Introduction: Postoperative peritonitis is a serious complication occurring after abdominal surgery, usually digestive. Like all diseases associated with care, its prognosis is often severe, marked by high morbidity, prolonged stays in intensive care and in hospital, and potentially serious sequelae. Material and Methods: This is a retrospective study of patients operated on in the visceral surgical emergency department with a passage to the visceral surgical emergency department for postoperative peritonitis from January 2021 to November 2022. Results: From January 2021 to November 2022 we operated 1493 patients including 14 postoperative peritonitis, i.e. 0.9%. Among the 14 patients: 4 were women (28.6%) and 10 were men (71.4%) with a sex ratio of 2.5. Occlusions were the dominant pathology. The multivariate analysis showed a significant relationship between age, delay before consultation and the occurrence of complications. Conclusion: PPO still have a high mortality but which continues to decrease thanks to an effective medical and surgical management.

Coronary Artery Disease is caused by plaque buildup in the walls of the arteries that supply blood to the heart (called coronary arteries) and other parts of the body. Plaque is made up of deposits of cholesterol and other substances in the artery. Plaque buildup causes the inside of the arteries to narrow over time, which could partially or totally block the blood flow. This process is called atherosclerosis. Coronary artery disease (CAD), when get worst, it is known as coronary artery syndrome (CAS). There are many allopathic medications which can stop, even at starting points of the disease (CAD). Hypolipidemic drugs like statins, fibrates, resins and niacin are well known agents used for prevention of CAD. There are ethnic-based medicinal herbs which can be used to treat or prevent CAD with narrow to moderate range of statistical significance. We compared Rosuvastatin 10 mg with Indian dates (Jujubes) as hypolipidemic agents. This research was conducted at Ghurki Trust Teaching Hospital, jalo park, Lahore, Pakistan. Duration of study was two months. Twenty to seventy years old 60 hyperlipidemic patients of both gender were included in research work with written consent. We divided these patients in two equal groups. Group-I was advised to take Tablet Rosuvastatin 10 mg, twice daily for two months. Group-II was advised to take 500 grams Indian dates for two months. Their baseline parameters like LDL-cholesterol, HDL-cholesterol, systolic/diastolic blood pressure was determined in the hospital laboratory. Separate file was maintained for their name, age, sex, occupation, and address. After two months therapy we compiled data related to tested parameters. Paired t-test was applied to compare changes in all parameters. Their mean values with ± SD before and after treatment were compared and analyzed statistically. It was observed that Rosuvastatin significantly decreased systolic/diastolic blood pressure, LDL-cholesterol, and increased HDL-cholesterol in 27 hyperlipidemic/hypertensive patients. Indian dates used in 30 hyperlipidemic patients significantly decreased systolic blood pressure, and LDL-cholesterol, but insignificant changes were seen in diastolic blood pressure, and HDL-cholesterol. We concluded from the research work that Rosuvastatin is potent hypolipidemic and hypotensive medicine as compared to indian dates.

Dentofacial deformities are commonly associated with the chin area when it is inappropriate in size, shape, and position. When three-dimensional facial analysis is made, the chin becomes an important part within the same since it can significantly alter the symmetry, balance, and facial shape. We present a report of A 26 year old female reported with complaints of facial asymmery. On examination she had facial asymmetry with deviation of chin to her left side. Her radiograph (OPG) revealed hypoplasia on the left side of mandible and (lateral cephalogram) with severe chin retrusion. Further evaluation with CT confirmed her diagnosis of Hemifacial microsomia. She was planned for osseous sliding genioplasty procedure under general anesthesia It provide obvious and satisfactory outcome in severe chin deformity which seem very concerning and may seem to include other complex osteotomies. Hence with proper planning and asessment, prioratising patients chiefcomplaint genioplasty can give very satisfactory outcome.

