A Retrospective Analysis on the Cystic Echinococcosis Cases Occured in Northeastern Punjab Province, Pakistan

A retrospective study was performed to report the case occurrence of cystic echinococcosis (CE) in three hospitals of north-eastern region in Punjab Province, Pakistan. We reviewed retrospectively the clinical records of patients in 4 hospitals which were diagnosed with CE during 2012–2017. A total of 198 cases, 82 (41.4%) male and 116 (58.6%) females were detected as CE. The most Highest incidence was revealed in.... 21–30 years-old group (24.2%) followed by 41–50 (22.7%), 31–40 (16.2%), 11–20 (13.6%), 51–60 (8.1%), below 10 (5.5%), over 71 (5.1%) and 61–70 year-old group (4.5%). CE was detected in various organs of infected individuals. However, most of CE cases were detected in the liver (47.4%) and lung (18.6%). The present study indicated that CE is more or less prevalent in surveyed areas and one of the most important public health problems in Punjab Province, Pakistan.

Audit of pediatric surgical emergency: need for self evaluation

Background: The clinical or surgical audit is a systematic process in which the standard of clinical care being provided to the patients is sought through review of clinical records against specific criteria. The clinical or surgical audit is a mandatory element of the professional competence in many countries

Objective: To evaluate the yearly performance and to establish the pattern and frequency of various Pediatric Surgical emergencies encountered

Methodology: This was an observational, descriptive study covering the year 2016 with retrospective data collection was carried out in the Department of Pediatric Surgery Emergency Mayo Hospital/King Edward Medical University, Lahore

Results: A total of 3880 patients including 2350[60.6%] males and 1530[39.4%] females were admitted during the study period. The highest number of admissions were Burn Patients with the percentage of 37.8%, followed by trauma cases 23.9%, and acute appendicitis 18.6%. There had been 86 deaths which gave rise to 2.2% Mortality

Conclusion: Burn injuries and trauma are common injuries in pediatric surgery ward. It is suggested that audit must be conducted routinely and should be officially declared as a compulsory action to provide vision and feedback to the working of surgeons

Methods of circumcision practiced in central Pakistan and their complications

Background: circumcision is the most common surgical intervention performed in non-medical settings. It is the most common but neglected procedure in our country. Barbers, quacks and other non-qualified persons perform circumcision by their own methods without proper sterilization and without knowing the consequences

Objectives: the objectives of our study were to determine different methods of circumcision and outcome of these methods in central Pakistan

Patients and Methods: this was an observational study conducted by the Department of Pediatric Surgery, Sheikh Zayed Hospital, Rahim Yar Khan. A total of 600 cases were included in this study and information was recorded on a pre-designed Performa. Attendants/parents having the best knowledge regarding circumcision of the child were interviewed. Related clinics were contacted to determine the methods of circumcision and sterilization techniques, where found necessary

Results: out of 600 cases 157 [26.17%] were circumcised in the 1st month of life [mean age: 10+/-3.5 days], 92 [15.33%] in first year [mean age: 7+/-2.4 months] and 351[58.5%] between one to twelve years of age [mean age: 6+/-2.33 years]. Regarding the personal who performed circumcision 110 [18.33%] cases were circumcised by the barbers, 139 [23.17%] by quacks, 210 [35%] by General Practitioners [GP] and 141 [23.5%] by surgeons [General and Pediatric Surgeons]. Regarding the methods of circumcision, bone cutter method was the commonest, 307 [51.17%], whereas, only 60 [10%] cases were circumcised by plastibell technique. Complications were more with barber method and less with plastibell technique. Under circumcision [too less prepuce is removed] is the commonest complication with barber method. Out of 110, the 11 children [10%] were under circumcised. In bone cutter method, out of 307 cases, 15 [4.87%] were under circumcised. No case was under circumcised with plastibell or open method. With barber method 06 cases [5.45%] got infected. They consulted doctors and were cured with antibiotics. Three [0.977%] cases were infected with bone cutter method. Bleeding occurred in 10 patients after bone cutter method and stitching was done. There was no bleeding with plastibell or open method

Conclusion: our study showed that a big proportion [41%] of male children are still getting circumcised by unskilled [quacks and barbars] operators and commonest method of circumcision was bone cutter method. There is a dire need to educate the people regarding age, methods of circumcision and their possible complications

FNAC of thyroid nodule; diagnostic accuracy of fine needle aspiration cytology [FNAC]

Clinically, solitary thyroid nodules are common, being present in up to 50% of the elderly population. The majority are benign with thyroid cancer representing an uncommon clinical problem. If euthyroid, then fine needle biopsy provides direct specific information about the cytology of the nodule from which the histology can be inferred. To determine the accuracy of fine needle aspiration cytology [FNAC] in the diagnosis of solitary thyroid nodule and to avoid unnecessary surgery. This study was conducted in the Department of Surgery, Sheikh Zayed Medical College/ hospital Rahim Yar Khan. September 2008 to August 2009 [one year]. Fifty patients were included in the study. Prospective analytical study. The results obtained were compared with histopathology and efficacy of FNAC was checked by calculating sensitivity, specificity, positive predictive value and negative predictive value. Out of 50 cases, FNAC showed 43 cases as benign and 7 cases as malignant lesions, while histopathological examination revealed 42 benign and 8 malignant lesions. FNAC was able to correctly pick 41 benign lesions, while 2 cases of benign lesion turned out to be malignant on histopathology [False negative].Out of total 8 cases which turned out to be malignant on histopathology, FNAC was able to pick 6 cases, while one benign lesion was misdiagnosed as malignant [false positive]. The analysis of study showed a sensitivity of 75% and specificity 97.6% of FNAC in detecting malignancy in solitary thyroid nodule. This study concluded that FNAC is highly effective in detecting thyroid malignancy in solitary thyroid nodule with a sensitivity of 75% and specificity of 97.6%