Pattern of gallbladder diseases in Pakistan: an audit of 163 consecutive patients operated at a teaching hospital

To find out the presentation and histological diagnosis of patients with gallstones. A retrospective review of 163 consecutive patients who underwent cholecystectomy in a teaching hospital between 01-01-93 to 31-12-96. Baqai University Hospital, Nazimabad, Karachi. One hundred sixty three patients who underwent cholecystectomy. Histopathological reports of gallbladder. One hundred sixty three patients were operated between 1993 to 1996 at a teaching hospital of Karachi. 96 patients were started as laparoscopic cholecystectomy. Of these, 12 were converted to open procedure. Rest were planned and done as open cholecystectomy. 11 patients had exploration of common bile ducts. The histological reports of all these patients were assessed. The commonest finding was chronic cholecystitis. We however, found that 9 female and 1 male patients had carcinoma of gallbladder. Our management of gallstone disease stems from conclusions based on figures from the West. This study shows that the risk of gallbladder carcinoma may be higher in this part of the world. We have seen that out of 163.patients, 10 patients had carcinoma of gallbladder [over 6%]. This is in sharp contrast to the West where the rate of incidental carcinoma is only 1-2% of routine cholecystectomy. It is about time that a large, multicentral, prospective study is designed in line of that done by Ranshoff et al. to find if the natural history of gallstones is any different in our country

Changes in pattern of bacteraemia at shaikh zayed medical complex Lahore

A retrospective study was conducted on 4101 blood cultures obtained from indoor patients from January 1996 to November 1996 at Shaikh Zayed Medical Complex, Lahore to compare the incidence of bacteraemia and report change in sensitivity pattern of micro-organisms to different antibiotics to that of a study conducted here earlier in 1993-1994. 637 samples were found to be positive and an overall incidence of 26.65 per 1000 admissions were obtained to that of 24.6 per 1000 reported earlier. Surgery department reported the highest percentage of positive cases, 48.82% of the total. The month of July and associated summer months showed a high percentage of positive sample. Staphylococcus species reported highest incidence while Pseudomonas species was close behind [26 and 24% of the total respectively]. Cefotaxime was 72% sensitive and Ceftriaxone was 61% sensitive overall while 97% sensitive for Salmonella species. Chlorampenicol showed resistance to about half the organisms exposed to while Ciprofloxacin was 93.55% sensitive. Ceftazidime was 77.78% sensitive