ABSTRACT
Objective: To determine the seasonal variation of acute appendicitis
Methods: A total of 320 patients fulfilling the inclusion criteria were enrolled in the study after getting the written informed consent. Appendectomies were performed by consultant surgeons and residents. After surgery histopathological examination of specimens was performed by consultant Histopathologists at Armed Forces Institute of Pathology Rawalpindi and CMH Peshawar. The patients presenting in different four seasons September to November as autumn, December to February as winter, March to May as spring, June to August as summer, were compared to determine seasonal variations
Results: In our study out of all 320 patients 188 [58.75%] were males and 132 [41.25%] were females. Sixty patients [18.75%] presented in autumn season [Sep-Nov], 52 patients [16.25%] in winter season [Dec-Feb], 78 [24.25%] patients in Spring season [Mar-May].130 [40.62%] patients presented in Summer season [Jun-Aug]. There was almost 24.37% increased incidence in summer as compared to winter season, 21.87% increased incidence as compared to autumn season, 16.37% increased incidence as compared to spring season
Conclusion: Acute appendicitis incidence is increased in summer months in Pakistan. Preventive measures can be taken during summer season [June to Aug] to decrease morbidity and mortality associated with this disease
ABSTRACT
Objective: To compare Early Oral Refeeding [EORF] with Routine Oral Refeeding [RORF] on outcome of patients of mild Acute Pancreatitis [AP] in terms of Mean Length of Hospital Stay [LOHS]
Methods: This randomized controlled trial was conducted at Surgical Department CMH Rawalpindi, from 1[st] Feb 2015 to 01st Aug 2016. A total of 60 patients with pain epigastrium were enrolled in the study. Severity of pancreatitis was assessed using Glasgow Scale. Patients were randomly divided in two groups. Group-A was started feeding within 12 hours [EORF group] and Group-B after 12 hours [RORF group]. Demographic details and data were recorded on a structured proforma. After discharge, LOHS was measured for both groups and outcome was compared
Results: The groups were comparable with respect to age, sex, etiology, Glasgow Scale, time from onset of pain and Serum Amylase levels at admission. Treatment was standardized according to international guidelines for both groups. The mean LOHS was 7.8 +/- 2.14 days in the Group-A and 10.03 +/- 1.75 days in Group-B. The difference in the mean LOHS between the two groups was statistically significant [p<0.05]
Conclusion: In patients of mild acute pancreatitis, early oral feeding is feasible and safe and has better outcome then those with routine oral refeeding