Introduction Laparoscopic appendectomy for nonperforated appendicitis is associated with improved outcomes. This study compares laparoscopic appendectomy and open appendectomy in cases of a perforated appendix by assessing surgical site infection, mean operating time, and length of hospital stay. Materials and methods This study was a prospective randomized study conducted at the Department of Surgery, Holy Family Hospital, Rawalpindi, Pakistan, from January 2016 to January 2017, by randomly allotting the laparoscopic or the open appendectomy technique to 130 patients by the lottery method. Patients having a perforated appendix were included after they provided informed consent. Data were entered and analyzed using IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Armonk, NY, US). Results The frequency of wound site infection was significantly higher in open appendectomy (27.69%) than in the laparoscopic approach (10.77%; p=0.01). Mean hospital stay was slightly longer in the laparoscopic approach (4.38 ± 1.09 days) than in open appendectomy (4.18 ± 0.77 days; p=0.23). Mean operating time for laparoscopic appendectomy and open appendectomy was 46.98 ± 2.99 minutes and 53.02 ± 2.88 minutes, respectively (p<0.000). Conclusion Laparoscopic appendectomy was associated with fewer surgical site infections and shorter mean operating time than an open appendectomy.

Introduction Thyroid surgery is one of the most frequently performed surgical procedures worldwide. Total thyroidectomy is a recommended procedure for most of the thyroid diseases. The most common complication resulting after this surgery is transient hypocalcemia - the incidence is 24% - which increases the morbidity rate and increases the length of stay in the hospital. The objective of our study was to compare the frequency of transient hypocalcemia after vitamin D and calcium supplementation with the control group for patients undergoing total thyroidectomy. Patients and methods It was a randomized controlled trial conducted at Department of Surgery, Pakistan Atomic Energy Commission General Hospital, Islamabad, Pakistan from January 2017 to July 2017. A total of 92 patients of both genders undergoing total thyroidectomy were included in the study. Patients undergoing reoperation for thyroid disease, American Society of Anesthesiologists (ASA) grade 3 or above, patients with chronic renal failure, preoperative hypocalcemia or hypercalcemia were excluded. The patients were sorted into two groups by lottery method; Group 1 in which Vitamin D (2,00,000 IU) and calcium (1 gm) was given 24 hours preoperatively. Group 2 was the control group. Total thyroidectomy was done and serum calcium levels were evaluated immediately after surgery on day two, seven and on the 30th day. The final outcome was measured at one month. Data was analyzed via the Statistical Package for Social Sciences version 22.0 (IBM Corp, Armonk, NY, USA). P value ≤ 0.05 was considered significant. Results The age ranged from 18 to 65 years with the mean age of 38.673 ± 8.63 years in group 1 while 41.217 ± 9.52 years in group 2, mean preoperative calcium level was 9.482 ± 0.49 mg/dl in group 1 and 9.678 ± 0.54 mg/dl in group 2. Hypocalcemia was seen in 3 (6.5%) in group 1 as compared to 12 (26.1%) patients in group 2 (p = 0.011). Conclusion Preoperative oral calcium and vitamin D supplements may prevent postoperative hypocalcemia, allowing a safe and early discharge. This will ultimately lead to improved patient satisfaction and significant cost savings.

Objective: To determine the difference in mean corneal curvatures before and after pterygium excision. Study Design: Quasi-experimental study. Setting: Department of Ophthalmology, Holy Family Hospital, Rawalpindi. Period: 1st January 2015 to 1st July 2015. Material & Methods: 68 patients aged between 18 to 65 years were included in the study. Patients with history of ocular trauma, ocular surgery, glaucoma, anti-glaucoma treatment, allergy to steroids, pseudo pterygium, recurrent pterygium and presence of corneal abnormalities such as, scarring that might affect the astigmatic value were excluded. All patients underwent comprehensive ophthalmic examination by slit lamp and best corrected visual acuity and keratometric values were noted. Pterygium excision was done by a single surgeon. BCVA and keratometric readings were taken again after 2 weeks of pterygium excision. Results: Mean age was 37.60 ± 11.11 years. Out of these 68 patients, 44 (64.71%) were male and 24 (35.29%) were females. Mean pre-operative corneal curvature was 2.99 ± 0.69D and post-operative corneal curvature was 1.70 ± 0.40D with P-value of <0.0001 which is statistically significant. Conclusion: This study concluded that pterygium excision brings significant change in corneal curvature in patients of pterygium induced astigmatism.

Forest plays an important role in the climate of a country and ecosystem's balance. During the last decade, District Abbottabad of Pakistan has gone through extensive land-use changes due to accelerated development, urbanization, and agriculture. This study examines the change in forest cover due to environmental factors with the help of satellite images (Landsat, Sentinel) and their classification through supervised classification, as well as the application of change detection technique after classification using geographical information system (GIS) over the last three decades (1986–2019). The land-use transition matrix was calculated from the year 1986 to 2019. The result shows an overall significant increase of 3.17, 17.24, and 7.24% in the forest, vegetation, and build-up areas, respectively; whereas, water bodies and others (barren land) have decreased significantly by 0.69 and 26.96%, respectively. This study also provides an assessment of the incline of carbon stock from the forest area over the period of the study by 17.19%.

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