Aim: To find out the frequency of perforated appendix among patients presenting with acute appendicitis. Study design: A cross-sectional study Place and Duration: This study was conducted at Sindh Employee Social Security Hospital Landhi Karachi, Pakistan from July 2020 to November 2021. Methodology: This study includes 205 patients. All the details like age, gender, and previous history associated with diabetes and fasting blood sugar were noted. The surgeries were performed by a single surgeon who detected the presence and absence of a perforated appendix. Results: Mean age of patients was 28 years with a standard deviation of ±13.63. A total of 64% of patients were male and 26% were female. About 11% of patients had perforated appendix after acute appendicitis. Conclusion: The frequency of perforated appendix in this study was 11% in patients undergoing appendectomy for acute appendicitis. Keywords: Appendicitis, perforated appendix, adults, prevalence

Objective: Laparoscopic cholecystectomy (LC) has recognized itself as the ‘gold standard’ treatment of gallstone disease, but it can, sometimes, be related with considerable complication leads to mortality and morbidity. Therefore, this study was intended to assess the frequency of many sources of bleeding in patients underwent laparoscopic cholecystectomy. Methodology: This was a cross sectional study conducted in the Department of Surgery, Bhitai Dental and Medical College Hospital by using consecutive sampling technique. The duration of study was about one year from Feb 2021 to  Dec 2021. A total of 163 patients of age between 30 to 55 years of both genders of diagnosed cholecystitis with cholelithiasis, disease duration of >6 weeks identified by patient’s history were included in the study. To assess the effect modification, age, gender, duration of disease, and amount of bleeding and operative time were stratified followed by application of chi-square with a p value < 0.05 considered as significant. Results: The study results showed that out of 163 cases of laparoscopic cholecystectomy, 141(87%) were females and 22(13%) were males with their mean age were 38.99±10.96 years. Bleeding in laparoscopic cholecystectomy from gallbladder bed was reported in 128(79%) cases followed by cystic artery in 28(17%) cases. There were78(80.4%) cases reported bleeding from gallbladder bed in < 40 years of age and 50(75.75%) cases reported in >40 years of age although with an insignificant association between them (p=0.477). 109(77.3%) cases reported bleeding from gallbladder bed in female and 19(86.3%) cases reported in males with an insignificant association between them (p=0.336).  Conclusion: This study concluded that the most frequent bleeding site was the gallbladder bed followed by cystic artery in laparoscopic cholecystectomy. Furthermore, bleeding from gallbladder bed was common in females and < 40 years of age although there was an insignificant association observed with respect to age and gender.

Aim: Gallstones are responsible for many hospitalizations and surgical interventions in our local population. Our main goal was to evaluate the relationship between age and gallstones as a risk factor in our local population. Methods: Cross-sectional study of all cholecystectomy patients with prior informed consent was conducted in the department of Surgery at Sheikh Khalifa Bin Zaid Hospital (PGMI), Quetta and Bacha Khan Medical Complex, Swabi for the duration of 06 months from 15th March 2021 to 15th August 2021. The stones are divided into 3 groups according to their colour: light yellow and whitish like a cholesterol stone, black and black-brown like a pigment stone, and laminated brownish or greenish yellow as mixed stones. The collected data was statistically processed using SPSS version 21. The types of stones were correlated with the age groups of the patients using the student’s test and / or the Chi-square test as appropriate. The confidence level was defined as 95% CI and p values below 0.05 were considered statistically significant. Results: The study included 100 patients 14(14%) men and 86 (86% women) with a female to male ratio of 13.2: 1, chi-square = 1190.70, p < 0.0001 and their mean age was 46.2 years (SD ± 9.4) (Range, 30 to 75 years). The most common pigment stones were found in 44 (44%). The highest incidence of gallstones was found in the age groups 41-50 and 31-40, 44% and 26%, respectively (p <0.05). Conclusion: From the study it can be concluded that age has an influence on the occurrence of gallstone disease. Keywords: Gallstone (GS); Pigment stones (PS); Mixed stones (MS); Cholesterol stones (CS);