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Objectives: To compare the results of linear closure technique with purse string closure technique in terms of surgical site infection, wound healing (scar cosmesis) and wound length. Study Design: Comparative Study. Setting: Surgical Unit V, Faisalabad Medical University, Faisalabad. Period: January 2016 to January 2019. Material & Methods: A total of 100 patients were operated in our unit during the study period & were allocated into two groups randomly: Group A (Linear closure) Group B (Purse string closure) included 50 patients in each group. The primary outcome measures were, surgical site infection, wound healing (scar cosmesis) and wound length. Results: During follow up period Surgical site infection was noted in 17 patients out of 100 with 14 patients in Group A and 03 Patients in Group B (p value 0.002). Regarding wound healing 60% patients were having good scar and 20% patients were having satisfactory and 20% having poor scar in Group A. while in Group B 82% patients were having good scar and 18% patients were having satisfactory scar (p value 0.00). Mean wound length in Group A was 5.14 with SD 1.2978 while in Group B mean length was 3.8 with SD 1.3095. Conclusion: Our study concludes that purse string closure is superior to linear closure technique in terms of surgical site infection, wound healing (scar cosmesis) and wound length.

Objective: To determine the role of preoperative administration of sildenafil on pulmonary hypertension in patients with mitral valve disease undergoing mitral valve replacement surgery. Study Design: Randomized Control Trial. Setting: Department of Cardiac Surgery, Faisalabad Institute of Cardiology, Faisalabad. Period: June 2018 to June 2020. Material & Methods: A total of 310 patients with mitral valve disease who underwent mitral valve replacement were included. The patients were divided into a control group of 155, who were not administered oral sildenafil, and a study group of 155 who received oral sildenafil preoperatively. TVPG, LVEF and NYHA class were recorded preoperatively and postoperatively and were compared. Results: In the study group, postoperative LVEFs and NYHA class were not statistically significant in both groups while postoperative TVPG was significantly lower in study group as compare to control group and is statistically significant (P<0.001). Conclusion: Our study concludes that oral sildenafil preoperatively can be used as an effective therapy to reduce pulmonary pressure in patients with pulmonary hypertension undergoing mitral valve replacement surgery.

Objective: To compare mean early post-operative pain and frequency of wound healing of pilonidal sinus using application of crystallized phenol versus wide excision with open healing. Study Design: Randomized Controlled Trial. Setting: Department of Surgical, Allied Hospital Faisalabad. Period: 13-10-2018 to 12-04-2019. Material & Methods: A total of 60 patients were operated in our unit during the study period and were allocated into two groups randomly: Group A and Group B. The patients in Group A underwent treatment using crystallized phenol. Patients in Group B underwent wide local excision of the pilonidal sinus tract. All patients were given single dose of broad-spectrum antibiotic at time of procedure. Analgesia in post-operative period was maintained by using Diclofenac Sodium (Inj Artifen 75mg/3ml IM) as requested by the patient as long as the safe dose is not exceeded. First assessment of all patients was done at 24 hours after surgery. The analgesic requirement and visual analog scale score were documented for patients of both groups at this time. Follow up visit for patients in both groups was scheduled at 3 weeks after treatment. All the data was collected with the help of a specially designed Performa. Results: Mean pain score in Group-A was calculated as 1.36±0.55 and in Group-B it was 3.23±0.82, p value was 0.0001, comparison of wound healing in both groups shows that wound healing in Group-A was in 80%(n=24) and in Group-B, it was 30%(n=9), p value was 0.0001. Conclusion: We concluded that mean early post-operative pain and frequency of wound healing of pilonidal sinus using application of crystallized phenol is significantly lower when compared with wide excision with open healing.

Pregnancy associated breast carcinoma is an entity which is diagnosed during pregnancy or within one year postpartum.Objective: (1) To understand the pathogenesis of pregnancy associated breast carcinoma. (2) To be able to manage this problem mosteffectively in the interest of fetus & mother. (3) To be able to avoid preventable complications of treatment. Conclusions: The pregnancyassociated breast carcinoma can be managed effectively with various treatment modalities during various stages of pregnancy & lactation.Prognosis & outcome: It is not worse than the stage wise carcinoma breast in non pregnant women of the same