Objectives: To correlate the clinically diagnosed prostatic lesion with histopathological evaluation, Gleason scoring andserum prostate specific antigen (PSA) levels in a tertiary care centre. Study Design: Observational Study. Setting: The current study was conducted in multiple centers of Sindh like Department of Surgery Unit-III, Peoples University of Medical and Health Sciences, Nawabshah CMCH Larkana, Jinnah Sindh Medical University and Al-Tibri Medical College and Hospital Karachi. Period: January 2018 to December 2019. Material & Methods: on 112 consecutive cases of clinically diagnosed prostatic disease, all the relevant demographic and clinical details including digital rectal examination (DRE) findings and serum PSA levels were recorded on a proforma designed for the study. PSA values of all these cases were recorded before the surgical procedure. The tissue sample of prostate was collected after surgery and histologically analysed for the confirmation of diagnosis and the Gleason scoring was made. All the results obtained were statistically analysed and tabulated. Results: The age of patients ranged 34-81 years, with mean age of 58+3.4 years. The adenocarcinoma was detected in 05 cases, hyperplasia in 92 cases and hyperplasia with prostatitis in 07 cases. The carcinoma was clinically diagnosed in 17 cases but after histological evaluation, the carcinoma was confirmed in 03 cases and 02 cases of cancer were confirmed among clinically diagnosed cases of hyperplasia. Majority of cases of hyperplasia were having the PSA level < 4ng/ml No any case of adenocarcinoma have PSA level below 4ng/ml, and majority of the cases of denocarcinoma were having PSA level above 20ng/ml. majority of malignant lesions were having PSA level above 20ng/ml and the Gleason score above 6. No any case of malignancy was detected in those patients having PSA level below 4ng/ml. Conclusion: The histopathological evaluation with serum PSA levels is necessary in all cases of prostatic disease to rule out the possibility of malignant pathology.

Objectives: To evaluate the histopathological findings in appendectomy specimens and observe the negative appendectomy rate (NAR). Study Design: Observational study. Setting: Department of Surgery Unit III, Peoples University of Medical & Health Sciences, Nawabshah. Period: January to December 2018.  Material and Methods: 117 consecutive cases of appendectomy. All the demographic data and the clinicopathological details were recorded on a proforma designed for the study. The histopathological assessment was carried out in all cases. The ultrasound examination and CT scan was carried out in selected cases. The data collected was statistically analyzed and the results were tabulated. Results: During study period 117 appendectomies were performed. The mean age of patient was 27+9.4 years, majority of patients (53.8%) were females with female to male ratio of 1.2:1. The histopathological diagnosis was made in all cases and the results indicates that 105 cases having positive appendectomy and in 12 (10.3%) cases the appendix was found histologically normal. Among 105 positive cases, 97 (83%) were diagnosed as acute appendicitis, 2 (1.7%) cases show fibrous obliteration and 6 (5.1%) cases were having unusual pathologies. The cases having histological diagnosis of acute appendicitis includs acute mucosal appendicitis, acute suppurative appendicitis with or without periappendicitis and peritonitis, acute necrotizing appendicitis and perforated gangrenous appendicitis. The 6 cases of unusual pathologies includes 3 cases of granulomatous lesions and one case each of carcinoid tumor, mucinous cystadenoma and worm infestation. The ultrasound was performed in 48 (41%) patients out of them 30 cases had positive findings on ultrasound examination were confirmed on histological examination and all 5 positive cases that were reported on CT scan were confirmed on histopathological examination. Conclusion: High rates of negative appendectomy in the female sex were observed, that can be reduced by the use of diagnostic imaging modalities specially ultrasound. The findings of abnormal pathologies on histopathological examination of the appendix suggest that histopathological analysis is necessary in all of the resected specimens.

Objective: This study was conducted with the aim to approach the diagnostic accuracy of fine needle aspiration cytology in supraclavicular lymph node swelling at outpatient department. Methods: The study is cross-sectional, descriptive conducted at General Surgery department Unit-III, of PUMHSW, Nawabshah, Sind, from 1st January 2019 to 31st December 2020. After the written permission from ethical Review Committee of PUMHS-W, all the patients attending Surgical/Medical outpatient department with supraclavicular lymph node swelling and sent for cytological examination from 1st January 2019-31st December 2020 were entered in SPSS-20, after filling of specially designed proforma. All the variables/demographic details were entered and analyzed by SPSS version 20. Results: Total of 153 cases diagnosed at the Department of Pathology, PUMHS-W, and Nawabshah during the two-year period. The most commonly lesion was TB Lymphadenitis 58(38%),and 43(28%) were cases of Reactive Hyperplasia, while the malignant metastatic lesions were 38(25%) and Lymphoma and NHL were positive in 5(3%) cases. The metastatic lesion were most commonly involve the left side 23(60.5%) and less commonly the bilateral 3(8%) involvement. The common metastatic malignancy found was squamous cell carcinoma 14(37%) followed by adenocarcinoma, undifferentiated carcinoma, small cell carcinoma, papillary thyroid carcinoma, ductal carcinoma breast, hepatocellular carcinoma and seminoma, 10(%), 5(% ),2(%), 2(%), 1(%), 1(%), 1(%) respectively. The most commonly involved age group by mixed lesions were 41-50 years of age, and less common group involved was above 70 years of age. The metastatic malignant lesion were commonly found in 61-70 years of age group and lymphoma and Non Hodgkin Lymphoma were seen up to 60 years of all age groups. Conclusion: Fine Needle Aspiration Cytology is a reliable diagnostic tool as it is cheap, less invasive, and timed modality for diagnosing the supraclavicular lymph node inflammation/metastatic and nodular malignancies.

