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Background: H. Pylori gastritis is considered to be the causative factor for gallstone disease. Though this infection is reported to be the leading factor contributing to the pathogenesis of gastro-duodenal ulcers, and gastric cancer. Its infestation of the gallbladder and causing chronic cholecystitis and cholelithiasis are still debatable. Methodology: This study was descriptive cross-sectional in nature, performed on 110 patients (chosen via non-probability, consecutive sampling), presented at Surgical OPD with symptomatic cholelithiasis. All the participants underwend for diagnostic endoscopy and a biopsy was taken for confirmation of h.Pylori gastritis. Those who had positive H. Pylori test, were treated by eradication therapy first and then submitted for the laparoscopic cholecystectomy and those who were negative submitted for the laparoscopic cholecystectomy. The study lasted 1 year from February 2021 to February 2022. Results: Among the subjects, 72.7% (n=80) were female, 32.5% were under 40 years old while male gender composed of 17.3% of the sample population. 3/4th of the population hailed from the rural setting. 70.1% (n=78) of the patients had positive H. Pylori test on histopathology. Upon the findings of diagnostic endoscopy, severe and moderate gastritis was found to be in 25.6% and 74.4% of the participants with positive helicobector gastritis, respectively. A significant association was found out between familial history of gall stones and helicobector pylori gastritis (p=0.02). Conclusion: A high prevalence of H. Pylori infection is among patients with symptomatic cholelithiasis, which also crossponds to the endoscopic findings. The association between the familial history of gall stones and helicobetor gastritis merits to be explore further to establish the casuality of the relationship.

Background: Complicated intra-abdominal infections have become a major health challenge that merits safe and efficacious therapy. Antibiotic therapy is the treatment of choice, however the duration of antibiotic use is debatable. Objective: To compare the safety and efficacy of the short course and long course antibiotic therapy towards the treatment and the progressive outcome of patients presented with complicated intra-abdominal infections. Methodology: This comparative study was carried out on 94 subjects (chosen via non-probability, consecutive sampling), who presented with complicated intra-abdominal infections, had signs and symptoms of infection along with ultrasound abdomen examination consistent with infective foci and routine blood test showing raised total leukocyte count, at the Department of Surgery - Liaquat University Hospital, Hyderabad. Subjects were divided into two groups (47 in each) through a random assignments. Group-A was kept on a short course (5-7-days) while Group-B was kept on a long course (7-10 days) antibiotic therapy. Data were documented using a structured questionnaire, including inquiries related to sociodemographic details, disease specifics, and observed for the outcome variables (mainly postoperative early resolution of infection and long hospital stay). Results: In Group A, resolution of infection was achieved in 59.57%, 29.79% and 10.64% patients on day 5, 6 and 7, espectively. In Group B, esoluation of infection was only reported as 42.55%, 36.17% and 21.28% on day 5, 6 and 7, respectively. The median duration of taking antibiotic was almost half in short course group than the long. Surgical site infections were commonly observed in Group B patients. There was no mortality observed in both groups. There is no significance difference observed in primary outcome of clinical cure among the groups. Conclusion: It can be concluded that the short course antibiotic therapy has good efficacy to treat CIAI when the primary foci of infection are surgically extracted with adequate source control.

Background: Psoas abscess is a rare condition but one with potential for severe morbidity. Many factors may be implicated in the treatment outcome of the condition and efforts must be directed to identify, understand and control the factors for a better prognosis. Objective: To identify the factors associated with surgical treatment outcome of psoas muscle abscess. Methodology: This descriptive cross-sectional study was conducted upon a sample of 58 patients (chosen via non-probability, consecutive sampling) scheduled for surgical treatment for psoas muscle abscess (aged 18 to 60 years) at department of General Surgery at Liaquat University Hospital, Hyderabad & Jamshoro. All the patients underwent surgical treatment. The data was recorded via pre-structured questionnaire comprising of inquiries pertaining to socio-demographic details, presenting complaints, and factors association with surgical treatment outcome (in terms of resolution of abscess cavity). Data was analyzed via SPSS version 20. Results: Mean age of study subjects was 37.6 ± 12.5 years. Out of all 72.4% were males and 27.5% were females. Most common presentation of patients was pain in flanks, followed by fever. The commonest etiological factor was tuberculosis (TB) and consequently spinal (TB) was the most common. Resolution of abscess cavity was noted among 77.5% of the cases with a greater proportion of recovery falling in line non- tuberculous etiology. Conclusions: After careful consideration, it can be concluded that secondary psoas muscle and that with tuberculous etiology have a poorer surgical outcome, thus greater care and more effective surgical techniques may be employed to achieve complete resolution of abscess.

