Objective: To compare the outcome of percutaneous ultrasound guided aspiration V/S open surgical drainage for psoas muscle abscess. Methodology: This comparative study was conducted in department of general surgery at Liaquat medical university hospital Hyderabad/Jamshoro, from June 2017 to November 2017. Diagnosed Patients of psoas muscle abscess size more than 5cm, between 18 to 60 years of age and either of gender were included. Patients were randomly divided into two groups, A and B by odd and even method, patients in group A abscess was aspirated by percutaneous ultrasound guided aspiration and patients in group B was underwent open surgical drainage, all the data were entered in the pre designed performa and analyzed into SPSS V:16.0 Results: A total of 58 patients of Psoas muscle abscess were selected, the mean age of study subjects of group A was 38.5+10.5 and group B was 36.5+12.7 (p-673). Early post-operative pain relief was assessed among patients of group A as compared to group B. As per outcome resolution of abscess cavity was significantly high among patients of group B (p-0.004), while post-operative Hospital stay was significantly lower in group A (p-0.002). Conclusion: Both techniques has their own benefits like percutaneous aspiration has shorter duration of hospital stay while in complete resolution of abscess cavity was found in open surgical drainage group of patients.

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 the clinical pattern and diagnosis of various types of solid testicular swellings and its management outcomes. Materials and methods: This prospective cross-sectional study was done at the surgery department of Muhammad Medical College, Mirpur Khas. Cases with different presentations raising suspicion about the disease were admitted to the hospital from OPD after recording the detailed history and clinical examination. All the patients presenting with solid testicular swellings underwent inguinal exploration through an incision above the inguinal ligament, regardless of age, were included. After taking verbal informed consent, all the cases underwent testicular biopsies, and specimens were sent to the diagnostic laboratory for histopathological diagnosis. Patients having neoplastic testicular changes were referred, and patients with non-neoplastic testicular swellings lesions were treated conservatively or surgically as per indications. The data and records of all the patients were taken and maintained by the study proforma. Results: A total of 50 cases of solid testicular swellings were studied; their mean age was 48.45+7.23 years. Painless enlargement was present in 70% of cases, enlargement was usually gradual with a feeling of heaviness, followed by painful enlargement in 10.0% of cases. 20(40%) patients were diagnosed as neoplastic testicular swellings, and 30(60%) patients had non-neoplastic swellings. Among 30 cases of testicular swellings, 40.0% had orchitis, 8.0% had trauma, Epididymo-orchitis 12.0%, testicular tuberculosis was in 4.0%, and 1 (2%) had mumps orchitis. All the non-neoplastic lesions were treated successfully and neoplastic lesions cases were referred for further treatment. Conclusion: As per the study conclusion, painless enlargement (usually gradual with the feeling of heaviness) was observed to be the most common clinical feature. However, orchitis, epididymo-orchitis, and tuberculosis of the testis seemed to be the most common diagnoses among non-neoplastic cases. Neoplastic lesions were frequently high. Keywords: Testicles, swelling, features, diagnosis

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.

Background: Informed consent (IC) is a critical step in ensuring that patients understand implications of their treatment decisions. Materials and Methods: It is observational cross-sectional study. Non probability purposive sampling was used to collect data from different surgical units. Adult postsurgical patients were questioned using a standardized questionnaire between the first- and fifth-day following surgery in two general hospitals in Sindh province (Hyderabad and Jamshoro). Data was analyzed using SPSS and Microsoft excel. Results: A total of 78% of individuals who claimed to have read it found informed consent to be easy to understand. Less than half of patients thought information brought them some emotional solace, while 23.2% of patients reported feeling more anxious after hearing information. This study suggests enhancing the process of obtaining consent forms by including additional information and avenues for discussion on written documents rather than relying solely on verbal communication. Conclusion: Patients under age of sixty and patients who had completed more schooling tended to read written informed consent forms more frequently. Orally communicated pre-operative information suited patients' requirements better than written informed consent. Surgeon needs to get informed permission from patient and inform them about operation type, potential consequences and other treatment options. Keywords: Informed consent, Medical Ethics, Surgery, Hospital, Surgeons, Health, Sindh.