Gender based outcome of acute cholecystitis

Objective: To find out whether or not male gender is associated with more severe gallbladder inflammation

Study design Retrospective review of records

Place and Duration of study: Sheikh Khalifa Bin Zayed Al Nahyan [SKBZ] Hospital / CMH Muzaffarabad, from January 2012 to June 2015

Methodology: A retrospective data analysis of patients who underwent laparoscopic cholecystectomy for acute cholecystitis was done. Data for 740 patients with cholecystitis was retrieved. Out of these 220 patients who had laparoscopic cholecystectomy within 72 hours of admission, were included in the study. Gallbladder inflammation was confirmed on histopathology report

Results: There were 110 male and 110 female patients in this series. There was a significant number of male patients who had severe gallbladder inflammation in comparison with female patients [p=0.002]. The male gender was confirmed in a multivariate analysis as an independent risk factor for severe cholecystits [p=0.018]

Conclusions: Male gender is a risk for severe gall bladder inflammation. Early surgical intervention is therefore warranted to prevent complications

Pattern of toy bomb injuries in Azad Jammu and Kashmir [a hospital based study]

An observational, hospital based study was conducted at CMH, Muzaffarabad to see the pattern of Toy Bomb blast injuries in a period from 1st Jan 2002 to 31st Dec 2003. On an incidence of Toy Bomb Blast injuries, patients reporting to a hospital in Azad Jammu and Kashmir [AJandK] were the core study material for this article. To study the pattern of injuries and their consequences in the studied population. Patients reporting to the hospital with history of toy bomb blast injuries were examined evaluated and followed up. Documents of patient with similar injuries in past treated in the hospital were also included in the study. A checklist guided the follow up of the patients from the incidence that triggered the study. The patients were scrutinized/evaluated according to Advanced Trauma Life Support [ATLS] system of trauma care. Altogether 48 patients record was checked. The age ranged from 1 - 63 years [majority of the patients [80%] were male below 13 years of age], 38 [79%] cases sustained major trauma with multiple injuries of head/neck, maxillofacial, chest, Abdomen and all four limbs. Twenty-four cases [50%] had permanent disabilities. Mortality rate was 20%. Wound infection was very high [60%]. The major complications were depending upon the organ involved/injured. This study points to the need for further studies of this unique method of causation of injuries [toy bomb blast injuries], the pattern they evoke and possible handling of such eventualities. It is desired that at one end the community must be informed and educated about the type, shape, injuries and prevention of the toy bomb casualties and on the other end quick evacuation and proper management of cases be ensured

Urinary bladder gossipyboma [retained post operative foreign body in urinary bladder]

A 57 years old gentleman was brought with history of recurrent UTI [Urinary tract infection] of 01 year duration. Following transvesical prostatectomy. UTI could not be controlled after using appropriate antibiotics. All relevant investigations were performed. His cystoscopic examination revealed retained gauze piece [12 inches] in urinary bladder, which was retrieved

Prolene darn: safe and effective method for primary inguinal hernia repair

The purpose of the study was to evaluate darn repair in terms of morbidity and recurrence rate. Descriptive study. Combined Military Hospital, Muzaffarabad from February 1997 to April 2001. Four hundred and sixty-five consecutive patients above the age of 20 years, with primary inguinal hernia underwent darn repair using polypropylene suture. Two hundred and forty-two patients were operated under spinal anaesthesia, 100 under local anaesthesia while 123 patients had general anaesthesia. Patients were examined on 7th and 12th postoperative day for early complications. Subsequently, they were examined at third month, six-month and then yearly for three years. Mean age in our study was 52 years [range 20-75]. Indirect hernia was present in 305 [65.5%] patients while 160[34.5%] patients had direct hernia. There were 11 [2.4%] postoperative wound infections. Three [0.6%] patients had hematoma formation. Twenty-one [4.5%] patients went into postoperative urinary retention. Three [0.6%] patients developed recurrence; all these patients were among those who had postoperative wound infection. There was no seroma formation. None of the patients developed any testicular complication or postoperative hydrocele. There was no case of dysejaculation or chronic residual neuralgia. It can be concluded from our results that darn repair using non-absorbable suture is safe procedure. It is easily performed and has a very low recurrence rate which is comparable to any other procedure for primary inguinal hernia