ABSTRACT… Objectives: To determine the clinical presenting pattern and postoperative complications of acute appendicitis. Study design: Observational and cross-sectional study. Setting: Isra university hospital Hyderabad. Period: 7 months. Methodology: All the patients above 12 years of age and both genders male/female after diagnosis of acute appendicitis had integrated in the study. Complete clinical pattern and postoperative complications had recorded. Results: Symptoms/sign nausea, vomiting, anorexia, rebound tenderness, fever, constipation, diarrhea and leukocytosis were noted with the percentage 98.0%, 65.0%, 95.0%, 90.0%, 85.0%, 58.0%, 30.0% and 89.0% respectively. Paraumblical pain was noted in 50.0% of the cases, right iliac fossa pain was in the 99.0%, epigastric pain was seen in 61.0% and the other abdominal pain was noted in the 39.0%. Postoperative complications found in 33.0% of the cases and majority was seen wound infection. Conclusion: In the conclusion of this study clinical features nausea, vomiting, anorexia, rebound tenderness, fever, and leukocytosis were seen as most common and the most important postoperative complication is infection which probably created with the uncompleted sterilization. Professional Med J 2016;23(3): 241-245. www.theprofesional.com ACUTE APPENDICITIS 242 2 Professional Med J 2016;23(3): 241-245. www.theprofesional.com ACUTE APPENDICITIS 244 4

Objectives: To determine the clinical presenting pattern and postoperativecomplications of acute appendicitis. Study design: Observational and cross-sectional study.Setting: Isra university hospital Hyderabad. Period: 7 months. Methodology: All the patientsabove 12 years of age and both genders male/female after diagnosis of acute appendicitishad integrated in the study. Complete clinical pattern and postoperative complications hadrecorded. Results: Symptoms/sign nausea, vomiting, anorexia, rebound tenderness, fever,constipation, diarrhea and leukocytosis were noted with the percentage 98.0%, 65.0%, 95.0%,90.0%, 85.0%, 58.0%, 30.0% and 89.0% respectively. Paraumblical pain was noted in 50.0%of the cases, right iliac fossa pain was in the 99.0%, epigastric pain was seen in 61.0% and theother abdominal pain was noted in the 39.0%. Postoperative complications found in 33.0% ofthe cases and majority was seen wound infection. Conclusion: In the conclusion of this studyclinical features nausea, vomiting, anorexia, rebound tenderness, fever, and leukocytosis wereseen as most common and the most important postoperative complication is infection whichprobably created with the uncompleted sterilization.

Aim: The goal of this research was to look at the microorganisms that cause infections on surgical site & their antibiotic susceptibility patterns. Study design: Cross sectional study Place & duration: This study was conducted at National Hospital and Medical Center Lahore, Pakistan from December 2019 to December 2020 Methodology: Surgical site infection samples were taken from patients who complained of post-operative discomfort, edema, drainage, and a delayed or non-healing wound. Following routine protocol, two swabs were taken from each patient’s surgery site. After 18-24 hours of incubation at 35°C-37°C, the diameter of antibiotic discs was classified & measured as sensitive (S), intermediate (I), or resistant (R) Results: According to the data, 60 (56.07 percent) of 107 samples acquired from post-operative patients with symptoms of wound infection indicated single isolates, 13 (12.14 percent) revealed multiple isolates, and 34 (31.77 percent) samples revealed no bacterial growth. In all, 86 isolates have been identified, including 29 (33.7%) Gram +ve and 57 (66.3%) Gram -ve organisms. Gram positive bacteria were very susceptible to vancomycin & linezolid (100%) and gentamicin (79.3%), while Polymyxin B (94.7%), as well as imipenem, were extremely vulnerable to Gram negative bacteria (79.3 percent ). Conclusion: The most prevalent organisms identified from the surgical site infection were Staphylococcus aureus (MAAS) and E.coli. Microorganisms, both gram positive and gram negative, acquired resistance to more regularly used medications such as penicillin, cephalosporins, and even cost-effective quinolones, according to the findings of this research. Keywords: surgical site infection, hospital acquired infections, gram +ve bacteria, gram –ve bacteria, antibiotics

Objective: To determine the management outcome of the endoscopic bandligation in the patients with internal haemorrhoids at isra university Hospital Hyderabad Sindh.Pakistan. Materials and methods: All the patients were under went sigmoidoscopy andcolonoscopy for the complete diagnosis and the patients were excluded, if polyps or evidenceof malignancy was found at colonoscopy. Haemorrhoids were sucked with the tip of endoscopefrom the anal canal and elastic bands were applied. After first treatment session, patients wereasked to complete a questionnaire to evaluate the subjective satisfaction, which was classifiedas poor, good and best. Patients who had with multiple haemorrhoids were recalled for theligation on remaining haemorrhoids after 2 weeks, if indicated. Results: Total 100 patients wereincluded in the study, In complications, intensive pain was found in the 55% of the cases whileother complications were seen in very few patients and many patients were seen without anycomplication. Hospital stay was only one day was noted in the very few patients and mostlypatients were discharged after few hours of the procedure. Outcome of the endoscopic bandligation was found excellent in 40% of the cases, good results found in the 45% of the cases andpoor results were seen only in the 15% of the cases. Re-endoscopic band ligation was donein the 20% of the cases and recurrence of hemorrhoids was noted in the 30% of the cases.Conclusions: We concluded that the endoscopic band ligation is very good management forhaemorrhoids without typical complications, with very short hospital stay and recurrences rate.