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Objectives: To determine the various prognostic factors of intestinal anastomosis leakage at tertiary care Hospital Material and Methods: This prospective cross-sectional study was conducted in Surgical Units of Liaquat University Hospital Jamshoro/Hyderabad. A total 100 patients were included those underwent intestinal anastomosis. After taking detailed history and clinical examination, in the patients’ relevant investigations i.e. Blood CP, X-ray abdomen, Methylene Blue Test (to confirm leaks) and ultrasound of the abdomen. If they remain free of any complication, they were discharged. After collection of data, the analyses were done using Statistical Package for Social Science (SPSS) program version 26.0 Results: Mean age of the patients was recorded as 51.5+3.5 years and males were found in the majority (76.6%). In the clinical presentation, abdominal pain was the most common (63.6%). Typhoid 75(25.0%) was the most common diagnosis. The pathological sites were found as Ileocolic 180(60.0%). Poor nutritional status was in 60.0% cases. Anaemia was 40%, diabetes 20%, and hypertension 10%. A high steroid dose history was in 10% cases and 6.6% had a history of chemotherapy. Ischemia of the intestine at the suture line was seen in 6%, local sepsis was 20%, obstruction distal to the anastomosis was 6.6%, postoperative early adhesions was 6.6%. Conclusion: Male gender, poor nutritional status, diabetes, anemia, presence of local sepsis, chemotherapy and high dose steroid were observed highly prevalent and suspected as factors of anastomosis leakage. Furthermore, many efforts need to be made to reduce the mortality and morbidity rates associated with anastomotic leaks.

Objective: To determine the incidence and management of post cholecystectomy biliary fistula at tertiary care Hospital.  Methodology: This was a prospective study which was conducted at general surgery department of Liaquat University of Medical and health Sciences, during one year from March 2017 to February 2018. All the patients those underwent laparoscopic cholecystectomy or open cholecystectomy, age more than15 years and either of gender were included. All the patients were evaluated for developed biliary fistula after cholecystectomies. All the patients of biliary fistula were managed conservatively and surgically and their management outcome was recorded. After operation most of patients were followed up to 6 months. The data was collected via study designed proforma. Data was analyzed by using SPSS version 20. Results: Out of 318 patients, 280 patients underwent laparoscopic cholecystectomies, 38 patients underwent open cholecystectomies. Mean age of the patients was 41.34+8.23 years. Females were in majority 233(73.3%) and males were 95(29.7%). Out of all post-cholecystectomy biliary fistula was seen in 10(3.14%) patients. Incidence of post-cholecystectomy biliary fistula was insignificantly associated with types of cholecystectomies (p=0.425), while it was highly prevalent in females (p=0.001). Conclusion: In the conclusion of this study the post cholecystectomy biliary fistula was observed to be 3.14% and mostly patients were manged via conservative treatment.

Objective: Role of C-reactive protein value in the diagnosis of appendicitis by correlating with severity of appendicitis on histopathological findings. Methodology: This descriptive study was conducted at the department of general surgery Unit-IV, Liaquat University Hospital Hyderabad from March 2016 to February 2017. All cases above 12 years of age with severe appendicitis based on presenting signs and symptoms were included. The patient underwent routine laboratory investigations including abdominal plain x-ray in an erect position and ultrasound abdomen. The blood sample was taken from each patient for C-reactive protein and was send to Hospital diagnostic laboratory. During surgery, a specimen of each patient was sent to a diagnostic laboratory for histopathology. All the data were record on Performa. Results: A total of 305 patients were studied; their mean age was 35.7+9.7 years. Males were found in the majority (73%). 75.41% of patients had leukocytosis. C-reactive protein was raised among 26.22% of patients. On histopathological findings, 04.91% of patients had a normal appendix, while 69.83% had gross inflammation of the appendix, 19.67% patients had gangrenous appendix, and 05.57% patients had perforation and peritonitis. Elevated C reactive protein (CRP) and leukocytosis were significantly associated with the severity of appendicitis, p value 0.001. Conclusion: C-reactive protein is a non-invasive and reliable indicator for surgical treatment of appendicitis. C-reactive protein and white blood cells (WBCs) were significantly associated with the severity of appendicitis.

Objectives: To determine the operative findings of patients underwentgastrointestinal surgeries and postoperative outcome according to Clavien-Dindo system. StudyDesign: Prospective study. Setting: Isra University Hospital Hyderabad and LUMHS Jamshoro/Hyderabad. Period: One year duration from 2014 to 2015. Material and methods: Total 50patients were included those were underwent Gastrointestinal Surgery. After taking detailedhistory and clinical examination, relevant investigations i.e. CBC, abdominal X-ray, MethyleneBlue Test to confirm the leaks and abdominal ultrasound were done. All operative findingsand postoperative outcome according to Clavien-Dindo system was recorded in the proforma.After collection of data was analysed by (SPSS) version16.0. Results: Total 50 cases studied,their mean age was 46.6+9.7 years, male were found in majority 36 (72.0%) while female were14 (28.0%). Most common diagnosis in of patients those underwent gastrointestinal surgerieswere typhoid perforation 22.0%, tuberculosis 18.0%, Duodenal perforation 20.0% and intestinalobstruction was 10.0%. Postoperative outcome was assessed according to the Clavien-Dindoscoring system as; majority of the cases 16 (32.0%) were found without complications, 12(24.0%) with grade II, followed by 10 (20.0%) were with grade I, 04 (08.0%) were with grade III,only 2 (4.0%) cases were found with grade IV and 06 (12.0%) cases were died during follow upand those were with grade V. Conclusion: It is concluded that most common operative findingswere typhoid perforation, tuberculosis, duodenal perforation and intestinal obstruction findingsinpatients those underwent gastrointestinal surgeries. According to the Clavien-Dindo scoringsystem and majority of the cases were with grade I and grade II and 6 cases were died thosewere enrolled as grade V.