Objectives: To assess the incidence of malignancy in patients with Multinodular goiter in southern Punjab. Study design:A retrospective study. Place & Duration of study: Department of General Surgery, Sheikh Zayed Medical College & Hospital Rahim YarKhan, from April 2010 to May 2012. Patients and Methods: All patients were presented in OPD with history of Multinodular goiter onclinical examination or USG neck. FNAC of any dominant nodule or suspicious nodule on USG neck was performed. All patients wereoperated & total thyroidectomies were done in all patients irrespective of the age. We sent all specimens for histopathological examinationand reports were collected from department. The whole information collected was entered in a pre designed proforma. Results: During 2years period, total 141 patients of thyroid disease were seen in OPD out of which 98 patients have Multinodular goiter. Histopathology ofthese patients showed 10 malignancies & 88 benign. Most of the patients that turned out to be malignant belong to 41-50 years agegroup. 7 patients were female and 3 were male. Among the malignancies 50% were papillary, 30% were follicular, and 10% wereanaplastic carcinoma & lymphomas each. Conclusions: Multinodular goiter (MNG) is the commonest indication of thyroidectomy iniodine deficient areas of Pakistan. This study concludes that don’t consider MNG as a benign disease anymore until proved otherwise.

Background: Every passing day brings new innovations to medical science and Thoracic Surgery is no exception to it. We have witnessed gradual evolution in VATS from multiple ports to single port over the last two decades. Objective: To evaluate whether this evolution is worth in terms of minimizing the postoperative complication. Study Design: Prospective randomized observational trial.

Background: Hyperhidrosis is bilateral, symmetrical and profuse sweating beyond physiological limits of the body. It is an important disease that causes social and emotional disturbances. Conservative treatment has poor results and most of the patients end up in surgical remedy eventually. The choice of operation is Bilateral Sympathectomy which has excellent results. Objective: The aim of this study was to assess the demographic features of patients and to evaluate the outcome of VATS Sympathectomy. Study Design: Prospective Study. Setting: Aseer Central Hospital, Saudi Arabia. Period: September 2017 to March 2020. Material & Methods: Bilateral VATS with resection of sympathetic chain from T2 to T5 was done depending upon the area involved in hyperhidrosis. Results: 28 (58.3%) male and 20(41.6%) female patients with mean age 21 years (range 19 to 53) were documented. 40% of the patients related their condition to be familial. Most common site of involvement was combined Palmer Plant and Axillary in 26(54%) whereas isolated facial hyperhidrosis was the least involved area. Complication rate was 12% with no mortality recorded. Excellent results with 98% patient’s satisfaction was found. Conclusion: Bilateral VATS sympathectomy is the gold standard surgical treatment for Primary Hyperhidrosis with excellent results.

Objective: To test the efficacy of posterior infundibular dissection during Laparoscopic cholecystectomy Place and duration of the study: Surgical ward of Bakhtawar Amin Trust Teaching Multan for 1 year Study design: A retrospective study Methodology: A total of 150 patients undergoing laparoscopic cholecystectomy were included in the study. Firstly, the bile duct, Calot's node and gallbladder neck were identified along with the lower third of the common duct. An incision was made in the peritoneum anterior to the Calot's node at infundibulum and extended laterally and posteriorly. By retracting the gallbladder cephalad and medially, dissection continued in avascular plane between posterior wall of gall bladder and posterior branch of cystic artery. Anteriorly, a plane is created above the calot’s node and inferior to cystic artery, which was facilitated by posterior dissection of infundibulum. Posterior clipping and division of the cystic artery and duct was done. The rest of the gallbladder was dissected from the liver. Results: 120 patients (80%) had an elective LC status and 30 patients (20%) underwent an emergency LC. 2 patients (1.3%) underwent subtotal cholecystectomy.26 patients (18%) underwent MRCP due to suspicion of stones. Out of these 26 patients, 3 patients (11.5%) underwent ERCP due to the presence of stones.No bile duct injury was recorded. Conclusion: Posterior first infundibular dissection reduces the risk of bile duct injury and ensures safe laparoscopic cholecystectomy. Keywords: Laparoscopic cholecystectomy, infundibular dissection, bile duct injury, cholecystectomy, safe calot’s dissection.

<p><strong>Background and Objective:</strong> The use of autologous rectus sheath as a sling to correct uterovaginal prolapse in the younger age group has promising results. As this is an infrequently performed procedure in our country, hence this study aimed to assess the effectiveness of using autologous rectus sheath in young patients presenting with uterovaginal prolapse.<br /><strong>Methods:</strong> A prospective study was conducted at Bakhtawar Amin Trust Teaching Hospital in Multan, Pakistan in which 21 female patients who underwent uterine conservation surgery by using autologous rectus sheath during a period of 2 years were included. All these patients were followed up at 1 week and 6 months after surgery for any recurrence or other complications.</p> <p><strong>Results:</strong> The mean age of the patients was 47.09 &plusmn; 10.17 years. According to the pelvic organ prolapse quantification classification, 38.1% of patients had first degree, while 61.9% of patients had second-degree prolapse. After surgical correction, only one patient presented with first-degree uterine prolapse during follow-up while no post-surgical complication was reported in the rest of the patients with success rate of the procedure being 97.5%.<br /><strong>Conclusion:</strong> Uterine conservation surgery using an autologous rectus sheath as a sling for uterovaginal prolapse is an effective method of surgery and cost-effective technique in women seeking uterine conservation in developing countries.</p>