Gastro-intestinal stromal tumor (GIST): Experience from a tertiary care center in a low resource country.

Objectives: The aim of this retrospective study was to review the overall survival (OS) and disease-free survival (DFS) of GISTs treated surgically at our center over the past decade.

Material And Methods: We undertook a 12-year retrospective review of our experience in treating this condition with a focus on long-term outcomes of treated patients in a resource-constrained environment. Incomplete follow-up information continues to be a major problem with studies conducted in low resource settings, and in order to overcome this, we undertook telephonic contact with patients or their relatives to get the necessary information about their clinical status.

Prospective comparison of single encounter versus distributed laparoscopic training in novice learners: A controlled trial.

Background: The traditional model of teaching surgical skills on "real" patients using graded responsibility is being seriously questioned, and there is a paradigm shift toward exploiting simulators. There is a lack of clarity on the impact of using simulation as a teaching strategy in novice learners. The purpose of our study was to determine if the number and duration of training sessions influence the acquisition and retention of laparoscopic skills in naïve learners.

Disclosing bad news of cancer diagnosis: Patients' preference for communication.

The majority of relatives of cancer patients in Pakistan request their clinicians to adopt a "do not tell approach" while counselling the patients regarding their disease. The current study aimed to assess patients' understanding of their disease and how they would prefer the physicians to deliver news about cancer diagnosis and its management plan. This was a cross-sectional study in which both patients and their immediate relatives were interviewed.

Surgical and oncological implications of aberrant arterial anatomy in patients undergoing pancreatoduodenectomy.

Whipple's pancreatoduodenectomy is a complex surgical procedure and any aberrant arterial anatomy may have serious surgical implications. The objective of our study was to analyse the frequency of aberrant hepatic artery and compare the outcomes in patients with normal anatomy. Clinical data and computed tomography scans of 45 consecutive patients who underwent Whipple's procedure from 2007 to 2016 were reviewed.

Sclerosing peritonitis presenting as complete mechanical bowel obstruction: a case report.

Introduction: Sclerosing peritonitis or abdominal cocoon syndrome is characterized by small bowel loops completely encapsulated by a fibrocollagenous membrane in the center of the abdomen. Although cocooning of the abdomen is mostly seen in patients on peritoneal dialysis, it can occur de novo; it very rarely manifests as complete mechanical bowel obstruction.

Case Presentation: A 46-year-old Asian man presented with complete mechanical bowel obstruction.

Changing trends in surgical management for acute cholecystitis, in light of Tokyo guidelines - 14 year experience.

Objective: To look for trends in surgical management of acute cholecystitis and compare the outcomes of patients with severe condition.

Methods: The retrospective study was conducted at Aga Khan University Hospital, Karachi, from January to December 2016, and comprised data of adult patients who underwent cholecystectomy for acute cholecystitis from January 1, 2001, to December 31, 2014. Record of patients from 2001 to 2007 was designated in Group-1 while Group-II covered period between 2008 and 2014.

Role of early contrast enhanced CT scan in severity prediction of acute pancreatitis.

Severe pancreatitis occurs in approximately 15-25% of patients with acute pancreatitis. The objective of our study was to compare the CT Severity Index (CTSI) with a clinical score (BISAP score) to predict severity of acute pancreatitis. Forty-eight consecutive patients with acute pancreatitis who underwent contrast enhanced CT scan within 72 hours of presentation were included.

Over a decade of changing trends in surgical mortality; audit from a tertiary care hospital.

Objective: A retrospective audit of the trend of mortality in the general surgery service at our hospital over the last decade was conducted to reflect the complexity of cases being seen.

Methods: Mortalities of 8 separate years, a decade apart, namely 1997, 1998, 1999, and 2000 as initial years (Group-I) and 2011, 2012, 2013 and 2014 as recent years (Group-II) were reviewed.

Results: Total number of admissions in the service and surgeries performed during these two periods experienced an increase of 50.

The many guises of primary hyperparathyroidism: An unchanged scenario.

Objective: To study the causes, characteristics and outcome of treatment of patients with primary hyperparathyroidism.

Methods: This retrospective cohort analysis was conducted at the Jinnah Postgraduate Medical Centre, Karachi, and comprised data of patients with primary hyperparathyroidism between 2004 and 2014. .

Nosocomial infections in the ICU: Pens and spectacles as fomites.

Nosocomial infections are a major cause of morbidity and mortality. Non-medical objects known as fomites may have a role in their genesis. We investigated the significance of writing pens and spectacles as fomites.

Carcinosarcoma of the esophagus.

Carcinosarcoma of the esophagus is a rare neoplasm characterized histologically by presence of carcinomatous and sarcomatous elements. Case report of carcinosarcoma of the esophagogastric junction whose morphological and immunohistochemical features makes it quite distinctive from other tumours is presented. It was an ulcerated lesion diagnosed in an elderly Afghan lady located 34 cms from the incisor teeth.

Minimally invasive papillary carcinoma of the extrahepatic bile ducts.

Invasive papillary carcinomas of the Extrahepatic Bile Ducts (EBD) are uncommon (4-5%). The course is less aggressive than conventional adenocarcinomas of the extrahepatic bile ducts. Non-invasive and minimally invasive papillary carcinomas are even rarer, behave as in-situ carcinomas and are associated with excellent long-term prognosis.

De novo primary squamous cell carcinoma of the ovary: a case of a rare malignancy with an aggressive clinical course.

Ovarian squamous cell carcinoma is a rare malignancy and the occurrence is attributable to malignant transformation of an existing ovarian dermoid cyst. The de novo occurrence of squamous cell carcinoma of the ovary, in the absence of an antecedent ovarian dermoid, is extremely rare. The case of a 31 year old Asian woman, evaluated for abdominal distension and discomfort is presented.