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Objective: To compare outcome of circumcision done by Plastibell versus conventional open method in terms of post op complications, operating time and cosmetic acceptance. Study Design: Comparative prospective study. Duration and Place of Study: Department of General Surgery, Combined Military Hospital, Peshawar Pakistan, from Sep 2019 to Mar 2020 over period of six months. Methodology: All patients (n=100) fulfilling inclusion criteria were randomly divided into two groups. Group-A (n=50) underwent Open Conventional technique while Group-B (n=50) underwent Plastibell technique. To measure outcome of surgery, bleeding rate, cosmetic appearance and post-operative infection were used as parameters. The mean operating time was also compared among both techniques. Results: In Group-A, the average operating time was 24.24±4.36 minutes whereas in Group-B it was 13.38±2.66 minutes (highly significant, p-value=0.0001). The bleeding rate was 14% in Group-A and 2% in Group-B (Not insignificant p-value=0.027). Infection rate was 4% in each group (highly insignificant). In Group-A, 47 out of 50 circumcisions had acceptable cosmesis as opposed to 48 circumcisions in Group-B, (p-value=0.646, insignificant). Conclusion: We conclude that circumcision by Plastibell technique is relatively easy technically and quick to learn. It can be performed quickly and hence parents anxiety associated with prolonged operative time is less. It also has fewer complications as compared to open technique most important being bleeding which can be devastating in children considering their less hemodynamic reserves as compared to adults. [ABSTRACT FROM AUTHOR]

Objective: To compare percutaneous A1 pulley release and steroid injection in terms of mean pain score in trigger digit. Study Design: Comparative cross- sectional study. Place and Duration of Study: Orthopedic Department Combined Military Hospital, Rawalpindi Pakistan, from Mar to Aug 2018. Methodology: Patients with trigger finger diagnosed clinically in Out Patient Department meeting inclusion and exclusion criteria were included in the study. Patients were randomly allocated to Group A & B by lottery method. Group A had percutaneous release of A1 pulley using a surgical blade 11, after preparation of the skin and injection of 1ml 2% plain Lidocaine. Group B had injection with corticosteroid. Both procedures were carried out in Out Patient Department under strict aseptic measures. Visual analogue score at start and end of the study was recorded. Results: A total of 185 patients were included in this study, 122(66%) were males and females were 63(34%). The mean age of patient was 37.80±11.80 years with range from 15-60 years. Mean score of Group A was 39.16±12.22 years and the mean age Group B was 38.93±10.98 years. 56(30.3%) patient had mild visual analogue score, 96 (51.9%) had moderate visual analogue, 33 (17.8%) had severe visual analogue. Conclusion: Percutaneous release was found better option for the treatment of the trigger digit with a high success rate. Surgery should be reserved only for cases refractory to steroid injection technique. Keywords: Per cutaneous release of A1 Pulley, Trigger Digit, visual analogue score. [ABSTRACT FROM AUTHOR]

Background: Spine tuberculosis is common in Pakistan and this needs expert treatment to decrease morbidity. The objective of this study was to compare Modified Kalafong (MKF) and Modified Hong Kong (MHK) operations for spinal TB patients regarding neurological recovery and deformity correction. Material and Methods: This cross sectional study was conducted at Combined Military Hospital (CMH), Rawalpindi, Pakistan, on data from February 2012 to November 2020. According to the selection criteria and availability of data, 70 patients out of 90 consecutive patients handled surgically by MKF or MHK Operations were chosen for this research. Frankel grade system, Cobb’s technique and Bridwell’s criteria were used for assessment of results. Results: There were thirty-one cases of MHK and thirty-nine cases of MKF patients. Age, Neurological recovery, and Numbers of Vertebrae involved with TB were comparable across the two groups. In the MHK, the mean operating time was 6.12 hours, whereas in the MKF, it was 5.37 hours. When compared to the MKF, where the mean blood loss was 0.921 L, the MHK had a greater mean blood loss of 1.139 L. Deformity correction with MHK was 79.467 % against 58.40% via MKF, which was statistically significant (P 0.001). The MHK group had a much shorter mean time to fusion (4.56 months) than the MKF group (6.74 months), which is significant (P 0.05) statistically. Conclusion: Our study revealed significant differences between MHK and MKF spinal tuberculosis surgeries in terms of fusion time, blood loss and deformity correction. [ABSTRACT FROM AUTHOR]