Objective: To determine the clinical presentation and different treatment modalities of obstructed jaundice at tertiary care Hospital. Study Design: Prospective observational study. Place and Duration: Present study was conducted in the Department of general Surgery of Liaquat University of Medical and Health Sciences, Jamshoro during two years from July 2015 to June 2017. Patients and Methods: Total 50 patients having obstructed jaundice and either gender were evaluated after taking history, clinical examinations including specific investigations like ultrasound of abdomen, liver function test (LFT), magnetic resonance cholangiopancreatography (MRCP), computed tomography (CT) endoscopic retrograde cholangio pancreatography (ERCP), magnetic resonance imaging (MRI), percutaneous transhepatic cholangiography (PTC) biopsy, tumor markers and x- ray chest for diagnosis and prognosis purpose. All the data was recorded via self-made proforma.                                                    Results: Out of all cases, 20 patients were in age group of 30 to 45 year, 21 patients were in age group 46 to 64 years and 09 patients were in age group 65 to 80 year. Thirty one patients were presented with intermittent jaundice and pain,14 patients had jaundice, pruritus, pale stool, dark urine and 5 patients were presented with jaundice, pruritus, pale stool with dark urine, pain, anorexia and weight loss. Thirty one patients were diagnosed with benign lesions and 19 patients had malignant lesions. Most of the patients (26.52%) were treated by ERCP, stent. Fifteen underwent open surgery, and 9 were treated by palliative procedure, chemotherapy, radiotherapy and gene therapy. Conclusion: Obstructed jaundice is a critical problem all over the world, in which initially patients present with jaundice, pain, pruritus with pale stool, dark urine and weight loss. Patients can be treated by ERCP, stent. Fifteen patients underwent open surgery and 9 were treated by palliative procedure, chemotherapy, radiotherapy and gene therapy.

Background: Liver trauma is the most commonly observed injured organ in abdominal trauma. The objectives of this study was to determine and evaluate the rates of complication in the management of liver traumaMethods: This cross-sectional observational study using non-probability convenient sampling technique was done at surgical unit of Liaquat University of Medical and Health Sciences, Jamshoro, for 06 months. After ethical approval from Institute’s Institutional Review Board (IRB), patients presenting to surgical emergency of the hospital between ages 16 to 60 years having blunt or penetrating liver trauma within 04 hours of incident, either road traffic accident, sustaining a fall, sporting injury, knife or stab wound were include while patients of liver trauma conservatively managed or had severe co-morbid, not fit for anesthesia, with multiple organs lesions (polytrauma) and all hepatic injury patients that were hemo-dynamically stable were excluded. SPSS version 23 was used for data analysis keeping p-value <0.05 as significant.Results: Among 136 patients with mean age 32.33±11.23 years, 120(88.2%) were males. 122(89.7%) of the patients were admitted due to liver trauma of blunt variety while 14(10%) with penetrating liver injury. Overall mean duration of hospital stay was 13.1±4.58 days. 41(30%) patients reported intra-abdominal sepsis, followed by recurrent hemorrhage in 33(24%) of patients while in 22(16%) of patients, biliary leakage was observed. An insignificant difference persisted in either surgical intervention in terms of the complication rates.Conclusions: Higher complication rates were observed in patients with peri-hepatic packing, however outcome of both surgical techniques in terms of complication rates were found to be insignificant. Further studies are needed to shed light upon the findings or this study.

Objective: To compare the efficacy of LigaSure Vessel Sealer in Near Total Thyroidectomy versus Conventional Clamp Knot Tie Technique in terms of bleeding, operative time and postoperative drainage. Methodology: This comparative cross sectional study was conducted at Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro. Study duration was one year from November 2019 to October 2020. All patients of any age with benign multinodular goiter and either of gender were included. The study subjects were grouped into two categories by randomization (odd / even). The odd numbers were given to patients operated for ligasure and even numbers were given to patients operated with conventional clamp knot tie technique.  Outcomes were observed with respect to post-operative calcium level, intra-operative bleeding, operative time, post-operative pain & post-operative hospital stay. All the data was recorded via study proforma. Data was analyzed by using SPSS version 20. Results: Total 55 patients were observed. Mean age was 33.25±10.60 years in clamp knot tie procedure group and 35.16±07.96 years in ligasure technique group; without significant difference (p-0.448). Pre and post-operative calcium levels were statistically insignificant among both groups (p-0.358 and 0.163), while loss of blood, hospital stay, post-operative pain and operative duration were significantly greater in clamp knot tie technique group in comparison to ligasure technique group (p-<0.001). Conclusion: LigaSure Vessel Sealer is a feasible and reliable surgical technique and significantly more effective as compared to conventional clamp knot tie technique in terms of post-operative bleeding, operative time, post-operative pain and post-operative hospital stay. However, calcium level was statistically insignificant.

Objective: To determine the frequency of surgical site infections according to the closure of abdominal incisions (skin staplers versus suture stitches) in General Surgery at Liaquat University of Medical and Health Sciences (LUMHS). Material and Method: This cross-section comparative study was conducted at the Department of General Surgery at LUMHS. The study was conducted for one year from January 2021 to December 2021. All the patients aged more than 12 years, both genders and who had undergone abdominal surgeries were included. Patients were divided into two groups group A and group B as per closure of the abdominal incisions. Patients in group A underwent staplers wound closure and patients in group B underwent wound closure by suture stitches. Patients were assessed for postoperative surgical site infection during hospital stay. All the data were collected via self-made study proforma. SPSS version 26 was used for the purpose of data analysis. Stratification with respect to the effect modifiers was done and a p-value < 0.05 was taken as significant. Results: In this study, a total of 41 cases were comparatively studied regarding surgical site infections as to the type of wound closure. The average age of the stapler’s patients’ group was 36.70+6.22 years and the average age of the suture patients’ group was 42.47+5.09 years. Males were most common in both groups without a significant difference (p-929), while average duration of closure was significantly lower in stapler group as compared to suture group (p-0.001). Of all, 12 cases had wound infection, particularly as 4 cases had infection grade I, 5 cases had grade II infection and 2 cases had grade III infection. Although frequency of surgical site infection was statistically insignificant (p-0.223). Conclusion: The wound closure skin stapler’s method was observed to be effective in terms of short duration, while the frequency of surgical site infection was higher in stapler closure but statistically insignificant as per both techniques. Keywords: Wound infection, stapler, suture, effectiveness

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