Intestinal tuberculosis-5 years experience in tertiary care hospital

Abdominal tuberculosis [TB] is a common disease in developing countries and reemerging in the west. This disease is still diagnostic dilemma for physicians and surgeons, as it mimics many abdominal diseases. To evaluate the clinical presentation and management of abdominal tuberculosis in our set up. Prospective study. This study was conducted in surgical unit III, Peoples University of Medical and Health Sciences Hospital Nawabshah, from July 2006 to June 2011. Total 70 patients were included in this study from 205 suspected cases. The cases were either previously diagnosed or diagnosed during operation performed for intestinal obstruction, peritonitis or appendicitis. Patients were confirmed on the basis of histopathology, cultures and AFB. Age of the patients ranged between 6 to 38 years. Male to female ratio was 1.3:1. Abdominal pain and weight loss were the most common symptoms. Common presentation was intestinal obstruction and peritonitis. Majority of patients underwent resection and anastomosis and limited right hemicolectomy. It has been emerged from our study that abdominal TB presents with different clinical features which are nonspecific and often diagnosed during laparotomy. Majority of patients underwent resection and anastomosis and limited right hemicolectomy

Lactoferrin levels in mother's milk

This study was aimed to see the significance of Lactoferrin in human breast milk among lactating mothers of healthy and sick babies. This study was conducted at pathology and paediatrics departments of Peoples University of Medical and Health Sciences Nawabshan, Shaheed Benazirabad between Jan 2011 to Dec 2011. Cross sectional study. Lactoferin levels in breast milk of 356 mothers of healthy babies were estimated and similarly lactoferrin levels in breast milk of 318 lactating mothers of sick babies were estimated and these results were analyzed. The mean lectoferrin level in breast milk of 356 lactating mothers of healthy babies was 9.37 mg/ml and the mean lactoferrin level in breast milk of 318 mothers nursing sick babies was 3.73 mg/ml. There is decrease in lactoferrin levels of lactating mothers of sick babies in their mature milk, which could account for the susceptibility of their babies to infection

Primary closure of perforated peptic duodenal ulcer

To find out the morbidity and mortality of primary Closure of perforated peptic duodenal ulcer with an omental patch. An observational descriptive study, from February 2003 to January 2006. This study is Carried out in Surgical units of People's Medical College Hospital Nawabshah on 92 patients of perforated duodenal ulcer were included in this study with male to female ratio 8:1. The age varies between 26-45 year with peak age incidence 35 years. The perforation closed primarily with vicry1-0 and supported with omental patch. Peritoneal lavage performed and drain kept in all cases. All patients were investigated for H. pylori and treated with eradication therapy in infected cases. Follow up carried out with upper G.I. Endoscopy at 6 weeks, and then six monthly for two years. Out of 92 cases, only 5 cases had recurrence within two years and wound infection remained the major post operative complication seen in 20% and chest infection in 15% of cases. No mortality seen in this study. Omental patch repair as primary closure of perforated peptic duodenal ulcer is effective surgical treatment with excellent results. The eradication therapy for H. pylori is adequate and comparable with definitive surgical treatment for peptic ulcer

Increased risk of carcinoma gall bladder in longstanding cases of cholelithiasis

To find out the incidence of carcinoma of gall bladder in longstanding cases of Cholelithiasis with history of more than 5 years. A prospective observational clinico-pathological study. Departments of surgery, Nawabshah Medical College Nawabshah. From March 2000 to Feb: 2005. Total 180 cases were included in the study among all the 520 cholecystectomies performed during this period, which were symptomatic proven cholelithiasis cases for past 5 years or more. Most patients were from rural area with urban rural ratio 30:70. All the specimens of removed gall bladder were examined histologically. Female to male ratio was 4:1 and age incidence was 5 1-72 years. Out of 180 cases included in the study 12 [6.6%] patients were of carcinoma of gall bladder with female to male ratio 3:1 and peak age incidence was 65 years. The longer duration of disease with gall stones increases the risk of carcinoma in gall bladder. The patient diagnosed cholelithiasis should be counseled for early operation and all the specimens of removed gall bladder should be examined histopathologacally

Primary closure of perforated peptic duodenal ulcer

To find out the morbidity and mortality of primary closure of perforated peptic duodenal ulcer with an omental patch. An observational descriptive study, from February 2003 to January 2006. This study is carried out in Surgical units of People's Medical College Hospital Nawabshah on 92 patients of perforated duodenal ulcer were included in this study with male to female ratio 8:1. The age varies between 26-45 year with peak age incidence 35 years. The perforation closed primarily with vicryl-0 and supported with omental patch. Peritoneal lavage performed and drain kept in all cases. All patients were investigated for H. pylon and treated with eradication therapy in infected cases. Follow up carried out with upper G.I. Endoscopy at 6 weeks, and then six monthly for two years. Out of 92 cases, only 5 cases had recurrence within two years and wound infection remained the major post operative complication seen in 20% and chest infection in 15% of cases. No mortality seen in this study. Omental patch repair as primary closure of perforated peptic duodenal ulcer is effective surgical treatment with excellent results. The eradication therapy for H. pylon is adequate and comparable with definitive surgical treatment for peptic ulcer

Outcome analysis of transvesical prostatectomy in our setting

To evaluate the outcome of suprapubic transvesical prostatectomy in our setting. Prospective and descriptive audit from July 2002 to July 2005. Department of Surgery, Peoples Medical College Hospital, Nawabshah. A total of 120 patients with lower urinary tract obstruction due to benign prostatic hyperplasia [BPH]. The details of all the above mentioned patients were recorded and the data analyzed for age, presentation, accompanying problems, blood transfusion, hospital stay, complications and mortality. The age range of the patients was from 50-90 years, mean age being 64.73 years. The indications for surgery were retention of urine in 64 [53.33%] cases, prostatism in 53 [44.17%] and haematuria in three [2.5%] cases. Associated problems were seen in 73 [60.83%] patients, including bladder stones in 19 [15.83%], inguinal hernia in 15 [12 .5%], haemorrhoids and renal stones in four [3.33%] each, and medical problems in 30 [25%] patients. The average operation time was 67.5 minutes and 51 patients needed blood transfusion [1-3 units]. Complications were seen in 49 [40.83%] cases including haemorrhage and urinary tract infection in eight [6.67%], clot retention in six [5%], wound sepsis in seven [5.83%], and transient incontinence and suprapubic urinary leakage in five [4.17%] cases each. The post-operative mortality was in 1.67% [two cases]. Transvesical prostatectomy [TVP] performed under spinal anesthesia is a safe and effective way of managing BPH. Its success has a durable effect and is a satisfactory modality in situations where facilities for transurethral resection of prostate [TURP] are not available