This study establishes a quality benchmark for readmission rates after transsphenoidal surgery for pituitary lesions and identifies delayed hyponatremia as the primary cause. Implementation of an outpatient care pathway for managing hyponatremia may improve readmission rates.

4 Laryngoscope, 126:2445-2450, 2016.

Objective: To compare the incidence of surgical site infection after appendectomy wound irrigation with regular saline solution and imipenem solution. Study Design: Comparative randomized control trial Place and Duration of Study: Department of Surgery Unit-1, Sandeman Provincial Hospital Quetta from 1st September 2020 to 30th April 2021. Methodology: Eighty patients of both genders were presented in this study. Patients detailed demographics age, sex and body mass index were recorded after taking informed written consent. Patients underwent for appendectomy wound irrigation were included. Patients were equally divided into two equal groups, I and II. Group I had 40 patients and received imipenem and group II irrigated with saline solution with 40 patients. Outcomes were surgical site infection, deep abscess formation was observed post-operatively. Results: The mean age of the patients in group I was 26.11±2.03 years with mean BMI 23.61±3.32 kg/m2 and in group II mean age was 25.14±3.12 years with mean BMI 22.14±4.88 kg/m2. In group I, 32 (80%) patients had inflamed appendix, perforated appendix was in 7 (17.5%) and gangrenous appendix in 1 (2.5%) while in group II inflamed appendix in 34 (85%), perforated appendix in 4 (10%) and gangrenous appendix 2 (5%). Surgical site infection in group I was 3 (7.5%) and abscess formation in 2 (5%) cases while in group II SSI in 6 (15%) and abscess formation in 3 (7.5%) cases. Conclusion: Imipenem irrigation after appendectomy reduces wound infection. Healthcare costs and patient suffering due to infection can be reduced. Keywords: Imipenem solution, Wound irrigation with saline, Appendectomy wound infection

BackgroundMonteggia fracture-dislocation is rare in children. Various reports attest to its rarity, while recording the many variant of this injury. It is, therefore, easy to miss the diagnosis in the absence of proper clinical examination and radiographs.Case ReportThis report highlights two rare variants of Monteggia fracture-dislocation seen in children. The first case was a 12-year old girl alleged to have fallen from a 15- feet tall tree and sustaining a combined type III Monteggia injury with ipsilateral Type II Salter-Harris injury of distal end radius with a metaphyseal fracture of the distal third of the ulna. The second case was a 13-year old who had sustained a closed fracture of atypical Type I Monteggia hybrid lesion, in a road traffic accident.ConclusionThis report highlights the rare variants of Monteggia fracture dislocation which could have been missed without proper clinical examinations and radiographs.

Objective: To compare the outcome of percutaneous aspiration with incision drainage for management of breast abscess. Study Design: Comparative study Place and Duration of Study: Department of Surgery Unit-1, Sandeman Provincial Hospital Quetta from 1st October 2020 to 31st March 2021. Methodology: One hundred and ten women age aged between 18-65 years of age were enrolled. Patients details demographics age, weight, height and body mass index were recorded after taking informed written consent. Women had breast abscess were included. Patients were equally divided into two groups, I and II. Group I had 55 patients and received percutaneous aspiration while in group II had 55 patients underwent for incision drainage. Results: Mean age of the patients in group I was 30.11±8.56 years with mean BMI 27.9±18.77kg/m2 while mean age in group II was29.17±9.44 years with mean BMI 28.9±55.27kg/m2. Mean weight of patients in group I was 72.19±17.44 kg and in group II mean weight was 74.35+19.78 kg. Mean height in group I was 154.12±9.55 cm and in group II was 156.08+8.71 cm. Restoration of breast feeding among group I was 47 (85.45%) and in group II 32 (58.2%) patients restored breast feeding. Satisfaction among patients in group I was higher than that of 45 (81.82%) as compared to group II, 31 (56.4%). Conclusion: Percutaneous aspiration in breast abscess was successful and affective as compared to incision drainage with less complications and high satisfaction rate among the women. Keywords: Breast abscess, percutaneous aspiration, Incision drainage