Background: Mortality from liver trauma remains high despite surgical advancements. The objective of this study was to determine the outcomes of surgical management of liver trauma at LUMHS Jamshoro.Methods: A cross-sectional observational study using non-probability convenient sampling technique was done at department of surgery LUMHS Jamshoro for 18 months. Patients between 14 to 50 years with blunt hepatic trauma presenting to the E.R. within 04 hours of incident were included and hepatic trauma patients managed conservatively, having multiple trauma and hemo-dynamically stable were excluded. SPSS version 20 was used for data analysis with mean and SD reported for qualitative and frequency and percentages for quantitative variables. Chi-square test was applied keeping p-value of < 0.05 as statistically significant.Results: From 136 patients with mean age of 32.33±1.23 years, 120 (88%) were male. 122 (89.7%) were admitted due to blunt trauma and 14 (10.3%) due to penetrating trauma. Peri-hepatic packing was performed in 116 (85.2%) and suture hepatorrhaphy in 20 (14.8%). Intra-abdominal sepsis was seen in 41 (30%) of patients followed by recurrent hemorrhage in 33 (24%) while 30 (22%) of patients died. Substantial differences (p < 0.001) were observed in terms of surgical technique and each of the complication i.e. sepsis, bile leak and recurrent hemorrhage among alive patientsConclusions: The most common post-operative complication was intra-abdominal sepsis followed by recurrent haemorrhage and bile leak. Significant mortality was observed in between type of complication as well as surgical technique.
Objective: To determine the complications associated various types of tumors of advanced stage of thyroid disease at tertiary care hospital. Study Design: Descriptive study. Place and Duration: Two years study from April 2018 to March 2020 was conducted in Liaquat University of Medical and health sciences Jamshoro. Patients and Methods: All patients were admitted from Outpatient department (OPD) with advance stage of tumor of thyroid and either of gender were included. The patients were evaluated fully after history and clinical examinations berries sign and specific investigations of thyroid profile (T3,T4,TSH), ultrasound of thyroid, fine-needle aspiration cytology FNAC, image guided biopsy, frozen section biopsy for confirmation of diagnosis, indirect laryngoscopy, x - Ray neck and MRI. All the patients were assessed for pre-operative evaluation (complications) with advanced stage of thyroid tumors. All the data regarding developed complications was recorded via study proforma. Data was analyzed by using the SPSS version 20. Results: Most of the patients were found with age groups of 20 to 34 years and 35 to 55 years. Out of all, 25 patients were diagnosed papillary carcinoma, 12 patients were diagnosed as follicular carcinoma, 7 patients had Anaplastic carcinoma, 4 patients were diagnosed lymphoma and 2 patients were diagnosed as medullary carcinoma. As per complications of advanced disease 23 patients had thyroid swelling with cervical lymphadenopathy and pain, 13 patients had thyroid swelling with change of voice, 7 patients had thyroid swelling with dyspnea and dysphagia, 5 patients were presented with thyroid swelling with bony pain, weight loss and pathological fractures, 2 patients were presented with thyroid swelling with diarrhea. Conclusion: Various complications such as swelling, pain, hemorrhage, cervical lymphadenopathy, change in voice, weight loos, pathological fracture, dyspnea and dysphagia were frequently seen in patients presented with advanced stage of thyroid disease.
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