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Objective: To examine the anthropometric, blood sugar, and lipid profiles of healthy adults, including those with and those without a history of type 2 diabetes mellitus. Study Design: Case-control study. Setting: Peoples University of Medical & Health Sciences for Women (PUMHS) in Nawabshah. Period: October 1st 2022 to 31st March 2023. Material & Methods: The research included 110 participants. 55 of them had at least one parent with type 2 diabetes mellitus, and the other 55 did not. Males and females between the ages of 18 and 25 were present in the study. The following measurements were compared: fasting blood sugar, lipid profile, waist height to hip ratio, and body mass index. Results: This case-control study compares offspring with and without a family history of type 2 DM to determine if there are any anthropometric or metabolic differences. Participant with a family history of type 2 DM showed higher BMI, WC, and WHtR according to the anthropometric measurements. Statistically significant differences were found in their BMI (P-value <0.0001). Even though BMI showed a significant difference, the mean value did not fit into the criteria to be categorized as obese. Conclusion: The present research has shown that people with a family history of type 2 diabetes mellitus are overweight and have abnormal lipid profiles even before they manifest overt type 2 DM. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of study is to ascertain the prevalence of malignancy in thyroid single/multiple nodules after ascertaining the features of nodules on different criteria. Study Design: Cross Sectional Study. Setting: Department of Surgical at PMCH Nawabshah. Period: April 2015 to April 2018. Material & Methods: All patients got admission from OPD and they were investigated for the disease. All biochemical examinations were done. Thyroid profile with thyroid scan was obtained. Fine Needle Aspiration Cytology (FNAC) was done to diagnose the type of cells either benign/ malignant. The decision of the surgical procedure was done according to the FNAC report of the thyroid nodule. Results: Total 80 patients were investigated. 55 (68.75%) females, 35 (43.75%) male and 60 (75%) showed the benign cells and 20 (25%) patient's reports had malignant cells. Biopsies were sent for histopathology. 60 (75%) showed thyroid adenomas after biopsy. 10(12.5%) patients papillary carcinoma, 7 (8.75%) follicular, 2 (2.5%) medullary, 1 (1.25%) anaplastic, 0 for thyroid lymphoma, 0 thyroid carcinoma. 0 for squamous cell carcinoma. 40 (50%) were treated conservatively with thyroxine, 20 (25%) were operated for lobectomy. All malignant cases were undergone for total thyroidectomy. Conclusion: it is summed up that the prevalence of malignancy in thyroid nodules in our setup is only 25% that is the lower one as compared to other studies. [ABSTRACT FROM AUTHOR]

Objectives: The purpose is to compare two options of management of appendicular lump in order to sort out the better one for the benefit and betterment of populace. Study Design: Cross Sectional study. Setting: Peoples Medical College Hospital Nawabshah. Period: 2016 August to August 2018. Material & Methods: Total 50 patients of appendicular lump were included in this research. All patients were divided into 2 groups. Group 1 included those patients undergoing emergency appendectomy. They were admitted, optimized and the required treatment was initiated. Results: Of total 50, 30(60%) were male and 20(40%) were females. Age was between 14 to 51 years. All patients presented with different clinical presentations. Pain in RIF was in 42(84%) patients whereas 47(94%) patients presented with lump in RIF. 20(40%) patients were operated for appendectomy in emergency and 5(10%) patients for right hemi-colectomy. Histopathological diagnosis was inflammation in 24(48%) patients and 1(2%) resulted in cecal tumor. Infected wound was found in 15 (30%) patients, hematoma in 3 (6%), wound dehiscence in 1(2%) and also cecal fistula in 1 (2%). Conclusion: Conservative treatment is better option to treat appendicular lump with least negative results. [ABSTRACT FROM AUTHOR]

