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were included in the study. Patients in group-A received antibiotic prophylaxis whereas patients in group-B did not receive any antibiotic prophylaxis. Results: Mean age of the patients was 44.91±13.37 and 42.28±13.76 years in group-A and B, respectively. In group-A there were 152 patients (46.7%) and in group-B 148 patients (45.5%) were males. In group-A 173 patients (53.3%) and in group-B 177 patients (54.5%) were females. In group-A, superficial site infection was seen in 4 patients (1.2%) and in group-B superficial site infection was observed in 13 patients (4.0%). The difference between two groups was statistically significant (p=0.027). Mean duration of symptoms was 5.75±0.50 and 5.77±0.92 days in group-A and B, respectively. Stratification with regard to age, gender and duration of symptoms was carried out. Conclusion:In conclusion, we recommend the use of pre-operative prophylactic antibiotics for patients who are undergoing elective low-risk laparoscopic cholecystectomy inorder to prevent postoperative infectious complications. Key words:Laparoscopic Cholecystectomy, Antibiotic Prophylaxis, Surgical Site Infection. Article Citation: Nauman SM, Haroon Y, Ahmad A, Saleem I. Surgical site infection; prophylactic antibiotics in laparoscopic cholecystectomy to reduce surgical site infection.

Gastrointestinal tract duplications are rare congenital malformations that are benign, presenting usually in childhood. Most common sites include the distal ileum and oesophagus. Rectal presentation is quite uncommon and is usually cystic. This is a case of a three year old boy who came with rectal prolapse. On further examination and imaging investigations a presacral cyst was located and a diagnosis of rectal duplication was made. The cyst was completely excised by a posterior sagittal approach.

Intussusception is the invagination of a segment of the intestine into the lumen of the distal or proximal segment. It is one of the commonest causes of intestinal obstruction in the toddlers. Ileo-colic intussusception is the most common type. At times the inussusceptum may protrude through the anal canal and mimic a rectal prolapse. The diagnosis may be delayed in such cases leading to increase morbidity as well as mortality. Therefore, a high index of suspicion is required in such cases. In this case where a colo-colic intussusception presented like rectal prolapse. Emergency surgical reduction was carried out under general anaesthesia and the baby had a smooth recovery.

Objectives: To evaluate the principal risk factors associated with development of intrahepatic cholestasis of pregnancy (ICP) in patients presenting to a tertiary care hospital. Study Design: Case control study. Place and Duration of Study: Department of Gynaecology and Obstetrics, Pakistan Naval Ship Shifa Hospital Karachi, from Jan to Dec 2019. Methodology: All pregnant women with symptoms of intrahepatic cholestasis of pregnancy confirmed on history, examination and investigations were included. A comparison cohort of pregnant women with neither hepatobiliary nor medical illness associated with pregnancy was selected. Comparison of risk factors was done between both the groups. Results: Out of 6932 obstetric patients, 90 (1.29%) had intrahepatic cholestasis of pregnancy. Pruritis was cardinal symptoms in all (100%) the patients followed by excoriation marks (75.55%). Intrahepatic cholestasis of pregnancy was significantly found in women with multiple pregnancy (OR=1.81; 95% CI 0.51-6.42), antecedent intrahepatic cholestasis of pregnancy (OR=36.81; 95% CI 8.53-158.79), family history of intrahepatic cholestasis of pregnancy (OR=17.80; 95% CI 2.29-137.91) and history of pruritis with obstetric cholestasis of pregnancy use (OR=16.25; 95% CI 0.91-289.08). Conclusion: Intrahepatic cholestasis of pregnancy was observed in less than two percent cases. Risk of intrahepatic cholestasis of pregnancy was found to be increased with multiple pregnancies, antecedent intrahepatic cholestasis of pregnancy, family history of intrahepatic cholestasis of pregnancy and history of pruritis with prior obstetric cholestasis of pregnancy use.