ABSTRACT
To assess the efficacy and benefits of splenectomy in Thalassaemic patients with hypersplenism. Prospective study from June 2003 to April 2006. Setting: Patients registered and referred from the Thalassaemia Control Centre of Husaini Blood Bank, underwent splenectomy at Hashmani?s Hospital and Hamdard University Hospital, Karachi. 23 patients of thalassaemia with hypersplenism underwent splenectomy, but only 20 were included as three could not be followed-up. Patients of thalassaemia are registered and treated at the Thalassaemia Control Centre of the Hussaini Blood Bank.Complete data of the patients is kept at the centre. Those with hypersplenism are referred for splenectomy. These cases were followed-up regularly and development of any complications noted. Out of the 20 patients, 13 were males and seven were females, with a mean age of 13.9 years [range 9-19 years]. Nineteen suffered from thalassaemia major and one from thalassaemia intermedia. Two [10%] cases deve-loped haematomas at the incision site while one [5%] had to be re-explored for venous bleeding on the fourth day. None of the post-splenectomized patients developed any serious infection in the follow-up ranging from four months to three years. There is a significant reduction in the number of transfusions required post-operatively. One patient died in the first 24 hours due to non-surgical causes resulting in a mortality rate of 5%. Splenectomy can be carried out relatively safely in patients suffering from thalassaemia with proper pre-operative cardiac and anaesthetic assessment. After splenectomy there was a significant reduction in the number of transfusions required. Those thalassaemic patients who are suffering from hypersplenism can avail the benefits of splenectomy without undue risk
ABSTRACT
To compare the results of Transhiatal and Ivor-Lewis operations for the treatment of Carcinoma Oesophagus. Comparative study conductedfrom 1[st] April 1999 to 30[th] March 2001. Ward 2, Jinnah Postgraduate Medical Centre, Karachi. Thirty patients with resectable carcinoma in the middle and the lower third o[the oesophaglls. The patients were randomly assigned to the two groups. Group-A patients [15] underwent Transhiata/oesophagectomy while Group-B patients [15] were operated by the Ivor-Lewis approach. The data of these patients was collected and analyzed. Student 't' test was applied for statistical significance. Among the thirty cases, 60% were male and 40% female. The average age of the patients was 55 +/- 11.29 years in Group-A and 50.53 +/- 13.83 years in Group-B. In 50% of the patients, the tumour was present in the lower 1/3 of the Oesophagus, in 46.66% in the middle 1/3 and in 3.33% patients both in the middle and the lower 1/3. Histopathology revealed that in 63.33% cases the tumour was squamous cell carcinoma, while in 36.66% it was adenocarcinoma. The mean operative time for Transhiatal Oesophagectomy was 3.75 hours, whereas it was 5.25 hours for the Ivor-Lewis procedure. There was no statistically significant difference in the result of both the procedures. We conclude that Transhiatal and Ivor-Lewis Oesophagectomies are comparable operations for resectable carcinomas of the Oesophagus
ABSTRACT
Variety of procedures adopted for the management of pilonidal sinus attest to the fact that the choice depends on the surgeon. The advantages of successful outcome in primary closure are obvious. This procedure is carried out under general anaesthesia, the hospital stay is minimal and postoperative care restricted to the basics. The problem with procedures carried out as day cases under local anaesthesia is the long and tedious follow-up required postoperatively till the wound heals. Of the 52 cases dealt by primary suture only one [1.92 percent] had recurrence and 2 of the initial 7 in whom suction drain was not kept required change of dressing because of soakage, prior to removal of stitches