Objectives: To assess the relation of LVH (left ventricular hypertrophy) due to essential hypertension with serum vitamin D3 and serum calcium levels. Study Design: Cross Sectional Research. Setting: Medicine/Cardiology department, Peoples Medical University Hospital, Nawabshah. Period: 1st January 2017 to 30th June 2017. Material & Methods: To assess the correlation of 25-hydroxycholecalciferol and serum calcium with left ventricular hypertrophy in essential hypertension. The thickness of inter ventricular septum (IVS) and posterior wall (PWT) on echocardiography were used to categorize LVH into mild, moderate and severe. Results: Male predominated in the present study. Male to female ratio was 1.65:1. Male and female comprised 62.33% and 37.67% respectively. Chi square value (X²-value) was 14.7 with significant p-value. Mean +SD of 25-hydroxycholecalciferol in mild moderate and severe LVH were noted as 30+7.8, 24.7+7.7 and 14.9+6.1 ng/dl respectively. Mean +SD of serum calcium in mild moderate and severe LVH were noted as 9.20+0.51, 8.93+0.72 and 8.678+0.44 mg/dl respectively. Conclusion: In subjects with left ventricular hypertrophy in essential hypertension the serum levels of vitamin D and calcium were low. There was a negative correlation with left ventricular hypertrophy and serum vitamin D and serum calcium. Thus it could be concluded that in subjects with left ventricular hypertrophy the low levels of serum vitamin D could be an independent modifiable risk factor. [ABSTRACT FROM AUTHOR]

Objectives: To detect the outcome of typhoid ileal perforation treated by primary repair at tertiary care hospital. Study Design: Cross sectional study. Setting: Surgical Department of PMC Hospital Nawabshah. Period: From August 2017 to December 2018. Material & Methods: This study included total 70 patients. All patients were admitted from surgical OPD and emergency department of PMCH Nawabshah. Out of 70, 45 (64.28%) were females and 25 (35.71%) were male patients. Age ranged from 27 to 52 and 24 to 47 in females and males respectively. The common presentation was pain in whole abdomen along with distention and fever, vomiting. Plain X ray chest/Abdomen and ultra sonography showed gas under diaphragm. Primary repair was done and also other surgical options but our study included only the postoperative outcomes of primary repair of typhoid ileal perforation. A few complications were detected after primary repair of the gut perforation. Results: Total 70 patients were included in this study. 45 (64.28%) were females and 25 (35.71%) were male patients. In females, 25 (55%) were found single perforations of less than 1cm whereas 7 (15.5%) had size of perforation less than 1.5 cm. In 25 males, 11 (44%) had single perforations of less than 1cm in size. 2 (8%) had < 1.5 cm size perforations and 12 (48%). Over all complication rate in this study was 26%. Conclusion: Primary repair is the best surgical option to treat typhoid ileal perforation in selected patients with least postoperative complications. [ABSTRACT FROM AUTHOR]

Introduction: Peptic ulcer perforation is the most common surgical emergency and the leading cause of peritonitis with high morbidity and mortality in all age groups throughout world. It is more prevalent in developing countries than developed ones. Graham's Patch/omentopexy for duodenal perforation and simple closure along with tissue biopsy for the gastric perforation are the procedures of choice respectively. Objectives: To detect the mode of presentation and the outcomes of surgical procedures along with prognosis in patients suffering from perforated peptic ulcer. Study Design: Cross sectional study. Place and Duration of Study: Surgical Department of Peoples University of Medical & Health Science for Women Nawabshah, From January 2016 to December 2017. Methodology: All patients were admitted through OPD/Emergency. Patients presented with peritonitis having history of peptic ulcer disease were studied. X Ray chest/X Ray abdomen Erect showed pnemoperitonium. Laparotomy and primary repair along with biopsy for gastric perforation and graham's patch for duodenal perforations were performed. Results: In our study, total 52 patients were included. Male Female ratio was 3.5:1.6. Mean age was 49 years. Majority of patients presented in 5th to 6th decade of their life. In 96% cases abdominal pain was the 1st symptom followed by vomiting and distension of abdomen. Different surgical procedures were performed and surgical site infection was the commonest complication in 37 (73%) patients in our study. Conclusion: Primary closure and graham's patch are the best choice as surgical procedures for the cases of gastric and duodenal ulcer perforations respectively. [ABSTRACT FROM AUTHOR]

