Benazir Bhutto Hospital, also known as the Rawalpindi General Hospital, is a hospital located on the Murree Road, Rawalpindi, Pakistan. It is a major teaching hospital offering basic specialties as well as psychiatry, orthopaedics, urology and cardiology. It is associated with Rawalpindi Medical College.It is the place where Benazir Bhutto died on 27 December 2007..
BACKGROUND:Laparoscopic transabdominal preperitoneal and open Lichtenstein repairs are established techniques for primary unilateral inguinal hernia, yet prior studies have reported differing conclusions regarding several key outcomes. OBJECTIVE:To compare perioperative and long-term outcomes between laparoscopic transabdominal preperitoneal and open Lichtenstein repair for primary unilateral inguinal hernias using data from randomized controlled trials. METHODS:A systematic review and meta-analysis was conducted, comparing primary unilateral inguinal hernia repair using either laparoscopic transabdominal preperitoneal or Lichtenstein repair in adults. Random-effects models were used to estimate pooled mean differences and risk ratios with 95% confidence intervals. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. RESULTS:Seventeen studies were included. Transabdominal preperitoneal repair resulted in significantly lower postoperative pain on day 0 (mean difference = -1.75, 95% CI -2.48 to -1.01), day 1 (mean difference = -0.72, 95% CI -1.37 to -0.07), and week 1 (mean difference = -1.14, 95% CI -1.76 to -0.52). Compared with Lichtenstein repair, TAPP was associated with reduced risks of surgical site infection (risk ratio = 0.36, 95% CI 0.17-0.76), hematoma (risk ratio = 0.27, 95% CI 0.14-0.52), chronic pain (risk ratio = 0.42, 95% CI 0.20-0.88), and short-term recurrence (risk ratio = 0.26, 95% CI 0.08-0.90). No significant differences were observed in return to normal activity, hospital stay, or long-term recurrence. CONCLUSION:Among adults undergoing primary unilateral inguinal hernia repair, transabdominal preperitoneal repair provides superior early outcomes and reduced chronic pain without increasing long-term recurrence, reinforcing its role as an effective minimally invasive option.
Background:Clavipectoral fascial plane block (CPB) is a novel regional anesthesia technique for clavicle fracture operation that provides effective analgesia while minimizing phrenic nerve involvement. Traditional approaches, including interscalene brachial plexus block (ISBPB) and superficial cervical plexus block (SCPB), are effective but may cause diaphragmatic paralysis and hemodynamic instability. Objectives:To evaluate the analgesic efficacy and safety of CPB compared with ISBPB, SCPB, or placebo in patients undergoing clavicle fracture operation. Data Sources:Electronic databases (PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials) were systematically searched from inception to June 2025. Study Eligibility Criteria:Randomized controlled trials comparing CPB with ISBPB, SCPB, or placebo in adults undergoing clavicle fracture operation. Participants and Interventions:Adult patients undergoing clavicle fracture operation who received CPB compared with ISBPB, SCPB, or placebo. Study Appraisal and Synthesis Methods:Meta-analyses were performed using random-effects models (RevMan v5.4.1). Results were expressed as mean differences (MDs) or risk ratios (RRs) with 95% confidence intervals (CIs). Evidence certainty was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results:Six randomized controlled trials including 320 patients were included. CPB significantly reduced postoperative pain at 2 and 6 hours compared with no block and SCPB, with efficacy comparable to ISBPB; no significant differences were observed at 12 or 24 hours. Pooled analysis demonstrated reduced opioid consumption (MD: -2.41; 95% CI: -2.84 to -1.98; p < 0.00001) and prolonged time to first rescue analgesia (MD: 11.06 h vs no block; 9.70 h vs SCPB; 4.19 h vs ISBPB). CPB preserved diaphragmatic excursion (MD: 1.28; 95% CI: 1.05-1.52; p < 0.00001) with stable hemodynamics. The overall certainty of evidence was moderate to low. Limitations:The limited number of trials, small sample sizes, and variability in comparator blocks and outcome reporting may affect the generalizability of the findings. Conclusions:CPB provides effective postoperative analgesia for clavicle fracture operation, reducing pain and opioid consumption while minimizing respiratory complications compared with conventional regional techniques. Larger, high-quality trials are needed to confirm these findings and define its role in multimodal analgesia protocols. Systematic Review Registration Number:PROSPERO registration number: CRD420251068022.
