Comparative study for conventional and laparoscopic cholecystectomy

Cholecystectomy, the surgical removal of gallbladder, is one of the most frequently performed operations as a common therapy for gall bladder disorders. This study was conducted to compare the conventional and laparoscopic method of cholecystectomy at the Surgical Department of Al-Gamhouria Teaching Hospital during the period from January 1 st to December 31 st, 2007. This is a comparative hospital-based study conducted for a period of one year, from January 1st, 2007 to December 31st, 2007. The study population included all adult patients operated for cholecystectomy at the study area and during the study period. The variables used were sex, age, clinical risk factors, operation time, complications and hospital stay. Quantitative data were tested by the student t-test for two means, while qualitative data were tested by the Chi-square test, the Fisher exact test and the Z-test. Statistical tesfs were applied with 95% confidence limits and p-value of <0.05 were considered statistically significant. Cholecystectomy was performed for 146 patients [72 by CC and 74 by LC], the females to males ratio was [6.3:1] and the common age operated was the fifth decade [40-49 years] 56.8%. The mean operation time was 149 min for CC vs. 48 min for LC, Morbidity, during and after CC, was higher than that of LC [38.9% vs. 9.5%, p=0,00003]. Mortality was reported for one patient operated by CC, but none for LC. The mean postoperative hospital stay was 9.7 days for CC vs. 2.4 days for LC. LC is a safe surgical technique, with shorter postoperative hospital stay and better perioperative morbidity and mortality. Complete Laparoscopic operation units should be available for training, and therapeutic pruposis should be available in this teaching hospital

Diabetic foot: clinical presentation and management in Al-Gamhuoria Teaching Hospital

The aim of this study is to determine the mode of presentation, medical and surgical treatment. and prevention of diabetic foot. This is a prospective descriptive study performed in the period from June 2004-December 2005. Eighty-three patients with diabetic foot lesion were presented to Al-Gamhorea Teaching Hospital. Data of these patient were collected for sex, age, duration of diabetes, blood sugar control, mode of presentation, presence of peripheral neuropathy, peripheral vascular disease, concurrent medical illness [ischemic heart disease and chronic renal failure], microbial flora, treatment by antibiotics, surgical treatment and duration of healing. Majority of patients were male above 50 years 68.7%, mean age 58.3 +/- 12 and female 3 1.3%. Most of them were type 2 on oral hypoglycemic drugs [89.16%]. Blood sugar was uncontrolled in 77.1% of them. History of trauma preceding diabetic foot infection was present in 74.7%. Foot ulcer was the most common presentation in 47% of patients. There was a significant association between the peripheral neuropathy and the following risk factors: duration of diabetes more than ten years 100% [p = 0.0000], poor glycemic control 95.3% p.000] and trauma 83.9% [p = 0.0000]. There was also a significant relationship between the major limb amputation and some predictive variables: previous foot ulcer 35.3% [p=0.0000]. poor glycemic control 17.2% [p = 0.04], peripheral neuropathy 17.7% [p = 0.03], peripheral vascular disease 75% [p = 0.000], and heart disease 33.3% [p = 0.01]. Debridement done for 9.4% and toe/s amputation for 30.2%, however 11 patients [13,3%] had major amputation. Staphylococcus aureus was the most common organism isolated in 34.9%. Duration of healing was 9-16 weeks for most of the patients 63.4%. Diabetic foot infection is a common health problem in Al-Gamhorea Teaching Hospital, particularly among men. Poor glycemic control, as well as peripheral neuropathy and peripheral vascular disease are the most precipitating factors. which can be prevented. Control of blood sugar, good debridement, and proper dressing can lead to early and complete healing in most of diabetic foot lesions