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

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

Objective: To evaluate the safety outcome of staple hemorrhoidectomy in grade III and IV hemorrhoids. Study Design: Descriptive study Place and Duration of Study: Department of Surgery, Shahida Islam Medical Complex, Lodhran from 1st July 2020 to 30th June 2021. Methodology: Seventy patients were selected who were suffering from third or fourth grade hemorrhoids. The age of the patients was between 21-56 years with both gender been presented. Longos method was opted with spinal analgesic been delivered in lithotomy positioning. The complete surgical protocol was maintained with preoperative antibiotic deliverance. The procedure took 30-50 minutes. Patient was then kept in recovery room for three hours post operation and all postoperative antibiotics were timely administered. Results: Mean age of study participants was 41.2±3.2. Men appeared to be higher in number as compared to women. Grade III patients were more in number as compared to grade IV. Most common complication which was observed in present study is postoperative pain. Majority of the patients (70%) showed no associated complications. Conclusion: Staple hemorrhidectomy is appeared to be a safe and reliable surgical procedure for the treatment of grade III and grade IV hemorrhoids. Keywords: Hemorrhoids, Surgical procedure, Stenosis, Efficacy, Conventional