Objective. This study was conducted to provide local data regarding the results and post-operative complications after single-stage resection and anastomosis for acute sigmoid volvulus, without intra operative colonic lavage. Study Design: Descriptive Cross Sectional. Setting: DHQ Charsadda. Period: May 2017 to December 2019. Material & Methods: This clinical study was done on 50 patients who presented with the signs and symptoms of acute sigmoid volvulus excluding those with complications of the illness such as gangrene, perforation and peritonitis. Surgery for all patients was carried out under General anaesthesia. All the patients underwent emergency resection and primary anastomosis, without mechanical bowel preparation. Data were collected regarding post operation complication and analysis by using SPSS version 23. Chi square test was used to compare at level of significance <0.005. Results: Median age of patients was 50 years with male to female ratio 5:3. Seven patients presented with wound infection, one dehiscence while zero Anastomotic leakage and zero death postoperative recorded. Conclusion:  Single stage resection and primary anastomosis without preoperative colonic lavage for acute sigmoid volvulus is a simpler and short procedure with low mortality and morbidity rates.

Objectives: To provide local data regarding the postoperative complications, pain, anal incontinence and recurrence after lateral internal sphincterotomy for chronic anal fissure. Study Design: Clinical Study. Setting: DHQ Charsadda. Period: May 2017 to December 2019. Material & Methods: It was done on 230 chronic anal fissure patients who had underwent prior conservative treatment. Surgery for all patients was carried out under General anaesthesia with open sphincterotomy. Postoperative follow up was carried till 6 months. Data were collected and analysis by using SPSS version 23. Chi square test was used to compare at level of significance <0.005. Results: Mean age of patients was 37.50 ± 7.28 years. Female presented with more postoperative complications than male but differences were statistically not significant. At the end of 6th months follow up period we observed that significantly higher numbers of patients were satisfied (91.4%) with a healing rate of (93.8%). Conclusion:  LIS is treatment of choice for chronic anal fissure.

Objective: To compare the surgical outcomes of hemorrhoidectomy performed by suture less with conventional technique. Study Design: Randomized Clinical Trial. Setting: DHQ Charsadda. Period: 15 May 2017 to 30 June 2018. Material & Methods: This was done on 60 admitted patients with grade 3 or grade 4 prolapsed hemorrhoids with failed conservative treatment from. These Patients were randomly assigned using sealed opaque envelopes containing computer‐generated random numbers into two groups, Group A, who would undergo scissors excision and group B would undergo diathermy without ligation. Postoperative follow up was carried till 6 months. Data were collected and analysis by using SPSS version 23. Chi square test was used to compare at level of significance <0.005. Results: Median age of Group A was 52 years with range 33-65 while In group B age ranged from 34-65 with a median age was 51 years. Length of hospital stay in both groups ranged 1-5 days, with a median of 3 days. Every patient experienced different pain at different levels but there was no statistical difference in the severity of postoperative pain between the two groups. Follow up results showed five subjects from Group A and two from Group B had mild anal strictures, which dilated with bulk laxatives alone. Conclusion: There are no significant differences in the surgical outcomes of hemorrhoidectomy done by both techniques.

Background: Laparoscopic cholecystectomy (LC) is the treatment of choice for symptomatic gall stones but controversy regarding the routine use of drainage after elective LC still exists. The objective of this study was to determine the efficacy of post-procedural drainage versus no drainage after simple laparoscopic cholecystectomy. The postoperative complications were also evaluated in both groups after the LC procedure.Material and Methods: This Randomized controlled trial (RCT) was conducted in patients who underwent Laparoscopic cholecystectomy according to a pre-set inclusion criterion. Ninety-three patients were randomly assigned into group A (with drainage tube) and group B (without drainage tube) using sealed opaque envelopes containing computer‐generated random numbers. Primary (like duration of hospital stay, Postoperative pain) and secondary outcomes (like postoperative complications) were noted in both groups. Chi-square, Fischer exact test and Mann witney U test were applied as appropriate and statistical significance was established at P < .05.Results: The number of patients with hospital stay exceeding two days were more in group A (n=23; 51.1%) than B (n=13; 28.8%) (P < .05). Group A presented with more postoperative complications but differences between the two groups were statistically non-significant. Both Groups experienced a high level of pain at six hours of surgery followed by progressive decrease in severity at 24 and 48 hours, respectively (P=.06).Conclusions: Post-procedural drain placement after laparoscopic cholecystectomy has no advantages as there is no significant difference in post-operative complications and duration of hospital stay in drainage versus no drainage groups.

Objective: Objective was to compare mean hospital stay in patients with abdominal surgeries with and without Nasogastric tube. Study Design: Randomized Controlled Trail study. Setting: DHQ Charsadda. Period: Jan to Nov 2018. Material & Methods: One hundred and thirty two patients who underwent abdominal surgeries according to a preset inclusion criteria were in this study. These Patients were randomly assigned using sealed opaque envelopes containing computer‐generated random numbers into with and without NG tube. Mean hospital stay was noted in both groups. Student ‘t’ test was used to compare the mean hospital stay of both groups. Results: Mean age of patients in group A was 28.50 ± 9.28 years and for group B was 30.12+_9.09 years. Mean hospital stay for group A was 5.64+_2.32days and for group B was 8.73+_3.43 days with a p-value of < 0.000. Conclusion: Patient with nasogastric tube stay longer in hospital than without tube.