Objective: To determine the frequency of post-operative asymptomatic hypocalcaemia in patients with total and subtotal thyroidectomy. Study Design: Cross-sectional study. Setting: Department of Surgery, Sheikh Zayed Hospital, Rahim Yar Khan. Period: 1st July 2021 to 30th April 2022. Material & Methods: One hundred and Sixteen post thyroidectomy male and female patients of age 18-50 years were included in the study using consecutive sampling technique and two groups were formed. Group-A included those patients who underwent total thyroidectomy and in Group-B patients underwent sub-total thyroidectomy. Samples for serum calcium levels were collected in gel tube before and 24 hours after surgery. Post-operative Hypocalcemia was defined by serum total calcium < 8.5 mg/dL 24 hours after surgery. Patients with symptomatic post-operative hypocalcemia following total or subtotal thyroidectomy or hypocalcemia due to any other reason or systemic disease e.g. renal disease and pregnant females were excluded by history and medical record. Data was analyzed using SPSS 20. Results: In Group A the Mean age was 30.94 ±9.6 years, while those in Group B were 31.59± 11.03 years. In Group A 62 (35.63%) and in 30 (17.245%) of Group B patients respectively were identified with asymptomatic hypocalcemia. A statistically significant difference was seen in both groups. 0.00 is the probability value. Conclusion: When compared to sub-total thyroidectomy, the frequency of asymptomatic hypocalcaemia was substantially higher following total thyroidectomy. Asymptomatic hypocalcaemia after complete or partial thyroidectomy might affect both men and women equally. After subtotal or total thyroidectomy, both younger and older age groups had an equal likelihood of developing asymptomatic hypocalcaemia.

Objective: To observe the effect of delayed serum separation on various chemistry analytes. Study Design: Quasi Experimental study. Setting: Clinical Chemistry Laboratory, Sheikh Zayed Medical College & Hospital, Rahim Yar Khan. Period: 1st December 2021 to 31st January 2022. Material & Methods: Fifty healthy volunteers of age 25-55 years from both genders were included in the study using consecutive sampling technique. Informed verbal consent was taken from all the study subjects. 4 cc blood was drawn from each subject and was divided into 3 plain tubes. 1 tube was analyzed at 1 hour for glucose, urea, creatinine, ALT, AST, ALP, sodium, potassium, chloride and calcium. 2nd tube was analyzed for same analytes 2 hours after sample collection and 3rd tube was analyzed at 4 hours. Results were recorded on a predesigned performa. Data was entered and analyzed using SPSS Software 23 for Windows. Data was presented in terms of mean and SD. P value p < 0.05 was considered significant. Results: Glucose, ALT, sodium, potassium and chloride showed statistically significant variation over time while others remained stable for up to 4 hours. There was decrease in glucose (p=0.000) while increase was observed in sodium (p=0.0001), potassium (p=0.0001), chloride (p=0.0001) and ALT (p=0.002). Conclusion: Blood samples should be transported to laboratory immediately and when received in laboratory samples should be centrifuged and processed within 2 hours as delayed transportation and separation affects many chemistry analytes and may lead to erroneous test results.

Objective: To determine the frequency of hypercholesterolemia in patients who are diagnosed with acute coronary syndrome and to also document the association of Non HDL-C with Acute coronary syndrome in these patients. Study Design: Observational Cross Sectional study. Setting: Department of Cardiology and Pathology of Sheikh Zayed Hospital, Rahim Yar Khan. Period: September 2019 to February 2020. Material & Methods: One hundred and thirty five patients with Acute coronary syndrome were included using non probability purposive sampling technique and equal number of patient who visited the outpatient department or admitted in indoor with complaints other than ACS were taken as control (n=135). Frequency and percentages were calculated and odd ratio was determined to see the association. Statistical significance was set at P-value<0.05. Results: Patient’s mean age was 55.5±12.4 years and there were 98(73%) male and 37(27%) female. Higher Non HDL-C (>130mg/dl) was found in 120(88.9%) cases and in 38(28.1%) controls with odd ratio 20.4211 at 95 %CI and p value <0.001.Hypercholesterolemiawas seen in 49(36.3%) of the cases while in 21(15.6%) of control group (without ACS) with odd ratio of 3.3 and p-value <0.001. Odds ratio was maximum for Non HDL cholesterol, followed by LDL cholesterol, HDL cholesterol and Total cholesterol. Conclusion: Non-HDL cholesterol showed a good association in patients with ACS than with primary target LDL-C or total cholesterol.

Bowel loop anastomosis is considered as major part of elective gastrointestinal surgeries. The anastomotic procedures being used now a days include hand sewn and stapled anastomosis. For appropriate gastrointestinal anastomosis, many factors should be considered such as intraoperative duration, restoration of blood supply, restoration of normal function of gastrointestinal tract and decrease tissue damage. Objective: The objective of the study was to compare the outcome of stapler and hand sewn anastomosis in elective gastrointestinal surgeries. Methods: Cross-sectional observational study conducted in department of surgery, Sheikh Zayed Hospital, Rahim Yar Khan from May 1, 2021 to August 31, 2022. Total 60 patients included in study and outcome variables such as anastomotic integrity, duration of procedure, post-operative hospital stay and return of bowel activity compared in hand sewn and stapled anastomosis. Results: The study included total 60 patients out of which 38 (63.33%) underwent stapled anastomosis and 22 (36.66%) underwent hand sewn anastomosis. Age (P value: 0.373), gender (p value: 0.372), anastomotic site (p value: 0.284) and return of bowel activity (p value: 0.331) did not show statistically significant difference between two groups. Anastomotic integrity (p value: 0.025), duration of procedure (p value: 0.002), post-operative hospital stay (p value: 0.037) show statistically significant difference between hand sewn and stapled anastomosis. Conclusions: Stapled anastomosis has better anastomotic integrity, reduced duration of procedure and decreased post-operative hospital stay as compared to hand sewn anastomosis with statistically significant difference between two groups.

Background: Laparoscopic cholecystectomy has replaced open surgery in the treatment of symptomatic cholecystolithiasis. Objective: To evaluate the clinical practices and outcome of laparoscopic cholecystectomy at our institute. Methodology: This was a cross sectional study, conducted at Surgical Unit II, Sheikh Zayed Hospital, Rahim yar khan, from November 2018 to October 2019. Sample size: 100 patients undergoing standard laparoscopic cholecystectomy selected by non probability sampling. All the patients of laparoscopic cholecystectomy during the study period having a clinical diagnosis of acute and chronic cholecystitis were included, whereas patients who had previously undergone midline abdominal operations, ventral hernias, with evidence of common bile duct pathology, having bleeding disorders and hepatitis were excluded. Study variables were operating time, duration of hospital stay, frequency of operative and post-operative complications. Results: There were 85 females and 15 males. Mean age was 40 ± 1.2 years. In this study, 68% patients were having chronic cholecystitis due to cholelithiasis whereas 32% were having acute cholecystitis. Abdominal ultrasound showed multiple stones in 82% and single stone in 18% patients. Adhesions in 30%, Mucocele in 1% and empyema in 2% patients was reported. Gall bladder was perforated in 12% patients and 8% patients converted to open procedure. The mean operative time for laparoscopic cholecystectomy was 71.2+ 2.6 minute. The post operative complications were; wound infection in 4%, shoulder pain 1% and surgical emphysema 1%. The mean hospital stay was 1.38 days. Conclusion: Laparoscopic Cholecystectomy proved a safe procedure in term of operative and post operative complications in our setup.