Frequency of common bacteria and their antibiotic sensitivity in patients with symptomatic cholelithiasis

To determine the frequency of common bacteria and their antibiotic sensitivity in patients with symptomatic cholelithiasis This cross sectional descriptive study was conducted at Department of Surgery, Lady reading hospital, Peshawar for 6 months i.e., from December 2012 to May 2013. The total number of patients were 126. They presented with symptomatic cholelithiasis. Bile was aspirated preoperatively before cholecystectomy from gall bladder and was sent for culture and sensitivity test. The data was analyzed using Statistical Package for Social Sciences[SPSS] version 10.0. On culture and sensitivity test, 74 [58.73%] have positive growth while 52 [41.27%] have no growth. The most common bacteria was E. Coli isolated in 28 [22.22%] patients followed by Klebseilla in 22 [17.46%], Salmonellain 16 [12.70%] and Shigella in 8 [6.35%] patients. On culture and sensitivity test, all the 4 isolated bacteria showed sensitivity to Cefuroxime, Ceftriaxone and Ciprofloxacin in more than 50 % cases, while all the four bacteria showed resistance to amoxicillin in more than 50 % cases. The most common bacteria of symptomatic cholelithiasis are E. coli and Klebseilla followed by Salmonella and Shigella. These bacteria showed maximum sensitive to cefuroxime and ceftriaxone

Modified posterior sagittal ano-rectoplasty: a new approach for the management of ano-rectal malformations in children

To introduce a technical modification in Posterior Sagittal Ano-rectoplasty [PSARP], commonly known as Pena's procedure, and to analyse the outcome of such modified procedure in terms of fecal continence and other relevant complications in children with ano-rectal malformations. It was a prospective and descriptive study, conducted at the department of pediatric surgery, Lady Reading Hospital Peshawar from January 2004 to December 2006. Forty patients were studied. All children of either sex with ano-rectal malformation who presented first to our department were included in our study excluding others treated some where else. Relevant investigations were performed in all patients. Diverting colonic or small bowel stoma was created in all patients at presentation to our department. The technique was performed at or after six months of age, depending upon the clinical condition of the patient. After discharge, all patients were examined and monitored in the out-patient department over a period of two years. Out of 40 patients 25[62.5%] were male and 15 [37.5%] were female age range from 6-12 months. On 35 [87.5%]. Isolated PSARP while on 5 [12.5%] patients modified PSARP with abdominal approach were performed. Anal stenosis was found in 3[7.50%] patients, rectal mucosal prolapse in 4[10%], faecal soiling and faecal incontinence in 17[43.58%] and 7[17.05%] patients were respectively. Faecal continence was good, fair and poor in 15[38.46%], 17[43.58%] and 7[17.94%] patients respectively. Our results of the present series suggest that this procedure is a valuable alternative to PSARP for the treatment of anorectal malformations

Complicated Jejunal diverticula as surgical emergency: experience at a tertiary care hospital in Peshawar, Pakistan

Diverticula of small intestine are rare. Jejunal diverticula can be single or multiple. Diverticula in the jejunum tend to be large and multiple. Clinically they may be asymptomatic or may give rise to symptoms like pain, flatulence and borborygmi, may produce malabsorption syndrome or may present in emergency with different acute pathologies like perforation, haemorrhage, obstruction, enterolith formation and inflammation. The Objective was to see the pattern of complications in jejunal diverticula presenting as a surgical emergency. This descriptive study was conducted at Surgical Units of the 3 tertiary care Hospitals of Peshawar, for 7 years from January 1, 2002 to December 31, 2008. Study included all patients presenting to and admitted in Surgical Unit, Hayatabad Medical Complex, Peshawar with complicated jejuna diverticula during the above mentioned period. Name, age, sex, other relevant data, history and examination findings and results of investigation were recorded. Uncomplicated jejuna diverticula were excluded from study. The operative findings and the type of complication were recorded. Ten patients were admitted during 7 years of study. Out of all patients 9 were male and 1 was female. Eight out of 10 patients presented with perforation of diverticula while 1 patient had severe inflammation of diverticulum causing pain, ileus and acute abdomen. One patient had acute pain due to adhesion formation. It is seen that complicated jejunal diverticulae are quite rare and the most common complication is perforation. Inflammation and adhesion are other complications with which jejunal diverticula presented during this study