Background: Peptic ulcer disease is very common disease in developing countries and so are its complications. With the introduction of H2 receptor antagonists and proton pump inhibitors, the incidence of elective surgery for peptic ulcer (PU) disease has decreased dramatically, although complications of peptic ulcer disease such as perforation and bleeding have remained fairly constant.Methods: A prospective study was conducted on43 patients presenting to KIMS Hospital, Hubli with features suggestive of hollow viscus perforation and intraoperative findings suggestive of peptic ulcer perforation from January 2015 to June 2016.Results: In this study, there were 43 cases of peptic ulcer perforation. Peptic ulcer perforation was common in third decade of life(n=12) with the mean age(SD) 39.88 years. Perforation is more common in males as compared to the female population 7.6:1. Post-operative morbidity is seen in 31 (72.1%) of patients and mortality in 4 (9.3%). Smoking, Alcohol beverage consumption, regular ingestion of NSAIDs were commonly seen in patients with peptic ulcer perforation but these factors were not significant risk factors for postoperative mortality and morbidity. Age ≥60 years (p-value 0.051), Female gender (p-value 0.012), Presence of co-morbid conditions (p-value 0.055), Shock on admission (p-value 0.029, perforation-surgery interval >24 hours (p-value 0.001), preoperative higher-grade ASA, purulent intraperitoneal collection (p-value 0.002) were statistically significant predictors of mortality.Conclusions: Perforated peptic ulcer (PPU) is a life-threatening disease with historically reported high morbidity and mortality rates. Age ≥60 years, female gender, presence of co-morbidities, preoperative shock, higher ASA grade, perforation-surgery interval >24 hours, Purulent intraperitoneal collection are inter-related statistically significant predictors of mortality. Therefore, proper resuscitation from shock, improving ASA grade and decreasing delay in surgery is needed to improve overall results.

A 40-year-old male who was diagnosed to be having ileocaecal tuberculosis by colonoscopy elsewhere was put on antitubercular treatment. Despite therapy over three months patient had recurrent bouts of lower abdominal pain and was admitted repeatedly with features of subacute intestinal obstruction. CT- abdomen revealed concentric large bowel thickening at multiple sites with features of stenosing lesions. Patient underwent an exploratory laparotomy and subtotal colectomy was done for the diseased large bowel. Post operative histopathological examination revealed it to be Behcet's disease. We report a rare case of intestinal Behcet's disease requiring subtotal colectomy.

Background: Skin grafting offers a method of regaining skin continuity. The common causes of skin graft failure are hematoma, seroma, infection. These affect the graft uptake maximally in the initial postoperative period by impairing graft adherence and subsequent revascularization. Aim of study was to compare graft uptake, rejection, seroma and infection among first postoperative dressing on day 3 versus day 5.Methods: A comparative, prospective study conducted at our institute from November 2015 to April 2021, with 100 patients who underwent SSG (split skin grafting) who were distributed into two groups. Group A underwent the first postoperative dressing on day 3 and group B on day 5. The second postoperative dressing was done 2 days following the first. The grafted site was then assessed on for the percentage of graft uptake, rejection, seroma, infection clinically and through culture and sensitivity.Results: The mean graft uptake in group A was 88.48% whereas in group B was 82.62% in the first dressing and in the second dressing, group A was 88.14% whereas group B was 78.02%, with statistically significant data and thus showing less rejection and infection rate in group A. Seroma was present in 82% of cases in group A and 74% in group B on 1st postoperative dressing which reduced to 6% and 12% respectively with the 2nd dressing.Conclusions: Thus, the first postoperative dressing done on Day 3 following skin grafting, significantly increased the final uptake of the graft, reduced seroma, infection and rejection rate.

BACKGROUND Gallstone disease is one of the most common problems affecting the digestive tract. The clinical spectrum of cholelithiasis ranges from an asymptomatic state to fatal complications. The prevalence of gallstones appears to be rising and each year approximately one million new cases are discovered. In India it is estimated to be around 4%, whereas in the western world it is about 10%. It is possibly due to change in dietary habits and lifestyle modifications. Studies on gallstone composition carried out in different parts of the world indicate a close link with dietary habits and ethnicity. MATERIALS AND METHODS This is a descriptive study conducted in Department of Surgery, KIMS, Hubli from April 2014 to Nov 2015. Totally 56 patients diagnosed to have symptomatic cholelithiasis with or without choledocholithiasis on Ultrasonography, who underwent surgery were studied. Initially all cases were examined, investigated, detailed history was taken and operated during the period. All patients have undergone detailed investigations; relevant investigations like Bile Culture and Cytology and Biochemical Analysis of Gallstones. RESULTS The highest incidence of cholelithiasis was in the 5th and 6th decade with maximum incidence in the 6th decade. There was an increased incidence in females, i.e. M: F= 1: 27. Pain was the most common symptom present in 94.64% of the patients, nausea and vomiting were the second most common symptoms presenting in 26.78% of patients and jaundice in 7.14% of the patients. Tenderness in the right hypochondrium was the most common sign present in 66.07% and guarding in 5.35% of the patients. 75% patients had mixed diet and 25% patients were vegetarian. Ultrasonography was the investigation of choice in our hospital. 78.57% patients had gallstones, 7.14% of patients had CBD stone, 17.85% of patients had single stone, 60.71% of patients had multiple stones, 19.64% of patients had thickening of gallbladder, 14.28% had dilated CBD, 21.42% had contracted GB and 25.00% patients had associated findings. 53.58% of patients underwent laparoscopic cholecystectomy, 14.28% of patients underwent open cholecystectomy and associated procedure with cholecystectomy done in 17.86% of patients. Wound infection was the most common post-operative complication occurring in 12.50% patients and 5.35% patients had post-operative bile leak. Histopathology revealed 69.63% patients had chronic cholecystitis, 10.70% patients had calculous cholecystitis and 3.57% had acute cholecystitis with cholelithiasis. Bile culture revealed no growth in 39.28% patients. Gallstones analysis showed pigmented stone in 47.36% of the cases as the most common variety, mixed stones in 42.10% of cases followed by cholesterol stones in 10.52% of the cases. There was no mortality in the present study. CONCLUSION Gallstones disease is more common in female sex. The incidence of gallstones was higher in the 5th and 6th decades of life. Gall stones incidence is more in non-vegetarians than vegetarians. Upper abdominal ultrasonography was t...