Objective: To conclude frequency for malignancies in subjects with mass in breast at the PUMHSW Nawabshah department of surgery Wards. Design of Study: This is an Observational research. Duration & Location of Study: Current research was carried out in surgery at Nawabshah People's Medical College Hospital (SBA) from November 20, 2018 to November 20, 2020. Methodology: This research comprised of 200 subjects. A comprehensive history was taken from total subjects with special consideration for breast nodules & axillary lymph nodes & recorded proforma to evaluate the affected area was specifically inspected. A systematic review was also conducted to identify comorbidities. Total subjects received baseline & specific tests, especially radiological & histopathological reports. The selection criterion was that total female subjects over the age of 15 associated with mass in breast were included in this research. Exclusion criteria were subjects with breast abscesses & those who were diagnosed & treated for breast cancer with recurrent lesions. Results: the range of age started from 15-65 years, 39+4.11 years was mean age. lesion of Benign nature on biopsy were were Fibroadenoma 22%, intraductal papilloma 9%, Phylloid Tumor Benign 6% & lactating adenoma 5%. Neoplastic nature was observed on biopsy invasive ductal carcinoma 19%, Invasive lobular carcinoma 11% & malignant phylloides tumor 9%. Conclusion: Study determined that frequency of breast malignancy in breast lumps was 58%.

Typhoid ileal perforation is the common complication of typhoid fever in third week of its phase of progression. It is the most common cause of mortality in developing countries. Small perforations are dealt with primary repair and the more complicated disease is treated by multiple other options. Prognosis is good with primary repair with least postoperative complications. Objectives: To detect the outcome of typhoid ileal perforation treated by primary repair at tertiary care hospital. Study Design: Cross sectional study. Setting: Surgical Department of PMC Hospital Nawabshah. Period: From August 2017 to December 2018. Material & Methods: This study included total 70 patients. All patients were admitted from surgical OPD and emergency department of PMCH Nawabshah. Out of 70, 45 (64.28%) were females and 25 (35.71%) were male patients. Age ranged from 27 to 52 and 24 to 47 in females and males respectively. The common presentation was pain in whole abdomen along with distention and fever, vomiting. Plain X ray chest/ Abdomen and ultra sonography showed gas under diaphragm. Primary repair was done and also other surgical options but our study included only the postoperative outcomes of primary repair of typhoid ileal perforation. A few complications were detected after primary repair of the gut perforation. Results: Total 70 patients were included in this study. 45 (64.28%) were females and 25 (35.71%) were male patients. In females, 25 (55%) were found single perforations of less than 1cm whereas 7 (15.5%) had size of perforation less than 1.5 cm. In 25 males, 11 (44%) had single perforations of less than 1cm in size. 2 (8%) had < 1.5 cm size perforations and 12 (48%). Over all complication rate in this study was 26%. Conclusion: Primary repair is the best surgical option to treat typhoid ileal perforation in selected patients with least postoperative complications.

Introduction: Epididymo-orchitis is common condition in scrotum found in surgical practice. It is commonly seen in young males. It can occur at any age. The common age is between 2nd to 4th decades of life. Its duration of illness is 6 weeks in acute condition and 12 weeks in in chronic conditions. It mostly occurs associated with sexually transmitted diseases. Chlamydia trachomatis and Neisseria gonorrhea are the common causative organisms. After age 40, the common organisms causing this disease are Escherichia Coli and Coliform bacteria found on G.I.T. There are also other causes of this disease. It is mostly managed conservatively but it can be operated it the condition develops complications. Even Orchidectomy is also done in some conditions. Objective: To evaluate the management options in epididymo-orchitis . Material methods: This is a cross sectional study done at surgical Unit 1 of Peoples Medical Hospital (PMCH) Nawabshah. The duration of study was one year from 10th August 2019 to 9th July 2020. All the patients were admitted through Surgical out Patient Department (SOPD) and emergency department of Peoples Medical College Hospital (PMCH) Nawabshah. Approval of study was taken from Ethical committee. Detailed history and thorough clinical examination was done. Routine investigations were done apart from viral markers including HIV. Urine DR and Culture ,Ultrasound of Scrotum and CT Scan were done. Management was planned accordingly. Results: Total 65 patients were included in this study. Of them, 20 (31%) had left sided pathology, 40 (61%) had right sided and 5(8%) had bilateral. Testicular abscess formation was seen in 8 (12.3%) patients. In 2 (3.07%) patients, testicular infarction was noted. 1 (1.5%) patient became infertile due to bilateral involvement. 3 (4.6%) patients had developed psychosis. Conclusion: It is concluded that most of the patients were treated conservatively and in a few patients, incision drainage and orchidectomy was performed. Keywords: Epididymo-orchitis. Neiserria Gononrhea, E.Coli, Incision Drainage, Orchidectomy.

Objectives: The purpose is to compare two options of management of appendicular lump in order to sort out the better one for the benefit and betterment of populace. Study Design: Cross Sectional study. Setting: Peoples Medical College Hospital Nawabshah. Period: 2016 August to August 2018. Material & Methods: Total 50 patients of appendicular lump were included in this research. All patients were divided into 2 groups. Group 1 included those patients undergoing emergency appendectomy. They were admitted, optimized and the required treatment was initiated. Results: Of total 50, 30(60%) were male and 20(40%) were females. Age was between 14 to 51 years. All patients presented with different clinical presentations. Pain in RIF was in 42(84%) patients whereas 47(94%) patients presented with lump in RIF. 20(40%) patients were operated for appendectomy in emergency and 5(10%) patients for right hemi-colectomy. Histopathological diagnosis was inflammation in 24(48%) patients and 1(2%) resulted in cecal tumor. Infected wound was found in 15 (30%) patients, hematoma in 3 (6%), wound dehiscence in 1(2%) and also cecal fistula in 1 (2%). Conclusion: Conservative treatment is better option to treat appendicular lump with least negative results.

Objectives: Pilonidal sinus is chronic inflammatory condition that usually affectyoung adult population, despite the current medical advances in the field of medical sciences.The acceptable management of pilonidal sinus is still lacking. This study evaluates the outcomeof pilonidal sinus after excision of the whole tract then its closure with a Z plasty technique whichis a simple cleft lip repair like method which provides a quick and comfortable remedy. Design:A seven years retrospective study. Setting: Surgical Department of Peoples Medical CollegeHospital (later University) and at Private Medical Center at Nawabshah. Period: January 2010to March 2017. Methodology: A total of 55 patients suffering from pilonidal sinus were admittedat both sites from the outdoor department. All the data were collected from the admitted recordand proforma. All required investigations were done. Excision of sinus followed by Z plastyclosure were done in a single stage with drain put by separate stab on one side of the wound.Results: Out of total 55 patients 41 (74.5%) patients recovered smoothly while 6 (10%) patientsdeveloped major wound disruption, 3 (5.45%) patients developed minor wound disruption and5 (9.09%) developed wound dehiscence. Conclusion: Primary closure of pilonidal sinus with Zplasty technique is technically a simple closure method which provides a comfortable closurewith minimum results of wound disruption and dehiscence. Healing is rapid due to comfortableapproximation of the wound flaps and thus avoids the problem created in simple closuretechnique. It can be applicable with every type of patients from heavy build to thin build type.