Background: Polyps are masses projecting into the bowel lumen beyond the surface of the epithelium with or without a pedicle/stalk and it can be taken to mean a protuberant growth which can be either benign or malignant. The objective of the study was to study the pattern of colorectal polyps among Sudanese patients at Soba university hospital. Patients and methods: The study was a prospective, descriptive, cross sectional hospital based study. Conducted at Soba University Hospital department of endoscopy, in a period from Oct 2017 to August 2018.The study was conducted on Patients with colorectal polyps finding in colonoscopy or flexible Sigmoidoscopy. All the patients have been followed for duration not less than 3 months to assess the outcome. The main objective was to study the pattern of colorectal polyps among Sudanese population. Results: A total of (120) patients with colorectal polyps out of (626) patients underwent lower GI endoscopy during the period of the study, with male to female ratio of 1.8:1.0.The age ranged between (4) to (94) years. The incidence of polyp at the study was (19%). Thirty nine patient (32.5%) are smoker, while (6.7%) of the patients were alcohol consumers. NSAIDs consumptions were found in (40%) of the patients. Considering the consumption of fiber diet the study showed most of the patients were using the moderate fiber diet (53%). Schistosomasis found in 4 patients (3.3%) and these patients had polyps showing inflammatory polyps of schistosomasis origin. Presenting complains includes bleeding per rectum, altered bowel habit, mucus per rectum, abdominal pain, weight loss, abdominal distension, anorexia and anaemic symptoms. The most common co-morbidities were DM in (17.5%), IBD in (11.7%), FAP (6.7.4%) and diverticular diseases in (1.7%). The mode of the diagnosis was either through sigmoidoscopy or colonoscopy, and the NBI was used in (7.5%). The most common type was sessile polyps (67.5%) followed by pedunclated polyps (29.2%). Most of the polyps are within the left side, mainly at the rectum, anal canal and sigmoid colon. The size of the polyps lies between (1 mm to 50mm).The most common modes intervention was snare polypectomy (66.7%), followed by excision via biopsy forceps (62.7), while other treatment options are less frequent. Histopathology showed that most of the polyps were benign polyps (74.2%). (10.8%) were of high degree dysplasia and the rest was less frequent. Thirty three patients showed inflammatory polyps (27.5%) followed by tubulovilous adenomatous polyps (20.8% ), tubuloadenomatus polyp (11.7), juvenile polyp (10.8),hyperplastic polyps (9.2%), villous adenomatus polyp (5%), tubularadenomatus polyp (4.2%), schistosomal polyp (3.3%), hamratomatous polyp (2.5%) , fibroepithelial polyp (2.5%), invasive adenocarcinoma (1.7%) and granulomatus polyp (8%). Conclusion: The pattern of Colorectal polyps among Sudanese patients at our study was in line with international pattern in age, gender, common presentation, risk factors, types, shape and histopathology and most of them were of benign nature..

Anal imperforation or anorectal malformations (ARM) are malformations concerning the rectum. ARMs are a spectrum of various birth defects that vary from fairly minor lesions to complex anomalies. There are three types: the high form, the intermediate form and the low form. They are more and more frequent in our undeveloping countries where resources are limited. Their management is expensive and complex, especially the high form. We report a case of anal imperforation with rectovaginal communication which was referred to us from another region of Mali more than 1000 KM, for care.

Introduction: Peritonitis is an acute inflammation of the peritoneum; it is a surgical emergency in children, as in adults. It is still common in underdeveloped countries because of the delay in diagnosis. There are primary and secondary peritonitis. The main symptom is violent and sudden abdominal pain in children. The objectives were to determine the hospital frequency of peritonitis, to describe the clinical and therapeutic aspects, to evaluate the mortality of peritonitis. This was a retrospective study that took place in the pediatric surgery department from January 2019 to December 2021; using patient records. All patients operated for peritonitis from 0 to 15 years old were included in this study. Results: During this study, we performed 650 surgeries, including 23 cases of peritonitis, or 3.53% of the surgeries. The ages were between 4 and 15 years old, the male sex was predominant, i.e. 65.21%: 15 cases. The average consultation time was 7 days. The clinical signs were dominated by abdominal pain in 100% of cases, asthenia and deterioration in general condition. All the patients had benefited from a biological assessment, the widal was positive in 12 cases. Abdominal X-ray without preparation and abdominopelvic ultrasound were performed in all patients. Abdominal X-ray without preparation objectified 6 cases of pneumoperitoneum, water levels in 10 patients. Ultrasound showed 16 cases of appendicular peritonitis, i.e. 69.56%. All patients underwent laparotomy and we found 16 cases of appendicular peritonitis 69.56%, 5 ileal perforations i.e. 21.73%, 1 perforation of the gallbladder i.e. 4.34% and tuberculous peritonitis confirmed by pathology 4.34%. The postoperative course was simple in 65.21%, parietal suppuration was observed in 21.73% of patients. We had recorded 3 cases of death or 13.04%.

Surgery is considered to be the primary mode of treatment of head and neck malignancies and the ultimate aim of surgical resection is to obtain a tumor-free margin. No uniform criteria to define a clear surgical margin exist among practicing surgeons. This study intends to find the adequacy of surgical margin marking intraoperatively by Lugol’s iodine solution considering the frozen section method for oral squamous cell carcinoma (OSCC). Intraoperative staining with Lugol’s iodine and Frozen section analysis of margins of the surgical bed was negative in anterior, superior, and inferior specimens in all the cases, except in one case (4.3%), a posterior margin was found to be positive (unstained) for tumor. The chi-square value of the Lugol’s stained margins following resection of the tumor and negative results of frozen section analysis of the same was found to be statistically significant with the P value <0.001. Hence, we conclude that Lugol’s iodine helps in obtaining a clear surgical margin intra-operatively where inter-surgeons bias/judgment errors regarding safe margin can be avoided, especially in cases where the frozen section is not feasible.