This is a prospective observational study carried out during last five years (Jan, 1998 to Nov, 2002) The purpose was to study guidelines of case selection for different available procedures to treat typhoid perforations. Ninety cases of typhoid perforation were treated by different procedures. The complete records were maintained and a designed protocol of management was observed. Male to Female ratio was 4 to 1. Average age 26 years (7 cases below 10 years and 6 cases above 40 years) Only 17 cases (18.88%) presented within 24 hours, the largest group of 31 cases (34.44%) presented after 72 hours. Although complication rate was very high in the late reporting, no significant mortality difference was noted. Primary ileostomy (group 1) 18 cases had no mortality, 53 cases of simple perforation closure had 5 mortalities (9.43%), resection anastmosis group that is 19 cases had 2 mortalities (10.5%), closure of the ileostomies (19 cases) had no mortality and a very low complication rate. In our study ileostomy is a good life saving procedure to be used judiciously, accepting its inconvenience to the patient.

Many socioeconomic factors influence the literacy rate in Pakistan. Poverty is known to be the main factor considered to have coexisted with low literacy skills and under achievements. There is an established link between poverty and illiteracy in developing countries. Poverty forces people into child labor, which produces illiteracy and these illiterates are forced to take low-income jobs that produce poverty. Thus, poverty and illiteracy have a cyclical relationship. The study was launched to further probe the link between family income and the acquisition of literacy skills. The main aim of the study was to: examine the co-occurrence of family income and participants’ learning achievement level; and to explore the role of income on participants’ literacy skills and to recommend certain measures to improve literacy. The study was descriptive, and the survey method was adopted to gather data from the people of the District of Bahawalpur. Two types of research tools were employed in the current study. The first tool was adapted by the Lao National Literacy Survey 2001, which was based on household information. The second tool was a test, adapted by the Lao National Literacy Survey 2001, which measures the basic literacy skills (reading, writing, numeracy, and visual skills) and background information of respondents. The researcher used two separate sheets for each respondent. One sheet was used for households' basic information and the other for the compilation of test results of the literacy skills of the respondents. After gathering the complete information from respondents, the data was organized and analyzed statistically. The main finding of the study reflective that high family income correlates with a higher level of literacy skills, and lower-income with a lower level of literacy skills. Based on the findings of the study, it was recommended that the government launch facilitating programs for the needy and vulnerable wards of society.

Objective: To compare fistulectomy and ligation of inter sphincteric tract in patients of fistula in ano in terms of postoperative pain and duration of wound healing. Study Design: Prospective Experimental study. Setting: Department of General Surgery of Faisalabad Medical University and Affiliated Hospitals. Period: 22-01-2021 to 21-07-2021. Material & Methods: Computer-generated random numbers were used to assign the type of treatment (group. A or B). Group A patient underwent treatment with fistulectomy. Group B patient underwent treatment with ligation of inter sphincteric tract (LIFT). Post-operative pain was noted and scored at 12, 24 and 48 hours and after one week on visual analogue scale (VAS). Healing time noted in both groups and patients followed up for 5 months. Results: Out of these 60 study cases, 46 (76.7 %) were male patients while 14 (23.3 %) were female patients. Mean age of our study cases was 43.17 ± 10.77 years. Mean pain score in group A was noted to be 4.77 ± 0.858 while that of group B was noted to be 3.07 ± 1.01 (P<0.001). Mean duration of wound healing in group A was 7 weeks and in group B was 3 weeks(P<0.001). Conclusion: Ligation of inter-sphincteric tract is better than fistulectomy in patients of fistula in ano as it is associated with significant reduction of pain and duration of wound healing.