Perceptions of doctors on being treated by a doctor just completing the house job

To determine the percentage of medical teachers and fresh doctors who feel that graduating doctors are competent or incompetent to handle common ailments and to evaluate the reasons for their perceptions. Sequential mixed method. First phase extending from December 2010 to December 2011 and second phase was conducted in March 2014. First phase comprised electronic distribution of questionnaire to 100 medical teachers and fresh doctors working in hospitals attached with 5 private and 5 public sector medical colleges of Lahore and Karachi to rate an average house officer on a frequency scale of 1 - 6 and do self-assessment, in case of a fresh doctor. The second phase included interviews of 20 medical teachers to explore justification for their rating in the survey questionnaire and for triangulation of data. Quantitative data was analyzed through SPSS version 15 to calculate frequencies and percentages and interviews were analyzed through quasi-statistical approach. In survey, 38.36% out of 73 medical teachers and 30% out of 20 medical teachers in interviews confirmed their confidence on consulting fresh doctors for common ailments as opposed to 61.64% and 70% respectively, expressing their dissatisfaction. Self-assessment of fresh doctors indicated that 40% are confident in handling common medical conditions as opposed to 33.3% out of 75 respondents, who are not confident about their clinical skills. Faculty and self-assessment of fresh doctors has a fair overlap, indicating room for further improvement in the house job training program

Chronic granulomatous inflammation of the abdominal wall after laparoscopy: a look at high level disinfection

Port site infections after laparoscopic surgery are a known complication and take away a lot of benefits attributed to the minimal access approach. Detecting the flora responsible is essential and atypical mycobacteria must also be considered. This case series is a compilation of the accounts of ten different patients with chronic granulomatous inflammation of the anterior abdominal wall presenting with port site discharging sinuses and lumps after laparoscopic surgery. Atypical mycobacterial infections must be considered in patients with persistent wound infections after laparoscopic surgery and warrants a revision of the high level disinfection [HLD] process.

Lichtenstein tension-free hernioplasty: an audit

This prospective, observational study was carried out to assess the feasibility of prosthetic repair for groin hernias in terms of infection, recurrence and cost-effectiveness in a government hospital set-up and to disprove the commonly held notion that using a mesh for groin hernia repair in our tertiary care teaching hospitals is expensive and can lead to infection. A total of 174 hernioplasties were carried out in 166 patients for primary inguinal hernia in the Department of Surgery, Jinnah Hospital Lahore, over a period of four years, starting from March 1999 to March 2003. Only males over 25 years of age, without any co-morbid diseases were selected. The patients were operated mostly under spinal anaesthesia, with three doses of a single antibiotic perioperatively. The patients were followed-up physically for four years on an out door basis. Only one [0.6%] recurrence and two [1.2%] superficial infections were noted. There was no deep-seated infection or any graft rejection. Urinary retention occurred in 9 [5.3%] cases, while hydrocele and haematoma occurred in three cases [1.7%]. There was no ischaemic orchitis, deep vein thrombosis or a varicocele following mesh repair. There was no effect on fertility in these patients. There was minimal pain with early return to work and, hence, minimum expenses. It is concluded that Lichtenstein Tension-Free Hernioplasty is a safe and effective procedure that can be performed in a government hospital under spinal and local anaensthesia with very low infection and recurrence rates. It has a good patient compliance due to early mobility and early return to work. All these factors make it cost effective as well