Objective: To determine the frequency of the causative factors and most common organisms of keratitis. Materials and methods: This descriptive cross- sectional study was conducted at the Ophthalmology department of Indus Medical College Tando Muhammad Khan. The study included both male and female patients diagnosed with microbial keratitis between the ages of 17 and 60 years. Slit lamp bio microscopy of the anterior segment was performed on all patients, and the corneal epithelial defect was quantified in millimeters using the slit lamp. Corneal scrapings were collected from the base of ulcer using a bent tip 26-gauge hypodermic needle under topical anaesthetic (Alcain), and the sample was immediately studied under an electron microscope, confirming the diagnosis of bacterial keratitis. Patients were then hospitalized, and at the conclusion of therapy, their healing was examined. The research proforma was used to gather all the data, and SPSS version 26 was applied for data analysis. Results: A total of 70 cases diagnosed with microbial keratitis were studied with an average age was 38.22+7.81 years and males were in majority 65.7%. A majority of the patients 55.7% were poor socioeconomically, followed by 32.9% had middle socioeconomic status and only 11.4% were rich socioeconomically. Contact lens and trauma were commonest factors as 28.6% and 24.3% respectively, followed by a history of steroid 11.4%, past ocular previous surgery 11.4%, ocular surface illness 14.3% cases, and others10.0%. Bacterial and fungus keratitis were commonest 55.7% and 27.1% respectively, followed by 12.9% viral keratitis, mixed microbial keratitis was 2.9% and only one case had Acanthamoeba keratitis. Conclusion: This study concludes that rural areas’ poor young males were highly affected by the microbial keratitis. Trauma and unhygienic lens wear were observed to be the prevalent causative factors, with highly prevalent bacterial and fungal microbial etiology. Keywords: factors, prevalence, microbes, keratitis

Objective: To evaluate success rate of the endoscopic third Ventriculostomy (ETV) in non-communicating type of hydrocephalus in pediatric age group. Material and Methods: This study was carried in the department of neurosurgery at Liaquat university hospital, Jamshoro in which an endoscopic third Ventriculostomy procedure was performed in patients (n = 55) with non-communicating hydrocephalus from October 2016 to April 2017. Post-operative follow-up was done on the 15th day post-operative to assess clinical and radiological improvement. Results: 55 patients were included in this study, 26 (47.27%) males and 29 (52.73%) females. The mean age was 3.96 years. The most common etiology was aqueductal stenosis 28 (50.90%) patients followed by posterior fossa tumors in 18 (32.72%) patients. The operative technique was successful in 41 (74.55%) patients. Out of 41 successful patients, 34 (82.92%) patients had clinical as well as radiological improvement whereas 7 (17.07%) patients had clinical improvement only. Conclusion: The success rate of ETV was 74.55% in the non-communicating hydrocephalus in the pediatric age group in our study. Endoscopic third Ventriculostomy is an effective treatment for non-Communicating hydrocephalus in pediatric age groups by diversion of CSF intracranially. This procedure provides shunt freedom and can be used alternative to shunts in pediatric age groups with non-communicating hydrocephalus.

Objective: To determine the frequency and presentation of colorectal carcinoma (CRC) among the patients presenting with lower gastrointestinal (GI) symptoms. Study Design: Observational study Place and Duration: Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro/Hyderabad from January 2013 to February 2014. Methodology: A sample of 105 patients complaining of lower GI symptoms was selected. Data regarding the age, sex, presenting symptoms and signs, local examination and location of lesions were noted in a pre-structured proforma. Patients were examined by digital rectal examination (DRE), proctoscopy, colonoscopy; computerized tomography and biopsy. Data analyzed on SPSS 21.0 at 95% CI (P≤ 0.05). Results: Age of the patients was 53.17±14.90 years (95%CI: 51.28 to 55.05). Of 105 subjects; 65 (61.9%) were males and 40 (38.09%) were females. The CRC was observed in 11 (10.47%) patients of ≤ 40 years, 77 (73.3%) patients of 40 – 59.9 years and 17 (16.19%) cases were ≥60 years of age. Anemia 81 (77.14%), weight loss 74 (70.47%), abdominal pain 60 (57.14%), bleeding per rectum 79 (75.23%), tenesmus 55 (52.38%) and constipation 48 (45.71%) were common presenting symptoms of the CRC patients. Adenocarcinoma was found in 87 (82.85%), carcinoid tumor in 11 (10.47%), lymphoma in 5 (4.76%) and squamous cell carcinoma in 2 (1.9%). Conclusion: Colorectal adenocarcinoma was most common tumor found in males in their sixth decade of life. Anemia, weight loss, abdominal pain and bleeding per rectum were common clinical symptoms and rectum was common tumor site.

