Khyber Teaching Hospital

Peshāwar, Pakistan

Khyber Teaching Hospital

Peshāwar, Pakistan
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Kamran K.,Khyber Teaching Hospital
Asian journal of endoscopic surgery | Year: 2013

The aim of our study was to determine the effect of sex on the outcome of laparoscopic cholecystectomy in terms of operative time, conversion to open cholecystectomy, postoperative complications and mean hospital stay. In this retrospective observational study, we analyzed the medical records of 2061 patients who underwent laparoscopic cholecystectomy in the surgical department of Khyber Teaching Hospital (Peshawar, Pakistan) between March 2008 and January 2010. χ(2) test and t-test were respectively used to analyze categorical and numerical variables. P ≤ 0.05 was considered significant. The study included 1772 female and 289 male patients. The mean age for male patients was 44.07 ± 11.91 years compared to 41.29 ± 12.18 years for female patients (P = 0.706). Laparoscopic cholecystectomy was successfully completed in 1996 patients. The conversion rate was higher in men (P < 0.001), and the mean operating time was longer in men (P < 0.001). Bile duct injuries occurred more frequently in men (P < 0.001). Gallbladder perforation and gallstone spillage also occurred more commonly in men (P = 0.001); similarly severe inflammation was reported more in male patients (P = 0001). There were no statistically significant differences in mean hospital stay, wound infection and port-site herniation between men and women. Multivariate regression analysis showed that the male sex is an independent risk factor for conversion to open cholecystectomy (odds ratio = 2.65, 95% confidence interval: 1.03-6.94, P = 0.041) and biliary injuries (odds ratio = 0.95, 95% confidence interval: 0.91-0.99, P-value = 0.036). Laparoscopic cholecystectomy is often challenging in men on account of more adhesions and inflammation. This leads to higher conversion rates and more postoperative complications. Optimized planning and a more experienced operating surgeon may help overcome these problems. © 2012 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.


Arif M.,Khyber Teaching Hospital
Journal of Ayub Medical College, Abbottabad : JAMC | Year: 2010

The purpose of this study was to evaluate the frequency of metastatic retinoblastoma on initial presentation. Prospective study. Supra Regional Centre for Retinoblastoma, Department of Ophthalmology, Khyber Teaching Hospital Peshawar Pakistan from 1st July 1999 to 31st January 2003. Data was collected from 80 registered Retinoblastoma patients admitted and examined under anaesthesia for tumours assessment. Diagnosis was supported with the help of CT scan and confirmed by histopathology of the enucleated specimen for evidence of optic nerve invasion by the tumour. Twenty (25%) patients were presenting as Metastasis on initial presentation. Mean age was 3.5 years, range was 7 months to 12 years. Out of these 20 patients with metastasis, 10 were male and 10 were female. Eighteen (90%) of them were from lower socio-economic group. Failure in early diagnosis of retinoblastoma, advance age and unilateral disease are associated with extraocular spread; this tragic scenario can be prevented best be early detection and prompt treatment plan implementation.


Khan M.A.,Khyber Teaching Hospital
Journal of Ayub Medical College, Abbottabad : JAMC | Year: 2010

Supracondylar fracture of humerus is the second most common fracture in children which account for 60-75% of all fractures around the elbow. There are various treatment modalities for type-III fracture, i.e., closed reduction and casting, skeletal traction, close reduction and percutaneous pinning and open reduction and internal fixation. This study was conducted to see the outcome of open reduction and internal fixation after failed closed reduction. This study was conducted in the Orthopaedics Departments of Khyber Teaching Hospital Peshawar and Ayub Teaching Hospital Abbottabad from February 2007 to Nov 2007 on 30 children. Patients included were of either gender with age range from 5-12 years with displaced supracondylar fracture (type-III) after failed closed reduction. All fractures were fixed with two cross K-wires by open reduction and internal fixation. The patients were assessed both clinically and radiologically and results were tabulated according to Flynn criteria. Twenty-eight patients had excellent results while two had good results according to Flynn criteria. None of the patients had either fair or poor result. Open reduction and internal fixation is a good and reliable method after failed closed reduction and gives stable fixation with anatomical alignment.


