Aim: To assess the different kinds of management provided to patients with Blunt Abdominal Trauma (BAT) in the surgical department of a tertiary care hospital. Study design: prospective study Place and Duration: This study was conducted at Liaquat University of Medical and Health Sciences Jamshoro from March 2021 to March 2022 Methodology: The present study includes 115 patients who presented with blunt abdomen trauma (BAT). The data was collected with the pre-designed questionnaire. Data were collected prospectively from all patients admitted to the hospital with abdominal trauma. The trauma was treated using ATLS (Advanced Trauma Life Support) techniques. Laboratory and imaging investigations were performed to diagnose and manage the patients. SPSS version 21 was used to analyze the data. Descriptive statistics were presented in mean, SD/median, frequency, and percentage. Results: During the investigation, 115 BAT patients were examined. The average age of the patients was 33.7 ± 7.2 years. Males (n=94, 81.7%) and symptomatic cases (n=108, 94%) made up the majority of the injured patients. More than half of the patients (n=73, 63.5%) had abdominal tenderness when they arrived. The majority of the patients had X-rays (n=87, 75.6%) ultrasound (n=75, 65.2%), lab investigation (n=83, 72.1%) and abdominal CT scan (n=35, 30.4%). Only a few patients died (n=17, 14.8%). Patients were treated conservatively in 83% of cases, while surgical treatments were used in 17% of cases. Conclusion: Non-operative therapy has become the gold standard for critically stable patients with traumatic injuries. Although non-operative management has a higher risk of failure in patients with multiple solid organ injuries, it should still be used with caution in most critically stable persons who do not have peritoneal symptoms. Keywords: Accident, Blunt Abdominal Trauma (BAT), Non-operative management, vitally stable.
Background: Blunt trauma to the abdomen most commonly leads to injury of the spleen. Patients usually presents with left hypochondriac pain or generalized abdominal pain which may radiate to the left shoulder. There can be associated left lower rib fractures. Diagnosis is made on contrast enhanced computed tomography (CT) of the abdomen. Surgical management is warranted in the cases according to AAST Grade of injury. Missed or delayed presentation of injury can lead to mortality hence careful evaluation of mode of injury, complete examination, appropriate investigation and monitoring are vital for patient management. Objective: The present study aims at the determination of incidence and causes of splenic injury after blunt trauma to the abdomen. Study design: A cross-sectional study Place and Duration: This study was conducted at Rawalpindi Medical University from November 2020 to November 2022 Methodology: A total of 195 patients were included in the study. The lowest age limit was 15 years and patients of both genders were considered. The patients with abdominal trauma were received in the emergency department. A detailed history of the event was taken from all the patients with simultaneous resuscitation. After that, a thorough clinical examination was performed on all the patients. The patients were sent for a FAST SCAN and CCET abdomen to diagnose and assess the extent of the injury. The type of trauma that lead to the injury of the spleen, such as road traffic accident (RTA), assault, and fall from height was recorded of each patient. Patients with AAST grade I and II were managed conservatively except in cases where exploration was required for concomitant abdominal injuries however patients with Grade III, IV and V underwent exploration, spleenoraphy or splenectomy respectivelyThe data was collected and analyzed in the IBM SPSS version 26. Result: A total of 195 patients were studied, out of which 48 (24.61%) were female and 147 (75.38%) were male. The mean age of the patients was 30.45±2.12 years. Overall 12 (6.15%) were detected with splenic injury. A total of 5 (41.67%) had an RTA, 4 (33.33%) had a fall from height, 2 (16.67%) assault, and 1 (8.33%) had sports injury. Conclusion: The most common type of blunt trauma to the abdomen which resulted in a splenic injury was road traffic accidents followed by fall from height. Early diagnosis is helpful in the proper management of the patient and increasing the survival rate. Keywords: Splenic injury, road traffic accident, blunt trauma