Objective: To compare the outcome of percutaneous ultrasound guided aspiration V/S open surgical drainage for psoas muscle abscess. Methodology: This comparative study was conducted in department of general surgery at Liaquat medical university hospital Hyderabad/Jamshoro, from June 2017 to November 2017. Diagnosed Patients of psoas muscle abscess size more than 5cm, between 18 to 60 years of age and either of gender were included. Patients were randomly divided into two groups, A and B by odd and even method, patients in group A abscess was aspirated by percutaneous ultrasound guided aspiration and patients in group B was underwent open surgical drainage, all the data were entered in the pre designed performa and analyzed into SPSS V:16.0 Results: A total of 58 patients of Psoas muscle abscess were selected, the mean age of study subjects of group A was 38.5+10.5 and group B was 36.5+12.7 (p-673). Early post-operative pain relief was assessed among patients of group A as compared to group B. As per outcome resolution of abscess cavity was significantly high among patients of group B (p-0.004), while post-operative Hospital stay was significantly lower in group A (p-0.002). Conclusion: Both techniques has their own benefits like percutaneous aspiration has shorter duration of hospital stay while in complete resolution of abscess cavity was found in open surgical drainage group of patients.

OBJECTIVE: To analysis the efficacy of 0.2% GTN in patients undergoing fistulectomy for fistula in ano low variety in terms of early wound healing. METHODOLOGY: A randomized controlled trail was conducted at general surgery department of Liaquat University Hospital Hyderabad from February 2013 to August 2013 among patients with low anal fistula. All participants underwent fistulectomy by a consultant general surgeon. Patients were divided into two groups using lottery methods. Group A treat fistula in ano with 0.2% glyceryl trinitrate ointment and group B treat fistula in ano without 0.2% glyceryl trinitrate ointment and wounds covered with pyodine soaked dressings. All patients were discharged on second postoperative day. Wound healing was assessed weekly for six weeks. Parameters of incomplete wound healing such as discharge, perineal irritation and pain were noted. Presence of granulation tissue at the end of 6 weeks was considered as sign of healing. Data was collected via study proforma. RESULTS: This study was conducted on 94 patients in Liaquat University Hospital Hyderabad. In GTN group 35(74.46%) were male while in Control group 38(80.85%) were male. In GTN group mostly observed single opening 37(78.72%) cases while in control group 35(74.46%) cases. The healing time in GTN Group was found to be between 21-36 days (mean 26.38 days), while the healing time control group was 32-46 days with a mean of 38.64 days (P. value

Objectives: The present prospective observational study was conducted to determine frequency and thyroid conditions as likely risk factors for hypocalcaemia following thyroid surgery. Study Design: Observational study. Place and Duration: Department of surgery, Liaquat University Hospital from December 2011 to December 2015. Materials and Methods: A sample of 201 patients, undergoing thyroid surgery with bilateral exploration, was selected according to criteria. Pre operative clinical work up was conducted for patient history, neck examination, thyroid hormone assay, serum calcium, Technetium99 thyroid scanning, laryngoscopy and sonography. Serum Ca++ was estimated before and after thyroid surgery.Hypocalcaemia was defined as calcium level

Objectives: To study mean platelet volume (MPV) in acute appendicitis andits correlation with leukocyte count. Study Design: Case control study Place and Duration:Department of Surgery, Liaquat University of Medical and Health Sciences Jamshoro/Hyderabadfrom January 2013 to February 2014. Subjects and Methods: Subjects with clinical suspicionof acute appendicitis were selected according inclusion and exclusion criteria. A sample of 49acute appendicitis patients and 37 controls were studied. The Blood samples were collected insodium citrate vacutainers and processed on Sysmex KX 21 analyzers. The main analysis wasthe comparison of the difference of MPV between acute appendicitis and controls. Data wasanalyzed on SPSS version 21.0 by student’s t-test, Chi-square test and Pearson’s correlation (r)was used to evaluate association of MPV with platelet counts and leukocytes. A p-value of ≤0.05was taken significant. Results: The mean platelet volume and leukocytes were significantlyelevated in patients with acute appendicitis. MPV and leukocytosis in controls and cases werenoted as 7.93±2.1 vs. 9.10±2.9fl (p=0.0001) and 6980±120 vs. 13980±340 μL-1 respectively.MPV was positively correlated with leukocytosis (r=0.419) (p=0.0001), while Platelets showeda negative correlation. Conclusion: Elevated MPV and leukocytosis are observed in acuteappendicitis. MPV may be exploited for clinical diagnosis of acute appendicitis but in a properclinical context along with leukocytosis.