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Association Between Perioperative Hypothermia And Surgical Site Infection After Elective Abdominal Surgery: A Prospective Cohort Study, Tayyab Siddiqiui, K. M. Inam Pal, Fatima Shaukat, Hadika Mubashir, Alisha Akbar Ali, Muhammad Jehangir A. Malik, Noman Shahzad Oct 2020

Association Between Perioperative Hypothermia And Surgical Site Infection After Elective Abdominal Surgery: A Prospective Cohort Study, Tayyab Siddiqiui, K. M. Inam Pal, Fatima Shaukat, Hadika Mubashir, Alisha Akbar Ali, Muhammad Jehangir A. Malik, Noman Shahzad

Section of General Surgery

Introduction: Surgical site infections (SSIs) account for 14-16% of nosocomial infections and are one of the major causes of increased morbidity, hospital stay, cost of care, and even mortality. Hypothermia as a risk factor for SSI is debated but there is lack of conclusive evidence. The present study explores the association of hypothermia with SSI.
Methodology: This is a prospective cohort study conducted on adult patients who underwent elective laparotomy. Patients were divided into two cohorts, the Hypothermia Cohort and the Normothermia Cohort, based upon episodes of hypothermia of <360C in the perioperative period. SSI was diagnosed based upon …


Management Of Early Rectal Cancer: Current Practice And Future, Bhavani Mothe, Hasnain Zafar, Shakil Ahmed Oct 2020

Management Of Early Rectal Cancer: Current Practice And Future, Bhavani Mothe, Hasnain Zafar, Shakil Ahmed

Section of General Surgery

Early rectal cancer management includes tumour stages TiS, T1 and some selected T2 lesions that undergo appropriate clinical pre-operatie evaluation. Local excision of these lesions with acceptable recurrence rate can be achieved through various transanal endoscopic techniques like transanal endoscopic microsurgery (TEM) and transanal minimal invasive surgery (TAMIS) that are superior to simple transanal excision (TAE). The current literature review was planned to present the oncological evaluation of local excision in the context of available evidence. An overview of perioperative adjuvant therapies employed along with local excision is presented, with an update on the latest trials.


Defining A Research Agenda For Layperson Prehospital Hemorrhage Control: A Consensus Statement, Eric Goralnic, Chibuike Ezeib, Muhammad Ali Chaudhary, Justin Mccarty, Juan P. Herrera-Escobar, Tomas Andriotti, Elzerie De Jager, Daniel Ospina-Delgado, Craig Goolsby, Adil H. Haider Jul 2020

Defining A Research Agenda For Layperson Prehospital Hemorrhage Control: A Consensus Statement, Eric Goralnic, Chibuike Ezeib, Muhammad Ali Chaudhary, Justin Mccarty, Juan P. Herrera-Escobar, Tomas Andriotti, Elzerie De Jager, Daniel Ospina-Delgado, Craig Goolsby, Adil H. Haider

Section of General Surgery

Importance: Trauma is the leading cause of death for US individuals younger than 45 years, and uncontrolled hemorrhage is a major cause of trauma mortality. The US military's medical advancements in the field of prehospital hemorrhage control have reduced battlefield mortality by 44%. However, despite support from many national health care organizations, no integrated approach to research has been made regarding implementation, epidemiology, education, and logistics of prehospital hemorrhage control by layperson immediate responders in the civilian sector.
Objective: To create a national research agenda to help guide future work for prehospital hemorrhage control by laypersons.
Evidence review: The 2-day, …


Surgical And Oncological Implications Of Aberrant Arterial Anatomy In Patients Undergoing Pancreatoduodenectomy, Muhammad Rizwan Khan, Saleema Begum, Dawar Burhan Khan, K. M. Inam Pal May 2020

Surgical And Oncological Implications Of Aberrant Arterial Anatomy In Patients Undergoing Pancreatoduodenectomy, Muhammad Rizwan Khan, Saleema Begum, Dawar Burhan Khan, K. M. Inam Pal

Section of General Surgery

Whipple's pancreatoduodenectomy is a complex surgical procedure and any aberrant arterial anatomy may have serious surgical implications. The objective of our study was to analyse the frequency of aberrant hepatic artery and compare the outcomes in patients with normal anatomy. Clinical data and computed tomography scans of 45 consecutive patients who underwent Whipple's procedure from 2007 to 2016 were reviewed. Group 'A' included patients with aberrant hepatic artery while group 'B' with normal anatomy. Aberrant hepatic artery was present in 11 (24%) patients and type V was the most common variant (n=5, 45%). Morbidity rate in group A was 82% …


Isolated Gallbladder Injury From Blunt Abdominal Trauma: A Rare Co-Incidence, Muhammad Rizwan Khan, Saleema Begum Feb 2020

Isolated Gallbladder Injury From Blunt Abdominal Trauma: A Rare Co-Incidence, Muhammad Rizwan Khan, Saleema Begum

Section of General Surgery

Gallbladder injury resulting from blunt abdominal trauma is a rare entity and generally associated with other intra-abdominal injuries. Incidence of isolated gallbladder injury has not been reported yet. The most common mechanism of injury reported is road traffic accident. Diagnosis is usually made on imaging as clinical presentation may vary from no symptoms to peritonitis due to extravasation of bile in the abdominal cavity. Cholecystectomy is the treatment of choice and minimally invasive approach can be considered in haemodynamically stable patients.


Congenital Morgagni Hernia Presenting As Complete Small Bowel Obstruction In The Adult - A Case Report, Sabah Uddin Saqib, Kulsoom Hamid, Tabish Umer Chawla Jan 2020

Congenital Morgagni Hernia Presenting As Complete Small Bowel Obstruction In The Adult - A Case Report, Sabah Uddin Saqib, Kulsoom Hamid, Tabish Umer Chawla

Section of General Surgery

Introduction: Congenital Diaphragmatic hernia (CDH) is a condition in which there is a defect in the diaphragm present at the time of birth. Morgagni hernia is one of the two most common types of CDH which constitutes 2%-4% of diaphragmatic hernias. They mostly remain silent or discovered as an incidental finding on radiological studies. Symptomatic adult Morgagni hernias are extremely rare.
Presentation of case: Elderly woman presented with a 1-day history of abdominal pain, vomiting, and acute onset of respiratory distress. There was no history of trauma to the chest or abdomen. After initial resuscitation, a Chest x-ray was performed …