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Background: Appendicitis is a surgical emergency and surgery is crucial for patients diagnosed with having acute appendicitis as any delay in surgery leads to perforation of the organ Methods: 50 Patients with provisional diagnosis of acute appendicitis were included in the study. Preoperative blood sample was analysed for neutrophil percentage. The patients were divided into two groups, each comprising of 25 patients on the basis of neutrophil percentage i.e. group A having neutrophils ≥ 75% and group B having neutrophils ≤ 75%. Patients were then followed-up and peroperative findings and histopathology reports were noted for differentiating between perforated and inflamed appendices. SPSS version 22.0 was used for analysis and Pearson's Chi square test was applied at 5% level of significance. Relative risks along with 95% confidence intervals were also calculated. Results: 15/25 (60%) patients in Group A developed perforation of appendix when compared to only 1/25 (4%) patient in Group B, who later developed perforation (Relative risk = 15.0, 95% confidence interval=2.1408 to 105.10, P value=0.00). No statistically significant association was observed between age and gender with perforation of appendix. Conclusion: There is a highly significant statistical association of shift to the left of neutrophils with perforation of appendix. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic Cholecystectomy (LC) is considered to be the gold standard treatment option for cholelithiasis. Various studies have shown that LC causes elevation in serum levels of certain hepatic enzymes. Objective:The objective of this study was to compare the mean pre-operative levels of serum Alanine Transaminase (ALT) with mean postoperative levels of serum Alanine Transaminase after Laparoscopic Cholecystectomy in tertiary care hospital of Rawalpindi. Materials & methods: This single group experimental study was conducted from January 2017 to March 2017 at Surgical Unit 1 of Holy Family Hospital, Rawalpindi. 44 patients with confirmed diagnosis of cholelithiasis undergoing LC were included. Their pre-op serum ALT levels were investigated. Immediately after LC, serum ALT levels were repeated to determine post-op serum ALT levels. Data was analyzed with SPSS v22 and in addition to descriptive statistics; Wilcoxon Signed Ranks test for paired data was applied at 5% level of significance. Results: After LC, serum ALT levels increased in 82%, decreased in 14% while remained same in 4% of the patients. Post-op Derangement of serum ALT levels (>43u/l) was observed in 50% of the patients, with normal baselines, undergoing LC. Mean Pre-op ALTs observed were 28±10 u/l while mean post-op ALTs were 42±15 u/l. Mean change observed between Pre op and Post op ALTs of patients after LC was 14±12 u/l. There was highly significant difference in mean pre-op and mean post-op serum ALT levels with P value 0.00. Results were statistically extremely significant. No relation between elevation of serum ALT levels and gender could be established (P value 0.103) while derangement of ALT levels (>43u/l) was observed more in male than in female patients. Mean change in ALT levels after LC increased proportionally with age. Conclusion: Significant change was observed in serum levels of ALT which suggests that pneumoperitoneum created during LC causes hepatocellular ischemia leading to cellular injury which might be the cause of elevation in serum ALT level. [ABSTRACT FROM AUTHOR]

Introduction: Hepatitis C virus is an RNA virus that is affecting almost 170 million people worldwide. Hepatitis C is also associated with increased incidence of chronic liver diseases, liver cirrhosis and hepatocellular carcinoma. Therefore serum levels of ALT are considered to be the more specific indicator of hepatocellular damage than serum levels of AST. Serum ALT levels vary according to age and gender. Materials And Methods:This is a descriptive cross sectional study that was conducted from September 2016 to April 2017 at Centre of Liver Diseases of Holy Family Hospital, Rawalpindi after approval from Institutional Research Forum of Rawalpindi Medical University. Consecutive nonprobability sampling technique was used. The findings of serum ALT levels were classified into 5 groups: <40u/l, 41-60u/l, 61-80u/l,81-100u/l and >100u/l. Normal value of serum ALT levels was <40u/l. Patients were divided into 5 age groups: 10-25 years, 25-40 years, 40-55 years, 55-70 years and >70 years. The data was analyzed using SPSS v22. Frequency and Percentages were calculated for gender, age and serum ALT levels. Results:405 (198 male and 207 female) patients were included in this research. Mean ALT levels in male patients were 89.5u/l while in female patients were 70.4u/l. The difference between their mean values was significant (P=0.016). Serum ALT levels of 24.2% (98) patients were within normal range (<40u/l) while they were deranged (>40u/l) in 75.8% (307) patients. Serum ALT levels were higher in female patients in all age groups Conclusion: It was concluded that serum ALT levels vary significantly with age and gender. Elevation of serum ALT is seen more frequently in male than in female patients although mean ALTlevels are higher in female patients in all age groups than in male patients. [ABSTRACT FROM AUTHOR]