Stapled hemorrhoidectomy in third degree hemorrhoids: a prospective study

To study the outcome of Stapled haemorrhoidectomy in 3rd degree hemorrhoids. 50 patients, who underwent stapled hemorrhoidectomy, were included in this study. The study took place at Surgical Unit-I, Civil Hospital, Karachi, from January 2009 to December 2010. Prospective interventional study. Stapled hemorrhoidectomy [SH] was performed in 3rd degree haemorrhoids in 50 patients. 3 patients had minimum pain and only 1 patient had persistent pain and one patient had post-operative minor bleeding which was managed conservatively. SH is an effective surgical procedure for the treatment of 3rd degree haemorrhoids. There is strong evidence that SH results in less postoperative pain than other procedures as well as earlier mobility. In our experience, SH is the treatment of choice for third degree hemorrhoids in hospitalized patients

Knowledge, attitude and practice about [Sudden unexpected death in epilepsy patients] among neurologists and paediatricians

Neurologists and pediatricians in Pakistan are generally not aware of sudden unexpected death in epilepsy patients and do they discuss this issue with the patients. To assess the Knowledge Attitude and Practices about [Sudden Unexpected Death in Epilepsy Patients] among neurologists and pediatricians. Department of Neurology, Jinnah Postgraduate Medical Centre, June 2005. Neurologists and pediatricians of Jinnah Postgraduate Medical Centre, Karachi were given a consent form to participate in the study. It was an interview-based study where a questionnaire was applied to the participants. There were 6 questions pertaining to the awareness about sudden unexpected death in epilepsy patients; about discussing the death with the patients and raising issue of sudden death in the discussion of epilepsy management. A total of 41 doctors [26 neurologists and 15 pediatricians] participated in the study. Amongst the neurologists, 13 [50%] were aware of and 6 [23.1%] had seen a case of unexpected death in epilepsy patients. Amongst the pediatricians, only 2 [13.3%] knew about it and had seen a case of sudden death. Overall 15/41[36.6%] doctors were aware of and 8/41 [19.5%] had seen a case of unexpected death in epilepsy patients. The patients of the above doctors never asked about it, except for one relative of a patient, who had lived abroad. Most of the doctors had never discussed this issue with the patients and none of them raised this issue in discussion about epilepsy management. The terminology of unexpected death in epilepsy patients was not known to many doctors and there is a need to increase awareness about this in doctors and general public

prospective study of outcome from rubber band ligation in third degree haemorrhoids

To evaluate the efficacy and effectiveness of rubber band ligation on 3rd degree haemorrhoids. Study was done at Surgical Unit, Civil Hospital Karachi, during a period of 19 months from December 2006 to July 2008. Out of 344 patients 80 patients were included in the study with 3rd degree internal haemorrhoids and were treated with Rubber band ligation [RBL]. Outcome data was recorded for success of treatment. Among 80 patients, 77 [96.25%] were symptom free. After completion of treatment, 1 [16.66%] out of 5 patients had the complaint of pain, 2 [2.85%] out of 70 had complaints of constipation. Before start of treatment 5 [6.25%] patients complained of bleeding per rectum and 73 [91.25%] complained of manually reducible/prolapsed haemorrhoids. Both complaints were cured 100% after treatment. RBL is an efficient, cost-effective and simple out patient procedure for symptomatic third degree haemorrhoids with minimum complications. RBL is a reliable, safe procedure requiring no hospitalization and no use of any anaesthetic drugs