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ABSTRACT… Appendectomy is the most common surgical procedure performed in surgical emergency. The advent of minimal invasive surgery has massively influenced the field of surgery. Laparoscopic surgery might offer clinical benefits in perforated and complicated appendicitis. Objective: To compare laparoscopic appendectomy and open appendectomy as treatment of complicated appendicitis in terms of mean requirement of post-operative analgesia, operative time and hospital stay. Study design: Randomized control trial. Setting: All subjects for the study were recruited from Department of Surgery, Independent University Hospital, Faisalabad. Duration: The duration of study was of 6 months duration from February 2012 to august 2012. Results: In this study the divided into two groups, group A for open appendectomy (OA) and group B for Laparoscopic Appendectomy (LA). Both groups had 43 patients each. The operating time for open appendectomy group A had mean operating time 37.21 minutes .The hospital stay in OA group was 2.63 days. The mean dosage of analgesia requirement was 258 mg of diclofenac. The operating time for open appendectomy group A had mean operating time 39.16 minutes. The hospital stay in OA group was 2.95 days. The mean dosage of was 258.14 mg of diclofenac. Conclusion: Our study concludes that both approaches laparoscopic and open approach have proved to be similar in terms of post-operative hospital stay, operating time and analgesia requirement. Where as LA is superior in terms of cosmesis and surgical site infection. Further studies with more number of patients are recommended to asscess the benefits of laparoscopic approach in complicated appendicitis.

Laparoscopic cholecystectomy is the gold standard treatment for patients presenting with acute gall stone disease necessitating hospital admission. Objective: To assess the impact of timing of laparoscopic cholecystectomy on conversion rate, hospital stay and morbidity. Period: Jan 2008-2010. Setting: Department of Surgery, Independent University Hospital, Faisalabad. Study Design: Experimental study. Material & Methods: The subjects were included by consecutive sampling technique. 81 cases were divided into 3 groups. Group A (Surgery within 72 hrs of onset symptoms). Group B (surgery between 72hrs to 96 hours of onset of symptoms). Group C (surgery after 96 hours of onset of symptoms). Results: The mean age was 41-95 years. Female to male ratio was 4.5:1. The overall complication rate was 12.69%. Mean hospital stay was 2.85 days. The open conversion rate was 8.64%. In group A the complication rate was 6%, group B 11.5% and group C 12.8&. The mean hospital stay and conversion rate had no significant difference. Conclusions: The timing of laparoscopic cholecystectomy has no significant impact on the conversion rate and length of hospital stay in cases with acute cholecystitis. However the complication rate was higher when surgery performed after 72 hours of onset of symptoms.

Introduction: Diagnostic Laparoscopy is considered to be the gold standard for the evaluation of the pelvis and is considered asafe procedure. Diagnostic Laparoscopy is a technique in the routine investigation and treatment of infertility as well as other gynecologicalproblems. Objectives: To determine, Laparoscopic findings in different gynecological conditions, different causes of infertility andcomplications of laparoscopy Design: Retrospective, descriptive study. Material And Methods: We reviewed case records of all patients whounderwent laparoscopy for their different Gynecological problems. Data were collected from patient case records in a data entry sheet Results:In our study a total of Thirty patients under went laparoscopy for investigation of different gynecological problems. There were 17 patients whohave primary infertility and 6 have secondary infertility while 7 presented with Lower abdominal pain. In our study the leading cause of primaryinfertility was Polycystic Ovarian Disease(29%).Other causes were bilateral tubal blockade (23.53 %) ,17% has PID and fibroid uteri, While onepatients shown Endometriosis as well as one patient had no obvious pathology.(5.88 %).On laparoscopic examination of secondaryinfertility 50% shown Tubal blocked while 16.67 shown Fibroid uterus and PID.One patient had normal pelvic findings(16.67). Regardingpatients presented with pain lower abdomen 57.15% has ovarian cyst,28.58% has Ectopic pregnancy while one case(14.29%) had hetrotropicpregnancy. In 24 patients had no complication and recovery was smooth. laparoscopy had to be converted into Laparotomy due to significanthemorrhage in two patient and wound infection was observed in two patients. One patient presented with post operative fever and onepresented with abdominal pain. Conclusions: Laparoscopy is a valuable diagnostic tool for females in different gynecological problems. Thebenefit of the laparoscopy to open surgery include less pain, less scarring, less disability and quicker recovery.

Objective: To document various endoscopic findings in patients undergoingupper GI endoscopy in our endoscopy unit. Design: Observational. Patients and methods: Thedata of 100 patients who underwent upper GI endoscopy in Endoscopy Unit of IndependentMedical College/ Independent University Hospital from April 2010 to December 2012 wasanalyzed. Demographic features, reasons for referral and endoscopic diagnoses were noted.Results: Among 100 patients, 35% were referred due to persistent vomiting, 28% due toepigastric pain / discomfort, 18 % due to dyspepsia and 7% due to retrosternal burning and uppergastrointestinal bleeding. Common endoscopic diagnoses were gastritis (28%), duodenitis(14%), gastroesophageal reflux disease / esophagitis (6%), esophageal varices (5%) andesophageal growth (4%). Conclusions: The most common presenting complaint was persistentvomiting followed by epigastric pain / discomfort and the most common endoscopic finding wasgastritis.