Management of patients with blunt abdominal trauma

To evaluate limitations of diagnostic peritoneal lavage and ultrasonography in patients with blunt abdominal trauma. The study was conducted in Accident and Emergency Department of Nishtar Hospital, Multan on 100 cases presented with BAT having equivocal abdominal findings during one year i.e. September 2007 to September 2008. It was a prospective comparative study. Main age group involved in accidents and BAT was between 40 to 60 years. Male to female ration was 5:1. Liver was main organ injured in most cases. It was observed that DPL was 100% sensitive and 91.3% specific while USG of abdomen was 88.9% sensitive and 100% specific. DPL is more sensitive while abdominal USG is more specific. Both are complementary to each other. By using these diagnostic modalities we can reduce both morbidity and mortality and also hospital stay

Management of intestinal stoma

To detect the various complications in all types of intestinal stomas and various operative and non-operative strategies applied in the management of these complications. All four units of Surgical Department including Accident and Emergency department, Nishtar Hospital, Multan. Six months. 100 patients. These 100 patients included in the study were admitted through the OPD and emergency department. Data of patients was recorded on a pre-designed proforma, which was later on used for analysis. Various types of complications were noted. The commonest age group for ileostomies and caecostomies was 13-20 years and for colostomies was 21-30 years. There were 10 female and 40 male patients in total. Labourers were the commonest to have a stoma. This was also true for ileostomies and colostomies; whereas students were the most common to have caecostomies. Nine cases of ileostomy, 6 cases of caecostomy and 35 cases of colostomy were studied. About 10 [20%] colostomies were made in transverse colon, 5 [10%] in descending colon and 20 [40%] in sigmoid colon. Eight [16%] colostomies were the only permanent stomas in this study. There were 3 [60%] tube caecostomies and 2 [40%] formal caecostomies. There were 6 [66.7%] loop ileostomies and 3 [33.3%] end ileostomies. The implementation of proper surgical techniques reduces the chances of local stoma complications

Open and mini cholecystectomy [comparative study]

Cholelithiasis is the most common biliary pathology. Patients complain of recurrent attacks of epigastric or right hypochondrial pain, often radiating to the right side of back, associated with nausea and vomiting. To compare the 2 procedures i.e. conventional and mini cholecystectomy regarding postoperative pain, hospital stay and cosmetics. The study was carried out in Nishtar Hospital, Multan from May 2006 to June 2007. A total of 60 cases [30 cases underwent conventional cholecystectomy and other 30 cases underwent mini cholecystectomy]. Out of 60 patients, 18 [30%] were of < 40 years, 18 [30%] between 41-50 years and remaining 24 [40%] were of > 50 years. 48 [80%] patients were female while 12 [20%] were male. Among 30 patients of conventional cholecystectomy average hospital stay was 6.5 days while among 30 patients of mini-cholecystectomy average hospital stay was 3.3 days. Among 30 patients of conventional cholecystectomy severe postoperative pain was found in 18 [60%], moderate postoperative pain in 9 [30%] while mild postoperative pain in 3 [10%] of patients. In remaining 30 patients of mini-cholecystectomy severe postoperative pain was found in 12 [40%], moderate postoperative pain in 6 [20%] while mild postoperative pain in 12 [40%] of patients. Among 30 patients undergoing conventional cholecystectomy, all the patients developed bad looking scar while in remaining 30 patients undergoing mini-cholecystectomy, all patients developed good looking scar. Mini-cholecystectomy is associated with less patients discomfort and decreased incidence of postoperative complications, short hospital stay, good cosmetic results. Mini-cholecystectomy also has the advantage that it neither requires expensive new equipment nor the acquisition of novel skills by the surgeon