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Introduction: A significant proportion of patients are being treated at hospitals in the government sector in Sri Lanka. Informal caregivers play a major role in taking care of hospitalized surgical patients while facing physical, social, and psychological challenges., Objective: To describe the socio-economic effects on informal caregivers of long-term hospitalized adult patients., Methods: A cross-sectional descriptive study was conducted among 202 informal caregivers of long-term hospitalized patients in a tertiary care hospital in Sri Lanka, using an interviewer-administered questionnaire. Sociodemographic assessment of both caregiver and care recipient, the health status of the care recipient, effects on social life, and economic aspect of informal caregiver were assessed., Results: Most of the caregivers were married (n=164, 81.2%), first degree relative of the care receiver (n=139, 68.8%), employed (n=115, 56.9%) and sole caregivers (n=130, 64.4%). Four out of 5 caregivers (n=181, 89.6%) showed moderate to severe socio-economic maladaptation. Increasing age (p=0.00), marital status (p=0.00) and sole caregiving (p=0.01) are significantly associated with the level of maladaptation., Conclusion: Moderate to severe levels of maladaptation is present among a substantial number of informal caregivers of long-term hospitalized patients. Sole caregiving is one of the contributing factors and can be addressed by adequate formal caregivers appointed by health care authorities or from voluntary services to minimize informal caregiver burnout.

Pancreatic cancer has a high mortality and morbidity and its incidence has increased over the years. Our objective was to analyze the demographic and clinical data among pancreatic adenocarcinoma patients who presented to the University Surgical Unit, CSTH from 2018 to 2021. Of the 103 patients included, majority were males above the age of 60. The commonest presentation was epigastric pain (54%). 46% were resectable at the time of diagnosis but 50% of the study population were lost to follow up due to a multitude of reasons.

Prediction of thyroid malignancy with fine needle aspiration cytology or individual ultrasound characteristics has several limitations. This study evaluates the usefulness of a combination of ultrasound characteristics in predicting malignancy in patients with thyroid nodules. We assessed 189 thyroid nodules using ultrasonography and histology. Each nodule was assigned a score based on ultrasonographic characteristics. This score was compared with histology to identify ability to predict malignancy. There were 28 malignant nodules. The scoring system was appropriate for clinical use, obtaining an area under ROC curve of 0.822 [p< 0.0001] 95% confidence. FNAC of nodules with a score of more than 4 can be recommended (100% sensitivity). Nodules with a score less than 8 can be offered total thyroidectomy when FNAC is inconclusive (97.5% sensitivity). A combination of ultrasonographic criteria increase the accuracy of predicting malignancy in thyroid nodules.

A retrospective comparative study was done to compare the outcome of intermittent Pringle manoeuvre (IPM) and selective hepatic vascular exclusion (SHVE) in 19 major hepatectomies in non-cirrhotic patients that were done from October 2003 to June 2009. Intra-operative blood loss (IBL), total operative time (TOT) and immediate outcome were assessed in the two groups. Thirteen underwent IPM and the others underwent SHVE. The mean age was 50 years (SHVE) and 39.2 years (IPM). Mean IBL was 641 ml and 802 ml in the SHVE and IPM groups respectively (p > .05). TOT was 4.7 hours in both groups. There was one mortality from myocardial infarction in the IPM group and no morbidities in both groups. The results obtained from this study shows that IPM is equivalent to SHVE, with regards to IBL, TOT and immediate outcome in major hepatectomies in non-cirrhotic patients.