Khalil J.,Khyber Teaching Hospital | Muqim R.,Khyber Teaching Hospital | Rafique M.,Institute of Kidney Diseases | Khan M.,Khyber Teaching Hospital
Saudi Journal of Gastroenterology | Year: 2011

Background/Aim: The aim of the study was to compare laparoscopic and open appendectomy (OA) in terms of primary outcome measures. Study design: A randomized controlled trial. Place and duration of the study: Khyber Teaching Hospital, Peshawar, Pakistan, February 2008 to December 2009. Patients and Methods: A total of 160 patients were divided into two groups, A and B. Group A patients were subjected to laparoscopic appendectomy (LA), whereas Group B patients were subjected to OA. Data regarding age, gender, and primary outcome measures, such as hospital stay, operative duration, and postoperative complication, were recorded and analyzed. Percentages were calculated for categorical data, whereas numerical data were represented as mean ±SD. Chi-square test and t test were used to compare categorical and numerical variables, respectively. Probability ≤0.05 (P≤0.05) was considered significant. Results: After randomization, 72 patients in group A and 75 patients in group B were analyzed. The mean age of patients in groups A and B was 23.09±8.51 and 23.12±10.42 years, respectively, (P = 0.981). The mean hospital stay was 1.52±0.76 days in group A and 1.70±1.06 days in group B (P = 0.294). The mean operative duration in group A and B were 47.54±12.82 min and 31.36±11.43 min, respectively (P < 0.001). Pain (overall level) was significantly less in group A compared with group B (P = 0.004). The two groups were comparable in terms of other postoperative complications, such as hematoma (P = 0.87), paralytic ileus (P = 0.086), urinary retention (P = 0.504), and wound infection (P = 0.134). Conclusion: LA is an equivalent procedure and not superior to OA in terms of primary outcome measures.


Khan M.,Khyber Teaching Hospital
Journal of Ayub Medical College, Abbottabad : JAMC | Year: 2011

Surgical site infections (SSI) are among the most common complications in surgical patients and have serious consequences for outcomes and costs. This study aimed to determine the rates and risk factors affecting surgical site infections and their incidence at Surgical 'C' Unit, Khyber Teaching Hospital, Peshawar, Pakistan. The study was conducted to compare with rates obtained by large international multi-centre studies. A review of all general surgical interventions involving an incision, excluding anal procedures, performed between December 2008 and March 2009 (n=269) was undertaken. Various clinical parameters were recorded. Infection rates were calculated. Data were analysed using the Fisher's exact test. The overall SSI rate was 9.294%, 4.88% in clean cases (C), 8.39% in clean contaminated cases (CC), and 20.45% in contaminated or dirty cases (D). There were significantly higher surgical site infection rates among patients with combined American Society of Anaesthesiologists scores II and III than those with ASA score I in clean contaminated (p=0.0007), and dirty cases (p=0.0212). There were also significantly higher surgical site infection rates among patients with combined Co-morbidity Scale score 1-6 than those with no comorbid factors in clean contaminated (p=0.0002). Surgical site infection rate was highest in gastrointestinal system surgeries. The Surgical site infections can be minimised by adopting international protocols for surveillance.


Khattak M.I.,Khyber Teaching Hospital
Journal of Ayub Medical College, Abbottabad : JAMC | Year: 2010

This study was aimed to find out the frequency of sputum positive Acid Fast Bacilli (AFB) cases among pulmonary tuberculosis patients and to determine those patients who are the potential source of transmitting infection. This study was conducted in four medical units of Khyber Teaching Hospital, Peshawar and Chest Unit, Ayub Teaching Hospital, Abbottabad in collaboration with the pathology unit of Khyber Teaching Hospital, Peshawar, and Kohat Institute of Medical Sciences, Kohat. Three specimens of sputum were collected for three consecutive days in the morning and were transported immediately to the laboratory along with full details of the patients. Out of two hundred total patients studied, 104 patients (52%) were sputum AFB positive. Among the 104 patients 60 patients (57.4%) were females. Sixty-four (61.52%) individuals were between 20-50 years. Majority of the patients were from poor, deprived and lower social class. Fifty-two (50%) patients had monthly income of less than Rs. 4,000; only 8 patients (7.67%) had monthly income of more than Rs. 12,000). Forty-eight patients <46.12% were house wives, 10 patients (9.61%) were unemployed. Most of the patients were under weight for their age and height. 24 patients (23.06%) were below 42 kg. The maximum (53.84%) number of patients was in weight range of 43-50 kg. Sputum AFB positive pulmonary tuberculosis is more in individuals of low socioeconomic group and in females. The patients put their children and family members at risk of tuberculosis infection. For the control of this disease early diagnosis of active disease and their treatment under supervision is important.