Introduction: Sigmoid volvulus is the surgical emergency and significant cause of large bowel obstruction in with high morbidity and mortality. Disease is more prevalent in developing countries than developed countries. It contributes 15% of total bowel obstruction. Resection and primary anastomosis is the procedure of choice. It obviates the need of colostomy and subsequent reversal. Objectives: To determine the frequency of postoperative complications of primary repair in patients with either viable or gangrenous sigmoid volvulus. Study Design: Retrospective study. Setting: Surgical Unit 1 of Peoples Medical College Hospital now Medical University. Period: 2007 to Dec. 2013. Methodology: Patients with large bowel obstruction suspected to have sigmoid volvulus on clinical and radiological grounds were studied. Laparotomy and resection of sigmoid colon followed by restoration of the continuity of the colon by single layer primary anastomosis were performed without colostomy. Results: In a total 50 patients, sigmoid volvulus male female ratio was 9:1. Mean age was 49 years majority of the patients were in 6th to 7th decade of age. In 96% cases abdominal pain was the 1st symptom followed by constipation and distention, vomiting was the rare symptom. Different postoperative complication results were surgical site infection was the commonest complication in 40 (80%) while in 1 (2%) leak was there with mortality of only 1(2%) case. Conclusion: Primary resection and single stage anastomosis is the best choice for the management of sigmoid volvulus disease in both possibilities of viable or non viable gut provided patients condition is stable. It obviates the burden of colostomy. [ABSTRACT FROM AUTHOR]

Objectives: Pilonidal sinus is chronic inflammatory condition that usually affect young adult population, despite the current medical advances in the field of medical sciences. The acceptable management of pilonidal sinus is still lacking. This study evaluates the outcome of pilonidal sinus after excision of the whole tract then its closure with a Z plasty technique which is a simple cleft lip repair like method which provides a quick and comfortable remedy. Design: A seven years retrospective study. Setting: Surgical Department of Peoples Medical College Hospital (later University) and at Private Medical Center at Nawabshah. Period: January 2010 to March 2017. Methodology: A total of 55 patients suffering from pilonidal sinus were admitted at both sites from the outdoor department. All the data were collected from the admitted record and proforma. All required investigations were done. Excision of sinus followed by Z plasty closure were done in a single stage with drain put by separate stab on one side of the wound. Results: Out of total 55 patients 41 (74.5%) patients recovered smoothly while 6 (10%) patients developed major wound disruption, 3 (5.45%) patients developed minor wound disruption and 5 (9.09%) developed wound dehiscence. Conclusion: Primary closure of pilonidal sinus with Z plasty technique is technically a simple closure method which provides a comfortable closure with minimum results of wound disruption and dehiscence. Healing is rapid due to comfortable approximation of the wound flaps and thus avoids the problem created in simple closure technique. It can be applicable with every type of patients from heavy build to thin build type. [ABSTRACT FROM AUTHOR]

Objectives: To find out the prevalence of surgical disease in rural areas of Pakistan. Place and Duration: All the surgical cases registered in Foundation Hospital Rajana District Toba Tek Singh in 2012-2013. Methods: The whole data is analyzed by SSPS and compared with the other studies of Pakistan and world. Results and Conclusion: Male and female are equal in number in Total 7788 cases excluding non-surgical cases between 1 day to above 70 years age. Majority of the cases were between 21-50 years age group. Common cause was Trauma, commonest disease was L.B.A and commonest operation was for Hernia and Gallbladder stones. [ABSTRACT FROM AUTHOR]

