It can be concluded that special attention must be paid during school sporting activities and breaks because they account for most of the accidents. Traffic education may reduce severe injuries. Specific knowledge of the growing long bones of the upper extremity and the hand is important for the diagnosis and treatment of school accidents.

Abstract Pakistan is an agricultural country where fodder cutter (Tokka) is a commonly used machine on the farms. While using it, farmers often meet with accidents causing injuries which are disastrous, and mainly involve the young generation often causing lifelong disability. This is a hospital-based case series, conducted from June 2018 to January 2019 in the Department of Surgery, Lahore General Hospital, Lahore. For this study the patient’s demographic data, site of injury, procedure performed and post-operative outcome were recorded. The study includes a total of 30 cases of tokka injury, (23 males and 07 females) with median age of 25 years. Most commonly injured part of the body was the upper limb, in 26 patients, while the lower limb was involved in 2 patients. There were 18 amputations, Continuous...

Introduction: The common practice in laparoscopic ventral hernia repair (LVHR)is to place a dual mesh to prevent visceral adhesions, as majority of the patients are not ableto afford the expense of these meshes. We use prolene mesh to repair hernia. Objectives: Theaim of this study was to determine the frequency of success of laparoscopic ventral hernia repair(LVHR) using omentum as a barrier in patients presenting with ventral hernia. Study Design:Descriptive case series. Setting: Surgical Unit 3, Services Hospital Lahore, Pakistan. Period:6 months duration from 16th of July 2015 to 15st January 2016. Methods: 60 patients wereselected fulfilling the criteria from Department of General Surgery. 10mm telescope angled at 30degree was employed. Hernial contents were reduced but the peritoneal sac was left as such.The prolene mesh was inserted into the abdominal cavity through a port of 10mm diameterand fixed. Omentum was then sandwiched between abdominal wall and viscera. Patients werefollowed-up in OPD for 12 months. Results: Majority of the patients were females (56.7%) withthe mean age of 46.40 years and mean weight of 68 kg. The patients were averagely foundobese with a mean BMI of 25.40kg/m2. Majority of the patients (n=50, 83.3%) had success inhernia repair. Stratification of patients by age, gender and BMI showed (p-value was >0.05 in all3 cases) statistically insignificant difference between various subgroups. Conclusion: LVHR is auseful technique and simple proline mesh with omental barrier is a safe and low-cost alternativeto dual mesh technique.

Abstract Objective: To evaluate the incidence of infection and patient satisfaction in terms of cosmesis between purse-string closure and the usual linear closure of stoma wound. Method: The experimental randomised clinical trial was conducted December 2017 to December 2018 at the Surgical Unit 1, Lahore General Hospital, Lahore, Pakistan, and comprised patients undergoing ileostomy stoma reversal. The patients were randomised into 2 groups using computer-generated random numbers. Group A underwent purse-string closure, while group B received linear closure. Both groups were followed post-operatively at 1 and 3 months for wound infection. Patient satisfaction was ascertained using standard tools. Data was analysed using SPSS version 20. Results: Of the 72 patients, there were 37(51.4%) in group A and 35(48.6%) in group B. Overall, there were 50(69.4%) males and 22(30.5%) females. Infection occurred in 2(5.4%) group A patients and in 8(22.8%) group B patients (p=0.023). Patients in group A were more satisfied at 3 months post-surgery than patients in group B (p=0.001). Conclusion: Purse-string closure was found to be associated with a lower incidence of wound infection and higher patient satisfaction compared to linear closure. Continuous...

Abstract Small bowel malignancy (SBM) is a rare malignancy in the gastrointestinal tract. Duodenum is the most commonly involved segment and the most common histological subtype is adenocarcinoma (40%). Due to a lack of screening tools and vague symptoms, its clinical detection is very challenging. A 27-year-old man presented at the surgical emergency of Lahore General Hospital in February 2019 with non-specific gastrointestinal symptoms (vomiting, abdominal pain), for which he had previously visited the hospital multiple times. Later, on further workup, he had been diagnosed as a case of intussusception on CT scan. On exploration, he had an impassable stricture in the jejunum. Resection anastomosis of the jejunum was done, but later, on histopathology it turned out to be adenocarcinoma. Adenocarcinoma of the small bowel is a rare entity, and, particularly in Pakistan, Continuous...