Objective: To compare the outcomes in relations to postoperative pain and complications, and hospital stay of laparoscopic versus open appendectomy in management of appendicitis. Study Design: Cross sectional study. Place and Duration of Study:    This study was conducted in department of surgery Unit III of PUMHS Nawabshah and Suleman Roshan Medical College Tando Adam, Sindh Pakistan, from January 2020 to December 2021. Methodology: This study consisted of 136 consecutive cases of either gender, aged between 13 to 60 years, that were enrolled during study period and matching with the inclusion and exclusion criteria. After the permission of ethical committee, a detailed history was taken from all the patients with special regard to the pain in RIF, Pain starting around umbilicus, nausea, vomiting, fever and altered bowel habits. All the cases were randomly divided into  Group A comprising of 68 cases which were operated by conventional open appendectomy (OA) and other group B also comprising of 68 cases which were operated by laparoscopically appendectomy (LA). All the clinical and demographic data was collected on a proforma designed for the study, and analyzed by using Statistical Package for Social Science (SPSS) software version 22. Effect modifier like age, gender was controlled by stratification and chi-square test was applied to see the effect of these on both open versus laparoscopic appendectomy outcome variable. P <0.05 was taken as significant. Results: In open appendectomy group male:female ratio of 1.2:1 and in laparoscopically appendectomy group male:female ratio of 1.5:1. The mean age was 31.28±4.30 years for OA group and 35.47±3.23 years for LA group (p 0.02).Alvarado score was showed <4 Score 0% in both groups, where as 4-7 Score in 9(13.23%) patients of OA group and 8(11.76%) patients of LA group, and > 7 Score was seen in 59(86.76%) patients of OA group and 60(83.23%) patients of LA group.  The mean time in OA group was 45.21±12.1 minutes and LA group was 43.44±9.4 minutes (p 0.026).Mild pain was felt in 7(10.29%) patients of OA group and 39(57.35%) patients of LA group, Moderate pain was seen in 31(45.58%) patients of OA group and 26(38.23%) patients of LA group, severe pain was described by 30 (44.11%) patients in OA group and 3(4.41%) patients in LA group (p 0.005).The common complications seen in this study Ileus was 29(42.64%) patients in OA and 18(26.47%) patients in LA group) followed by wound infection 10(14.70%) patients in OA and 1(1.47%) patients in LA group. The duration of hospital stay was longer about 3-4 days in 58(85.29%) of OA patients as compared to LA cases where majority 65(95.58%) were discharged within 2 to 3 days.    Conclusion: We conclude that laparoscopic appendectomy procedure has a low rate of complications, earlier mobilization, implies a shorter hospital stay and offers the patient a more comfortable postoperative period than open appendectomy procedure.

Objectives:  To evaluate the frequency of reactive and clonal thrombocytosis based on age, sex, clinical findings, and severity of thrombocytosis. We also highlight the determination of hematological parameters for the diagnosis of these disorders required the management of thrombocytosis to reduce the morbidity and mortality rate. Methods: This descriptive experimental study was conducted in the Diagnostic and Research laboratory, Peoples University of Medical and Health Sciences, Nawabshah and department of Pathology, from July 2017 to June 2018. Total 325 patients including 260 patients with reactive thrombocytosis and 65 patients with clonal thrombocytosis, their age ranged between 12 and 45 years and 35 to 68 years were selected. The male to female ratio were 1.5:1 and 2.5:1 while clinical history and clinical examination were noted. The blood samples were taken from all these patients for the analysis of hematological parameters by a hematological analyzer (Nihon Corden) and an iron profile performed for assessment of iron status to confirm the diagnosis of iron deficiency anemia. The examinations of peripheral blood smears and bone marrow smears in the case of clonal thrombocytosis seen in chronic myeloid leukemia essential for the diagnosis. Results: The mean ages and male to female ratio among 325 patients with reactive and clonal thrombocytosis were 28.5 + 16.5, 51.5 +16.5 and 1.5:1, 2.5:1 ratio were found in this study. The mild to moderate thrombocytosis were found in reactive thrombocytosis while moderate to severe thrombocytosis was detected in patients with chronic myeloid leukemia. Conclusions: The frequency of thrombocytosis was higher in clonal thrombocytosis than the reactive type.