Role of investigations and Alvarado score in acute appendicitis at peoples medical college hospital Nawabshah

Role of investigations and Alvarado score in acute appendicitis at Peoples Medical College Hospital Nawabshah. Prospective observational study. Two years study from October 2008 to November 2010. Was conducted in Peoples Medical College Nawabshah. The study comprises 50 patients all were admitted from OPD [Out Patients Department] and COD [Casulty Department]. The patients were evaluated fully after history, clinical examination and specific investigation, blood CP, X-Ray abdomen, supin and erect posture, X-Ray KUB, ultra sound of abdomen and general assessment. All Patients of pain in right iliac fossa included all patients were manage on the basis of Alvarado score, Complete Blood Picture and Ultra Sound report. In this study 50 patients of acute appendicitis in which 25 were female and 25 were male. The maximum of patients were in age group 15 to 40 years. Peak age group 25 years. Out of 50 patients 42 patients were present leucocytosis. On the behalf of Ultra sound report 38 patients were diagnose acute appendicitis. 10 patients were diagnose perforated appendix, 2 patients were diagnose appendicular abscess. 8 patients were present Alvarado score 3 to 4.30 patients were present Alvarado score 6-7, 12 patients were present Alvarado score 8-9, Patients were operated through procedure of appendectomy then tissue sent for histopathology. Acute appendicitis is a common cause of acute abdomen. Anorexia, migrating pain, tenderness and rebound tenderness are evidence of acute appendicitis

Frequency of hypocalcaemia in thyroid surgery

To determine the frequency of hypocalcaemia in thyroid surgery. This prospective study has been conducted at Surgical-IV in Liaquat University Hospital, Jamshoro/Hyderabad and Surgical Unit-II in Peoples Medical College, Nawabshah over a period of Two years from February 2006 to January 2008. This is a hospital based case series of 100 patients, who underwent subtotal, near total and total thyroidectomy for benign and malignant thyroid lesions. The age of the patients ranged between 15-70 years with mean age 32 years. 85 patients are female and 15 are male. In 18 patients, out of 100, hypocalcaemia has been observed clinically as well biochemically. It is concluded that frequency of hypocalcaemia is significant but only a few of them present with symptoms and permanent hypoparathyroidism is very rare

Gynaecomastia: management in a developing country

Gynaecomastia is a benign enlargement of male breast. It is common in the general population, resulting from various pathophysiological mechanisms. The aim of this study was to describe the presentation and outcome of treatment for gynaecomastia at a University Hospital in Pakistan. A three year retrospective study was carried out of one hundred men with gynaecomastia. Patients were evaluated in detail clinically and by appropriate investigations. They were counseled and kept on hormonal therapy for three months. Surgery was considered for patients with long standing gynaecomastia, failed medical therapy and for cosmetic reasons. Post operative complications and patient's satisfaction was assessed. Most [90%] cases were idiopathic. Other causes were liver cirrhosis in 4 cases, testicular tumour in two, thyrotoxicosis in one and drug induced [use of cimetidine and Kushta] in two. Carcinoma of the breast was diagnosed in one patient. Most of the patients had bilateral, non tender lump in the breast. Three cases of idiopathic gynaecomastia resolved on danazol. Eighty-eight cases underwent surgical treatment. The mean age of patients who underwent surgery [n=88] was 30.5 +/- 9.59 years. Most of the patients belonged to 21-30 years age group. Major indications for surgery were failure of medical treatment [45.5%] and cosmetic reasons [34.0%]. Mean operating time for subcutaneous mastectomy was 42.2 +/- 3.70 [36-48] minutes. Mean hospital stay after subcutaneous mastectomy was 5.2+2.44 [2-10] days. The only postoperative complication noted was wound infection [24%]. Seventy -two [81.8%] were satisfied with the results of their surgical treatment. Gynaecomastia is the common condition affecting male breasts and most common cause of gynaecomastia is idiopathic. Secondary gynaecomastia may regress in size by treating the primary cause. Idiopathic gynaecomastia do not respond to danazol so they needed surgical treatment. Subcutaneous mastectomy through a periareolar skin incision is a valid procedure for treatment for gynaecomastia and provides satisfactory cosmetic and provides satisfactory cosmetic results