Incidence of benign ovarian tumors in rural areas: a 10 years study in a tertiary care hospital Nawabsha

To determine the frequency of benign ovarian tumors attending the tertiary care hospital Nawabshah. Descriptive cross-sectional study. This study consisted of 419 patients of benign ovarian tumors admitted through the outpatient department, as well as from casualty department of Peoples University Hospital Nawabshah. Detailed history of duration of complain and clinical examination of the patient was done. All patients underwent for base line and specific investigations especially ultrasonography and biopsy sampling for assessment of histopathological examination. All patients in the reproductive age group between 15 to 60 years with any one or more presenting complains of ovarian tumors like abdominal mass, bloating, discomfort, pain or pelvic swelling were included. Exclusion criteria were patients more than 60 years of age, previous history of ovarian tumor and non-consenting women. Results were prepared with help of tables and graphs. Data was analyzed through SPSS software No. 16. 419 patients included in this study. There was wide variation of age ranging from a minimum of 10 years to 60 years. The mean age was 31.68 +/- 5.45 years. In this study incidence of ovarian neoplasm slowly increase per year. Clinical examination of patients revealed that pain in abdomen was the commonest presenting symptom 396 [94.5%] followed by mass per abdomen seen in 297 [70.88%], bloating in 146 [34.88%] and abdominal swelling in 167[39.85%]. Histopathology findings revealed was serous cystadenocarcinoma in 182 [43.4%] cases, mucinous cystadenoma 116 [27.7%] cases, mature teratoma 98 [23.4%] cases, thecoma 16 [3.8%] cases, fibroma in 05 [1.2%] cases and Brenner tumor 02 [0.5%] cases. In conclusion our study revealed that histopathologically most common type is serous cystadenoma followed by mucinous cystadenoma. The peak incidence of benign tumors was seen in the 3[rd] and 4[th] decades of the life

Intestinal tuberculosis-5 years experience in tertiary care hospital

Abdominal tuberculosis [TB] is a common disease in developing countries and reemerging in the west. This disease is still diagnostic dilemma for physicians and surgeons, as it mimics many abdominal diseases. To evaluate the clinical presentation and management of abdominal tuberculosis in our set up. Prospective study. This study was conducted in surgical unit III, Peoples University of Medical and Health Sciences Hospital Nawabshah, from July 2006 to June 2011. Total 70 patients were included in this study from 205 suspected cases. The cases were either previously diagnosed or diagnosed during operation performed for intestinal obstruction, peritonitis or appendicitis. Patients were confirmed on the basis of histopathology, cultures and AFB. Age of the patients ranged between 6 to 38 years. Male to female ratio was 1.3:1. Abdominal pain and weight loss were the most common symptoms. Common presentation was intestinal obstruction and peritonitis. Majority of patients underwent resection and anastomosis and limited right hemicolectomy. It has been emerged from our study that abdominal TB presents with different clinical features which are nonspecific and often diagnosed during laparotomy. Majority of patients underwent resection and anastomosis and limited right hemicolectomy

Role of investigations and Alvarado score in acute appendicitis at peoples medical college hospital Nawabshah

Role of investigations and Alvarado score in acute appendicitis at Peoples Medical College Hospital Nawabshah. Prospective observational study. Two years study from October 2008 to November 2010. Was conducted in Peoples Medical College Nawabshah. The study comprises 50 patients all were admitted from OPD [Out Patients Department] and COD [Casulty Department]. The patients were evaluated fully after history, clinical examination and specific investigation, blood CP, X-Ray abdomen, supin and erect posture, X-Ray KUB, ultra sound of abdomen and general assessment. All Patients of pain in right iliac fossa included all patients were manage on the basis of Alvarado score, Complete Blood Picture and Ultra Sound report. In this study 50 patients of acute appendicitis in which 25 were female and 25 were male. The maximum of patients were in age group 15 to 40 years. Peak age group 25 years. Out of 50 patients 42 patients were present leucocytosis. On the behalf of Ultra sound report 38 patients were diagnose acute appendicitis. 10 patients were diagnose perforated appendix, 2 patients were diagnose appendicular abscess. 8 patients were present Alvarado score 3 to 4.30 patients were present Alvarado score 6-7, 12 patients were present Alvarado score 8-9, Patients were operated through procedure of appendectomy then tissue sent for histopathology. Acute appendicitis is a common cause of acute abdomen. Anorexia, migrating pain, tenderness and rebound tenderness are evidence of acute appendicitis

