary carcinoma. Majority [68.18%] of cases were seen between 40 to 60 years of age with a male of female ratio of about 3:1. Lateral wall of the bladder was the most common site [50%] followed by posterior wall [18.18%] and anterior wall [13.64%]. Cystoscopy and transurethral resection were the main for diagnosis and treatment, while radiotherapy and chemotherapy were less frequently used

Ileal typhoid perforation: a study of 40 cases

This is a retrospective study of 40 patients, who presented as acute abdomen and underwent emergency surgery for ileal perforations. High grade fever, abdominal pain, vomiting and constipation were common symptoms, while generalized tenderness, rigidity and obliteration of liver dullness were the main clinical findings. Sex incidence revealed male predominance, 33 male versus 7 females. The ages of the patients ranged from 12 to 75 years with a mean of 34 years. Ileal perforation due to typhoid enteritis was the diagnosis in all cases. Surgical procedures carried out included primary closure of the perforation in 27 cases and primary closure with loop ileostomy in 12 cases. In one case right hemicolectomy was performed. A mortality rate of 15% was seen in this series

Goitre management: a study off 106 cases

One hundred and six cases of thyroid swellings were seen in this 5 years retrospective study. Amongst them the highest incidence was of simple multinodular goiter [46%] followed by cold nodules [22%]. Female to male ratio was found to be 6:1. The mean age was 31 years while our youngest patients was 16 years old and the eldest 69 years. Maximum number of patients [54.70%] belonged to the age group 21 to 40 years. Subtotal thyroidectomy was the commonest procedure, performed in 42% cases. The average postoperative stay of patients in the ward was 4.25 days