Sharafat Z.,Khyber Teaching Hospital
Medical Forum Monthly | Year: 2014

Objective: To find out the demographic profile, type of antepartum haemorrhage, maternal and perinatal complications and maternal and perinatal mortality. Study Design: Prospective study Place and Duration of Study: This study was a carried out at Gynae B, Labour Room, Khyber Teaching Hospital Peshawar for a period of one year from January 2013 to December 2013. Materials and Methods: This study was carried over on patients who presented to gynae B labour room Khyber Teaching Hospital Peshawar with antepartum haemorrhage. All the patients were admitted and relevant informations including age, parity, booking status, education, residence and occupation etc. were noted in the study proforma. Patients were followed till discharge.Records about mode of delivery, intrapartum and postpartum complications were made. Details of the babies like weght, sex, maturity, apgar score, whether live or dead were recorded and data analyzed. Result: Incidence of ante partum haemorrhage was 3.01% Maternal and perinatal morbidity was very high with increase rates of anaemia (100%) cesarian section rates (68%) post partum haemorrhage (11.5%), need of blood transfusion (100%). Puerperal pyrexia (13.1%) coagulation failure (11.5%) low birth weight (36%) and birth asphyxia. Maternal and perinatal mortality was very high( 2.1%) and (37%) respectively. Conclusion: Antepartum haemorrhage is a grave obstetrical emergency associated with very high maternal and perinatal mortality and morbidity.


Faiz-Ur-Rehman,Khyber Teaching Hospital
Journal of Ayub Medical College, Abbottabad : JAMC | Year: 2011

Both hepatitis B and C are common infections affecting masses and are leading causes of Chronic Liver Disease in Pakistan as well as worldwide. In majority of cases both viral diseases spread by factors that are preventable. The present study is conducted to determine the identifiable risk factors in patients admitted with Chronic Hepatitis B and C. An observational study was carried out for a period of 6 months. All age groups and both sexes were included. The patients were interviewed and the identifiable risk factors were looked for. The standard methods for detection of Hepatitis B and C were used. One-hundred and ten patients were studied from January to July 2009. Sixty-five patients had Hepatitis C, 35 had Hepatitis B, and 10 had both Hepatitis B and C. Ninety-three patients had a history of injections and transfusions etc., and 38 had surgical scars. Tattoos were present in 42 patients and nose and/or ear piercing marks were present in 28 patients. The number of risk factors increased in co-infection. There is a role of unhygienic health delivery practices, lack of awareness and resources for standard screening protocol for spread of Hepatitis B and C.


Zaman M.,Khyber Teaching Hospital | Ashraf S.,Khyber Teaching Hospital | Dreyer N.A.,Outcome science | Toovey S.,University College London
Emerging Infectious Diseases | Year: 2011

Human infection with avian influenza (H5N1) virus raises concern for the possibility of a pandemic. We report 20 cases, which ranged from asymptomatic to fatal, in Pakistan in 2007. These cases indicate human-to-humanto- human transmission of this virus, and the number of cases may be higher than realized.


Akhtar S.,Khyber Teaching Hospital
Medical Forum Monthly | Year: 2014

Objective: To evaluate the risk factors and management of femoral fractures related to birth trauma. Study Design: Descriptive Case series Study Place and Duration of Study: This study was conducted in Department of Orthopaedics& Traumatologyand Department of Obstetrics & Gynecology of Khyber Teaching Hospital, Peshawar from April 2008 to March 2013. Materials and Methods: Over a period of 5 years,cases of femoral fractures in newborns due to birth trauma presenting to Orthopaedic&Taumatologydepartment or occurring in Obstetrics & GynecoIogyDepartment of Khyber Teaching Hospital Peshawar were recruited to the study. Birth histories of the cases were explored with respect to period of gestation, birth weight, presentation at birth and mode of delivery.Type of fracture and management used was documented. Cases were followed till recovery. Results: Mean gestational age was 38.1 weeks and mean time to diagnose was 3 days. Presentation of baby was breech and mode of delivery was Caesarean section in majority of cases.Mid shaft fracture was present in ten cases and three had subtrochanteric fracture. All patients showed complete union at a mean duration of 3.2 weeks. Conclusion: Femoral fracture due to birth trauma in newborn is a rare injury. It is more common in cases of Caesarean section done for breech presentation. Risk is high in preterm and/or low birth weight babies. Fracture mostly involves shaft of femur.These fractures have very good prognosis and show complete healing following immobilization.

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