Objective: Effectiveness of aspiration under ultrasound guidance in breast abscess in terms of early resumption of breast feeding. Study Design: Randomized controlled trial Place and Duration: Mardan Medical Complex and Teaching Hospital and Jinnah International Hospital, Abbottabad, from November, 2021 to April, 2022. Methods: There were a total of 140 female participants. The patients ranged in age from 16 to 50. After obtaining the patient's written consent, demographic information including age, weight, height, and body mass index were collected. Breast abscess diagnosed on clinical examination and ultrasound breast were included. Seventy patients were assigned to Group I and treated with percutaneous aspiration, whereas the same number were assigned to Group II and underwent incision drainage. Early breast feeding was restored in both groups and compared for their respective outcomes. The entire dataset was analyzed using SPSS 20.0. Results: We observed that the percentage of patients in group I who were able to resume breast feeding was 61 (87.1%), and in group II was found in 42 (60%) patients. The level of comfort experienced by patients in group I 60 (85.7%), as compared to group II 35 (50%), was significantly greater. Conclusion: In this study, we came to the conclusion that percutaneous aspiration in breast abscess was successful and effective in comparison to incision drainage, with less problems and a high percentage of satisfaction among the women. Keywords: Incision drainage, Breast abscess, Percutaneous aspiration

Laparoscopic cholecystectomy (LC) is supposed to be a first line treatment for complicated bile stones and is regarded as the minimally invasive surgery. Objectives: To determine the levels of CRP as a measure of stress response after open and Laparoscopic cholecystectomy. Methods: A total of 120 patients of both genders aged 20 years or above with fever, abdominal pain, vomiting, nausea and anorexia with symptomatic gall stone were chosen. Laboratory tests, ultrasound and chest radiography were carried out to verify the diagnosis of cholecystectomy and prevent a negative abdomen exploration. The comparison of CRP levels between the two groups was done at 4, 8 and 24 hours. The values ​​of CRP in both procedures were compared with the t-test with P-0.000 taken as significant. Results: The patients mean age was 36.09 ± 8.10 years. There were 50 men and 70 women. Mean CRP was 7.20 ± 2.10 after 4 hours of laparoscopic cholecystectomy; however, after open cholecystectomy, it was 11.30 ± 1.80, CRP after 8 hours in LC was 13.50 ± 7.01 and 21.04 ± 2.14 after open cholecystectomy. The mean CRP levels in laparoscopic cholecystectomy after 24-hrs were 23.40 ± 7.92 and 34.81 ± 7.04 after open cholecystectomy. The most affected age group was 20-35 years in 39(32.5%) patients, 31-50 in 47(39.2%) and 51-65 in 34(28.3%) patients. This study did not find postoperative complications or mortality. Conclusions: CRP is a valuable marker in determining the response to stress in subjects with laparoscopic and open cholecystectomy.

Aim: The purpose of this study is to compare the incidence of wound infection in laparoscopic and open appendectomy. Study Design: A randomized, controlled study Place and Duration: In the Surgical department of Khalifa Gul Nawaz Medical Teaching Institute, Bannu and Ayub Teaching Hospital, Abbottabad for the duration from January 2021 to June 2021. Methods: In this study, 220 patients with the diagnosis of acute appendicitis were selected and divided randomly into two groups; OA group (open appendectomy) and LA group (laparoscopic) appendectomy. In both groups, the general anesthesia was given for appendectomy. The wound was examined on the 1st, 2nd and 3rd postoperative day, and then on the 7th and 14th day postoperatively and was scored conferring to the wound asepsis Score. The SSI and total wound asepsis score was calculated subsequently. Results: Total of 200 patients with acute appendicitis were selected. In laparoscopic appendectomy (LA); 22.0±7.85 years was the mean age and 24.12±9.08 years was the mean age in open appendectomy (OA) group. There were 70 men and 40 women in the LA group, and 50 men and 60 women in the OA group. The LA group has M:F ratio of 1.9: 1 in the and 1: 1.3 in the OA group. While 108 patients had no complications and surgical site infection were noticed in two patients only in the LA group, 98 patients in the OA group recovered and surgical site infection were seen in 12 patients. Conclusion: Laparoscopic appendectomy is a safer and better choice than open appendectomy which decreases postoperative complications significantly such as wound infections. Keywords: Open appendectomy, Laparoscopic appendectomy, Acute appendicitis and Surgical site infection.

Objective: To compare the pattern of complications of open vs laparoscopic cholecystectomy Materials and Methods: A Randomized Controlled Trial was carried out at the Department of Surgery, Khyber Teaching Hospital, Peshawar from January 2019 to July 2019 laparoscopic cholecystectomy. A total of 200 patients (100 in each group) with the indication of cholecystectomy fulfilling the inclusion criteria were subjected to open and laparoscopic cholecystectomy. The complications were observed and plotted in terms of frequencies and percentages; were compared through SPSS (Statistical Package for Social Sciences) version 21. Results: A total of 200 patients with indication of cholecystectomy were operated on, which were divided into two equal groups. The mean age was 42.14 years ±9.34 2SD. Out of 200 patients, 21% were male while 79% were female. No common bile duct, duodenal or colonic injuries were noticed while wound infection was reported more in the open group (5%). Intraoperative bleeding (02%) and gallbladder perforation (10%) was seen more in the LC group as compared to the open group with a 1% occurrence of such complications. Conclusion: The open technique will remain valid as long as the laparoscopic technique remains in motion since the laparoscopic technique has shortfalls that are managed by the open approach only. Thus, the importance of both techniques is justified.

Introduction: Perforated duodenal ulcer is the communal emergency seen in surgical department, and postoperative complications of this emergency surgeries are very high which requires the related factors identification with this incidence. Aim: This study was designed to evaluate duodenal ulcer in older patients by revealing the patient's health status, early and late repair, choice of surgical procedure, and differences between older and younger duodenal ulcer patients. Study Design: A Retrospective study. Place and duration: In the Surgical Unit 2 of, Sheikh Zayed Medical College/ Hospital Rahim Yar Khan for two-year duration from January 2020 to December 2021. Methods: This study included 140 patients were alienated into 2 age groups as geriatric patients’ group (A) and adult age group (B). Patient age, gender, co-morbidities, drug use, presence of Helicobacter pylori infection, medical conditions that may have been affected by perforation, such as characteristic pain (severe upper abdominal pain or vague abdominal pain), extent of symptoms at presentation, smoking, outcomes of late repair versus early repair was recorded. Results: 140 patients were registered in the analysis. Group I (n = 70) consisted of geriatric patients (age> 65) and Group-II (n = 70) adults’ patients (age <65). Both groups have male dominance in this study. In both groups, the most common comorbidities were diabetes (25.7% and 8.6%, respectively) and arterial hypertension (42.8% and 41.4%, respectively), hypertension (p = 0.002) and coronary artery disease (p = 0.035) was much high in group I, while morbidity and mortality were higher in the group of elderly patients. Conclusion: Duodenal perforation is a serious disease that requires urgent surgical intervention, especially in the geriatric age. Keywords: Duodenal ulcer perforation, acute abdomen, geriatric surgery.