Fournier's gangrene a urological emergency

A retrospective study to collect data about Fournier's gangrene done in Surgical-IV Liaquat Medical College Hospital Jamshoro/Hyderabad. During five years period from January 1994 to December 1998, thirty cases were collected with median age of 53 years. Pain, fever, erythema and swelling of the genitalia were present in all cases. The crepitus was found in fifteen cases and 33.3 percent patients developed multiple organ failure. The cause of infection was urological in 90 percent cases and anorectal in 10 percent cases. Associated systemic diseases were diabetes mellitus in 66.7 percent, uraemia 86.7 percent, cardiac failure in 33.3 percent cases and hepatic failure in 10 percent cases. The operations done were debridements in all cases, cystostomy in 83.3 percent and colostomy in 6.7 percent cases. Twenty patients [67 percent] died due to multiple organ failure

Choledochoduodenostomy in the management of choledocholithiasis

A two years study from January 1993 to December 1994 was carried out to determine the safety and effectiveness of Choledochoduodenostomy as the definitive treatment of Choledocholithiasis. A total of 30 patients underwent the operation. In 22 cases the Choledochoduodenostomy was done alongwith cholecystectomy and 8 patients had cholecystectomy / CBD exploration done previously. At the time of admission 83.3% patients had pain, 46.7% had jaundice, and 50% had past history of jaundice. Fever with rigors was present in 46.7% cases and at operation common bile duct diameter was less than 2cm in 20 cases and more than 2 cm in 10 cases. Post operative wound infection occurred in 26.7% cases, 10% developed cholangitis and 2 [6.7%] had leakage from anastomosis out of which one patient [33.3%] died

Comparative study of haemorrhoidectomy with rubber band ligation for second and third degree hemorrhoid

A prospective study was carried out to compare the results of rubber bond ligation with haemorrhoidectomy for second and third degree haemorrhoid for two years from July 1992 to June 1994, at surgical unit III Liaquat Medical College, Jamshoro [Pakistan]. A total of 120 cases were studied. In 60 cases haemorrhoidectomy was done and 60 cases underwent rubber band ligation [RBL]. Results showed that mean age of the patients was 30 to 40 years, sex incidence male female ratio 5: 1, and mean duration of symptoms 3 years. Bleeding per rectum was present in 96.6% cases, prolapse in 41.6% self reducible and in 58.3% manually reduced, pain in 4.2%, constipation 83.3% and external piles 16.6%. Complications encountered were bleeding in 1.66% with RBL and 5% in haemorrhoidectomy, pain 100% in haemorrhoidectomy 1.66% in RBL, urinary retention in 58.3% in haemorrhoidectomy while none in RBL, off work 1 to 3 days in RBL, and 2 to 4 weeks in haemorrhoidectomy. Out of 40 cases of RBL, followed for 1 year, 92.5% were asymptomatic, 5% improved and 2.5% did not improve. Out of 25 patients of haemorrhoidectomy followed 96% were asymptomatic and 4% showed improvement. It is concluded that rubber bond ligation as on out patient procedure is reasonable alternative to haemorrhoidectomy for the treatment of second and third degree haemorrhoids