Background and Aim Early hemorrhoidal disease is usually treated conservatively with fiber diet and medical therapy with flavonoids or calcium dobesilate. The purpose of this study was to compare the efficacy of these two agents in the treatment of early hemorrhoidal disease. Materials and Methods Patients having grade I and grade II hemorrhoidal disease were recruited in the study. One group received flavonoid therapy and the other group took calcium dobesilate treatment for three weeks. The symptoms and size of hemorrhoids were then assessed at the fourth week. Results In this study, 70.2% of patients were male and 29.8% of patients were female. Of the total patients, 58.65% of patients were below 45 years of age and 41.34% of patients were above 45 years of age. Moreover, 83.65% of patients had grade II hemorrhoids, whereas 16.34% of patients had grade I hemorrhoids; 80.8% of patients showed a decrease in frequency and amount of bleeding after being treated by flavonoids, whereas 67.3% showed a decrease in frequency and amount of bleeding after administration of calcium dobesilate. A decrease in the size of hemorrhoids was seen in 67.3% of patients after treatment with flavonoids and 38.46% after giving calcium dobesilate. Conclusions Treatment of early hemorrhoidal with flavonoid therapy was more effective in improving the symptoms of disease as compared to calcium dobesilate treatment.

Pilonidal sinus is a widespread condition. There have been several surgical methods described for treating the sacrococcygeal pilonidal sinus. The Limberg flap after rhomboid excision is the method that is most frequently utilized. By flattening the natal cleft, a big, well-vascularized flap is used to create a tension-free repair. The best treatment options are said to have a recurrence rate of 0–5% and complication rate during surgery of 0–16%. Aim: This study was held to assess patient characteristics and treatment outcomes for pilonidal sinus patients who had rhomboid excision and reconstruction with Limberg flap in our setting. Methods: Information was collected retrospectively by analyzing the records of patients who were done with rhomboid excision and reconstruction with Limberg flap for sacrococcygeal pilonidal sinus in General Surgery department, Lady Reading Hospital, Peshawar during the period from January 2020 to December 2022. Results: The study included 40 patients in total, 34 (85%) men and 6 (15%) women. The mean age was 25.10. (range 18–45 years). The mean stay in hospital was 4.2 days, with 3 to 7-day of range. The primary disease affected 38 out of the 40 individuals, and a recurring disease affected 2 patients.

The intussusception adults are rare and almost always as a result of secondary condition. The aim of this study is to review the adult intussusception's presentation, diagnosis, and pathophysiology was the goal of this study. Methods: This retrospective analysis study was held in the surgical department of Lady Reading Hospital, Peshawar from April 2022 to September 2022. This study included 24 cases of intussusception in patients >18 years of age. Results: 24 cases of intussusception among adult were reported. The mean age was 49.2 years on average (range 20-75 years). All patients' initial complaints in this study was pain accompanied by abdominal distension (37.5%), Vomiting (79.2%) and currant-jelly stools (33.3%) were other symptoms.12 patients (50%) had a palpable lump, while 8 patients (33.33%) had tenderness and generalized guarding was seen in 6(25%) of patients. Eleven patients (45.8%) had an acute intestinal obstruction on admission. The range of symptoms' lengths was 20 hours to 10 months, with a median of five days. The laparotomies were done in 19 patients. Five patients; two with ileoileal intussusception and three with ileocolic, were scheduled for surgery, but over the course of a few hours, their lump disappeared with symptoms improvement.

Background: Modified radical mastectomy (MRM) remains the mainstay of breast cancer surgery in under-developed countries like Pakistan as it reduces the morbidity and mortality associated with radical surgery. This study aims to delineate the clinicopathological findings and postoperative outcomes of patients undergoing modified radical mastectomy for breast carcinoma in a local setting.Material and Methods: This cross-sectional study was conducted in Gulab Devi hospital Lahore, Punjab Pakistan, from January 2016 to December 2019. Patients (n=70) with carcinoma breast planned for modified radical mastectomy were included in the study. Two suction drains were placed (in the axilla and under the flap) and removed when drainage was less than 30 cc in 24 hours. The patients were followed-up weekly for one month and then at monthly intervals for up to one year. Independent t-test and chi-square test were used to study associations between different variables. A P-value less than .05 was considered statistically significant.Results: The mean age of the patients was 48.43 ± 12.3 years. Most of the patients (42.86%) had stage-II, grade-I carcinoma (50%) with invasive ductal carcinoma as the most frequent histological variety (80%). Majority of the patients (n=60; 85.57%) were ER/PR positive. Mean duration of surgery was 124.8 ± 20.33 minutes, the mean duration of drains was 3.5±4.5 days, and the mean length of hospital stay was 4.67 ± 1.07 days. Most common complications of mastectomy were wound infection (23.57%) and seroma formation (20%). Six (8.57%) developed recurrence of disease in one year follow-up. Neoadjuvant chemotherapy increased the mean duration of surgery and drains placement (P<.05) but had no effect on mean hospital stay and complications associated with surgery (P>.05).Conclusions: Grade-I invasive ductal carcinoma with ER/PR positive receptor status was the most frequent variety of breast carcinoma. Neoadjuvant chemotherapy was associated with increased operative time and increased duration of drain placement.