Surgical site infection; frequency after open cholecystectomy using Southampton wound scoring system in surgical unit Khyber teaching hospital Peshawar

To assess the post operative wound complication after open cholecystectomy for uncomplicated Cholelithiasis. Cross sectional descriptive. Surgical unit of Khyber Teaching Hospital Peshawar Pakistan. 223 patients underwent elective open cholecystectomy January 2011 to July 2012. 90% patients had normal healing [grade 0 or I] ,7.5% had minor complications [grade II or III], 2.5% patients had major complication [grade IV or V] recorded during hospital stay. On follow-up in out-patient department 81%patients found to have normal healing [grade 0 or I], 15% patients had minor complications [grade II or III] and 4% patients had major complications [grade IV or V]. There was an increase noted in wound grades during follow up for surgical site infections as compared to their record during hospital stay. Southampton wound scoring system is a useful tool for detection of surgical site infection and standardization. Auditing of surgical site infection by Southampton wound scoring will help the patient, surgical team and sterilization protocol to be improved

Inguinal hernia; mesh repair recurrence

To find out the frequency of recurrence in inguinal hernia mesh repair in Surgical Unit, Khalifa Gulnawaz Teaching Hospital Bannu / DHQ, Bannu. 60 consecutive cases of inguinal hernia [direct/ indirect] of either side, in this study were repaired by Lichtenstein's repair. The study was conducted from January, 2010 to October, 2010 with an initial follow up of one year. Cases above 76 yrs were excluded from the study. The procedure of choice for inguinal hernia repair is tension free mesh repair

Diabetic foot infections

The objective of this study is to know the frequency of methicillin resistant Staphylococcus aureus and its antibiotic sensitivity in diabetic foot infections in our setup. Cross sectional descriptive study. Surgical Department, Khyber Teaching Hospital, Peshawar. January 2008 to January 2010. A total of 84 patients, including 64 males and 20 females. Patient's identity, age, gender and the bacterial isolate on culture and sensitivity report were noted on a standardized proforma and analyzed on SPSS version 16.0. Patients of 18 years and both gender with type I and II Diabetes mellitus, diabetic foot ulcers of Wagner Classification System Grade 1 to 5 of 3 weeks duration, with infection and with no evidence of healing were enrolled in the study. The overall mean age of patients was 60.8 years +/- 6.5SD with 9.2 +/- 0.5% HbA1c level. Frequency of methicillin resistant Staphylococcus aureus was 28.57%. Methicillin sensitive Staphylococcal aureus [51.19%], Pseudomonas aeruginosa [48.80%] and Escherichia coli [46.42%] were the common organism cultured. Methicillin resistant Staphylococcus aureus showed 100% sensitivity to Vancomicin, Linezolid, Meropenem, Imepenem and Pipracillin/tazobaclam. There is an alarming trend of increase in methicillin resistant Staphylococcus aureus because of indiscriminate use of antibiotics in our set up which should be discouraged and a detailed knowledge of bacterial susceptibility to antimicrobial agents is necessary

Mortality in above 40% thermal burns patients

To find out the frequency of mortality of thermal burns in different ages and gender. Descriptive study. The study was conducted in Burn Unit, Khyber Teaching Hospital Peshawar, from October 2007 to 31[st] March 2008. One hundred patients with TBSA more than 40%, any degree of depth and any thermal cause were included in the study. The interpretation and analysis of data were done with the help of SPSS 10.0. There were 52 [52%] males and 48 [48%] females. The mean age was 17.90 year + 14.5 year. The maximum number of patients [30%] were less than 10 year of age, followed by 18 [18%] of 21-30 year and 15 [15%] of 31- 40 year age group. According to TBSA burns, 47 [47%] patients had 51-60% burns, followed by 40 patients [40%] having 40-50% burns. Fifty five patients died, including 28 males [50.90%] and 27 females [49.10%]. Mortality was 100% in patients who were above 80 year of age having more than 80% TBSA burns. Thirty three patients [60%] died of septicemia, followed by 11 [20%] and 10 [18.19%] patients with acute renal failure and irreversible shock respectively. The mortality in this study was high due to large TBSA burns, deep burns, referral from peripheral areas without proper treatment, failure to avail medical treatment in time and septicemia

Colorectal carcinoma; frequency of common histological types in patients below 40 years of age presenting to tertiary care hospital

Colorectal cancer is the second commonest cause of death in the world. Its incidence in young patients is on rise. To determine the common types of colorectal carcinoma in patients below 40 years of age presenting to tertiary care level hospital. Study Descriptive study It was carried out at Surgical Department, KTH, Peshawar January 2007 to January 2008. Total of 50 patients younger than forty years of age with colorectal cancer were included in study for the determination of histologic types. There were 66% males and 34% were females. The commonest affected age group was 31-35 years old having 46% cases. On history 86% patients complained of altered bowel habits and on clinical examination anemia was present in 72% patients. Left and right sided tumors were found in 70% and 30% patients respectively. Adenocarcinoma was the commonest type found in 94% cases followed by lymphoma [4%]. The incidence in young age group [