Background Breast cancer remains the most common cause of cancer related mortality amongst women in Pakistan. Postoperative complications can demoralize the patients and potentially delay adjuvant treatment, leading to adverse outcomes. The overarching aim of the study is to delineate the early postoperative outcomes of breast cancer surgery in Pakistan. Materials and Methods A retrospective study involving patients who underwent breast cancer surgery from June 2016 to December 2019 was conducted. Perioperative morbidities (30 days) were evaluated and documented. The results obtained were analyzed using the SPSS 23 software (IBM Corporation, Armonk, NY). Results A total of 94 patients were included in the study, with the mean age of 50±12.8 years. Breast conserving surgery was performed in 32% (n=31) of the patients, while the remaining 68% (n=63) underwent modified radical mastectomy. The most common complications were seroma formation, flap necrosis and hematoma formation and were observed in 5.3% (n=5), 4.3% (n=4) and 3.2% (n=3) of the patients, respectively. Conclusion Early postoperative complications can delay the commencement of adjuvant systemic therapy required for further management of breast cancer. These complications elicit equally grave consequences for patients undergoing breast conserving surgery and modified radical mastectomy.
In the past, efforts have been made to determine the influence of sleep quantity and its deprivation, on functioning efficiency of human beings. However, determination of sleeping patterns that could improve intellectual performance has been largely neglected. This study is designed to discover the effects of different sleeping patterns on academic performance among medical students. A descriptive study was carried out in King Edward Medical University in Lahore, Pakistan during a six-month time span from May 11 th , 2011 to September 30 th , 2011. Of the total population of 1350 students in King Edward Medical University, 591 undergraduates were included in the study. A questionnaire designed on sleeping patterns and academic performance was distributed in May 2011. What was described as outstanding students were greater in number in group 4 (7/19) 36.8% and group 6 (6/19) 31.6%. Above average students with sleeping patterns were in group 4 (13/37) 35.1% and group 6 (10/37) 27%. Average students were shown to have sleeping patterns of group 4 (11/25) 44% and group 6 (7/25) 28%. Below average students were shown to have sleeping patterns of group 4 (3/3) 100%. Most of our students had a reduction in the total amount of sleeping hours throughout the years. Midnight to 6 o'clock in the morning with an afternoon nap was the sleeping pattern that was most commonly seen in all groups. We concluded that different sleeping patterns do not affect the performance of medical students in the academic prospective. Many other factors may be involved in the lack of significant achievement, in order to prove that the sleeping patterns are not related to the academic performance, and more data would need to be collected.
Background: Peripheral vascular trauma is fairly common and its repercussions lead to need for urgent management and multidisciplinary approach. We hereby evaluate the presentation, management and outcomes of peripheral vascular injuries presenting in a tertiary care hospital in Islamabad, Pakistan. Material and Methods: This was a prospective clinical study conducted in the Department of General Surgery, Pakistan Institute of Medical Sciences (PIMS) Hospital, Islamabad Pakistan from January 2016 to June 2018. A total of 60 patients with vascular extremity trauma were included in the study. Initial assessment and resuscitation were done and patients with vascular injury were directly shifted to operating room for primary vascular repair (if defect size < 2 cm) or vein graft (great saphenous). Fractures and nerve injuries were also treated. Fasciotomies were performed where indicated. Post-operative monitoring of limb was done for palpable pulses, temperature and color changes. Collected data included age, gender, duration of injury, nature of injury, operative findings, other associated injuries, type of definitive repair, involvement of artery, complications including amputations, infections, re-exploration, ligation or death. Statistical Package for Social Sciences (SPSS) version 23 was used to analyze data. Results: Out of total 60 patients, 53 (88.3%) were males and 7 (11.7%) were females, with a mean age of 27.8±14.1 years. Most of the patients presented after 6 hours of trauma (n=36; 60%). Blunt trauma accounted for 37 (61.7%) while penetrating trauma was seen in 23 (38.3%) patients. Per operatively, 33 (55%) patients had intimal injury, 7 (11.7%) had partial tear and 20 (33.3%) had complete transection of artery. Primary repair was performed in 9 (15%) patients and reverse vein graft in 51 (85%) patients. Most commonly injured arteries were femoral (n=21; 35%), brachial (n=18; 30%) and popliteal (n=12; 20%) arteries, respectively. Amputations were significantly related to presentation of patients later than 6 hours (P=0.035). Conclusion: Patients who present with vascular trauma need an early diagnosis, referral and timely management in order to save both limb and life of patients with special concern for good quality of life and cost-effective management.
Background: Appendicitis is a common surgical emergency and diagnostic dilemma. Making the correct diagnosis is often difficult as the clinical presentation varies according to the age of the patient and the position of appendix. The objective of this study was to identify clinical applicability of C- reactive protein, as a diagnostic test for appendicitis. Methods: This prospective study was carried out in Federal government Polyclinic hospital, Islamabad from January to July 2019, 114 patients underwent appendectomy for clinically diagnosed acute appendicitis. The decision to operate the patient was given by senior registrar. The blood samples for C-reactive protein were drawn before taking the patient to the operating theatre. Removed appendices were sent for histopathological confirmation of diagnosis. The C-reactive protein was then compared with the results of histopathology to determine its validity. The data was entered and analysed in SPSS 23. Results: The sensitivity, specificity, positive and negative predictive values of C-reactive protein in patients with clinical diagnosis of acute appendicitis were found to be 94%, 78%, 93% and 74 % respectively. Conclusion: CRP is helpful in making diagnosis of acute appendicitis. It is highly sensitive but has a relatively low specificity.
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