Introduction: According to statistics damage venous circulation of the lower extremities are among the most common diseases in the world. Although the treatment varicose veins (VV) modernized using non-invasive-endovenous procedures, forecast on short term is not quite satisfactory. Aim of this study was to examine the results of treatment vv lower extremities to the appearance of improving the quality of life and the emergence of recurrence 1 year after operating (OP) and endovenous laser ablation (EVLA) treatment.

Background: Endoscopic Retrograde Pancreoticocolangiography (ERCP) is performed for resolving cholestasis by sphincterotomy and/or stone extraction and is done with deep sedation or general anesthesia. Aim: Our aim was to evaluate the effects of the depth of anesthesia on oxidative stress provided via Bispecteral Index (BIS) monitorisation during the ERCP procedure by analyzing the biochemical parameters. And also was the effects of anesthesia depth on propofol consumption and postoperative sedation status.

Introduction: Circumcision remains the commonest performed surgical procedure in outpatients. Circumcision with Plastibell is the most popular used method of circumcision among surgeons. As any other surgical procedure, it inherits complications, bleeding being the commonest. The aim of this study is to compare the incidence of post-operative complications in circumcision performed with Plastibell with and without coagulation hemostasis in male infants in the outpatient department of Pediatric Surgery, Combined Military Hospital, Lahore.

Background: When liver bleeding cannot be controlled by conventional methods, a topical hemostatic patch can be applied during surgery. In recent years new hemostats have become available. The aim of this study was to investigate the degree of adhesion and inflammation for three topical hemostatic patches, TachoSil®, Hemopatch™ and Veriset™.

Sepsis associated encephalopathy (SAE) is the most common encephalopathy in ICU and may contribute to a high mortality. Few data are available on the risk and outcome of SAE after patients with gastrointestinal (GI) perforation. We reviewed all patients admitted to our department of general surgery with GI perforation over a 3-year period. We used the sepsis-related organ failure criteria for diagnosis of SAE (GCS<13 score in absence of sedation). Exclusion criteria were present evidence of meningitis/ encephalitis and other primary encephalopathy. Of 58 patients admitted for GI perforation during the study period, 22 patients (37.9%) developed sepsis. Of them, 9 (40.9%) patients (7 male, mean 79y) had SAE according to the inclusion/exclusion criteria. The presence of SAE was significantly associated with increased age (79.0±11.3 vs. 59.6 ±16.3, p=0.006), lower mean arterial pressure (MAP) (70.7±15.3 vs. 90.4.±16.8, p=0.000), lower GCS score (9.7±3.6 vs. 15±0.0, p=0.000), elevated SOFA score (8.9±3.3 vs. 3.6±1.6, p=0.000) and qSOFA score (1.9±0.3 vs. 0.4 ±0.5, p=0.000), and higher mortality at 30 days (66.7% vs. 7.7%, P=0.000). Nevertheless, in Cox regression analysis, only a lower MAP was associated with worse survival in SAE. Sepsis occurred in 37.9% of patients after GI perforation. These patients had more frequent SAE and needed more aggressive ICU therapy; a lower MAP is significantly influence outcome.

Purpose: The elbow bone traumas are very serious lesions that can compromise the function of this joint in the future. These lesions are most severe when there is a defect of bone which affects one component of the joint. Case report: We report a case of open trauma of the left elbow from a right-handed girl of 21 years, during an accident on the highway. On admission, the victim had a signifi cant defect of skin-muscle of the anterior medial aspect of the elbow. The exploration revealed a major loss of bone affecting the humeral

Objective: Evaluate the characters of labrum tear morphology in recurrent anterior dislocation of shoulder via arthroscopy. Material and method: Retrospective demographic study 55 recurrent shoulder dislocation patients underwent arthroscopic labrum repair in Saint Paul University Hospital and Hanoi Medical University Hospital from 2009 to 2013. Results: 65.5% patients with grade 2 tear with 2-3 cm length; The location of tear is anterior and anterior inferior occupied 81.9%; mobile torn labrum is 50.9% and bone healed labrum is 34.6%

Aim: There are an increasing number of wound closure materials and techniques types in skin surgery. Still now, there is much controversies about optimal procedure of wound closure. This study tries to achieve this goal. Material and Methods: This study was included 37 patients suffering from skin wounds of variable size and sites. These wounds were closed by using double tips needle from under the skin without any sutures or adhesives on skin surface. The follow up period ranged from 3 to 19 months.

To evaluate the conversion rate of lap cholecystectomy and analyze the factors leading to the conversion to open surgery. Design: Observational Study Place and Duration: Department of surgery, Doctor’s Hospital and Azra Naheed Medical College Lahore, Pakistan Patients and Methods: We retrospectively analysed 250 patients admitted with gallstone disease who were deemed to be fit for laparoscopic procedure. (June 2011 through May 2016)