Risk Assessment of Toxic Metals from Drinking Water of Taluka Ghorābāri, Sindh, Pakistan

In the current study, the quality of groundwater used for drinking purposes was assessed in Taluka Ghorābāri, Sindh, Pakistan. Twenty-five sampling locations were selected for the collection of groundwater. Samples were analyzed for physicochemical and heavy metal analysis, followed by standard methods. Detection of heavy metals was conducted using Atomic Absorption Spectrophotometer. Heavy metals which exceeded the WHO safe limit included Cr (28%), Fe (16%), Mn (48%), and Ni (16%) from the drinking water of the study area. The Cu and Zn were found within the safe limit in all drinking water samples of the study area. The Daily Intake of heavy Metals (DIM) and Health Risk Indexes (HRI) Assessments were calculated to determine risk assessments; the order of mean DIM values was observed as Ni &gt; Cu &gt; Fe &gt; Zn &gt; Cr while HRI was observed in the order of Cu &gt; Mn &gt; Zn &gt; Fe &gt; Cr. The HRI values were observed less than one for both adults and children, which shows the lack of possible health hazards for the people of the study area.</jats:p

Comparison of Clipped Laparoscopic Cholecystectomy and Clipless Laparoscopic Cholecystectomy in Context of Biliary Leakage

Objective: To compare the outcome of clipped laparoscopic cholecystectomy and clipless laparoscopic cholecystectomy in context of biliary leakage. Study Design: Cross-sectional analytical study Place and Duration of Study: Department of Surgery Unit-II, Benazir Bhutto Hospital Rawalpindi from 1st September 2021 to 31st August 2022. Methodology: One hundred and twenty patients were included in the study and divided into two major groups. The biochemical analysis and ultrasonography was performed post 8 hours fasting. Group one had those cases which underwent clipped laparoscopic cholecystectomy while group 2 had those cases which underwent clipless laparoscopic cholecystectomy. The age of the patients was selected between 40 to 60 years and the prevalence for this sampling was considered as 20% in Pakistan. The demographic details, clinical history, signs and symptoms, clinical diagnosis based on USG, lipid profiling, and variables as post-operative time, hospital stay and ease in procedure were documented. Results: The mean age of the cases underwent clipped laparoscopic cholecystectomy was 42.3±12.11year with 40 females and 20 males who underwent those procedures. The mean age of the cases underwent clipless laparoscopic cholecystectomy was 40±11.05 years with 45 females and 15 males. The present study results evidently highlighted the fact that there were high percentage cases of biliary leakage seen in clipped cases than in the clipless cases. There were22 cases with 36.6% in clipped groups while 9 cases with biliary leakage such as 15% in clipless group. Conclusion: Clipless laparoscopic cholecystectomy is a better optional procedure with efficient usefulness in context to biliary leakage, operation time and hospital stays. Keywords: Outcome, Clipped laparoscopy cholecystectomy, Clipless laparoscopic cholecystectomy, Biliary leakage</jats:p

Comparision of Postoperative Complications Associated with Closed Lateral Sphincterotomy and Fissurectomy with Dorsal Sphincterotomy in Chronic Anal Fissure

Background: Chronic anal fissure is clinical entity associated with significant pain and discomfort with bleeding. Different surgical options are being used nowadays to treat the ailment. Closed lateral sphincterotomy is being considered as gold standard treatment however, dorsal sphincterotomy with removal of chronic fissure is also used as treatment.&#x0D; Objectives: To compare effectiveness and patient satisfactions after both surgical procedures. To identify the common complications associated both surgical procedures.&#x0D; Methodology: The cross sectional conducted at Ghulam Muhammad Maher Medical College Sukkur from January 2016 to December 2019. Total 300 male patients with history of Chronic Anal Fissure for more than 6 months were included in the study. The patients were divided into two groups Group-A (150 patients) underwent lateral sphinterotomy whereas in Group-B (150 Patients) dorsal sphincterotomy with fissurectomy was performed. Randomization for grouping was performed by single blind sealed envelope technique. Patients with additional anorectal disease, haemorrhoids, HIV, HBV, HCV, and female patients were excluded from study. After performing surgery in both the groups follow-up was performed for 2 years and data was analyzed.&#x0D; Results: Mean age was 30.5 4±12.3 years, most common site of fissure among our study population was 6 O’ Clock (p-value=0.003), pain was seemed to be significant post-operative completion in both the groups however, both the treatment strategies appeared to be equally effective though patients in group B were more satisfied than group A.  &#x0D; Conclusion: Both methods of surgeries seemed to be equally effective in treating the ailment. Recurrence after both surgeries was uncommon though pain was common postoperative complication.</jats:p