Introduction: Covid-19, a global pandemic has a huge impact on surgical practice. There is transmission risk of Covid-19 during the elective surgery and nowadays it is a part of informed consent process. This has an impact on patient decision making as it creates anxiety and fear. Objective: To evaluate patient experience (fear of getting Covid-19) from elective surgery and challenges of elective surgical practice and ways to overcome during this pandemic era. Materials and Methods: This study was an observational cross-sectional survey and it has been conducted in General Surgery Department of Dr Akbar Niazi Teaching Hospital, Islamabad, from May to August 2021 after approval by the Institutional Review Board (IRB). Participants for elective surgery and their negative report of Covid-19 infection by polymerase chain reaction (PCR) were included in the study. Fear of Covid-19 infection was measured through “fear of Covid-19 scale” by Ahorsu et al and analyzed. All findings were entered in a structured Proforma. Data was entered in SPSS version 26 and analyzed. Effect modifier chi-square was used to find out the patient’s dropout due to getting Covid-19 infection from surgery. Results: Total of 200 patients were included; 62% of patients were male and 38% were females. The mean age of the patients was 38.64±12.08 years. The statistical analysis showed that there was a very significant association between FCV-19 scale and getting Covid-19 infection from elective surgeries (p ≤ 0.05). When stratified FCV-19 scale with education status of all patients there was a very significant association between them (p=0.001). The patient’s observations regarding FCV-19 questionnaire, most of the patients were disagreed (46.3%) to getting Covid-19 infection from their elective surgeries or any fear of Covid-19 infection. The actual dropout of patients from elective surgery due to fear of getting Covid-19 infection during surgery or staying in hospital was 7.5%. Conclusion: Fear of getting Covid-19 is still present in some of the patients who visit hospitals for elective surgeries. Discussing the various steps taken by the institute to improve patient safety and minimize risk of Covid-19, greatly enhanced their confidence in elective surgery and improved satisfaction level.

Objective: To compare the outcome (in-terms of mean post-operative pain and hospital stay) of intraperitoneal onlay mesh (IPOM) with open sublay mesh repair in patients undergoing ventral hernia repair. Materials and Methods: A total number of 150 patients of ventral hernia planned for hernia repair were included in this randomized controlled trial from Jan-2020 to June-2021. Patients were divided into Group I (IPOM) and group II (OSM). IPOM; in these patients intraperitoneal onlay mesh (IPOM) repair was done laparoscopically. OSM group; in these patients open mesh repair was done. Post-operative pain score and hospital stay were main study outcomes. Results: Mean duration of herniation was 5.96±3.24 months in IPOM and 6.28±2.35 months in OSM group (p-value 0.49). Hypertension was the commonest morbidity was hypertension, diagnosed in 40 (53.3%) patients in IPOM and in 41 (54.7%) patients in OSM group (p-value 0.88). Mean post-op pain was significantly high in OSM group; 2.60±1.06 versus 1.68±1.06 in OSM group (p-value <0.0001). Mean hospital stay was shorter in IPOM group; 4.44±1.62 days versus 5.65±1.98 days in OSM group (p-value <0.0001). Conclusion: IPOM repair is a viable and safe option, according to the results of our research. The open SUBLAY approach has a higher morbidity than IPOM laparoscopic ventral hernia repair. A shorter hospital stay is another benefit of the IPOM. Keywords: undergoing intraperitoneal onlay mesh (IPOM), open sublay mesh repair hernioplasty, post-operative pain.

Objective: To compare the outcome of clamp-and-tie with Ligasure technique in total thyroidectomy patients. Material and Methods: A total 60 (30 in each group) patients undergoing near total thyroidectomy for benign goiter were included in this study. After taking informed consent, demographic data (age, gender, duration of goitre, place of living and BMI) were noted. All selected cases were be divided into group A & B by lottery method. In group A patients total thyroidectomy was done by using ligasure while in group B patients, near total thyroidectomy was done by clamp-and-tie technique. Operation time and intra-operative blood loss were measured for each patient. Results: Mean age of patients was 45.60±12.1 years included in this study. Mean disease duration was 7.8±4.5 months. Mean BMI was 24.80±3.61 kg/m2. There were 43 (71.67%) females and 17 (28.33%) male patients. There were 13 (21.67%) patients were from rural area and 47 (78.33%) were from urban area. Mean operative time in group A was 61.33±5.98 hours versus 75.06±6.61 hours in group B (p-value <0.001). Mean intra-operative blood loss was 53.40±6.11 ml in group A versus 81.47±9.29 ml in group B (p-value <0.001). Conclusion: Thyroid surgery with Ligasure resulted in dramatically reduced mean operational time and postoperative blood loss compared to traditional approach. Keywords: clamp-and-tie technique, Ligasure, total thyroidectomy.