ABSTRACT… Objectives:To determine the frequency of hepatitis b & c viral infection in surgical patients. Study Design: Descriptive case series. Place and Duration of Study: This study was conducted at surgical department of multiple hospitals and compares the results, JPMC Karachi, Civil Hospital Naushahro Feroze and Jamshoro, Pakistan from August 2014 to December 2015. Methodology: All 2645 patients were admitted for emergency and elective surgery. All patients taken detail history regarding demographic parameter and risk factors like previous surgery, blood transfusion, barbar, Road Traffic accident, haemodialysis, Tattoos/ body piercing, injecting drug user, family history of hepatitis, previous history of jaundice and Hospitalization. Hospital laboratory was used for screened HBsAg and Anti HCV using immunochromatography (ICT method). Patients excluded who were those did not need the surgery or known case of HBsAg and Anti HCV. Data collected was entered into and analyzed by using statistical package for the social science -20. Results: Out of 2645 patients, male to female ratio were 1.9:1. The mean age was 40.2+6.12years (20 to 60 years). Out of 2645 patients, Anti HCV was positive in 288(10.88%) cases followed by HBsAg was in 152(5.74%) cases. While both positive in 36 (1.36%) cases. We observed Previous surgery was main risk factor in the reactive 156(32.77%) cases followed by Barbar, Blood transfusion were 74(15.54%) and 47(9.87%) respectively. Conclusion: We conclude that preoperatively screening of hepatitis B and C should be performed.
. Methodology: This study consisted of 145 patients. All patients presenting with multiple neck swellings attended as outdoor patient at a tertiary care hospital. Before FNAC, patients were screened, which included the recording of clinical history and clinical findings are important. The proper investigations were carried out according to the needs. After a brief description of the procedure, the patient's informed consent was obtained. Results: 83(57.24%) males and 62(42.75%) females. Ratio between the male and female is 1.33:1. Mean age was found to be 41.57+4.54 years (25 to 60 years). Patients presented in OPD for multiple neck swelling likely lymph nodes were involved in 70(48.27%) cases, followed by Salivary Gland in 26(17.93%) cases and thyroid in 35(24.16%) cases. Soft tissue and other were involved in 8(5.51%) cases and 6(4.13%) cases respectively. Fine needle aspiration cytology results showed Lymph node mostly involved in tuberculous 42(28.96%) cases while metastatic involved in 4(2.75%) cases. Thyroid FNAC showed mostlygoitre 21(14.48%) cases and rarely involved malignant disease like papillary carcinoma 1(0.68%) case and medullary carcinoma in 2(1.37%) cases. Salivary Gland results showed pleomorphic adenoma in 14(9.65%) cases and sialadenitis in 8(5.51%) cases were involved. Lipoma in 5(3.44%) cases. Conclusion: We conclude that fine needle aspiration cytology is a rapid, simple and accurate diagnosis of tissues that can be made from outside the patient. FNAC provides a simple method of diagnosis of neoplastic and non-neoplastic lesions of head and neck. Key words:Fine needle aspiration cytology, neck swelling, neoplastic neck swelling, non-neoplastic neck swelling.
Objectives: The objective of this study was role of fine needle aspirationcytology (FNAC) and neck swellings. Study Design: Observational study. Place and Durationof Study: This study was conducted at surgical department of multiple hospitals and comparesthe results, JPMC, Civil Hospital Karachi, Naushahro Feroze and Jamshoro, from January 2015to October 2015. Methodology: This study consisted of 145 patients. All patients presentingwith multiple neck swellings attended as outdoor patient at a tertiary care hospital. BeforeFNAC, patients were screened, which included the recording of clinical history and clinicalfindings are important. The proper investigations were carried out according to the needs. Aftera brief description of the procedure, the patient’s informed consent was obtained. Results:83(57.24%) males and 62(42.75%) females. Ratio between the male and female is 1.33:1.Mean age was found to be 41.57+4.54 years (25 to 60 years). Patients presented in OPDfor multiple neck swelling likely lymph nodes were involved in 70(48.27%) cases, followed bySalivary Gland in 26(17.93%) cases and thyroid in 35(24.16%) cases. Soft tissue and other wereinvolved in 8(5.51%) cases and 6(4.13%) cases respectively. Fine needle aspiration cytologyresults showed Lymph node mostly involved in tuberculous 42(28.96%) cases while metastaticinvolved in 4(2.75%) cases. Thyroid FNAC showed mostlygoitre 21(14.48%) cases and rarelyinvolved malignant disease like papillary carcinoma 1(0.68%) case and medullary carcinomain 2(1.37%) cases. Salivary Gland results showed pleomorphic adenoma in 14(9.65%) casesand sialadenitis in 8(5.51%) cases were involved. Lipoma in 5(3.44%) cases. Conclusion:We conclude that fine needle aspiration cytology is a rapid, simple and accurate diagnosis oftissues that can be made from outside the patient. FNAC provides a simple method of diagnosisof neoplastic and non-neoplastic lesions of head and neck.
Moyamoya disease is a very rare chronic cerebrovascular disease of unknown etiology characterized by recurrent ischemic or hemorrhagic strokes. Initially diagnosed in Japan and named after finding puff of smoke like collateral blood vessels around the occluded blood vessels of circle of Willis. With increase awareness this disease is now diagnosed more often. Medical and surgical treatment have been used to treat the disease, with surgical treatment been mostly experimental. Special attention should be given to the surgical treatment which has shown to have an edge over the medical treatment in some clinical trials especially in young patients with recurrent strokes to prevent progressive cognitive decline and to improve their quality of life. In our patient, who is a young man, the diagnosis was picked up late and when surgical evaluation was performed, it was considered to be fruitless with findings of nonviable brain tissue on MRI imaging.
Objectives: To determine the complications and their management in patientswith giant inguinal hernia. Place and Duration of Study: This study was carried out in inSurgical Unit-IV, Liaquat University Hospital Jamshoro, from October 2013 to December 2015.Methodology: This study consisted of 30 patients of giant inguinoscrotal hernias. DetailedHistory was taken from all the patients with special regard to the inguinoscrotal swelling.Detailed Clinical examination of the patient was done .Site of swelling was especially examinedfor assessment of three grades. Grade–I means hernia reaching upto middle of thigh, Grade-IImeans inguinoscrotal contents reaching upto knee joint and Grade-III means contents goingbelow knee level. All data was entered in a specified proforma designed for this purpose.Inclusion criteria were all diagnosed patients of giant inguinoscrotal hernia on the basis ofhistory, clinical examination were included in this study. Exclusion criteria included patientsunfit for surgery, patients below age of 12 years, patients with severe co-morbidity and morbidobese patients. Results: 30 patients included in this study. There was wide variation of ageranging from a minimum of 30 years to 70 years , mean age was 46.28+7.20 years. The patientspresented with more common in right side 21(70%) cases and left side 9(30%) cases. Patientspresented with grade-I 11(36.66%) cases, grade-II 9(30%) cases, grade-III 7(23.33%) cases andgrade IV 3(10%) cases. Giant inguinal hernia were operated Orchidectomy and hernioplasty12(40%) cases, followed by Debulkation of contents and hernioplasty 9(30%) cases andGradual Pneumoperitoneum and hernioplasty 4(13.33%) cases. Complications seen in thisstudy was Respiratory in 3(10%) patients, Abdominal compartmental syndrome in 1(3.33%)patients, Paralytic Ileus in 2(6.66%) patients and Wound Infections in 4(13.33%). Conclusion:In conclusion our study revealed it is commonly to live in our population due to ignorance ofhernia poverty in remote areas and lack of knowledge of disease complications.
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