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Objective: To compare the outcome of humeral shaft fractures treated by functional cast brace versus "U" slab in terms of union. Study Design: Quasi-experimental study Place and Duration of Study: Department of Orthopaedic Surgery/Traumatology Unit-II, Mayo Hospital, Lahore, Pakistan from Jul to Dec 2018. Methodology: One hundred and four patients fulfilling inclusion criteria were included. Patients were randomised into two groups by random tables. Group-A patients were treated with a "U" slab outdoors, and Group-B patients were treated with a customised functional brace from the Orthopaedic workshop as indoor cases. Results: The mean age of patients was 47.99±14.15 years, with minimum and maximum ages of 16 and 65 years, respectively. According to the operational definition, the union was achieved in 88(84.6%) patients. In Group-A, 38(73.1%) patients and in Group-B, 50(96.2%) patients had union. A significant association between union and study Groups was noted, i.e. Group B had a high union rate when compared to Group A, with a p-value of 0.001. Conclusion: To conclude, in patients with humeral shaft fracture, a functional cast brace is a better choice for achieving union as it reduces the burden of non-union, and patients recover early, assessed by callous formation.

Introduction: Knowing the temporal trends as to when and how many pediatric surgery patients present and are operated on in a newly developed unit is crucial in the allocation of resources and policy making in health care center. Aims & Objectives: The aim of this study is to describe the spectrum and pattern of operated pediatric surgery patients in a newly developed pediatric surgical unit of Pakistan. Place and Duration of Study: This study was conducted at Pardiatric Surgery Unit of Holy Family hospital, Rawalpindi between January 2020 and September 2021. Material & Methods: This was a retrospective descriptive study conducted on all patients that were operated under Pediatric surgery unit over a period of 20-months. Data regarding age, sex, diagnosis, and procedure performed were obtained. Diagnoses were categorized based on organ system. SPSS version 22 was used to perform the data analysis., a p-value of ?0.05 was considered significant. Results:898 procedures were performed in total with a male to female ratio of 2.03:1. Most of the patients fell under 2-8 years of age. Digestive system disorders (164, 18.3%) and genitourinary (377, 42%) made most of the cases observed, with inguinal hernias making up to 15.0% of all cases. Oddsratio was calculated for different variables which showed that male patients , patients with gastrointestinal problems had greater odds of being operated. Conclusion: The expected number of operated cases in a newly developed unit is comparable to other units that have been established for a long time.More focus research needs to be done on different aspects of pediatric surgery in our region and to try for integration of pediatric surgery into public health programs including primary and secondary health centers to meet the increasing demand of pediatric surgical patients presented to tertiary care.

Objective: To present an experience of the first 50 cases of appendectomy performed via laparoscopy assisted open technique. Study Design: Descriptive case series. Place and Duration of Study: This study was carried out at Pediatric Surgery department, Pak Emirates Military Hospital Rawalpindi, from Jan 2016 to Apr 2018. Material and Methods: Fifty patients (

Conjoined twins, a rare anomaly in which same-sex fetuses are partially or completely joined, present unique challenges in diagnosis and management. This article reports the first successful operative separation of pyopagus conjoint twins in Pakistan, an achievement in a low-resource setting. The female twins, diagnosed prenatally, underwent a planned cesarean section at 37 weeks. The initial physical examination revealed an 18 cm conjoined area with a shared anal opening. Postnatal monitoring in the neonatal intensive care unit detected abdominal distension, leading to pelvicdivided colostomies. A multidisciplinary team, including gynaecologists, anesthesiologists, pediatric medicine specialists, neurosurgeons, and pediatric surgeons, collaborated on the operative procedure of the six-month-olds. The process involved bone removal, dural incision, and anorectoplasty. Postoperatively, one twin experienced cerebrospinal fluid leakage, which was managed conservatively. The twins were discharged after a week with a one-month follow-up.