efficacy of normal saline irrigation to prevent surgical site infection

The aim of the study was to evaluate the efficacy of normal saline irrigations to prevent surgical site infection [SSI]. A comparative study. The study was conducted at surgery and gynecology Dept CMH Chunian from 1[st] Jan 2012 to 1[st] Nov 2012. Two hundred clean surgical and gynecological cases were included in the study. Hundred cases which were randomly selected had their wound washed with warm normal saline for 60 sec and then mopped dry with clean swabs. Subcuticular Stitches were applied to all the 200 cases. The surgical wounds were examined on 3[rd] post operative day and then finally on 15[th] post operative day. Patients with wound infection developed pain at the operation site and fever on third post operative day. Wounds were examined for swelling, redness, discharge and stitch abscess. Routine investigations were done as per protocol. Wound swabs were taken for culture and sensitivity. The study was carried out on 200 clean cases [general and gynecological]. They were 130 females and 70 males. The 100 cases whose wounds were washed with normal saline only 1 patient developed wound infection while in the other group who did not had saline irrigations 8 patients out of 100 developed wound infection. The commonest infective organisms were staphylococcus aureus and the other organisms were streptococcus pyogenes, proteus, Klaebsiella, E coli and pseudomonas. No MRSA was detected. In our study washing the wound with warm normal saline for 60 seconds resulted in the wound being infection free. Wound infection is associated with delayed wound healing, prolonged hospital stay and increased economic pressure on the patient and on the state

Combat trauma experience at forward treatment centre during Swat operation

To have an overview of combat trauma experience at Forward Treatment Centre during Swat Operation. Descriptive study. Forward Treatment Centre of a medical battalion in Swat from Jan 2009 to August 2009. All battle casualties of different age groups operated under general anaesthesia were included in the study. Surgeries performed under local anaesthesia were excluded. Relevant information was recorded in specially prepared proforma. Two hundred and sixty eight surgeries were performed under general anaesthesia over the course of eight months. Twenty two [8.2%] were officers, 12 [4.5%] JCOs and 234 [87.3%] were soldiers. Majority of the casualities were between 20 -30 years of age [86%]. 73.9% of the casualities reached Forward Treatment Centre within 4 hours while 3.3% reached after 24 hrs. Most of the patients sustained injuries due to bullets [50.7%] and splinters [39.9%]. Most of the patients were putting on bullet proof jackets at the time of injury and sustained injuries to the limbs [237/268, 88.4%]. Blood transfusion was carried out in 32 [11.9%] cases. Fifteen [5.6%] cases required less than two and 17 [6.3%] cases required more than two units of blood transfusion. Most of the casualities were sustained by younger age group and were caused by bullets and splinters. Majority of the injuries were sustained on the limbs and less on the chest and abdomen. Blood transfusion and timely evacuation to a Forward Treatment Centre providing effective trauma surgical care to combat casualities saved a number of lives

Follicular carcinoma thyroid in pendred syndrome

Pendred syndrome is a rare inherited disorder of bilateral sensorineural deafness with goitre. Presence of follicular carcinoma thyroid makes it even rarer. A case of a young girl is described with the features of Pendred syndrome and euthyroid state. Follicular carcinoma of thyroid was detected on histopathology requiring re-tailoring of the management