Objectives: To determine the frequency of obstructive appendicitis in patients undergoing open appendectomies for acute appendicitis. Negative appendectomy rate will also be calculated. Study Design: Cross-Sectional study. Setting: Department of General Surgery of Ayub Teaching Hospital Abbottabad. Period: September 2019 to February 2020. Material & Methods: The study population included patients of any gender, age from 10 years to 45 years found to have acute appendicitis diagnosed by clinical and ultrasound findings and confirmed by open appendectomy. Sample size of 174 was calculated, using WHO software for sample size calculation. After detailed examination and investigations, patients who underwent open appendectomy as per advice of visiting consultants were included; by filling predesigned research per forma. Results: Mean age of the patients was 26.33±11.177 and more than half were male i-e 106 (60.9%). Where majority i-e 93(53.4%) of appendices were of obstructed type, this wasn’t statistically higher than the non-obstructed type (p=0.363). In frequency of operative findings, acutely inflamed appendix was most common with 71(40.8%) patients. While suppurative, gangrenous and perforated samples were noted in 55(31.6%), 13(7.5%) and 8(4.6%) cases respectively. Negative appendectomy was done in 27(15.5%) patients. Conclusion: This study concluded that obstruction was noted in more than half of the cases i-e 93(53.4%), but it was not statistically higher from the other subtype. Negative appendectomy rate was 15.5%; higher than globally set target, but was similar to the one noted in Pakistan by previous researchers.
Objective: To look into the relationship of Ramadan with peptic ulcer perforation. This will include assessing the effect of fasting as well as other Ramadan related factors like changes in eating and smoking habits. Study Design: Retrospective Analysis. Setting: Three Tertiary care hospitals of Peshawar i-e Hayatabad Medical Complex, Khyber Teaching Hospital and Lady Reading Hospital. Period: 6th May 2019 to 26th May 2020. Material & Methods: Patients presenting with the aforementioned complication of peptic ulcer during the research period were divided into two groups. Patients presenting during the two Ramadan months were designated as cases (Group 1). While those presenting during the rest of the period i-e 11 months, were the controls (Group 2). So comparison of these groups was done on basis of various predisposing factors of the disease. Inferences were drawn by applying Student’s t, Chi-square and Fischer’s exact chi-square tests. Results: A total of 129 patients were considered. Among these, 36 were cases (Group 1) and 93 were controls (Group 2) as per our study design. Number of perforations per month were statistically higher in Group 1 in comparison to Group 2 (i-e 18 patients per month vs 8.4 patients per month, p<0.05). Patients with dyspepsia and preference for fried food were significantly higher in Group 1 (p<0.001 and p=0.022 respectively). Whereas smoker were significantly lower in Group 1 (p=0.048). Conclusion: Analysis concluded that the incidence of perforation is higher during the Ramadan. Since Ramadan is not only about fasting, and it affects eating and smoking habits, this rise in rate of perforations can be considered to be an interplay of such changes and the complication of peptic ulcer.
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