Pattern of microbes associated to acute appendicitis at Liaquat University Hospital

To identify the most common of causative microbes associate to acute appendicitis and choice of different antibiotics according to sensitivity. Observational and Prospective Study. This was carried out in the Department of Surgery, Liaquat University Hospital, Hyderabad from January 2009 to January 2010. In this study patients various cultures obtained at the time of appendectomy was sent under sterile conditions for isolation of organisms and their sensitivity were sent to university hospital. the condition of the appendix regarding catarrhal inflammation, perforation and gangrene were noted on the preformed. Cultures were sent from the appendix wall and peri appendix peritoneal fluid for aerobics and anaerobic cultures. Total number of 100 culture reports of the patients who underwent open appendectomy was enrolled in this study irrespective of sex. The Pipracillin + Amikacin was the most effective [41.8%, n= 55] antibiotic followed by Ceftazidime + Amikacin, the second commonest effective antibiotic in 17 patients [30.9%]. We conclude that the most common isolated organisms of the aerobes were found sensitive against cephalosporins. Pipracillin tazobactum and Quinolones are the most sensitive antimicrobial to most of the pathogens isolated in our study

Efficacy of strictureplasty in tuberculous strictures of small intestine

To assess the efficacy of strictureplasty for tuberculous stricture of small intestine. This is a retrospective descriptive study, conducted at Liaquat University Hospital Jamshoro [LUH] during period of 5 years from July 2004 to June 2009. Sixty patients of small intestinal tuberculosis presented with stricture of small intestine and underwent strictureplasty were the subject of this study. The procedure was done conventionally in all cases, in 70% intestine was closed in two layers while in remaining it was done as single layer. Early complications were seen in 23 cases which included anastomotic leakage with fistula formation [9 cases [15%]], burst abdomen [5 cases [8.34%]] and subdiaphragmatic abscess [9 cases [15%]] The late complications observed after mean follow up of two years include intestinal obstruction that necessitated readmission was seen was in 9 cases [15%], however the re-exploration was required in five cases. Incisional hernia was seen in 9 cases [15%].Though the post operative complications are frequent after strictureplasty yet the procedure is safe and simple for tuberculous stricture of small intestine as it requires minimum expertise, less operative time and above all preserve gut's length

Clinical pattern and management outcome of phyllodes tumor of breast

To determine the clinical and histopathological pattern, surgical protocol and need of adjuvant therapy for phyllodes tumour of breast Case series. Surgical department of Liaquat University Hospital Jamshoro, from November 2000 to October 2006. All female patients with phyllodes tumor of breast diagnosed after triple assessment were included. Non probable purposive sampling technique was used. Female having carcinoma breast were excluded. After taking consent data related to age, parity, site, size of tumor, treatment options, histopathology and metastatics work up done [in case of malignant disease]. Patients were advised follow up for minimum period of two years. Data was collected on proforma and analysed by SPSS version 10. A total of 35 patients with phyllodes tumor were studied. Out of these 23[67.5%] were benign, 5[14.3%] were borderline and 7[20%] were malignant. Mean age was 24 years. All patients were assessed by triple assessment. Nine[25.7%] patients had lumpectomy and 26[74.3%] underwent mastectomy. Patients with proven malignancy and borderline disease on histopathology were submitted for adjuvant chemoradiotherapy. Patients were followed for minimum period f two years. There was one recurrence after lumpectomy among benign disease [16.66%] while there was no recurrence after mastectomy with or without chemoradiotherapy. Phyllodes tumor must be vigorously treated with wide local excision or mastectomy followed by adjuvant chemoradiotherapy in malignant or borderline tumor to minimize recurrence

Persistent mullerian duct syndrome with transverse testicular ectopia

A case report of a 3 months old male child is presented, who had right inguinal hernia with left impalpable testis. During herniotomy we found both testes on right side [transverse testicular ectopia] with presence of mullerian duct structures