Background: Fistula in ano is one of the commonest condition in coloproctological. This study is being done to Aim the incidence of fistula in ano in rural population as well as results of fistulotomy surgery. Methods: This study has been conducted in department of surgery Index Medical College Hospital and research Centre, village khudel, dist. Indore from July ' 14 to January'17. In all 92 patients were included of Low fistula in Ano during above mentioned period. All 92 patients were subjected for fistulotomy surgery. The present study has been done to see incidence of low level fistula in ano in rural population and male female ratio along with the outcome of one surgical procedure i.e. fistulotomy in terms of postoperative pain, duration of wound healing, infection, incontinence and recurrence. Results: Incidence of fistula in ano in rural area was grossaly around 8.6 per 1 lakh population and male: female ratio was 11.8:1. Patients age group belong to 22yr to 55yr, mean age was around 38yr post-operative pain remained for 2.9± 2 days, duration wounds healing 28.5 ± 7days.No patient had anal incontinence and only 3 patients out of 92 (3.2%)had Recurrence. Conclusion: Incidence of low fistula in ano in rural papulation of distt. indore is around 8.6 per 100000 and male: female ratio 11.8:1. Fistulotomy in our study is one of the ideal surgical procedure.

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Background: This study has been carried out on 60 patients of inguinal hernia (either direct or indirect) from February 2016 to August 2017 who were admitted in the surgical ward of Index Medical College Hospital & Research Centre, Indore (M.P.). All patients were admitted through outpatient department. Method: The patients were divided into two groups: Group I and Group II. Each group consisted of 30 patients. Only male patients were included in the study. Surgery was organized within the hospital structure in the same way as other elective patients admitted in general surgical ward. Patient was fully explained about the procedure and its complications and was included in the study only after his written consent. Written explicit consent was taken in patients own language for group I patients. Result: The mean age of patients in nerve excision group (I) was 51.6 ± 18.1 years whereas in nerve preservation group (II) it was 50.3 ± 11.6 years. All the patients in both the groups were male. Patients suffering from pain were relatively much higher at 1 month irrespective of preservation or division of nerve. At 3 months after surgery both the groups had equal number of patients (2) with pain and continued resolution of pain symptom was thus noted. Conclusion:There is considerable evidence in world literature that supports the contention that in inguinal Hernia Meshplasty Neurectomy is associated with decreased incidence of pain after open hernia surgery. Keeping in mind the results emerging from the present study it may be suggested that routine identification and elective excision of the ilioinguinal nerve may be reasonable option without any significant added morbidity to prevent the chronic; pain in inguinal hernia repair with mesh. But a larger prospective randomized study is still required to confirm the benefit benefits of routine ilioinguinal neurectomy while doing open inguinal hernia repair with mesh.

Background: Wounds expose a patient to serious hazards like wound infection, tissue destruction, disfiguring and disabling scars. Use of nanosilver with collagen matrix in infected wounds, ulcers, diabetic wounds, burns reduced morbidity and hospital stay with its early wound healing effect. To evaluate the effect of nanosilver with collagen matrix V/s povidone iodine on similar types of wounds. Methods: This prospective study included one hundred patients with different types of wounds who attended Department of Surgery, index medical college & hospital, indore from January 2015 to January 2017. The patients were divided into two groups. Group A where topical management and dressing was done using nanotrix and group B where topical management and dressing was done using povidone iodine. Results: A standard grading in terms of percentage decrease in wound size, peri wound oedema/ erythema, pus discharge and percentage increase in granulation, fibrin and epithelisation was noted in various types of wounds in both groups. Nanotrix treated wounds showed significant reduction in inflammation and earlier healing than those treated with povidon iodine. Conclusion: Nanotrix application was found to be safe having no pain and allergic manifestation.

Background: Old age patients are at a increased risk for post-operative complications and disability. Older adults express that the maintenance of functional independence is the most important health outcome when they prioritize their health decisions, in deciding whether to go through with a major elective operation. Frailty has been promoted as a simple, brief assessment tool that can be completed before surgery with the goal of improving the surgeon's ability to accurately counsel geriatric patients and their families about anticipated post-operative outcomes. Methods: This was a prospective study from June 2014 to June 2016at our institutes. A total of 200 patients undergoing elective major surgical procedures (160 general surgery and 40 orthopedics), were enrolled in the study. Informed consent was taken and ethical clearance from ethical committee of the institutes was obtained. Patients were evaluated pre operatively and at the end of 1,3and 6 months post operatively for complications and mortality. Results: In this study 200 patients were taken into observation and they were divided into three groups Group 1-fast group (<10 seconds), Group 2-intermediate group (11-14 seconds), and Group 3-slow group (15 seconds or more).Age distribution was divided into 61-70, 71-80 and >80 years. Mean age of our study group was 69.51 years. Majority of our patients underwent colorectal surgery (n=77, 38.5%) followed by head and neck malignancy surgery (n=52, 26%).There was a male preponderance in our study group (m:f=1.89:1).Complications were mostly seen in Group 3 patients (23/52) as compared to Group 1 patients (9/84,p<0.05) which was statistically significant. Post-operative mortality was also significantly higher in Group 3 (14/52) as compared to Group 1 (1/84).This difference was also statistically significant (p <0.05). Conclusion: frail older adult. The benefit of using walking speed as a single measure to define the frail patient is that full measurement of phenotypic frailty is time consuming and often impractical. Limiting the evaluation of frailty to measuring walking speed would likely gain wider acceptance for implementation because of its simplicity and brevity.Our study proves that it is a practical tool for assessing the health outcome of patients. Even post-operative mortality can be predicted using this tool and can be effective tool in minimizing the mortality of such high risk patients by keeping them under extended surveillance.