Objective: Over bearing, appendectomies have continuously been pushing the surgical wisdom to connote on non-operative option of treatment so this study was designed with an objective to assess the outcomes of antibiotics as primary therapy for un-complicated acute appendicitis. Methods: A total of 96 patients of both genders from 16 to 60 years of age having uncomplicated acute appendicitis enrolled in this study were treated with antibiotics and were discharged on third day with having oral treatment on ciprofloxacin (500mg) twice a day and metronidazole (400mg) thrice a day for 07 days. Routine follow up was taken on days 15, 30, 90 180 and 360 and outcomes were recorded. Results: Among 96 patients, 10 (10.41%) worsened in symptoms (pain on visual analogue scale) were confirmed with WBC & Ultrasound reports and under went for appendectomies during initial hospital stay. While within 9 months, during follow up 11 (11.45%) patients were readmitted in hospital and operated after confirmation on re-examination and re-investigations. Total of 21 (22%) patients were subjected to appendectomy. Conclusion: Under proper observation, antibiotic treatment can be safe and effective in un-complicated acute appendicitis with reduced recurrence.

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%.

Background: Hemophilia is a genetic disorder related to blood, in which the blood is impotent to clot the draining due to paucity of blood clotting factor. Objective: The dramatic theme of this research was to evaluate the knowledge skills about hemophilia in healthy individuals and cradle regarding familiarity of this ailment was also evaluated. Methods: Crossectional randomized research was conducted on 274 study subject’s normal population of rural areas of Sindh and frequent questions apropos cognizance of this disease were probed from all participants and SPSS software was used for the analysis of the data. Results: From the given data, it was estimated that 59% of the population were familiar with hemophilia, whereas 36% study subjects had no idea about this disease, feminine gender were more familiar with risk factors and people who had more knowledge about hemophilia were graduate in qualification. Chi Square value was found 0.001. Conclusion: It was concluded from the research that there should be promotional seminars should be conducted from health care providers regarding hemophilia and its risk factors.

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.

Objective:  The objective of this study was to find out frequency of anastomotic leak at a hospital and deplore the morbidities, duration of hospital stay.Methods:  A total of 102 patients of both genders from 18 – 60 years in age underwent for bowel resection and anastomosis through laparotomy incision at surgical unit one of People’s University of Medical & Health Sciences, Nawabshah, from January 2013 to December 2016 were enrolled in this cross-sectional study. Every patient received appropriate antibiotics for duration according to need post-operatively. Follow-up was every fortnightly for four months to evaluate the primary outcome as prevalence of leak and secondary outcome as morbidities, length of hospital stay incisional hernia and mortality.Results:  The results showed that, out of 102 patients underwent open primary hand sewn gastro intestinal anastomosis, 16 (15.68%) were found with anastomotic leak. Among these 16 patients having anatomic leak, 11 (11%) were male & 5 (5%) were female. While, mortality occurred in 05 (5%%) patients.Conclusions:  Anastomotic leak following gastrointestinal anastomosis is less complication in this study. Further studies are requested with large data and more follow-ups to ensure the findings of this study at national level.