Aim: To evaluate Post-Laparoscopic infection in Mesh followed by inguinal hernia repair. Study design: A retrospective study Place and Duration: This study was conducted at Jinnah Postgraduate and Medical Centre Karachi from April 2021 to April 2022 Methodology: A total of 80 participants were included in the study. All the patients had an extensive infection in the mesh followed by mesh hernia repair through laparoscopy. The preoperative workup was done for all the patients before a laparoscopic excision of mesh. A drain was placed in the preperitoneal space after the removal of the mesh. Closure of the peritoneal flap was done after that with a 3/0 absorbable suture. Result: The course of the operation was uneventful for all the patients. Only two patients required a sigmoidectomy for the repair of the fistula. Three patients presented with contralateral side infection and mesh residues around the pubic. A second laparoscopy was done on those three patients. Recurrence of hernia was seen in four of the cases observed on follow-up. Conclusion: Laparoscopic removal of the mesh is a superior approach to the open surgical removal of the mesh for the treatment of mesh infection. However, prevention of infection by prophylactic antibiotics, maintaining an aseptic environment during hernia repair surgery, and proper sterilization of the instruments can prevent the infection. Keywords: laparoscopic, mesh infection, inguinal hernia repair
OBJECTIVE: To analysis the efficacy of 0.2% GTN in patients undergoing fistulectomy for fistula in ano low variety in terms of early wound healing. METHODOLOGY: A randomized controlled trail was conducted at general surgery department of Liaquat University Hospital Hyderabad from February 2013 to August 2013 among patients with low anal fistula. All participants underwent fistulectomy by a consultant general surgeon. Patients were divided into two groups using lottery methods. Group A treat fistula in ano with 0.2% glyceryl trinitrate ointment and group B treat fistula in ano without 0.2% glyceryl trinitrate ointment and wounds covered with pyodine soaked dressings. All patients were discharged on second postoperative day. Wound healing was assessed weekly for six weeks. Parameters of incomplete wound healing such as discharge, perineal irritation and pain were noted. Presence of granulation tissue at the end of 6 weeks was considered as sign of healing. Data was collected via study proforma. RESULTS: This study was conducted on 94 patients in Liaquat University Hospital Hyderabad. In GTN group 35(74.46%) were male while in Control group 38(80.85%) were male. In GTN group mostly observed single opening 37(78.72%) cases while in control group 35(74.46%) cases. The healing time in GTN Group was found to be between 21-36 days (mean 26.38 days), while the healing time control group was 32-46 days with a mean of 38.64 days (P. value <0.001). The complications were also found significantly higher in the control group CONCLUSION: In conclusion our study revealed that postoperative 0.2% GTN after fistulectomy can be used as a primary treatment of low fistula in ano as a shorter period of time for wound to early heal and the less incidence of complications is comparable to that of control group. Key words: fistula in ano, 0.2% GTN, Effectiveness
Aim: To determine the frequency of different clinical symptoms in (PCS) Post Cholecystectomy Syndrome patients, at a secondary care facility Study Design: A cross-sectional study Place and Duration: This study was conducted at Liaquat University of Medical Health Sciences Jamshoro, Pakistan from May 2020 May 2021. Methodology: For the purpose of this study, 100 patients were selected. Only those individuals were selected who qualified against an inclusion criterion which was set based on the patients’ history of cholecystectomy. For this purpose, a questionnaire was made. The patients that were selected had to go through CT (computed tomography) scans and sonographic tests. Blood testing was also done and sera were prepared for in-depth laboratory tests. Data from the research were analyzed by using SPSS version 19. Results: Most common clinical symptom after post-surgery was right upper quadrant pain (114 patients). Epigastric discomfort was present in 97 patients. Fever was third in line (73 patients) with jaundice being fourth (23 patients). Abdominal tenderness (19 patients) was followed by bile leakage (7 patients), fluid in the peritoneal region (19 patients), CBD dilation (39 patients), recurrent stone in CBD (12 patients), retained stone in CBD (19 patients), dysfunctioning of Oddi sphincter (37 patients) and remnants of the cystic duct stump was present in 41 patients. Conclusion: The results of this study show that post cholecystectomy symptoms and conditions vary among patients and all of them need to be kept in while proposing proper follow-up treatment Keywords: post cholecystectomy syndrome, bile leak, sonography, CT scan
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