Comparison of rubber B and ligation versus injection sclerotherapy in second degree haemorrhoids

The objective of this study was to compare the efficacy of rubber band ligation versus injection scierotherapy in second degree haemorrhoids. This randomized control study has been conducted at Surgical O.P.D Nishtar Hospital Multan from 3rd April 2008 to 3[rd] October 2008. The study included 70 patients divided randomly in two equal groups. Patients in group A were subjected to injection sclerotherapy while patients in group B were treated with rubber band ligation. The patients were followed up at two weeks after the treatment and history regarding bleeding and pain was taken and proctoscopy was done to see pile core sclerosis. No patient was below 20 years of age in each category. Males were affected more than females. Only 31.43% of patients complained of mild pain after RBL while 60% of the patients had no pain at all. 91.43% and 88.57% of patients were free from the cardinal symptoms of bleeding and prolapse respectively, after RBL, at the end of 2 weeks of follow up 62.86% and 65.71% of patients were free from the cardinal symptoms of bleeding and prolapse while 34.29% of patients complained of mild pain after injection scierotherapy at 2 weeks. Rubber band ligation showed better results and good efficacy as compared to injection scierotherapy and should be considered as a procedure of choice for outpatient treatment of second degree haemorrhoids

Criteria for Early Laparotomy in abdominal stab wound

Patients with an abdominal stab wound presenting with shock, peritonitis or eviscerarion are usually subjected to early laparotomy, although very few studies have been done to validate the criteria. To validate that early laparotomy for stab wounds is compulsory or other diagnostic methods may be helpful to prevent unnecessary laparotomy in certain cases. The study was carried out in surgical unit-1, Nishtar Hospital, Multan during the period from January 2003 to June 2008. A total of 110 patients with stab wounds of the anterior abdomen, flank or lower chest were evaluated for their accuracy in predicting the presence of significant abdominal organ injury. Overall, 47 patients had a significant abdominal injury [42.7%]. The signs of peritoneal penetration including omental evisceration, air under the diaphragm or free fluid in the abdomen were not the independent predictors of significant injury. Signs of major internal haemorrhage or generalized peritonitis are reliable criteria by themselves for early laparotomy. Peritoneal penetration is a poor indicator of significant organ injury and warrants direct organ specific evaluation, such as computed tomography or laproscopy, to identify, patients who can safely be treated without operation