GENERAL SURGEONS; WORK LOAD & MANAGEMENT PATTERN IN MEDICAL TEACHING INSTITUTION LADY READING HOSPITAL PESHAWAR

Abstract

ABSTRACT… Objectives:The objectives of this study were to find out the frequency of surgical cases and types of surgical interventions in a tertiary care hospital of Peshawar. Study Design: Descriptive observational study Period: Jan to June 2015. Setting: Surgical "D" Unit of Medical Teaching institution, Lady Reading Hospital Peshawar. Material and methods: Relevant information's were recorded on a pre-designed proforma prepared in accordance with the objectives of the study. Results: A total of 842 patients who were admitted in the MTI-LRH Surgical D Unit were enrolled in the study irrespective of age, gender and geographical representation. Out of total 58% were males and 42% females. The age range of patient was from 2 years to 92 years the maximum. The mean of age with SD was 30 years +3.5 SD. Mode of age was 27 years. The frequency of surgical cases presentation (via emergency or outdoor department) were; Acute appendicitis 26%, cholilithiasis 17%, acute abdomen 9.2%, fire arm injuries/medico-legal cases 3.3%, peri-anal problems (pilonodal sinuses, hemorrhoids, fistula, anal fissure) 8.8%, Hernia (RIH& LIH 13%), carcinoma cases (stomach, rectum, pancreas) 1.5%, diabetic foot 3%, intestinal perforation & ileostomy 2.8%, etc. The frequency of types of surgical procedures were; The frequency of types of surgical procedures were; Open appendicectomy 25%, Exploration laprotomy 8.4%, debridement 2%, Peri anal surgeries (EUA, Haemorridictomy, anal dilatation, fistulectomy 9.4%), hernirraphy and hernitomy 16%, open cholecystectomy 13%, laproscopic cholecystectomy 4.4%, orchiodectomy & orchidopexy 5%, and colostomy reversal 2.2% etc. 2% patients managed conservatively. Eight patients expired during the treatment (1%). 97% discharged satisfactorily. There were 2 medico-legal cases that after discharged went in law in forces custody. Conclusion: The commonest cause of seeking surgical care was acute abdomen, FAI/MLC, cholilithiases, perianal disorders, hernia and testicular/scrotal problem are major surgical emergencies that we receive in our unit. In response the major types of surgical interventions are appendicectomy, Exploration laprotomy, open cholecystectomy, laproscopic cholecystectomy, hernirraphy and hernitomy, orchiodectomy &orchidopexy and colostomies. There is 1% moratlity rate as observed.