Objectives: To determine the various prognostic factors of intestinal anastomosis leakage at tertiary care Hospital Material and Methods: This prospective cross-sectional study was conducted in Surgical Units of Liaquat University Hospital Jamshoro/Hyderabad. A total 100 patients were included those underwent intestinal anastomosis. After taking detailed history and clinical examination, in the patients’ relevant investigations i.e. Blood CP, X-ray abdomen, Methylene Blue Test (to confirm leaks) and ultrasound of the abdomen. If they remain free of any complication, they were discharged. After collection of data, the analyses were done using Statistical Package for Social Science (SPSS) program version 26.0 Results: Mean age of the patients was recorded as 51.5+3.5 years and males were found in the majority (76.6%). In the clinical presentation, abdominal pain was the most common (63.6%). Typhoid 75(25.0%) was the most common diagnosis. The pathological sites were found as Ileocolic 180(60.0%). Poor nutritional status was in 60.0% cases. Anaemia was 40%, diabetes 20%, and hypertension 10%. A high steroid dose history was in 10% cases and 6.6% had a history of chemotherapy. Ischemia of the intestine at the suture line was seen in 6%, local sepsis was 20%, obstruction distal to the anastomosis was 6.6%, postoperative early adhesions was 6.6%. Conclusion: Male gender, poor nutritional status, diabetes, anemia, presence of local sepsis, chemotherapy and high dose steroid were observed highly prevalent and suspected as factors of anastomosis leakage. Furthermore, many efforts need to be made to reduce the mortality and morbidity rates associated with anastomotic leaks.

Background: Gallstone disease (cholelithiasis) remains the commonest medical issue leading to surgical intervention. Causes of the Gall stone has been not properly understood, but it is thought to have several factors. Untreated gall stones can cause the various complications like inflammation of gall bladder, tissue damage, gallbladder tears and infection. Objective: To determine the clinical pattern and frequency of comorbidities among patients presented with cholelithiasis at Isra University Hospital Hyderabad, Pakistan. Materials and methods: This cross-sectional study was conducted at general Surgery department, Isra University Hospital, Hyderabad. All the patients having diagnosis of gall stone disease, age>18 years and either of gender were included in the study. Patients were selected on outpatient department (OPD) basis. Complete clinical examination was done including abdominal ultrasound and required laboratory investigations. Data regarding demographic information including clinical presentational and comorbidities like diabetes, hypertension and obesity was recorded and also smoking status was assessed. All the data was recorded via study proforma and was analyzed by SPSS version 20. Results: A total of 149 patients were studied, their mean age was 49.23+7.33 years. Females were commonest as 57(38.3%) and males were 92(61.7%). As per clinical presentation pain was found to be most common, particularly as epigastrium pain was found in (93.95%) cases, right Hypochondrium pain (73.82%), pain radiation was more towards scapula (50.33%), dyspepsia was noted in (49.66%), nausea was observed in 44 patients, flatulence in 45 patients and vomiting was least common (21.47%). Diabetes mellitus was 76(51.0%), hypertension was 67(45.0%), overweight were 63(42.3%), obese were 25(16.8%), HCV positive cases were 34(22.8%) and HBV positive cases were 09(59.7%). However smokers were 48(32.2%) and 06(4.0%) were alcohol consumers. Diabetes mellitus, hypertension and obesity were significantly more prevalent in females as compared to males (p=<0.05). Smoking habits and alcohol consumption were mostly found in males (p=<0.05). However HCV and HBV infections were statically insignificant according to gender. Conclusion: It was concluded that gallstone is a common problem and most of the patients who were diagnosed with gallstones were females, obese (BMI>27kg/m2), diabetes mellitus and belonged to fourth decade (40 to 50 years) of their life. Commonest clinical presentations were epigastrium pain, right Hypochondrium pain, pain radiation towards scapula and dyspepsia.