Background: The pandemic affected the day-to-day routine of millions of people, with the healthcare sector being at the frontline.  The surgical units have seen a drastic decrease in the amount of patient load, elective surgical procedures, and consequently a decrease in the quality of surgical training.Methods: A cross-sectional study was conducted using a self-structured questionnaire, containing questions about concerns during COVID-19 Pandemic, availability of PPEs and the effect of surgical training during the pandemic, administered on already enrolled surgical trainees of major tertiary care hospitals of the country. A total of 207 surgical trainees were conveniently enrolled in this descriptive study. Results: Out of a total of 207 surgical trainees, 41.7% were first-year residents, 37.9% were second-year, 1.9% were third, 4.4% were forth and 14.1% were fifth-year surgical trainees. 62.6% of doctors reported that their stress levels have increased, most of them were worried about transmitting the infection to their families and vulnerable patients (p<0.01). 56.4% of surgical trainees reported being satisfied with their department’s response to the pandemic, 30.1% doctors said that the testing capacity was insufficient but 60.7% were satisfied with the support of their own hospital. Only 1.9% of doctors were satisfied from their training during the pandemic (p<0.01)Conclusions: The system needs an urgent improvement in the provision of safety measures, an increase in the use of technology for the purpose of training and an easy provision of psychological support to trainees.

Background: Diabetes is a common disease known to cause morbidity and mortality. Individuals with diabetes are at greater risk of complications from coronavirus and have recently gains attention of researchers and practitioners. Aim: To assess the effect of diabetes mellitus on clinical course and outcome of coronavirus infection. Study design: Prospective cohort study Place and duration of study: Coronavirus Disease High Dependency Unit Jinnah Hospital, Lahore from 01-01-2021 to03-04-2021. Methodology: Three hundred and seventy six patients of either genders and age range of 15-75 years were enrolled. They were divided into diabetic or non-diabetic groups. The various attributes such as demographic data, medical history, COVID-19 exposure history, symptoms and signs, laboratory findings, chest radiograph findings, the treatment measures and complications of diabetes and in hospital outcome were compared for both the groups. Result: Statistically different from each other in terms of oxygen requirement, lymphocyte %, neutrophil to lymphocyte ratio (P=0.026), alanine aminotransferase (P=0.038), C-reactive protein (P=0.048), ferritin (P=0.031), lactic acid dehydrogenase (LDH) (P=0.011), D-dimer (P=0.024), Quick sequential organ failure assessment score (qSOFA score) (P=0.001) and Chest X-ray (P=0.049), blood sugar random (P=0.000), treatment during hospital stay (P=0.000), insulin dose increase (P=0.000), complications during hospital stay (P=0.042) and shifting to the intensive care unit (P=0.002). Conclusion: Diabetic coronavirus patients have poorer prognosis due to higher risk of severe pneumonia and related complications including mortality than their non-diabetic counterparts. Keywords: Diabetes, Coronavirus, Diabetes mellitus, COVID-19, Co-morbidity, Cytokine syndrome, Diabetic ketoacidosis (DKA)

No abstract

Introduction: Necrotizing soft tissue infection is a potentially fatal ‘flesh-eating’ disease that requires prompt intervention to save a patient’s life. Identification of parameters that indicate worsening of the disease (predictors of mortality) is an important part in management that guides a surgeon towards rapid surgical treatment. Aims & Objectives: This retrospective study aims to identify factors that are associated with mortality in adults with NSTIs. This study also aims to propose solutions for the better management of these infection to improve surgical outcome and survival. Place and duration of study: OPD & Emergency of Surgical Unit I and II of Shaikh Zayed Hospital, Lahore over a period of 10 years between the years 2010 to 2021. Material & Methods: This is a cross-sectional epidemiological, retrospective study conducted on patients presenting in the Outpatients Department, as well as the Emergency of Surgical Unit I and II. A total of 72 patients meeting the inclusion criteria were enrolled in this study. SPSS version 23 was used for data analysis. Results: Out of 72 patients, 31.94% of patients were receiving some form of immunosuppressive treatment (n=23), out of which 7 patients lost their life (30.43%, p=0.000). There was a preexisting immunosuppressive disease in 48.61% patients (n=35), and in this subset, a total of 10 patients didn’t recover (28.57%, p=0.000). 13 out of 17 patients who died received first debridement after 12 hours from presentation (p=0.021). High mortality was seen in patients who had the presence of shock at hospital admission. Conclusion: Delay in diagnosis and surgical treatment, the presence of shock at admission accompanied by evidence of organ dysfunction, increasing comorbidity index are reasons for the higher mortality seen in these patients of NSTIs. The timing of the first surgery is of the essence thus highlighting the importance of the “Golden Hour” for the Management of NSTIs.

ABSTRACT… Objectives:To obtain and compare the exact visual status before and after excision of sella supra sellar tumors using the computerized perimetry as a standard measuring tools and then compare with the international studies. Background: Sella suprasellar tumors are though not so common but affect visual acuity of patients and their quality of life drops. These tumors include pituitary adenoma commonest in the adult population, meningioma, Craniopharyngioma, astrocytic glioma, Optic nerve Glioma, Germinoma, Dermoid, Pituitary metastases. We planned a descriptive case series study to compare the pre and post excision visual field defects using computerized perimetry. Study Design: Case series study. Setting: Department of Neurosurgery, Pakistan Institute of Medical Sciences, SZABMU, and Islamabad. Period: 2 years from January 2015 to December 2016. Methods: A total of 73 patients with sella suprasellar tumors were identified and enrolled. Patients between the age of 10 and 55 years were selected on the basis of having sella supra sellar tumor on CT/MRI brain with contrast. Patients whose age was less than 10 years and more than 55 years were excluded. Moreover, patients with post radiation necrosis diagnosed on MRI and MR spectroscopy brain, those operated for other eye pathology and patients with sella supra sellar SOL having comorbidities like diabetes mellitus, hypertension etc. were also excluded from the study. The study outcome was measured in terms of comparison of visual field defects after excision of sella suprasellar tumors using computerized perimetry. Results: The average age of patients was 42.1 + 6.8 years ranging from 10 to 55 years. Female gender was predominant; there were 40 (54.8%) female patients. The mean computerized perimetry was 0.65 + 0.34 LogMAR before surgery which improved to 0.19 + 0.12 LogMAR after surgery. Overall, of the 73 cases, 63 (86.4%) had improvement whereas 10 (13.6%) study cases had no improvement in the visual field on follow-up. Conclusion: It can be concluded that after craniotomy and excision of sella suprasellar tumors, perimetry showed improvement in the majority of the study cases. Key words:Sella suprasellar tumors, excision, computerized perimetry, visual field. The comparison before and after excision of sella supra sellar tumors by performing the pre and post-op computerized perimetry. Professional Med J 2017;24(10)