ABSTRACT
To determine the sensitivity pattern of Staphylococcus au reus in surgical site infection after elective surgery. Cross sectional descriptive. January1, 2012 to May 31,2013. Patients with minor or major surgical site infection [SSI] were selected by the treating surgeons and swabs taken for culture and sensitivity testing on blood agar, chocolate agar and MacConkey's agar plates [incubated at 370C] aerobically. The suspected colonies were subjected to catalase test and later coagulase test to confirm as Staphylococcus au reus and tested for sensitivity against commonly used antibiotics. Staphylococcus au reus was isolated in 59.2% of positive cultures. The highest resistance of S.aureus was against Cefixime [95.1%] followed by Cefaclor [77.1%]. The least resistance was against Sulbactam and Cefoperazone [8.2%] followed by Sparfloxacin [11.5%] and Amikacin [16.4%]. S. au reus was variably resistant to other commonly used drugs. Staphylococcus aureus is sensitive to less commonly used drugs like combination of Sulbactan and Cefoperazone and Sparfloxacin. Resistance to commonly used drugs like Cefixime and Cefaclor exists in surgical site infection and needs appropriate measures for prevention and control
ABSTRACT
To determine the validity of early [one hour postoperatively] parathyroid hormone [PTH] assay [[2] 10 pg/ml], keeping gold standard as the serum ionic calcium level, for predicting sub-total thyroidectomy-related hypocalcaemia and to calculate the sensitivity and specificity of latent signs of tetany. Cross-sectional validation study. Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad from August 2008 to August 2010. Patients undergoing sub-total thyroidectomy were included by convenience sampling. PTH assay was performed 1 hour post sub-total thyroidectomy. Serum calcium levels were performed at 24 and 48 hours, 5th day and 2 weeks after surgery. Cases that developed hypocalcaemia were followed-up for a period of 6 months with monthly calcium level estimation to identify cases of permanent hypocalcaemia. Symptoms and signs of hypocalcaemia manifesting in our patients were recorded. Data was analyzed through SPSS version 10. 2 x 2 tables were used to calculate sensitivity and specificity of PTH in detecting post-thyroidectomy hypocalcaemia. Out of a total of 110 patients included in the study, 16.36% [n=18] developed hypocalcaemia including 1.81% [n=2] cases of permanent hypoparathyroidism. The sensitivity of one hour postoperative PTH assay as a predictive tool for post-thyroidectomy related hypocalcaemia was 94.4% while its specificity was 83.6% with 53% positive predictive value and 98.7% negative predictive value. One hour post sub-total thyroidectomy PTH assay can be helpful in predicting post sub-total thyroidectomy hypocalcaemia. Moreover, it can be useful in safe discharge of day-care thyroidectomy patients
ABSTRACT
To determine safety of diode laser by studying post operative complications after endourological procedures in co-morbid patients. A descriptive study. Shalamar hospital, Lahore from June 2009 to June 2012. We studied post-operative complications [up to 3 months] in 3 groups [prostatic obstruction, bladder growths ,urethral strictures] of total180 patients with ASA III and IV. We assessed hematuria, UTI, abdominal pain, suprapubic discomfort, urinary retention, dysuria, incomplete procedure, cardiac or respiratory compromise, fluid overload, mortality, catheterization times and mean postoperative hospital stay In prostate group, mean age was 70.8 +/- 8.6 years and follow-up period was 3 months. Complications were: mild transient haematuria in 65 [100%], creamy urine in 50 [77%], urinary tract infection in 25 [38.4%], dysuria in 16 [24.6%], retreatment required in 06 [9.2%], suprapubic discomfort in 3 [4.5%], TURP syndrome in 1 [1.5%] and significant hemorrhage requiring blood transfusion in 1 [1.5%],. In urethral strictures, the complications were: microscopic hematuria in 80 [100%], urinary tract infection in 52 [65%] suprapubic discomfort in 9 [11.2%], dysuria in 6 [7.4%] mild transient hematuria in 5 [6.2%]. In bladder growths, the complications were: mild transient haematuria in 30 [85.7%], creamy urine in 19 [54.2%], suprapubic discomfort in 18 [51.4%], dysuria in 9 [25.7%], urinary UTI in 8 [22.8%], ablation performed in two sittings in 1 [2.8%]. No mortality in any group. Diode laser is a safe and useful modality in patients with co-morbidities [ASA III and IV]
ABSTRACT
Objectives: To determine the incidence of carcinoma of rectum and sigmoid colon in patients with bleeding per rectum using sigmoidoscope[rigid]
Design : Observational and interventional study
Setting: A total of 231 patients attending surgical outpatient department from 1-1-2000 to 31-12-2002 with complaints of bleeding per rectum
Interventions: Per rectal digital and sigmoidoscopic examination was done in all patients. Biopsy taken of all ulcers, bleeding or hyperemic areas, polyps and growths and histological examination was done to determine the true positive case of rectal or sigmoid colon cancer
Results: Endoscopic Examination completed in 204 subjects. Three rectal and one growth at recto sigmoid junction were found [frequency 1.96%] three were males and one was female. The two growths in rectum were polypoid and one was annular involving whole circumference. The growth at recto sigmoid junction was fungating mass. All were Aden carcinoma. Three were well differentiated and one moderately differentiated sigmoidoscopy identified bleeding source in 197 subjects [96.6%]. No significant complication was observed
Conclusion: Rectal and sigmoid carcinoma is less frequent in our population than western community. Sigmoidoscopy [rigid] is an important diagnostic tool in evaluation of bleeding per rectum with less frequent complications