Frequency of Post-Operative Wound Contamination in Bakhtawar General Hospital, Jamshoro

Background: Surgical site wound infection (SSI) imposes a great challenge worldwide. It is the third most commonly reported nosocomial infection. The objective of the study was to assess the frequency of postoperative wound infections in a newly developed health organization.Material and Methods: This cross-sectional study was conducted from June 2017 to May 2018 in Bakhtawar General Hospital, Jamshoro. A total of 364 cases of surgery, from Obstetrics and Gynecology and General Surgery department were included. Surgical interventions involving an incision were assessed. Infection (SSI) rate was noticed and data was analyzed by SPSS version 18.Results: Healthy discharge rate was 97%. The overall surgical site wound infection rate was 3.1%. These infections were high in genitourinary surgeries (9.09%). Among Obstetrics & Gynecology surgeries, maximum number of SSIs were reported in cases of emergency Lower Segment Cesarean Section (LSCS).Conclusions: The overall rate of SSI for different types of surgeries performed at Bakhtawar General Hospital, Jamshoro was only 3.1%. Frequency of SSI was highest in genitourinary surgeries followed by gastrointestinal and obstetrics and gynecology surgeries, respectively.Key words: General Surgery, Genitourinary surgery, Obstetrics & Gynecology surgery, Post-operative wound contaminatio

Accuracy, Sensitivity and Specificity of Oral Brush Cytology in the Diagnosis of Oral Epithelial Lesions

Background: Oral Squamous cell carcinoma (SCC) is highly prevalent in Pakistan than the rest of the world. Five-year survival rate is 80% if SCC is diagnosed at an early stage. The survival rate declines to 20% if diagnosed at a later stage. The objective of the present study was to find out the usefulness of oral brush cytology in detecting oral lesions. Material and Methods: In the present prospective observational study, 88 samples were collected from Maxillofacial Surgery Out-Patient Department (OPD), Liaquat University Hospital and ISRA University Hospital from July 2015 to December 2015. After taking written informed consent, oral brush cytology was performed and stained with standard Papanicolaou (PAP) staining protocol. The biopsy of the patients was performed by standard protocols of oral biopsy and specimen preserved in 10% buffered formalin. Cross tabulation between diagnosis of brush cytology and biopsy of same patients was done and accuracy, sensitivity and specificity were calculated. Results: According to the distribution of patients on brush cytology, 59.1% patients were diagnosed with malignant tumors, whereas 17.1% had benign tumors. On biopsy of the same patients, squamous cell carcinoma was confirmed in 72.7% and benign tumors were found in 17% of the patients. Comparison of brush cytology with biopsy of same patients revealed no significant difference. Accuracy, sensitivity and specificity of brush cytology of the oral cavity for detection of malignant tumor were calculated as 86.36%, 81.25% and 100% respectively. Whereas accuracy, sensitivity and specificity of brush cytology of the oral cavity for detection of benign and inflammatory conditions were 100%. Conclusion: Oral brush cytology has good accuracy, sensitivity and specificity for detection of oral epithelial lesions and can be useful in early detection of oral cancer as well as other lesions. Moreover, as an easy-to-do, painless and non-invasive procedure, it can be a good screening method for detection of oral lesions

Altered Coagulation Pattern in Different Histological Grades of Squamous Cell Carcinoma

Background: The incidence of squamous cell carcinoma has doubled in the last three decades associated with a high rate of morbidity and mortality. The incidence of bleeding and/or thrombosis in advanced stage cancer necessitates a need for research in blood coagulation abnormalities in malignancy. The objective of the present study was to determine the alteration in coagulation pattern among patients diagnosed with squamous cell carcinoma (SCC). Material and Methods: This cross-sectional study was conducted in Pathology department of Isra University Hospital, Hyderabad over a period of 06 months. A total of 126 samples were selected through non-probability convenient sampling. Both male and female patients of all age groups having SCC of skin, gastrointestinal and genital tract were included. The coagulation profile was analyzed by Sysmax CA 50 and Nycocard reader II. Data was entered into SPSS version 22.0 and results were analyzed. Results: The mean age of the patients with SCC in the present study was 55.5 ± 12 years with more male patients (n=81; 64.3%) as compared to females (n=45; 35.7%). Oral SCC was found to be the most common site of squamous cell carcinoma (43.7%). Majority of the patients had well differentiated SCC (42.1%) followed by moderately differentiated (40.5%) and poorly differentiated SCC (17.4%). The comparison of severity of SCC with coagulation profile revealed that PT (P=0.01), APTT (P=0.001), D-dimers (P=0.01 and TT (P=0.01) were significantly increased, whereas fibrinogen was significantly decreased (P=0.001). Conclusions: The histological differentiation of SCC (from well differentiated to poorly differentiated tumors) showed a highly significant association with different coagulation profile parameters like PT, APTT, BT, CT, D-dimer, TT, and fibrinogen levels