Incidence of gall bladder malignancy in patients with cholelithiasis

A prospective study was carried out in the Department of Surgery, Chandka Teaching Hospital Larkana from January 1997 to December 1998. One hundred cases of cholelithiasis were reviewed for malignancy [80 females and 20 males]. Out of these 10 percent patients were found to have carcinoma of the gall bladder. Their ages ranged from 41 to 69 years, with mean age of 52.2 years. Carcinoma of the gall bladder was found to be more common in the 5th decade of life. Common presenting symptoms were upper abdominal pain [100 percent] nausea and vomiting [80 percent], weight loss [50 percent], jaundice [40 percent] and anorexia [20 percent] Abdominal mass was palpable in two patients. Preoperative diagnosis with the help of ultrasound was possible only in three cases. Histopathologically, all the cases were adenocarcinomas. In majority of the cases, stones were mixed with cholesterol as a predominant component

Antibiotic prophylaxis in surgery

During a period of one year i.e from March 1997 to February 1998, 182 patients undergoing clean surgical procedures were studied in Surgical unit II and IV of Civil Hospital, Karachi. Patients were divided randomly into Group A which received prophylactic antibiotics and Group B which received none. Group A patients received one gram of cephradine and 80 mg of gentamicin intravenously at the time of induction of anaesthesia and two more doses at 8 hours interval. Postoperative wound infection rate in Group A was 2.2% and in Group B-7.6%. In majority of cases wound infection became obvious on 8th postoperative day. Culture and sensitivity of pus from infected wounds revealed Staphylococcus in 61%, E. coli in 19%, Pseudomonas in 12%, and Klebsiella, Streptococcus and Proteus in 8% each. In 2.2% cases of Group A, which developed infection, the causative organisms were hospital acquired strains of Staphylococcus and Pseudomonas resistant to cephradine and gentamicin. The incidence of postoperative drain site infection, respiratory tract infection and urinary tract infection was also less in Group A