Comparison of different modalities of treatment of hypertrophic scars and keloids

Hypertrophic scars and keloids are extreme overgrowth of scar tissue. To improve the cosmesis and symptomatology, to compare the results of different treatment modalities and to find out the most workable treatment option. Prospective randomized clinical trial. This study was conducted at the Allied Hospital, Faisalabad from April 2009 to September 2011. In this study 72 patients were studied. Most of them were treated on outdoor basis while others in wards. Detailed history and physical examination were carried out and applied different treatment options and followed them up. In our study of patients of hypertrophic scars and keloids, 29 were males and 43 were females. There was 20% recurrence rate in intralesional injections of steroid, 255 in silicone gel sheeting, 25% in surgery and postoperative intralesional injection, 50% in case of surgery and postoperative irradiation and 20% in surgery alone. In case of intralesional injections of triamcinolone acetonide 62.5% patients had excellent results. In both combined surgery with radiotherapy 1 patient improved while the other got recurrence. After surgical excision of hypertrophic scars 40% patients had excellent results. Intralesional injections of triamcinolone acetonide had good results. In early lesions silicone gel sheeting was useful option while recurrent scars can be treated by combined modalities of treatment

Etiology and diagnosis of obstructive jaundice, our experience

Obstructive jaundice is a common problem faced by surgeons. To ascertain various etiologies of obstructive jaundice in our set up and to evaluate the usefulness of available diagnostic modalities. Descriptive study. This study was conducted at Allied and District Head Quarter Hospital, Faisalabad from April 2010 to Sep. 2010. Eighty-five patients with obstructive jaundice were included in the study. They were evaluated on the basis of history, clinical examination, biochemical tests and ultrasonography. CT scan abdomen was done in suspected malignant cases only. Operative findings were compared with preoperative ultrasound and CT scan findings. The results were then prepared and analyzed. In our study. 56.5% patients were of benign etiology and 34.5% were of malignant etiology. Female to male ratio was 2:1. Serum bilirubin was raised more in malignant diseases than in benign diseases. and accuracy of 80% of ultrasound and 86% of CT scan abdomen was found out after performing different surgical procedures in our patients. In benign group of patients the most common cause was choledocholithiasis, 47.1% while in malignant group the most common cause was carcinoma of head of pancreas, 34.1%. Common causes of obstructive jaundice in our study were choledocholithiasis and carcinoma head of pancreas. Ultrasound is a reliable tool for diagnosis of obstructive jaundice and CT scan is helpful in evaluation of malignancy scan is helpful in evaluation of malignancy

Midline neck swellings - frequency of occurrence of thyroglossal cyst

To study the frequency of occurrence of thyroglossal duct cyst in comparison to other midline neck swellings. It is a prospective descriptive study. It is conducted in SUI in Allied hospital Faisalabad from March 2006 to March 2008. In this study 35 patients were studied. They were admitted through outdoor to surgical unit I with midline neck swellings. Patients of both sexes from 5 to 45 years old were examined. Their detailed history and physical examination were carried out. It was determined on physical examination that the midline swellings were solid or cystic, tender or non tender and moved with swallowing and tongue protrusion or not, All patients with central midline swellings of the neck, Patients with lateral neck swellings were excluded from this study, In our study of 35 patients of midline neck swellings, 21 were males and 14 were females, Out of 35 patients 20 patients [57.14%] were having acute or chronic lymphadenitis, One out of 35 patients had Hodgkin's lymphoma [2.85%],3 patients [8.5%] had thyroglossal cysts,8 patients [22.85%] had solitary thyroid nodule of isthmus,2 patients [5.7%] were suffering from dermoid cyst while 1 patient [2,8%] had plunging ranula, Out of 3 patients of thyroglossal cysts 2 [5.71%] were males and 1 [2.85%] was female, The age range was between 5 to 45 years. Lymph node enlargement are among the most common causes of midline neck swellings. Thyroglossal cysts are also found among the midline neck swellings but not as frequently as solitary thyroid nodules of the isthmus. Dermoid cysts and plunging ranulas are quite rare causes of midline neck swellings