Background: The anal fissure is a small spilt in the distal anoderm, and it most commonly occurs in the posterior midline of anal canal. Anal fissure causes severe sharp pain on defecation, occasionally accompanied by streak of blood on outside of stool or blood on toilet tissue. Fissures are classified as acute or chronic, acute fissure usually heal spontaneously within six weeks. Fissurectomy had been used as separate technique in the treatment of chronic anal fissure with favorable result. Parallel inside sphincterotomy produces an enduring fall of anal resting pressure, that reestablish mucosal perfusion bringing about recuperating, yet genuine drive component is obscure, and the instrument that travel from intense to constant gap stay dark. This study is design to assess the outcome between two groups, than better modality of the two could be chosen. Objective: To compare fissurectomy and lateral internal sphincterotomy in the management of chronic anal fissure. Patient and Methods: The Randomized controlled trial was conducted during 18-02-2015 to 17-08-2015 at Department of surgery,Liaquat University of Medical & Health Sciences, Hyderabad. A total of 218 patients with chronic anal fissure were included in this study. Patients were randomly divided into two groups. Patients in Group A were underwent fissurectomy and patients group B was underwent lateral internal sphincterotomy. Surgery was performed and patients were followed for 8 weeks on regular basis and satisfactory out comes was noted. Information along with demographics was entered in the proforma. Results: Rate of satisfactory outcome was significantly high in group B as compare to group A [92.66% vs. 76.15%; p=0.001]. Conclusion: Subcutaneous sidelong internal sphincterotomy is a significant surgery for patients with persistent anal fissure. It is compelling and safe, offers fast help of torment, and advances early gap mending without being gone to by any significant complexities.

Objective: To determine the frequency of incidental findings on diagnostic laparoscopy in patients undergoing elective laparoscopic cholecystectomy at tertiary care hospital Jamshoro. Study design: This is a descriptive cross sectional study. Setting: Study carried out at department of general surgery, Liaquat University of Medical & Health Sciences (LUMHS) Jamshoro from 1st February 2019 to 30th July 2019. Materials and methods: A total of 164 patients of both gender undergoing diagnostic laparoscopy in patients of laparoscopic cholecystectomy were included in the study. Laparoscopy was done under general anesthesia in all patients. The whole of peritoneal cavity was sequentially                 visualized using trendelenberg and reverse trendelenberg positions, and right or left tilt as      required. Results: Age range in this study was from 20 to 79 years with mean age of 43.622±9.31 years. 40.2% patients were of male gender and 59.8% patients were females. Peritoneal band & adhesions was seen in 9.8% patients, Ovarian Cyst 5.5%, Abdominal Tuberculosis 19.5% and Gall Bladder Carcinoma was 3%. Conclusion: We conclude that laparoscopy is very safe, can obviate the need for a full exploratory laparotomy & minimize the surgical trauma in chronically ill patients.

Objective: To determine the frequency and presentation of colorectal carcinoma (CRC) among the patients presenting with lower gastrointestinal (GI) symptoms. Study Design: Observational study Place and Duration: Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro/Hyderabad from January 2013 to February 2014. Methodology: A sample of 105 patients complaining of lower GI symptoms was selected. Data regarding the age, sex, presenting symptoms and signs, local examination and location of lesions were noted in a pre-structured proforma. Patients were examined by digital rectal examination (DRE), proctoscopy, colonoscopy; computerized tomography and biopsy. Data analyzed on SPSS 21.0 at 95% CI (P≤ 0.05). Results: Age of the patients was 53.17±14.90 years (95%CI: 51.28 to 55.05). Of 105 subjects; 65 (61.9%) were males and 40 (38.09%) were females. The CRC was observed in 11 (10.47%) patients of ≤ 40 years, 77 (73.3%) patients of 40 – 59.9 years and 17 (16.19%) cases were ≥60 years of age. Anemia 81 (77.14%), weight loss 74 (70.47%), abdominal pain 60 (57.14%), bleeding per rectum 79 (75.23%), tenesmus 55 (52.38%) and constipation 48 (45.71%) were common presenting symptoms of the CRC patients. Adenocarcinoma was found in 87 (82.85%), carcinoid tumor in 11 (10.47%), lymphoma in 5 (4.76%) and squamous cell carcinoma in 2 (1.9%). Conclusion: Colorectal adenocarcinoma was most common tumor found in males in their sixth decade of life. Anemia, weight loss, abdominal pain and bleeding per rectum were common clinical symptoms and rectum was common tumor site.

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