IntroductionTo study the role of intraperitoneal drainage in the resuscitation of patients of perforation peritonitis during corona pandemic. Materials and methodsThis retrospective study was conducted in the general surgery department of Nishtar Medical University/Hospital Multan from April-2020 to September-2020. Patients of peritonitis who presented with bilateral pulmonary crepitations, SpO2 less than 92%, PaO2 less than 60 mmhg on arterial blood gas (ABG's), and chest X-ray (CXR) finding of bilateral infiltrates are included. Due to high suspicion of associated coronavirus infection such patients needed polymerase chain reaction (PCR) for virus detection and special measures were required for resuscitation before any definitive treatment. A delay of six to eight hours is usually encountered while ensuring proper safety measures and dedicated operation theaters. Initial resuscitation started with intravenous fluids and broad-spectrum antibiotics were given to all patients. Twenty-seven patients were resuscitated with preoperative intraperitoneal drainage while waiting for the report of PCR and 13 patients were resuscitated without drainage. Data analysis was carried out using SPSS version 19 software. The mean was calculated for age while, frequency and percentages were calculated for gender, comorbidities, and causes of delay. The mortality was compared using the Chi-square test. ResultsThe mean age of patients was 43.73 ± 16.04 years. The common cause of peritonitis were perforations due to duodenal ulcer, typhoid, tuberculous (TB), and biliary origin. The variables that led to suspicion of coronavirus were SpO2 < 92%, PaO2 <60mmHg and bilateral infiltrates on chest x-ray. PCR for coronavirus was positive in nine patients. Mortality was 29.6% in those resuscitated with intraperitoneal drainage before the definitive procedure and 54% in those not resuscitated with intraperitoneal drainage. ConclusionsThe surge of coronavirus infection has put the healthcare staff at great risk. This has led to strict protocols and precautionary measures in the management of patients with perforation peritonitis with suspected corona infection. The local guidelines of management of patients with acute abdomen should include aggressive measures right from the start during the corona pandemic. Intraperitoneal drainage, early in the management of perforation peritonitis decreases morbidity and mortality in suspected corona infected patients.

Integrity of well structure is a vital factor to produce hydrocarbons fromsubsurface. It is important that well structure along with cement behind thecasings remains intact to get controlled and risk free production during lifeof a well. This objective is achieved by making every effort to ensure goodcement behind pipe and selecting suitable well tubulars honoring reservoirfluid composition and fluid flow rates. In case the criteria of well integrityis not met, flow of fluids behind casing and communication between tubularscreate problems and may lead to uncontrolled flow of well fluid creatingenvironmental and safety hazards. Bagla gas field is located within the Indus Basin with producing horizon inLower Goru Formation of Cretaceous age. This is a single well field, which wasdrilled by Phillips Petroleum Exploration Ltd during 1988. Later on OGDCLacquired this field. The field could not be developed due to its marginalreserves, remote location, non-availability of gas buyer in near vicinity ofthe field and non-attractive economics in case gas is sold to SSGCL due to highcost of pipeline quality gas to SSGCL gas transmission network. During April 2004 gas channeling to surface was observed in the nearby arealocated within a radius of 2–3 km from the Bagla well. This gas channeling wascausing environmental and safety hazards in the area. This paper discusses themeasures taken by OGDCL to diagnose the cause of problem and efforts made tocontrol the well to contain the environmental and safety hazards in thearea. Introduction Bagla is a single well gas condensate field located in Thatta Exploration Lease. The field is located about 150 km East of Karachi and 87 km South ofHyderabad. Nearest OGDCL well Nur # 01 is located at 3.5 km towardssouthwest.

Introduction: Though there is no scientific proof, some physicians and medical staff believe in association or influences of the zodiac signs on health. It was quite interesting to note that Kudva et al. from India found few definite attributable dental morphological traits and health to the specific sun signs and numerology. Salib from UK describes the distribution of suicide by hanging appeared significantly higher in those with a birth sign of Virgo and the lowest in Sagittarius and Scorpio. Aim: The aim of our study is to evaluate if there are any statistically significant documented frequencies of hospital admission emergency and elective for particular zodiac sign at all, and if they can be linked to astrological phenomena. Patients and Methods: Retrospective review of records of all the patients with hospital admission in a general surgical unit has been collected from July 2003 to June 2005. Demographic and clinical data were collected specifically Star signs and its relationship. Appropriate statistical analyses were performed. Results: In a period of 2 years, 1209 patients were admitted under one general surgeon of which 675 patients were male and 552 were female. Aries males and Cancer females had the most elective admissions while Libra females and Sagittarius males had minimum number of elective admissions. Aquarius male and Scorpio females had the most emergency admissions while Aquarius female and Scorpio male had the least emergency admissions. In elective setting, Pisces female and Aquarius male had minimum hospital length of stay (LOS) while both Cancer male and female had maximum LOS. In the emergency setting, both Cancer male and female had the minimum LOS while Pisces male and female had the maximum LOS. The incidence of acute appendicitis was the highest in Pisces at 19.39%. Conclusion: Our retrospective data analysis documented some significant influence on hospital admission and length of stay under the influence of the star signs. This study sample was only General Surgical patients which exclude the number of other surgical and medical specialties. To achieve a real sample we need data of all the patients coming to the hospital. Keywords Astrological InfluenceA. Chandio et al.OALibJ |

Introduction: Gall stone disease a second commonest abdominal problem after acute appendicitis,which needs proper and early investigation to reduce the agony and complications of the disease. For acute attacksof cholecystitis in old days, conservative treatment was recommended. Objective: To compare the conventional openand mini-cholecystectomy. Material and Methods: Setting: Nishtar Hospital, Multan. Duration: Six months (From Oct1998 to Mar 1999). Sample Size: 50 cases. Sampling Technique: Purposive, non-probability. Study Design:Comparative, cross-sectional study. Results: Among 50 patients of gall stone, 8 (16%) were male and 42 (84%) werefemale. As regards age, 16 (32%) were of < 40 years, 14 (28%) between 41-50 years and remaining 20 (40%) wereof > 50 years. Out of 50 patients, 32 (64%) patients presenting with pain right hypochondrium, in 14 (28%) patientspresenting complaint was pain epigastrium. In 25 patients of group-A, who were treated conventional opencholecystectomy; the average hospital stay was 8.66 days with shortest stay of 6 days and longest stay of 10 days. Outof 25 patients (16 (64%) patients were discharged after 8th day while 4 (16%) patients were discharged after patientswere discharged after 6 days. In the 25 patients of group-B who were treated by minicholecystectomy, the meanhospital stay was 3.33 days with shortest of 2 days and longest of 5 days. Eight (32%) patients were discharged on 2ndpostoperative day, while 14 (56%) were discharged on the 3rd postoperative day. Conclusion: Mini-cholecystectomyis associated with less patients discomfort and decreased incidence of postoperative complications.

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