When compared to the open cholecystectomy, laparoscopic cholecystectomy (LC) has the benefits of less post-operative pain and quicker return to work. However, up to 80% of individuals after laparoscopic surgery still experience significant pain and needing pain relief. Methodology: The reason for this research was to compare the results of LC performed with and without LPP. LC requires the surgeon to choose a pneumoperitoneum pressure that maximizes working space while avoiding unintended side effects. This study used a Randomized Controlled Trial (RCT) design, and it was done at the West Surgical Ward at Mayo Hospital in Lahore. The study enrolled 60 participants who met the inclusion criteria. The patients were split in two groups: Low-pressure pneumoperitoneum-LPP (Group A) (06-10 mm of Hg) and pneumoperitoneum at standard pressure (SPP) is part of Group B. (12-16 mm of Hg). All had opted for a LC to treat their symptomatic gallstone disease. At 4, 8, and 24 hours following surgery, the severity of postoperative shoulder pain (if present) was evaluated using a visual analogue pain scale (VAS). The frequency of postoperative nausea and vomiting was assessed at 4, 8, 12, and 24 hours. Results: The patients were 35.63 years old on average. Majority of these two groups has no complications. Based on the data, we discovered that the frequency of episodes of nausea/vomiting in both groups was very low and that only a few patients had bouts of nausea/vomiting in the 4 hours and 24 hour time intervals. Conclusion: We have come to the conclusion that LP laparoscopic surgery is a viable and risk-free alternative to SP laparoscopic operation for the treatment of benign gall stone disorders. Our findings lead us to the conclusion that LPP is a superior option for the LC since it reduces the post-operative pain in the shoulder and the risk of PONV while not significantly increasing the risk of intraoperative complications. Keywords: Benign Gall Stone, Treatment, Low-Pressure Laparoscopic Surgery,

Diabetes mellitus is the most common metabolic problem all over the world. Over 150 million people worldwide, are affected with this problem.1, 2 In Pakistan, the prevalence of diabetic patients are between 7.6% to 11%.3. Objective and Methodology: The aim of this study is to compare the relative efficacy of hydrogel and papaya dressings for diabetic foot ulcers. Patients from the General Surgery Department at Mayo Hospital in Lahore were 114 in total. Patients were randomized into: group H, who received hydrogel dressings, and group P, who received papaya dressings. Both dressings were done in ward for 20 days, every 48 hours and if wound healing occurred earlier and slough decreased then dressings were stopped and patient was discharged. The wound was assessed by photographic wound assessment tool (PWAT). Results: In Group P, mean age of patients was 52.98±8.90 and in Group H, mean age of patients was 50.98±9.62. In Group P, 34(59.6%) patients were male and 23(40.4%) were female. While in Group H 29(50.9%) patients were male and 28(49.1%) were female patients. We used Wound Assessment tool “PWAT” to compare the efficacy of these two treatment regimes. As per final “PWAT” score hydrogel dressing is more effective as compared to Papaya dressing for diabetic wound healing. i.e. Group P (Papaya dressing): 5.09±1.65 vs. Group H (hydrogel Dressing): 6.02±1.78, p-value=0.005 Conclusion: Depending upon the outcomes of this research, it can be concluded that hydrogel dressing is more useful than papaya dressing for treating diabetic wound. Although papaya dressing also have a beneficial effect on diabetic wound but still its efficacy is less as compared to hydrogel dressing Keywords: Papaya, Hydrogel, Dressing, Diabetic Foot, Wounds, Ulcer.

In the field of General Surgery AA is the frequent clinical condition for which patients who need emergency surgery present with abdominal pain.1 Diagnosis of this pathology is made with the help of history, patient symptoms, and clinical exam and lab investigations. Ultrasonography (USG) and computed tomography (CT) images for acute appendicitis should be considered.2 Methodology: The purpose of the study is to compare the diagnostic accuracy of Modified Alvarado Score (MAS) and Ohmann Scores (OS) in diagnosing the pathology of Acute Appendicitis, while retaining histopathology as the basis for final diagnosis. A total of 411 patients were admitted via the Accidents & Emergency Department of Mayo Hospital Lahore, meeting the inclusion and exclusion requirements having the clinical diagnosis of acute appendicitis. For each patient, both Modified Alvarado and Ohmann scores were assessed prior to undergoing the procedure, i.e. open appendectomy. Abdominopelvic assessments and laboratory results were assessed and abdominal USG was performed in all patients. Biopsy of the removed appendix was sent for histopathology to Pathology Department of King Edward Medical University. Results: For the modified Alvarado and Ohmann score; sensitivity and specificity of was 89.74%, 90.48%, 85.13% and 80.95% respectively. The positive predictive value (PPV) and negative predictive value (NPV) for “modified Alvarado score” was 99.43% and 32.2% and for “Ohmann score” it was 98.81% and 22.67% respectively. Conclusion: Both scoring system are sensitive and specific enough for diagnosis of acute appendicitis. However, sensitivity and specificity of modified Alvarado score is higher as compared to Ohmann score. Keywords: Acute Appendicitis, Diagnostic Accuracy, Modified Alvarado Score, Ohmann Score, Histopathology.