Jinnah medical college Peshawar, Peshawar, Pakistan
Professor Dr. Muhammad Ishaq is the fellow of College of physicians and surgeons of Pakistan, Royal College of Surgeons of Ireland, Royal College of Physicians & surgeons of Glasgow and Royal college of Surgeons of England. He is the examiner to the Royal College of Surgeons in UK. Moreover, He is the founder chairman of Jinnah Medical College Peshawar Pakistan. A well reputed Medical Institute of undergraduate medical education in the Province of Khyberpakhtunkhwa Pakistan. He is a general Surgeon and Head of the Department of surgery of DHQ Hospital and Naseerullah Khan Baber Memorial Hospital. He is also the founder Chairman of Ghulam Yousaf Education System (Pvt Ltd) which promotes medical education and allied education in the province in collaboration with the Khyber Medical University and University of Peshawar, Government of Khyberpukhtunkhwa Pakistan. He is also the chairman of Jinnah institute of paramedical sciences and Fatimah Jinnah institute of public health under the auspices of Pakistan nursing council. He is a busy surgeon and has more than 20 publications to his credit in the reputed Journals of the country.
Objective: This study was planned to find out the clinical presentation and postoperative outcome of different surgical procedure in low type in low fistula in ano. Design: Prospective observational study. Place and duration of the study: Study was conducted in teaching hospital setting at LUMHS Jamshoro, Zia ud Din Teaching Hospital Karachi and DHQ JMC Teaching Hospital Charsadda. Liaquat University in Surgical Unit-I Jamshoro from May 2010 to June 2012. Patients and methods: One seventy cases of low type fistula in ano with single external opening, irrespective of age and sex admitted in surgical unit-I, were examined. Mean age was 37 years, patient’s rages from (15-60 years). Patients having high type fistula in ano identified pre and per operatively excluded from the study. A detailed history physical examination including local examination of anorectum focusing on the level of internal opening was done. Investigation like fistulogram was done in selected case. Fistulectomy and fistulotomy performed in all these cases and patient followed up minimum upto the 6 months’ time. Results: Maximum number of cases were seen in 3rd, 4th, decade of life 50 (29.6%) and 64 (37%) respectively. Mean age was 37 ranges from 15 to 60 years. Out of 172 patients, 142 (85.7%) were males and 24 (14.3%) females. Male to female ratio was 6.1:1. Majority of patient’s one forty two (82%) presented with discharge. Discharge along with swelling was noted in 132 (76.7%). Hundred twelve (65%) underwent fistulectomy, 38 (22%) of the patients got fistulotomy and (12%) of patients underwent fistulectomy along with haemorrhoidectomy and fissurectomy. A total of 72 (41.4%) patients experience different post-operative, surgical and anesthetic complications. Conclusions: Incidence of low type fistula in ano is higher in 3rd and 4th decade of life. The disease was found more common in male, discharge, pain, itching are common symptoms of low type fistula in ano. Anofistulotomy in low type fistula is safe procedure. Post-operative complications can be prevented by careful treatment efforts.
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