The objective of this study is to see the incidence of malignant obstructive jaundice. It is a descriptive study carried out at. Nishtar Hospital Multan from January 2000 to January 2002. Total 100 patients with obstructive jaundice were included in study. The patients with benign diseases were excluded. The patients having malignant obstructive jaundice were studied in detail and incidence of malignant obstructive jaundice was noted. The main presenting symptoms were progressive painless jaundice, pruritis, anorexia, weight loss, abdominal pain and mass right upper abdomen. 84 patients (84%) were suffering from malignancy and 16 patients (16%) were suffering from benign diseases. The incidence of various malignancies was CA gall bladder 44 patients (52%), CA Pancreas 26 patients (31%), Cholangiocarcinoma 8(10%) and Hepatoma 6 patients (7%). Incidence of malignancy in obstructive jaundice is 84%, which gradually increases with the increasing age. The most common malignancy responsible for obstructive jaundice in female patients is CA gall bladder (52%) and in male patients is CA head of pancreas (31%).

Objective of this study is to provide best therapy in terms of hospital stay and post operative complications after closed lateral internal sphincterotomy under local anaesthesia in the treatment of chronic anal fissure. It is descriptive type of study carried out at Nishtar Hospital Multan, from February 2001 to April 2001. Thirty patients underwent closed lateral internal sphicterotomy in local anaesthesia in OPD. Internal anal sphincter divided up to dentate line by introducing no.11 surgical blade in the intersphicteric groove. Pts were allowed to go home just after the surgery. Follow up for complications was done for the period of 6months. Mean postoperative stay was for 12 minutes. Postoperative complications were soiling (6.6%), incontinence to flatus (3.3%) and recurrence (3.3%). CLIS can be done safely under local anesthesia in OPD with low complication rate and less postop period of stay.

The objective of this study is to compare the postoperative complications of Lichtenstein tension free repair and pure tissue repairs like modified Bassini or Shouldice. This was an interventional (quasi experimental) study. This study was carried out on 100 patients having primary inguinal hernia. After taking detail history, examination and necessary investigations, only tit patients were included in the study and rest were excluded. A separate file was maintained for each patient to note the complication rate of different hernia`s repairs. Patients in group I underwent modified Bassini (35%) and Shouldice repair (15%). Patients in group II underwent Lichtenstein repair (50%).30 (30%) complications were observed. Out of these 23(23%) were in group I and 7(7%) were in group II. All were managed conservatively. The main complications were wound hematoma (9%), Wound infection (3%), scrotal edema (1%), postoperative neuralgia (6%), retention of urine (8%) and recurrence (3%). Wound infection, wound hematoma and recurrence were seen more in group I. Post operative neuralgia was more common in group II. Although follow up was for a shorter period of time and complications like recurrence and post operative neuralgia could not be assessed accurately. It was concluded that Lichtenstein tension free repair is simple and effective method of repairing inguinal hernia, with low complication rates and low recurrence rate. The method is much easier and should be considered in majority of patients with inguinal hernia.