Frequency of malignancy in benign enlarge prostate at peoples medical college hospital Nawabshah

To determine the frequency of Malignancy in Benign enlarge prostate. Prospective observational study: Two years study from October 2008 to October 2010. Was conducted in Peoples Medical College Nawabshah. The study comprises 50 patients all were admitted from OPD [Out Patients Department]. The patients were evaluated fully after history, clinical examination DRE and specific investigation of PSA X-ray Lumbo sacral spine Trans rectal, Endo luminal ultra sound flow metery Trans rectal biopsy C.T scan and Bone scan and General assessment. All Patients with enlarged prostate included out of 50 patients 48 patients under went surgery and tissue sent for histopathology. In this study of 50 patients of enlarge prostate total number of patients were in age group 55 to 75 years, Out of 50 patients 9 patients suspected malignant on the basis of DRE. But PSA will raise in 7 patients. Regarding the histopathology the results 7 patients showed malignancy adeno carcinoma. Prostate carcinoma more common enlarged prostate as compared to fibro tic prostate

Reasons for conversion from laparoscopic to open cholecystectomy

To determine the frequency and reasons of conversion of laparoscopic cholecystectomy [LC] to open cholecystectomy [OC]. This prospective study was carried out in the Surgical unit III, Peoples Medical College Hospital from April 2006 to October 2009 male and female] were included in the study, all were evaluated fully preoperatively in respect to disease and general fitness of the patient for surgery and counseled regarding possibility of conversion from LC to OC. 6 patients [8.8%] were converted to open procedure. Obscure anatomy of Calot's triangle, bleeding and bile duct injury were common reasons of conversion. Even in difficult cases LC is a safe procedure with low incidence of conversion and complications in hands of experienced laparoscopic surgeon, where as junior surgeons being in learning curve are less confident and skillful, so are prone to more complications. Therefore they are advised to convert to open procedure earlier according to the criteria laid down, before complication occurs

Outcome analysis of lateral sphincterotomy in the management of chronic anal fissure

To evaluate the post operative outcome, following lateral sphincterotomy for chronic anal fissure [CAF], in our set up. This prospective study was conducted in the Department of Surgery, Peoples Medical College Nawabshah from July 2005 to September 2009. A total of 80 patients with symptoms of CAF requiring surgery were included in the study having 48 males and 32 females, age ranged between 20-60 years. The diagnosis was made on clinical presentation and confirmed on pen anal examination; lateral sphincterotomy was performed under local or general aesthesia. Patients were followed on weekly bases to see any complication. All the cases of acute and complicated anal fissure were excluded from the study. Anal pain and bleeding. were the leading presentation found in 72 [91%] and 63 [78%] patients respectively, commonest site of fissure was posterior midline in 73 [92%] of cases. Post operative pain was observed in 5 [6%] cases, flatus incontinence in 15 [20%] patients, fecal incontinence in 3 [4%] cases, bleeding in only in 1 [1.2%] patients and infection was observed in 3 [4%] cases. Lateral sphincterotomy is the procedure of choice for the treatment of CAF. It has low rate of incontinence to stool and flatus, low recurrence and healing rate is faster. We advocate this procedure as an ideal treatment for CAF

audit of peripheral lymphadenopathy

To evaluate the causes of Peripheral Lymphadenopathy. A descriptive and cross sectional study conducted from July 2004 to June 2006. Department of Surgery and Pathology, Nawabshah Medical College and Hospital, Nawabshah. A total of 116 patients with Peripheral Lymphadenopathy. The patients were evaluated for outcome parameters in relation to age, sex. Site and specific cause of peripheral lymphadenopathy. A total of 116 patients including 64 [55.17%] females and 52[44.82%] males were evaluated for peripheral lymphadenopathy. Their ages ranged between nine months to 70 years with a mean age of 27.14 years; majority belonged to the age group 11 to 20 years. Forty seven [40.51%] patients had cervical lymph nodes enlargement, 42 [36.20%] mesenteric, 24 [20.86%] axillary and 3 [2.85%] inguinal nodes enlargement. Tuberculosis and malignancy were the main causes of lymphadenopathy with an incidence of 53.44% and 13.79% respectively. Nine [7.75%] cases had acute lymphadenitis and 27 [23.25%] reactive hyperplasia, while in tow [1.72%] cases no pathology was detected. Peripheral Lymphadenopathy without any obvious cause presents a diagnostic dilemma