Imrana Zulfikar, Farhan Zaheer, Abdul Khaliq, Farhat Jaleel.
Appraisal of General Surgical Admissions and Procedures, Influencing Training of Post Graduate Residents at Newly Developed Tertiary Care Teaching Hospital-Karachi.
J Dow Uni Health Sci Jan ;9(3):112-6.

Objective: To assess the pattern of surgical admissions and procedures which influence for the training of post graduate residents at a newly developed tertiary care teaching hospital of Karachi. Study Design: Descriptive Cross sectional Place and Duration of Study: This study was conducted in the Department of Surgery; Dow University Hospital affiliated with Dow International Medical College, Ojha Campus Dow University of Health Sciences from 1st June to 30th November 2013. Materials and Methods: This study includes all general surgical admissions at Dow University hospital during six months period. Demographic data, mode of admission, diagnosis, procedure performed and hospital stay were collected from hospital records. Data was analysed with SPSS 17. Results: There were total 306 surgical admissions recorded of which 194 (63.4%) were elective admissions and 112 (36.6%) were admitted through emergency. There were 160 (52.3%) female and 146 (47.7%) male patients with mean age of 41.3 ± 15.01 years. Mean hospital stay was 2.7(±2.6) days. The most common diagnosis in elective admissions was cholelithiasis in 70 (36%) patients followed by 26 (13%) patients of inguinal hernia. Less frequent admissions were of carcinoma breast (3%), thyroid disease, testicular carcinoma and gynaecomastia comprising of 1% admissions. Admissions through emergency were most common for acute appendicitis / lump in 31 (27%) patients, acute cholecystitis in 25 (22%), and acute pancreatitis in 12 (10.7%) patients. Commonest procedures performed were laparoscopic cholecystectomy in 70 (27%) patients followed by hernia repair in 42 (16.4%) and emergency laparotomy in 20 (8%) patients. Conclusion: The gall stones and hernia were the leading cause of elective and acute appendicitis as commonest emergency surgical admission. Laparoscopic cholecystectomy was the leading surgery performed electively. This pattern underscores the deficiency of other major disease burden. Resident must be exposed to other important diseases as well as their surgeries during their training. At present the institute offers rotation in orthopaedics, neurosurgery and urology. It should also be considered that internationally general sugery is further sub specialised as colorectal surgery, hepatobiliary, breast and thyroid /endocrine surgery. Rotations at subspeciaties and Electives at other affiliated institutes can solve the current situation.

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