Duplication of gallbladder: a rare anomaly of biliary tract- A case report.

Incomplete duplication of gall bladder or vesica fellea divisa is one of the rare anomalies of gallbladder. Until now, 25 cases have been reported; of which four were proceeded with laparoscopic cholecystectomy. In our case, we diagnosed this nadir anomaly laparoscopically, posing a technical challenge since no radiological clue was observed beforehand. Successful laparoscopic resection of duplicated gall bladders was performed followed by Magnetic Resonance CholangioPancreaticography.

Safety culture implications on safe work practices and work place exposure incidents in Operation Theater.

BACKGROUND & OBJECTIVES: The study was undertaken to estimate the prevalence of body and blood fluid exposure incidents such as needle stick injuries, direct contact, splashes, and cuts among health care personnel (HCP) in operation theaters (OTs). The study objective was to investigate perception of safety culture and potential challenges faced by HCP in Pakistani context. METHODS: An analytical cross-sectional survey was conducted in four tertiary care hospitals of Rawalpindi and Islamabad that were Akbar Niazi Teaching Hospital (ANTH), Fauji Foundation Hospital (FFH), Benazir Bhutto Hospital (BBH) and Holy Family Hospital (HFH) during March, 2019 to June, 2019. The data of the current study was collected from surgical staff in OTs at four tertiary care teaching hospitals including nurses, house officers, post graduate trainees, registrars, consultants, and technicians in the twin cities i.e., Rawalpindi and Islamabad. RESULTS: In our findings (N=367) there was a high prevalence of exposure incidents in past six months, 45% had had got a needle injury, 36% have got a splash, 28.8% had direct contact and 35.6% had a cut once respectively in past six months, the occurrence of exposure incidents twice, thrice and more is also enormous. CONCLUSION: The study reflected a dire need of trainings at hospitals so that very strategically the importance of safety being a priority and value of HCP is inculcated on daily basis.

Comparison of mean pain score using topical and oral metronidazole in post milligan morgan hemorrhoidectomy patient; A randomized controlled trial.

BACKGROUND AND OBJECTIVES: Milligan Morgan Hemorrhoidectomy is one of the most commonly performed surgeries. Post-operative pain is the major cause of morbidity in post hemorrhoidectomy patients. Metronidazole has an established role in relieving post hemorrhoidectomy pain. The objective was to evaluate the pain score by using topical and oral metronidazole in post Milligan Morgan hemorrhoidectomy patients. METHODS: A prospective randomized controlled trail was done in surgical departments of Akbar Niazi Teaching Hospital, Islamabad. A total of 166 consecutive patients with 3rd and 4th degree hemorrhoids were presenting in surgical OPD and who underwent Milligan Morgan hemorrhoidectomy between July 2018 and December 2018 were included in the study. Patients allocated in two groups, Group-A received topical metronidazole 10% post hemorrhoidectomy for seven days and Group-B were given oral metronidazole 400mg for 07 days. Analgesics were given on patient's requirement. Patients post hemorrhoidectomy pain was recorded by using VSA scale at baseline (1st day) and on 7th post-operative day. Data analysis was done by using SPSS 21. Pain calculated by compared in terms of mean, standard deviation between groups and independent sample T test was used. Association between demographic details like gender and ages of the patients with pain scale on 7th day was measured and chi-square distribution was used. RESULTS: Total 166 patients were included in this study. The mean ages of the patients were 44.07±10.62 years with minimum 20 and maximum 60 years. Out of 166 patients, female were 55 (33.1%) and male were 111 (66.9%). Results showed significantly lower pain in patients using topical metronidazole as compared to oral metronidazole (p=0.001). Association of pain with respect to ages was insignificant (p=0.202) whereas between genders inside the groups showed significant difference (p=0.028). CONCLUSION: These results showed that topical metronidazole significantly reduces pain in post hemorrhoidectomy patients as compared to oral metronidazole overall and even when data stratified among age, gender and type of hemorrhoids.

Analysis Of Level Of Satisfaction Of Postgraduate Trainees On Surgical Floor.

BACKGROUND: Organizations flourish with a satisfied workforce. There is little known information on demographic characteristics and motivators for job satisfaction among Pakistani postgraduate trainees in surgery. Job satisfaction is predicted by intrinsic motivators (personal growth and perceived ability to work) and extrinsic motivators (perceived social support). Work family interference/enhancement and job stressors (workload and long working hours) also impacts job satisfaction; predicting overall life satisfaction. This study aims at examining life satisfaction predicted by personal and professional characteristics.. METHODS: The postgraduate trainees in the public and private hospitals of Rawalpindi and Islamabad were surveyed using validated measures of life satisfaction, personal growth, perceived social support, perceived ability to work, work family interference/enhancement, job stressors, co-workers support, supervisors support, and job satisfaction from September 15 to December 28, 2017. RESULTS: Personal growth, perceived ability to work, availability of social support, and work family enhancement positively correlate to job and life satisfaction. Work life interference and job stressors negatively relate to job and life satisfaction. Job satisfaction is also partially mediated by intrinsic and extrinsic motivators on life satisfaction, whereas job stressors weakened the relationship between job satisfaction and life satisfaction. Long working hours is negatively related to job satisfaction and life satisfaction. CONCLUSIONS: Life satisfaction is predicted by job satisfaction that is characterized intrinsic and extrinsic motivators. Healthcare organizations face challenge of providing reduced working hours, increased salaries, supportive working environment, and increased supervision to enhance the job satisfaction of employees and to improve the functioning of the healthcare environment.