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Background: During cholecystectomy, to avoid common bile duct injury or other per operative complication, the knowledge of cystic cyst anomalies is imperative. This study aimed to highlight cystic duct anomalies identified during laparoscopic cholecystectomy and report their implications
Methods: This prospective study was conducted at Liaquat University of Medical and Health Sciences, Jamshoro over a period of six years [2009-2014] in the department of Surgery. Over this specified period a total of 775 patients underwent cholecystectomy and were included in this study
Results: Among 775 patients who underwent laparoscopic cholecystectomy, abnormal confluence was found in 7.22%, short cystic duct in 26.78%, long cystic duct in 17.86% and double cystic duct in 12.50%. Surgical problems encountered due to these variations were cystic duct avulsion, common bile duct injury, bleeding and bile leak
Conclusion: During laparoscopic cholecystectomy, unidentified anatomical variations of cystic duct may cause drastic complications including ductal injuries which significantly increase morbidity and may raise mortality
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Background: Vitamin E is a fat soluble vitamin and plays key role in many body systems. It has been in clinical practice for mastalgia for decades, however there is still limited literature defining its precise role
Methods: This case series was retrospectively collected from a prospectively established database of a dedicated breast clinic for a period of 16 months. A total of 100 patients came with a complaint of breast pain; 20 patients excluded as 17 were having palpable lump while 3 were post menopausal. Eventually 80 patients were included in this study. They were given Vitamin E 400 mg a day for six months. They were followed up at six weeks then at three months and finally after six months. Patients were given a pain chart to mark severity of pain on daily basis
Results: Follow up initially at six weeks, three and six months suggested significant improvement in the symptoms of cyclical mastalgia [p<0.001]
Conclusion: Vitamin E is relatively safe supplement with a better compliance, therefore can be safely considered as first line management of mastalgia in premenopausal young patients
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Objevtices: Shearwave elastography has recently got approval for its use in clinical imaging. It has got its established accuracy in assessing liver fibrosis, where biopsy for the staging of cirrhosis has been minimized. There is emerging data showing its superiority in detecting breast and other cancers as compared to conventional imaging methods. This study aimed to analyse role of shearwave elastography in detection of primary impalpable lesions in breast and abdomino-pelvic regions and those missed on conventional imaging modalities
Setting: Shearwave Elastography Unit, Liaquat University of Medical and Heath Sciences, Jamshoro, Pakistan
Design and methods: The study is an observational pilot project including the patients presented to surgery and oncology departments with metastatic cancer suggested on conventional imaging or cytology of the metastatic site but primary sites were not known and suspected to be in the region of breast, abdomen or pelvis. Shearwave elastography was applied as supplementary tool to re-do B-mode ultrasound. Aixplorer Ultrasound System Multiwave version 8.2.0 [Supersonic Imagine S.A., Aix-en-Provence, France] was used in this study. This study selectively includes the patients who were called on experimental basis to see the effectiveness of the system on trial basis, the calculation of the sensitivity, specificity, positive predictive value and negative predictive values were not determined
Results: There were seven patients including four with axillary lymph nodes and three having liver metastases. In patients with axillary lymph nodes mammogram and conventional ultrasound failed to show primary breast lesions, histopathology of the axillary lymph nodes suggested infiltrating ductal carcinoma. In patients with liver metastases conventional ultrasound abdomen and CT scan failed to reveal primary lesions. Shearwave assisted B- mode ultrasound suggested a solid mass in a complex cyst in the kidney in one patient and in the other there were multiple benign cysts and a solid mass however the third patient with liver mass found to have primary from gall bladder. These findings were later confirmed on histopathology or cytology
Conclusion: Shearwave elastography is an emerging non invasive technology showing potential role to supplement B-mode ultrasound in detecting unknown primary cancerin breast and abdomino-pelvic region
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OBJECTIVE: This study was designed to compare short term outcome of post operative pain in patients operated for haemorrhoidectomy alone and haemorrhoidectomy with internal sphincterotomy
METHODOLOGY: This comparative observational study conducted at Liaquat University Hospital Jamshoro during August 2012 to July 2014. One hundred and sixteen patients of 3rd or 4[th] degree hemorrhoids were enrolled in the study. Patients were divided into two comparable groups. Group A underwent open haemorrhoidectomy along with lateral sphincterotomy whereas group B was operated for open haemorrhoidectomy alone. Postoperative pain was analyzed by using visual analogue score at 24 hours, 48 hours and on 10th post operative day
RESULTS: Total 116 patients were included in the study. Fifty eight patients in each group
The mean age of the patients was 42+/- 10.2. Male were 77 [66.4%] and 39 [33.6%] were female. Male to female ration was 2:1. During follow-up periods, patient in group A experienced less postoperative pain as compared to group B [p value is
CONCLUSION: Lateral internal sphincterotomy combined with haemorrhoidectomy significantly reduces postoperative pain without increasing morbidity