IntroductionColonoscopy is a diagnostic procedure used not only for screening and assessment but also for therapeutic management of various diseases such as removal of polyps, flat lesions, etc. In this study, we determine various outcomes of colonoscopy done in the gastroenterology unit of Ghulam Muhammad Mahar Medical College and Teaching Hospital in Pakistan.Methods and MaterialsThis retrospective cross-sectional review was carried out at the colonoscopy unit of Ghulam Muhammad Mahar Medical College and Teaching Hospital in Sukkur, Pakistan. Data was gathered from medical records of patients and by calling their physicians if necessary from July 1 to December 31, 2018. ResultsIn our study, the most common site for colonoscopy was a rectosigmoid colon (37.85%, n=134), almost parallel to the anal canal (37.57%, n=133). Normal colonoscopy was reported in 25.42% (n=90). The most common pathology was hemorrhoids (32.48%, n=115), followed by ulcers (17.79%, n=63).ConclusionColonoscopic detection of hemorrhoids was the most common finding in colonoscopy. Normal colonoscopy was less compared to other literature, suggesting physicians are carefully screening patients in advising colonoscopies.
Objective: To compare the efficacy of non-surgical conservative management with surgical management in cases of uncomplicated acute appendicitis in children. Study design: Prospective comparative study. Settings: Pediatric surgery Department, Ghulam Muhammad Mahar Medical College Sukkur. Study duration: 1st February 2020 to 31st May 2021. Materials and Methods: Ninety patients of either gender with age range from 5-12 years, diagnosed as uncomplicated acute appendicitis, were divided in two groups. Group C patients were managed conservatively with antibiotics (ceftriaxone 100 mg/kg/day, amikacin 10mg/kg/day and metronidazole 22.5 mg/kg/day) and maintenance fluids were started. Patients were observed for improvement or any signs of deterioration. Those who deteriorated within 24 hours were managed with surgical management immediately. Follow-ups were carried out after discharge on the 7th day, 1 month, and six months. Patients reporting a recurrence of symptoms were managed with appendicectomy. Group S patients were managed with appendicectomy with the open technique. Patients were observed for post-operative complications. Results: Demographic data of both groups was comparable. In group C, 34 (75.56%) patients were successfully treated with conservative management, whereas in group S, 39 (86.67%) were successfully treated with surgical management. The difference was insignificant with a p-value of 0.114. In group C, 5 (11.11%) patients did not respond to conservative management and they were managed with appendicectomy and recurrence of symptoms was seen in 6 (13.33%) patients in group C, they were also managed with appendicectomy. In group S, 6 (13.33%) patients suffered post-operative complications. Mean length of stay in hospital was 4.31±1.20 and 4.09±1.12 days in group C and S respectively. This difference was statistically insignificant with a p-value of 0.368. Conclusion: It is concluded in our study that uncomplicated acute appendicitis in children can be successfully managed with non-surgical conservative management.
Objective: This study was aimed at determining the frequency of surgical site infection in children undergoing elective inguinal herniotomy with and without prophylactic antibiotic. Study design: Prospective comparative study. Settings: Pediatric surgery Department, Ghulam Muhammad Mahar Medical College Sukkur. Study duration: From 1st February 2020 to 31th March 2021. Methodology: One hundred and sixty patients selected for this study and were equally divided into two groups. Group A received antibiotic prophylaxis (Injection ceftriaxone 50mg/kg) before the induction of general anesthesia, whereas Group P received placebo before the induction of general anesthesia. Demographic data and duration of surgery was noted on a proforma. Surgical procedure was carried out following standard surgical protocols. Post-operatively all patients were observed by an independent observer. Patients were observed for post-operative fever, inflammation of the surgical site and discharge from the site of incision. Wound was examined on 1st, 3rd, 7th and 30th post-operative day. For labeling Surgical Site Infection, Center of Disease criteria was followed. Results: Demographic data of both groups was comparable. Mean duration of surgery in group A was 29.61±7.47 minutes, while it was 32.97±8.73 minutes in group P with p-value of 0.08. Out of 160 patients, thirteen patients developed surgical site infection; 5 (6.25%) patients belonged to group A, while 8 (10%) belonged to group P with a p-value of 0.385. Conclusion: It is concluded in our study that use of prophylactic antibiotics in elective herniotomy cases performed in pediatric patients do not significantly decrease the incidence of Surgical Site Infection.
Objective: To determine the efficacy of ultrasound guided tube drainage of Perinephric abscess. Study Design: Observational study. Setting: Surgical Unit-II and Urology Ward Ghulam Muhammad Mahar Medical College Teaching Hospital Sukkur & Mustafia Hospital Sukkur. Period: February 2016 to January 2020. Material & Methods: 70 cases with Perinephric abscess underwent ultrasound guided tube drainage. Diagnosis was established by history, clinical examination, investigations like ultrasound & CT scan. Patients with emphysematous kidney & chronic sinus formation and with small abscess were excluded from the study. Patients were followed up for 4 weeks for complete regression of abscess cavity on ultrasound. Results: Out of 70 Patients 61.4% were male and 35% were female. 58.5% of the patients had right sided Perinephric abscess. Majority of the patients(42.8%) belonged to age group 41-50 years. 31.4% of the patients were diabetic. Clinically 95.7% of the patients reported with fever and 88.5% with flank pain. Ultrasound guided tube drainage was successful in 65(92.8%) while in 5(7.1%) patients it failed and open drainage was performed. Conclusion: Ultrasound guided tube drainage is an effective way to treat Perinephric abscess with very few minor complications as compared to open drainage.
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