Enhanced Recovery after Surgery (ERAS) is a collection of strategies that combine in a structured... more Enhanced Recovery after Surgery (ERAS) is a collection of strategies that combine in a structured pathway allowing the surgical and anaesthetic teams to decrease the physical insult and aid recovery enabling earlier discharge. 222 patients undergoing elective colorectal surgery-106 cases and 116 controls were included in a prospective comparative study done over a period of two years. Patients were matched for age, gender, co-morbidity, type of disease, American Society of Anesthesiologists (ASA) grade, type of surgery and stoma formation. Primary outcome measures of this study were length of hospital stay, mortality and morbidity. Secondary outcome measures were early oral feeding, return of bowel functions and number of readmissions within 30 days. Mean post-operative hospital stay was 4 days for patients in ERAS group compared to 8.7 days for the control group. There was no significant difference between the ERAS and control group for morbidity (22.6% Vs 31.1%; P = 0.16) and mortality (0% Vs 0.86%; P > 0.05). Regular feeding was tolerated much earlier in ERAS group (3days Vs 7days; P = 0.00). Bowel functions returned earlier in ERAS group (2.9 days Vs 5.3 days; P = 0.00). Readmission within 30 days of discharge was higher for ERAS group (6.6% Vs 0%; P = 0.05). Treatment of colorectal surgery patients according to an enhanced recovery after surgery programme leads to faster recovery and shorter hospital stay. Principles of ERAS programme are applicable and will be most beneficial for the patients.
International Journal of Otorhinolaryngology and Head and Neck Surgery
Background: The objective of this prospective study was to report our experience of presentation ... more Background: The objective of this prospective study was to report our experience of presentation and management of esophageal foreign bodies at GMC Doda.Methods: This prospective study was conducted in the department of ENT at GMC Doda from January 2019 to October 2022. During this time period 43 patients of foreign body ingestion were admitted in the department of ENT. Of the 43 patients 27 were male and 16 were female patients. 34 were children and 9 patients were adults. After doing through examination, plain radiograph was done on admission in all patients. Age appropiate rigid endoscope was used for foreign body extraction under general anaesthesia.Results: In children the coin was the most common type of foreign body (28 patients, 82.3%), with about 39% managed conservatively after overnight observation,as the coin passed on spontaneously. In adults chicken bone was the most common type of foreign body (5 patients, 55%). Upper esophagus (cricopharynx) was the most common site ...
IP Journal of Diagnostic Pathology and Oncology, 2020
Introduction: FNAC is simple, rapid, inexpensive, minimallyinvasive technique and with the absenc... more Introduction: FNAC is simple, rapid, inexpensive, minimallyinvasive technique and with the absence of complications done on OPD basis to diagnose different types of swellings located in the head and neck. Head and neck swellings commonly originate from cervical lymph node, thyroid glands, salivary glands, subcutaneous/cutaneous swellings and soft tissues. Aims and Objectives: To study the role of FNAC in the diagnosis of non-neoplastic and neoplastic lesions of head and neck in all age groups in Chenab valley. Materials and Methods: This prospective study was done over a period of 9months from May 2019-January 2020 in GMC Doda. It was a hospital based study. In this study 116 cases of FNAC Lesions of various age groups were studied by pathologist for cytology and accordingly diagnosis were made. Results: The Present study was carried out on 116 patients presenting with head and neck swellings over a period of 9 months from May 2019 to January 2020. Out of all cases Cutaneous/Subcutaneous swellings constituted maximum number of cases I;e 46 cases (39.65%); all were of benign nature followed by lymphnode lesions I;e 41 cases (35.344%) followed by thyroid lesions I;e 23 cases (19.82%) followed by salivary gland lesions I;e 6 cases (5.17%) Conclusion: To conclude; FNAC is considered to be the most reliable technique in the early diagnosis of various Head and Neck lesions so that proper intervention could be taken at earliest possible time in early stages and should be considered as first line investigation in the evaluation of lesions in head and neck region.
Overview Hemorrhoidal disease (HD) is a common surgical disorder. The treatment modalities can be... more Overview Hemorrhoidal disease (HD) is a common surgical disorder. The treatment modalities can be surgical or nonsurgical. Every surgical option has its own indications and limitations. Postsurgical symptomatic recurrence rates are low and vary between different techniques. The ideal way to deal with recurrent HD is not clear. Material and Methods The present prospective case series enrolled a total of 87 patients (54 male/33 female). Thirteen out of 87 patients (15%) had history of previous intervention for HD. A modification of the standard technique was adopted for patients with recurrent HD. A mean follow-up of 22 months was achieved. Results Stapled hemorrhoidectomy (SD) was performed in 13 patients who had history of previous surgical intervention for HD. There were no adverse events related to the technique. Patients with recurrent HD had severe pain scores with SH as compared to patients who underwent SH at the first time. There were no wound related complications. Conclusio...
