Gastric MALT lymphoma: a rarity

Association of Helicobacter pylori [H.Pylori] infection with gastric 'Mucosa Associated Lymphoid Tissue' [MALT] lymphomas [MALTomas] is well established. In this study the frequency and characteristics of gastric MALToma over a period of 18 years was evaluated. During this period 24 patients with gastric MALToma were diagnosed; out of them, 13 [54.2%] had active H.Pylori infection. The mean and median age was 49.7 and 53.5 years. The male: female ratio was 17:7. The common presenting complaints were epigastric pain [n=10] and dyspepsia [n=9]. Endoscopic findings revealed mild gastric hyperemia [n=16], superficial erosions [n=4] and superficial ulcers [n=4]. It was concluded that the prevalence of gastric MALToma was very low in contrast to a high H. pylori gastritis in the Pakistani population

Immunoproliferative small intestinal disease [IPSID]

This study describes the frequency, demographics, clinical presentation, endoscopic findings, histopathological features, treatment and outcome of 'Immunoproliferative small intestinal disease' [IPSID]. Archives contained a total of 27 cases of IPSID diagnosed and treated over an 18-year period. A M: F ratio of 2.4:1 was seen with a mean and median ages of 28.7 and 25 years. Most patients [68.8%] presented with abdominal pain and diarrhoea. In the majority [62.5%], duodenum was the primary site of involvement. Endoscopy showed polypoidal, raised or flat lesions. Biopsy findings included blunting or flattening of villi with dense plasma cell infiltrate and lymphoepithelial lesions. Twenty-four cases were categorized as stage A and B [benign and intermediate] and three were categorized as stage C [malignant, diffuse large B-cell lymphoma with plasmacytoid features]. Stage A and B patients responded well to antibiotic treatment [tetracycline] with regression of the lesions while for stage C patients standard CHOP chemotherapy was administered

Laproscopic versus open appendectomy: a comparative study

To compare the results of open with laparoscopic appendectomy in terms of postoperative pain, rate of wound infection and hospital stay. This quasi-experimental study was conducted in Deprtment of Surgery, Ziauddin University Hospital, Karachi, over a period of six months. Patients undergoing surgery for acute appendicitis were randomly assigned into one of the two groups [A or B] after obtaining written and informed consent. In Group-A patients underwent open appendectomy and in Group B laparoscopic appendectomy was performed. Post operatively pain chart and wound infection was recorded and, at the time of discharge, number of days in hospital was calculated. Sixty patients [38 male, 22 female], with clinical diagnosis of acute appendicitis based on Alvarado score of six and above, were included in the study. They were randomized into 2 groups of A and B with 30 patients in each group. Group-A comprised open appendectomy procedure and Group-B comprised laparoscopic appendectomy. Mean comparison of postoperative pain by visual analogue scale, was significantly low in Group B, compared with Group A, on day 0, 1 and 2. Number of days in Hospital was 4.1 +/- 0.8 days in Group A and 1.5 +/- 0.06 days in Group B. None of the patients in Group B, while 8 [26.67%] patients in-Group A, developed postoperative wound infection at 1 week follow up. Laparoscopic appendectomy is safe and effective. Wound infection and postoperative pain is significantly lower after this mode of surgery