Metronidazole in acute non-perforated appendicitis

Objective: To compare the infective complication rate after open appendicectomy in patients with nonperforated appendicitis receiving cefazolin with metronizadole and cefazolin alone

Study design: Randomised controlled trial

Place and Duration of study: PAEC General Hospital Islamabad, from March 2015 to June 2016

Methodology: Patients with acute non-perforated appendicitis were divided into two groups. Group A patients received cefazolin with metronizadole and Group B received only cefazolin. A total of three doses were given, one preoperatively and two postoperatively in each group. Patients in both groups were followed up for 30 days postoperatively for any surgical site infections [SSI]

Results: A total of 242 patients were operated of whom 11 were excluded as they did not come for follow-up. There were 111 patients in group A and 120 in group B. Infection rate in group A patients was 7.21 % and in group B, 8.33%. There was no significant difference of wound infection in both the groups [p=0.427]

Conclusion: Addition of metronizadole in patients with non-perforated acute appendicitis did not reduce the rate of surgical site infection

Outcome of peri-anal surgeries without use of prophylactic antibiotics, in terms of post operative wound infection

Objective: To determine the outcome of perianal surgeries without use of antibiotics in terms of post operative infection. Study Design: Descriptive study. Place and Duration of study: Department of general surgery, Pakistan Atomic Energy Commission General Hospital, from Jan 2014 to Jun 2015

Material and Methods: All patients, both male and female admitted for hemorrhoidectomy, fistulectomy and lateral internal sphincterotomy for Anal Fissure with minimum 02 months follow-up were included in the study through non probability consecutive sampling technique. The selected patients were not administered any antibiotics pre or postoperatively. All these patients were followed up for any post-operative surgical site infection up to 02 months. Patients were advised only to take pyodine sitz bath regularly

Results: One hundred and eighty two patients were selected for the study. Patients mean age was 48.0 +/- 11.4 years. 68.68% were male and 31.3% were female patients. In our study most frequent clinical presentation was hemorrhoids [37.9.0%], followed by anal fissure [33.5%]. Least frequent clinical presentation was of anal fistula [28.57%]. None of the patients developed surgical site infection post operatively

Conclusions: In our study we found that there was no additional beneficial role of prophylactic antibiotics in perianal surgeries Perianal surgeries can safely be performed without the use pre or post-operative antibiotics there by significantly reducing health care expenses

Association of student.s intrinsic motivation and autonomous support of teachers on academic performance of dental undergraduates of Karachi

Objective: To assess the impact of teacher.s autonomous support on student.s academic performance among dental undergraduates of Bahria University Medical and Dental College [BUMDC], and to find out the influence of intrinsic motivation [self- determination theory] on academic performance of dental undergraduates of BUMDC

Methodology: It was a cross sectional study conducted among dental undergraduates of BUMDC. Total sampling technique was used in this study. Out of total 200 dental students in all four years of BDS, 185 questionnaires were completely filled in all aspects and therefore included for data analysis

Results: The final calculated scores of two sub-scales of the Learning Self-Regulation Questionnaire [SRQ-L, autonomous motivation and controlled motivation] had an average mean of 5.1 and 3.95. The average of the Learning Climate Questionnaire [LCQ] for tutor autonomy support was 4.51. The average academic performance score was 74.1%. More than half of the respondents [60%] were autonomously motivated. Students. autonomous support and perception towards tutors. autonomy support was [5.1 and 4.51 out of 7 scoring] respectively

Conclusion: It was concluded from this study that the intrinsic motivation of dental undergraduate has direct association on strong academic performance of learners. On the other hand, teachers. autonomous support has an inverse relationship over academic performance of dental undergraduates

Neuroendocrine carcinoma of breast

Neuroendocrine tumours [NETS] are rare tumours. The commonest site of occurrence is the gastrointestinal tract. NETS in the breast are even rarer, accounting for less than 0.1% of all breast cancers and less than 1% of all NETS. We are reporting a case of primary neuroendocrine carcinoma of the breast in a 60 years old female. Investigations were done to rule out any other associated lesion. Patient was treated by modified radical mastectomy and adjuvant chemo and radiotherapy

Symplastic leiomyoma of uterus: a rare histological variant

Symplastic leiomyoma is a rare histological variant of leiomyoma. This is a case report of a young nulliparous patient who presented with primary infertility for 2 years and swelling in lower abdomen for 6 months. Intramural fibroid was diagnosed during a pelvic ultrasound. Histopathology of that myomectomy showed symplastic leiomyoma with absent mitotic figures. The patient was managed as for a benign tumor