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Background: Typhoid fever is spread by ingestion of contaminated food or water, which is linked to infrastructure; specifically, sewage and sanitation. In developing countries, infrastructure varies according to socioeconomic status (SES). Balochistan is the least developed province of Pakistan. Aims: To analyse the association between the clinical features of typhoid fever and socioeconomic status. Methods: A quantitative, cross-sectional study was conducted in Quetta, Balochistan, Pakistan. Between May and October 2017, 143 patients presented to tertiary care hospitals and private clinics with a complaint of fever lasting ~3 days, along with a clinical history of headache, malaise, diarrhoea or constipation, abdominal pain, dry cough, and anorexia. All patients had a positive blood culture for Salmonella enterica serotype Typhi. Eighteen patients dropped out of the study, leaving 125. Results: Seventy (56%) participants had low socioeconomic status (SES), 40 (32%) middle SES and 15 (12%) high SES. The strongest predictors of reporting typhoid fever were patients’ clinical condition when presenting to health facilities, followed by SES. Most respondents had a treatment duration of 1–2 weeks. SES had a high impact on source of drinking water supply. Conclusion: The strongest predictor of reporting typhoid fever was the current clinical condition of the patients, followed closely by SES. The incidence of typhoid fever in the low SES patients was almost the same as in the middle and high SES patients. Patients with low SES were more susceptible to contracting typhoid fever due to poor health status and facilities.

ABSTRACT        COVID-19 pandemic has afflicted the individuals, national economies, and healthcare system worldwide. It has badly struck the ongoing and planned surgical procedures in nearly all healthcare centers which has led the surgical procedures to come to a grinding halt. This serious issue invites comments from surgical experts throughout the world.

BACKGROUND & OBJECTIVE: Surgical site (SSI) infections are important cause of morbidity and mortality in admitted patients worldwide. The objective is to determine the incidence of surgical site infection in General Surgical ward of tertiary care hospital. METHODOLOGY: Analytical cross-sectional study conducted at Department of General Surgery, Bolan Medical College/ Post-Graduate Medical Institute Quetta (PGMI) for a period of one year from 1st August 2019 to 31st July 2020.  Descriptive statistics were used to present social economics, factors related to surgery and surgical antimicrobial prophylaxis received. Chi square test was used for checking association between infections and different factors keeping p≤ 0.05 as significant. RESULTS: A total of 1500 patients underwent surgery, of which 500 (33.33%) patients were operated as elective cases and 1000 (66.66%) cases as emergency. Out of total 600 (40%) patients developed Surgical Site Infection (SSI). Risk associated with higher incidence of SSI was found to be age (30-45 years) and Diabetes mellitus (uncontrolled diabetes in perioperative period). Postoperatively obesity was noted to be having significant effect with p=0.002, American Society of Anesthesiologists (ASA) score having p-value 0.045, hospital stay with p<0.001 and surgical type and previous surgical history with p<0.001, were as duration of surgery was having <0.001. CONCLUSION: Prevention of SSI’s requires a multipronged approach with emphasis on optimizing preoperative issues, adhering to strict protocols during the intraoperative period and addressing and optimizing metabolic and nutritional status in post-operative period.

BACKGROUND & OBJECTIVE: Fournier's Gangrene is a quick development of necrotizing, fulminant infection of the scrotum, perineum, and lower abdominal wall and can  involve the groin. Synergic aerobic and anaerobic organisms can cause this disease. The aim of this study is to evaluate the causes, complications and optimal treatment of Fournier’s Gangrene. METHODOLOGY: A total of 150 patients were included. Fournier’s Gangrene was diagnosed clinically. Detailed clinical examination was performed, and the complications and modes of treatment were recorded. Calculation of descriptive statistics was done by the stratification and application of independent T-test and Chi-square test wherever applicable for post-stratification, considering p-value ≤0.05 as significant. RESULTS: The mean age was 31.74±6.24 years. The most common presenting complaint was the dusky appearance of the overlying skin. In the diabetic group, (66)44% had intense genital pain and tenderness, while in the non-diabetic group (72)48% observed a dusky appearance of the overlying skin and (37)24.7% had morbid obesity. No significant association was found between mortality of study groups, their age groups and their duration of hospital stay. CONCLUSION: Most common presenting complaint was the dusky appearance of the overlying skin. The anal abscess was the most common etiology, followed by a strangulated inguinal hernia. The mortality rate was 24%.