Objectives: In elderly patients, recent research has also questioned the effectiveness of this surgery. The objective of our study is to evaluate the safety and applicability of laparoscopic cholecsytectomy in geriatric patients (over 60 year of age) for the symptomatic cholelothiasis. Study Design: Prospective and observational study. Setting: Different surgical wards at LUHMS Jamshoro / Hyderabad who undergone for laparoscopic cholecystectomy. Period: One year from 01-03-2017 to 28-02-2018. Material & Methods: 100 patients of 60 years of age and above having gall stone disease. All elderly patients of cholelithiasis (over 60 years) presenting with symptoms of gallstone disease will be included in this study irrespective of their sex. Results: A total of 100 patients were included in this study. The minimum and maximum age range was 65 to 83 years. The mean age + SD, was 69.72 + 10.31 years. Most of the patients i.e. 60 (60%) were seen in the age group 60 to 65 years, 45(5.0%) patients were observed in the age group > 65 years. 52.0% (n=52) patients had co-morbidities followed by hypertension in 20 (20.0%), Diabetes Mellitus 15 (15.0%), COPD 7 (7.0%), Coronary artery disease 9 (9.0%) and cardiac arrhythmias 1 (1.0%) patient only. Most of the patients had duration of operation 90 to 120 minutes. The mean + SD operative time was 90.12 + 35.5 (60 to 250 minutes). Total operative complications were seen in 15(15.0%) patients who had injury of CBD in 3 patients and 4 patients had bleeding, failed to clip cystic duct 2 cases and 3 patients died. Nineteen (19.0%) elderly patients had postoperative complications and they were not undergone for laparoscopic surgery due to low intensity and occurrence. Overall mortality was seen 1(1.0%) because of acute myocardial infarction and it was occurred on the second day of the operation. Conclusion: Laparoscopic cholecystectomy is as safe and effective in old patients as compared to young patients with less complications, morbidity and mortality are very low and lesser than open cholecystectomy. The pain free post-operative period and early ambulation lead to saving of valuable working hours.
Acute appendicitis is the most common cause of emergency abdominal surgery worldwide. Postoperatively, surgical site infection (SSI) occurs in 3% to 60% of appendicectomized patients, depending on pathological state of appendix. SSI is a devastating complication from biologic and economic point of view and has enormous impact on patient’s quality of life. Objectives: To determine the frequency of surgical site infection after appendicectomy in patients presenting as acute appendicitis and correlate it with per-operative morphological appearance of appendix. Study Design: Cross-sectional study. Setting: Department of General Surgery, Liaquat University of Medical and Health Sciences Jamshoro. Period: One year from March 2015 to February 2016. Material & Methods: This study was carried out on 200 patients. All male and female patients above age of 12 years with clinical diagnosis of acute appendicitis or localized peritonitis due to perforated appendix undergoing appendectomy by grid iron incision and whose skin closed primarily by interrupted silk 2/0 stitches were included in the study. Operative findings were recorded and inflammation of appendix was graded into four categories. Postoperatively patients were followed for period of 30 days to check the development of SSI. Results: Out of 200 patients, 42 suffered from SSI (21%). On the basis of per-operative morphological appearance of appendix, uncomplicated appendicitis was significantly high 135(67.5%) than complicated appendicitis 65(32.5%). SSI developed in 12(28.5%) cased of uncomplicated and 30(71.5%) cases of complicated appendicitis. Conclusion: It was not possible to establish a relationship between SSI and per-operative morphological appearance of appendix. Frequency of SSI reported here (21%) is comparable with literature. We recommended that avoiding delay in diagnosis, use of peri-operative antibiotics, sound surgical technique to avoid wound contamination and continuing surveillance is necessary to further reduce SSI rates after open appendicectomy.
In this study we have tried to conduct a rather detailed research on "does according to Quran only a man has the right to Nikkah? Does the man has the right to Nikkah only because he is the breadwinner? Is woman actually subordinate to man in case of Nikkah according to Quran? Quran has set Nikkah as a contract between a man and a woman according to which the man and the woman will live together having sexual relations while respecting some conditions and limits set by Shari'ah. The topic under review explains that according to Quran man and woman both have equal right to Nikkah and also The Quran puts the responsibility of protecting the Nikkah on both the man and the woman. That is why the status of woman, rights and position do not lessen after her marriage. In the matter of Nikkah independent consent of both parties is a must. Both shall be bound to the limits set by Allah. Since Nikkah, according to Quran is an agreement, which is undertaken by the two parties, hence it cannot be a one-sided matter. The woman has the right to engage in the agreement of Nikkah and to be broken it. The religion of God and Shari'ah is not only for men but it addresses all in general. Both men and women means both shall spread the religion of Allah and act upon it. Denial of women's freedom and rejection of her right to chose neither fulfills Allah's will nor it could establish a healthy society.
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