Enhanced Recovery after Surgery (ERAS) is a collection of strategies that combine in a structured... more Enhanced Recovery after Surgery (ERAS) is a collection of strategies that combine in a structured pathway allowing the surgical and anaesthetic teams to decrease the physical insult and aid recovery enabling earlier discharge. 222 patients undergoing elective colorectal surgery-106 cases and 116 controls were included in a prospective comparative study done over a period of two years. Patients were matched for age, gender, co-morbidity, type of disease, American Society of Anesthesiologists (ASA) grade, type of surgery and stoma formation. Primary outcome measures of this study were length of hospital stay, mortality and morbidity. Secondary outcome measures were early oral feeding, return of bowel functions and number of readmissions within 30 days. Mean post-operative hospital stay was 4 days for patients in ERAS group compared to 8.7 days for the control group. There was no significant difference between the ERAS and control group for morbidity (22.6% Vs 31.1%; P = 0.16) and mortality (0% Vs 0.86%; P > 0.05). Regular feeding was tolerated much earlier in ERAS group (3days Vs 7days; P = 0.00). Bowel functions returned earlier in ERAS group (2.9 days Vs 5.3 days; P = 0.00). Readmission within 30 days of discharge was higher for ERAS group (6.6% Vs 0%; P = 0.05). Treatment of colorectal surgery patients according to an enhanced recovery after surgery programme leads to faster recovery and shorter hospital stay. Principles of ERAS programme are applicable and will be most beneficial for the patients.
International Journal of Otorhinolaryngology and Head and Neck Surgery
Background: The objective of this prospective study was to report our experience of presentation ... more Background: The objective of this prospective study was to report our experience of presentation and management of esophageal foreign bodies at GMC Doda.Methods: This prospective study was conducted in the department of ENT at GMC Doda from January 2019 to October 2022. During this time period 43 patients of foreign body ingestion were admitted in the department of ENT. Of the 43 patients 27 were male and 16 were female patients. 34 were children and 9 patients were adults. After doing through examination, plain radiograph was done on admission in all patients. Age appropiate rigid endoscope was used for foreign body extraction under general anaesthesia.Results: In children the coin was the most common type of foreign body (28 patients, 82.3%), with about 39% managed conservatively after overnight observation,as the coin passed on spontaneously. In adults chicken bone was the most common type of foreign body (5 patients, 55%). Upper esophagus (cricopharynx) was the most common site ...
IP Journal of Diagnostic Pathology and Oncology, 2020
Introduction: FNAC is simple, rapid, inexpensive, minimallyinvasive technique and with the absenc... more Introduction: FNAC is simple, rapid, inexpensive, minimallyinvasive technique and with the absence of complications done on OPD basis to diagnose different types of swellings located in the head and neck. Head and neck swellings commonly originate from cervical lymph node, thyroid glands, salivary glands, subcutaneous/cutaneous swellings and soft tissues. Aims and Objectives: To study the role of FNAC in the diagnosis of non-neoplastic and neoplastic lesions of head and neck in all age groups in Chenab valley. Materials and Methods: This prospective study was done over a period of 9months from May 2019-January 2020 in GMC Doda. It was a hospital based study. In this study 116 cases of FNAC Lesions of various age groups were studied by pathologist for cytology and accordingly diagnosis were made. Results: The Present study was carried out on 116 patients presenting with head and neck swellings over a period of 9 months from May 2019 to January 2020. Out of all cases Cutaneous/Subcutaneous swellings constituted maximum number of cases I;e 46 cases (39.65%); all were of benign nature followed by lymphnode lesions I;e 41 cases (35.344%) followed by thyroid lesions I;e 23 cases (19.82%) followed by salivary gland lesions I;e 6 cases (5.17%) Conclusion: To conclude; FNAC is considered to be the most reliable technique in the early diagnosis of various Head and Neck lesions so that proper intervention could be taken at earliest possible time in early stages and should be considered as first line investigation in the evaluation of lesions in head and neck region.
Overview Hemorrhoidal disease (HD) is a common surgical disorder. The treatment modalities can be... more Overview Hemorrhoidal disease (HD) is a common surgical disorder. The treatment modalities can be surgical or nonsurgical. Every surgical option has its own indications and limitations. Postsurgical symptomatic recurrence rates are low and vary between different techniques. The ideal way to deal with recurrent HD is not clear. Material and Methods The present prospective case series enrolled a total of 87 patients (54 male/33 female). Thirteen out of 87 patients (15%) had history of previous intervention for HD. A modification of the standard technique was adopted for patients with recurrent HD. A mean follow-up of 22 months was achieved. Results Stapled hemorrhoidectomy (SD) was performed in 13 patients who had history of previous surgical intervention for HD. There were no adverse events related to the technique. Patients with recurrent HD had severe pain scores with SH as compared to patients who underwent SH at the first time. There were no wound related complications. Conclusio...
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