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Objectives: To evaluate the spectrum of non-appendicular perforation peritonitisand their management outcome in a peripheral teaching hospitals. Study design: Retrospectivedescriptive, Interventional. Setting: Surgical Department Aziz Bhatti Shaheed (Teaching)Hospital Nawaz Sharif Medical College University of Gujrat& Surgical Department Islam MedicalCollege Sialkot. Study period: February 2011 to June 2013. Results: All the patients with clinicaldiagnosis of Acute Peritonitis were included, however patients with peritonitis secondary toperforated appendix and traumatic GIT perforations were excluded from study when foundpreoperatively. Total 100 patients with acute peritonitis were operated. 79 patients were male and21 were female. Mean age was 39.9 years, youngest patient was a 12 year old boy whereas oldestwas 73 year old. Perforated duodenal ulcer was the commonest cause of peritonitis seen in 42cases followed by intestinal tuberculosis 18%. Enteric gut perforation was seen in 17% cases.Mortality was 9% and sepsis and multi organ failure was the main cause of death. Conclusions:Management of perforation peritonitis is a complex and demanding. We can avoid thiscomplication by primary prevention, adequate& timely treatment of diseases like Peptic ulcer,tuberculosis and Typhoid fever which are the commonest cause of GUT perforations in Easternregion/ Tropical countries. Early diagnosis of acute peritonitis, adequate efficient resuscitationand early exploration preferable within six hours is the key to reduce both morbidity and mortalitythese patients

The purpose of this study is to access the level of knowledge, training and compliance of these house officers to universal precautions to HIV transmission. Study Design: Cross Sectional study. Setting: Aziz Bhatti Shaheed Teaching Hospital Gujrat. Period: July-September 2019. Material & Methods: Self reported questionnaires were provided to 80 house officers and results were analyzed in SPSS 20. Results: knowledge attitude and compliance of house officers towards universal precautions was not up to date. This could be due to the fact that 78.79% of our participants have not received any form of training regarding universal precautions. Conclusion: It is urgently needed that training sessions for newly recruited doctors are arranged on regular basis to prepare them protect themselves against communicable diseases. Also strategies should be devised to implement strict compliance to universal precautions.

Objective: to study the spectrum of various thyroid disorders presentingin peripheral teaching hospitals of Gujranwala region. Study Design: Descriptive, Crosssectional, Interventional. Setting: Department of Surgery Islam Teaching Hospital Sialkot &Surgical Department of Aziz Bhatti Shaheed (Teaching) Hospital. Nawaz Sharif medical College,University of the Gujrat. Study Period: February 2011 to June 2016. Results: A total of 236patients of all age groups with thyroid gland disorders were enrolled in this study. Majority ofpatients were of middle age group with mean age of 43+ years. Male to female ratio was 1:4.Nodular thyroid enlargement was the commonest presentation. Solitary thyroid nodule was thecommonest variant of nodular goitre seen in 48.52% cases. Thyroid carcinoma was found in36.45% cases among the nodular goitres. Conclusion: Thyroid disorders are common in hillyareas of Pakistan, more common in female population. High prevalence thyroid malignancy inpopulation of the Gujranwala Division of Central Punjab is an alarming and worrisome finding inour study. Larger multicenter studies are suggested in this particular region to know the exactincidence, predisposing factors/ carcinogens etc if any responsible for thyroid malignancies inthis region.

Objectives: To assess the efficacy of early Gastrojejunostomy to managecorrosive induced gastric outlet obstruction. Study Design: Prospective, Descriptive, &Interventional. Study Period: February 2011 to April, 2015 Setting: Surgical Department AzizBhatti Shaheed Teaching Hospital Gujrat. Material & Methods: Data of 21 patients presentingwith corrosive induced gastric outlet obstruction during the study period were analysedwith reference to effectiveness of early gastrojejunostomy in symptomatic improvementand nutritional outcome. Results: Total of 21 patients with corrosive induced gastric outletobstruction were managed during the study period. Only 02 patients were male and 19 (90.47%)were female. Mean age was 19.06 years. House hold toilet cleaner was the only corrosive usedin all cases. Suicidal intention was the commonest intention, only one patient was known caseof some psychological illness. Gastrojejunostomy proved to be an effective option in relieving.Conclusion: Early gastrojejunostomy (within 6-8 weeks of corrosive ingestion) is an effectivesurgical procedure to achieve good symptomatic and nutritional outcome in corrosive inducedgastric outlet obstruction.