Frequency of infection in cholelithiasis

To determine the frequency of infection in cholelithiasis and find common infecting organisms with their antibiotic sensitivity. A descriptive study. This study was conducted in Surgical Unit - I, Jinnah Postgraduate Medical Centre [JPMC], Karachi, Pakistan, from April 2001 to March 2002. First 100 cases of cholelithiasis, selected and operated by open or laparoscopic cholecystectomy were included in this study. Patients with acute cholecystitis, history of jaundice, stones and / or dilated common bile duct were excluded from the study. Ultrasound was the main tool for pre-operative diagnosis. During cholecystectomy, bile was aspirated and specimens were sent to laboratory for microbiological examination. The results were recorded on a proforma. Out of 100, 36 patients had positive bile culture. The most common organism was E. coli [17 patients] followed by Klebsiella [9], Pseudomonas [6], Staphylococcus aureus [2], Salmonella [1] and Bacteroids fragalis [1] patient. In this study, most of the biliary organisms were highly sensitive to the 2nd generation cephalosporins and quinolones. From the bacteriological assessment, it seems that both endogenous and exogenous contamination were the causes of wound sepsis. It was also found that the infection of bile did not increase the risk of postoperative wound infection when prophylactic perioperative antibiotics were used

Complications of laparoscopic cholecystectomy: a learning curve

The objective of the study was to find out the rate of complications of laparoscopic cholecystectomy being performed by trainees under supervision. Case Series. Place and Duration: Study was conducted in Surgical unit-1 [ward-3] of JPMC Karachi from November 2001 to November 2005. All the patients above twelve years of age of both sexes were admitted for laparoscopic cholecystectomy after evaluation in the outpatients department who were diagnosed as cases of chronic cholecystitis with cholelithiasis. A total of 620 patients were included in the study. Biliary complications were 0.16% and non biliary 0.8%. Vascular injury, diaphragmatic injury and pneumothorax did not occur in our study. Complications of laparoscopic cholecystectomy in the hands of trainees can be minimized by adhering to the principles of good laparoscopic surgery

Experience of karadykis procedure in the treatment of pilonidal sinus

To evaluate the advantages of karydakis procedure for the treatment of the pilonidal sinus Interventional study. The study was conducted in surgical unit 1[ward 3], Jinnah Post Graduate Medical Center, Karachi from January 2001 to December 2004. In this study we enrolled 1 00 adult patients who presented with pilonidal sinus. All the patients where evaluated by thorough history, physical examination and were investigated before undergoing primary asymmetrical closure of pilonidal sinus by a procedure describe by Karydakis. In this study average age of patients was 28 years. Male/female ratio was 10:1. Most of the patients were hairy 81 percent and over weight 85 percent. Single sinus opening present in the midline of natal cleft in 69 percent patients. Results showed uneventful recovery in 93 percent patients, postoperative wound infection in four patients 4 percent. seroma formation and recurrence in three patient 3 percent. Average hospital stay was 4 days. Experience of karydakis procedure in the treatment of pilonidal sinus is worth adopting and sharing with others, with all its advantages, as with this procedure patient has short hospital stay, early wound healing and less postoperative complications

Causes of intestinal obstruction: a study of 257 patients

To find out the common causes of intestinal obstruction in our practice. Design: Descriptive study. Place and Duration: The study was conducted in Surgical Unit-I, Ward-3 of Jinnah Postgraduate Medical Centre, Karachi, Pakistan between February, 2000 to January, 2004. Patient And In this study we included only those patients of intestinal obstruction who underwent exploratory laparotomy. Total of 257 patients of intestinal obstruction were diagnosed on the basis of clinical history, examination, radiological findings and investigations. After resuscitation exploratory laparotomy was performed to confirm the diagnosis and relieve the obstruction. The most common cause of intestinal obstruction was tuberculosis, 38.13% followed by obstructed/strangulated hernia 26.84%, post-operative adhesions 17.12%, large gut malignancy 10.09%, volvulus 6.22% and small gut malignancy 0.77%. The causes of intestinal obstruction are variable in different parts of world. Tuberculosis is one of the leading cause of intestinal obstruction in Pakistan