BACKGROUND:Intraoperative bleeding during endoscopic sinus surgery (ESS) impairs visualization and increases operative risks. Hot saline irrigation (HSI) has been proposed as a simple, safe hemostatic adjunct compared with room temperature saline. OBJECTIVE:To evaluate the effects of HSI versus room temperature saline on surgical field visibility, blood loss, operative duration, and hemodynamic stability in ESS. METHODS:Systematic review and meta-analysis of randomized and nonrandomized controlled trials identified through PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov up to 30 October 2025. Outcomes were pooled using random-effects inverse-variance models in RevMan 5.4.1 by Cochrane. RESULTS:Seven studies (n = 453 patients) were included. HSI significantly improved Boezaart bleeding scores (mean difference [MD] -0.68, 95% confidence interval [CI] -1.01 to -0.34; P = .0002; I2 = 79.7%), reduced intraoperative blood loss (MD -56.33 mL, 95% CI -57.22 to -55.44; I2 = 37.1%), and shortened operative time (MD -9.78 minutes, 95% CI -14.62 to -4.94; P < .0001; I2 = 85.0%). No significant difference was observed in mean arterial pressure (MD -0.68 mmHg, 95% CI -2.22 to 0.86; P = .39). CONCLUSION:HSI significantly enhances surgical field visibility, reduces blood loss, and shortens operative duration during ESS without affecting hemodynamic stability. It represents a safe, low-cost alternative or complement to pharmacological hemostatic agents.
Objective: To compare the effectiveness and safety of preoperative intracameral dexamethasone versus postoperative topical dexamethasone in controlling immediate intraocular inflammation following phacoemulsification. Study Design: Quasi-experimental comparative study. Place and Duration of Study: This study was conducted at the Outpatient Department, Ophthalmology Department, Benazir Bhutto Hospital, Rawalpindi, Pakistan, from August 2024 to November 2024. Methods: Following Institutional Research Forum approval and written informed consent, eligible patients undergoing uncomplicated phacoemulsification were enrolled. Patients were non-randomly allocated into two intervention groups: the intracameral dexamethasone group (0.1 mL of 0.4 mg/mL administered at the end of surgery) and the topical dexamethasone group (0.1% eye drops administered postoperatively). The primary outcome was effectiveness, defined as the absence of, or minimal, anterior chamber inflammation (SUN grade 0 or trace) on postoperative Day 3, assessed by slit-lamp bio microscopy. Safety outcomes included measuring intraocular pressure, assessing anterior chamber flare as a postoperative inflammatory finding, and evaluating for toxic anterior segment syndrome. Results: The mean age of participants was 57.01 ± 5.41 years, with 76.7% aged 50-60 years. Effectiveness was significantly higher in the intracameral dexamethasone group (73.3%) compared to the topical dexamethasone group (23.3%) (P<0.001). Postoperative inflammatory findings and safety outcomes, including raised intraocular pressure and toxic anterior segment syndrome, were infrequent and did not differ significantly between groups. Conclusion: Intracameral dexamethasone is more effective than topical dexamethasone for controlling immediate postoperative intraocular inflammation following phacoemulsification, without an increased risk of adverse outcomes. Its targeted delivery provides reliable early control of inflammation while reducing dependence on postoperative topical therapy. How to cite this: Khanam H, Kamran K MB, Akhter S, Hareem Z, Niazi FAK. A Comparison of Intracameral with Topical Dexamethasone to Control Immediate Post-Surgical Intraocular Inflammation Following Phacoemulsification: A Quasi-Experimental Study. Life and Science. 2026; 7(1): 73-79.doi: http://doi.org/10.37185/LnS.1.1.1096
Remote postoperative wound assessment may help improve follow-up after laparoscopic surgery in resource-limited settings. This study evaluated the feasibility and patient satisfaction of smartphone-based postoperative wound assessment following general and bariatric laparoscopic surgery. We conducted a prospective cohort study from June 2022 to June 2023 at a public sector teaching hospital. Consecutive adult patients undergoing elective laparoscopic general or bariatric procedures were invited to participate. Consenting patients submitted wound photographs and clinical queries to their surgeon within 14 days of discharge using an encrypted messaging platform. The primary outcome was patient satisfaction measured using the Patient Satisfaction Questionnaire Short Form (PSQ-18). Secondary outcomes included the proportion of patients requiring escalation to in-person review and the type of remote intervention provided. A total of 113 patients were enrolled. Of these, 21 (18.6%) required escalation to in-person review. Among the 92 patients managed remotely, 52 (46.0%) received reassurance only and 40 (35.4%) required medication prescription or adjustment. The mean PSQ-18 score for the cohort was 79.66 ± 11.24 (range 18-90). Satisfaction was comparable across procedure types. Smartphone-based postoperative wound assessment appears feasible and acceptable in this setting, with most postoperative concerns managed remotely and favourable patient satisfaction. Further controlled studies are needed to assess safety, diagnostic accuracy, and cost-effectiveness.