Introduction: Postoperative inguinal pain is one of the most significant complications following inguinal hernia repair. Routine ilioinguinal nerve excision has been proposed as a means to avoid this complication. Objectives: To compare the postoperative pain after preservation and elective division of ilioinguinal nerve during inguinal hernioplasty. Methods: This was a Randomized Controlled Trial conducted at the department of general surgery at KVSS Site Hospital for a period of 6 months from Jun 2011 to Nov 2011. 84 patients who underwent mesh hernioplasty for unilateral inguinal hernia, were randomly assigned into two groups (A and B), 42 in each group. Ilioinguinal nerve was preserved in group A patients, whereas elective division was carried out in patients of group B. Mean postoperative pain scores were recorded using numerical analogue scale on first and third postoperative day, and one month after surgery. The SPSS version 16 was applied to the data. Results: Mean±SD age was 38.46±14.36 years. Seventy four (88.1%) patients were male whereas ten (11.9%) were female, with male to female ratio being 7:1. Using the numerical analogue scale to detect pain severity on postsurgical day 1 and 3, mean scores±SD in the nerve-preservation and nerve-excision groups were 2.88±0.43 versus 2.04±0.39, and 1.95±0.39 versus 1.43±0.44, respectively (p<0.05). At 1 month after surgery, these scores were 1.73±0.62 versus 0.98±0.25, respectively (p<0.05). Conclusions: Postoperative pain after inguinal hernioplasty significantly decreases in elective division of ilioinguinal nerve as compared to nerve preservation. [ABSTRACT FROM AUTHOR]

Objectives: To assess the degree to which Latent Tuberculosis exist among long-term inmates in jail. Study Design: Prospective Cohort Analytic Experimental Quantitative Data. Setting and Period: Jails at Bahawalpur between 2009-2010. Methods: We monitored the Mountex Test of prisoners within 48 to 72 h and those who were 10 mm or more were considered positive and for HIV positive 5 mm criteria were set to declare positive. Group 1-who were in jail for more than a year and those, Group- 2-who were in jail for less than one month. Data was collected on a proforma. Each prisoner had thorough clinical examination with detailed clinical history and Chest X-ray. Inclusion Criteria: 1. All those prisoners who never had tuberculosis in past. 2. All those prisoners who were not on Anti Tuberculous Therapy. 3. All those prisoner whose chest x ray was normal and had no symptoms of tuberculosis. Exclusion Criteria: 1. All those who had tuberculosis in past or were on antituberculous treatment currently. 2. All those who were having chronic cough. Results: Total number of prisoners in group 1 were 298 and number of prisoners in group 2 were 128. Latent tuberculosis was found in total of 31(10.40%) of prisoners in group 1 and none of prisoners in group 2 were having latent tuberculosis. Conclusions: Jail inmates for more than 1 year did show more numbers of latent tuberculosis patients than the new inmates. These results suggest that the close contacts harbor the live tubercle bacilli and in future they may convert into active cases. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of tuberculosis in prisoners of jail. Design: Descriptive study. Place and duration of study: Central Jail Bahawalpur, all prisoners who were jailed in prison were included. It comprises prisoners of ten years (from 1999). Patient and Method: The study population comprised of 2552 prisoners, 2540 were males and 12 were females. The important variables included symptoms of patients (cough, fever, hemoptysis), age, duration of stay in jail and radiological features seen on chest X Ray. Data was analyzed on SPSS. Results: There were 2540 males and 12 females. Forty-six patients had tuberculosis (1.80%) with mean age 37 ± 12.07 years and their mean stay in jail was 802 ± 1118 days. Among prisoners diagnosed as tuberculosis 39 (85%) had cough and hemoptysis was present in 10 (21.73%) of tuberculosis patients along with cough. Chest X Ray showed 22 (48%) had cavitations and bronchiectasis on chest x ray. Upper lobe alveolar infiltrates were found in 19 (41%) of cases while pleural effusion was present in 5 (11%) of tuberculosis patients. Conclusions: The study revealed that tuberculosis exists in jail of South Punjab Pakistan thus represents an important screening site for TB. [ABSTRACT FROM AUTHOR]

A rare case of leiomyoma of round ligament is reported. It presented as irreducible right inguinal hernia. Its shape and size was of a normal kidney for which peroperative I.V.U was done to exclude the ectopic kidney. No. such case has been reported in the literature so for. [ABSTRACT FROM AUTHOR]

Most of patients with colorectal carcinoma end up with colostomies and ileostomies. Different complications are described pertinent to ileostomies. We are presenting a very rare presentation of ileostomy, the metastasis from mucinous adenocarcinoma of caecum, without ileostomy dysfunction, local bleeding as presenting complaint along with a ileostomy growth. [ABSTRACT FROM AUTHOR]