Introduction: Acute appendicitis remains the most common general surgical emergency seen in most hospitals and the most common cause of acute abdomen requiring surgical intervention. Aim: The aim was to study the intraoperative features and postoperative outcomes of appendicular perforation in adults. Objectives: First, to study the incidence, clinical presentation, and complications of perforated appendicitis in a tertiary care hospital. Second, to study morbidity and mortality in an operated case of perforated appendicitis. Materials and Methods: This prospective observational study was conducted at a tertiary care centre in a government setup from August 2017 to July 2019. Data were collected from patients ( N =126) who had an intraoperative finding of perforated appendicitis. The inclusion criteria are as follows: patients over the age of 12 with a perforated appendix, as well as any patients with intraoperative findings like perforated appendicitis, gangrenous perforated appendicitis, or a disintegrated appendix. The exclusion criteria are as follows: all patients with appendicitis below 12 years of age with perforated appendicitis; all patients with appendicitis with intraoperative findings of acute nonperforated appendicitis; and all patients with intraoperative findings of an appendicular lump or mass. Results: Perforation was found in 13.8% of the cases of acute appendicitis in this study. With a mean age of 32.5 years, the most common age of presentation in perforated appendicitis was 21–30 years. The most prevalent presenting symptom in all patients (100%) was abdominal pain, followed by vomiting (64.3%) and fever (38.9%). Patients with perforated appendicitis had a 72.2% complication rate. Peritoneal pollution of more than 150 ml was linked to a 100% increase in morbidity and mortality (54.5%). The mean duration of the hospital stay in patients with a perforated appendix was 7.28±5 days. Surgical site infection (42%) was the most common early complication, followed by wound dehiscence (16.6%), intestinal obstruction (1.6%), and faecal fistula (1.6%). The most common late complications were intestinal obstruction (2.4%), intra-abdominal abscess (1.6%), and incisional hernia (1.6%). The mortality rate in patients with perforated appendicitis was 4.8%. Conclusion: To conclude, prehospital delay was an important factor contributing to appendicular perforation and leading to adverse outcomes. A higher rate of morbidity and prolonged duration of hospital stay were seen in patients with delayed presentation, with features of generalised peritonitis and perforation of the base of the appendix. Delayed presentations in as elderly population with underlying co-morbid conditions associated with severe peritoneal contamination were associated with higher mortality (26%) in perforated appendicitis. Conventional surgery and open procedu...

Introduction: A small percentage of men are affected by breast diseases and awareness of male breast disease is less and presentation is often delayed due to embarrassment. The most common presentation is gynaecomastia, where cosmetic correction is sought. Over the last two decades the rate of male breast complaints increased from 0.8% to 2.4%, while 1% of all breast cancer occur in males. Aim: To study the pattern of various male breast diseases in a tertiary care centre of Aurangabad District in Maharashtra, India. Materials and Methods: This prospective clinical interventional study was carried out in 44 male patients above age of 12 years coming with complaints related to breast to Department of General Surgery of Government Medical College, Aurangabad from 1st August 2017 to 31st July 2019. Detailed history was taken and any underlying causative disease/risk factor or medication if any was noted. Thorough clinical examination and laboratory investigations were done. Ultra-sonography of breast was done in all patients. Mammography was done in three patients who were having clinical suspicion of malignancy. Continuous variables were presented as mean, Standard Deviation (SD) or median if the data is unevenly distributed. Categorical variables are expressed as absolute numbers and percentages. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 17.0. Results: The youngest patient was 12 years old and eldest was 85 years old. In the present study, 38 benign and 6 malignant male breast diseases were diagnosed. Out of total, 33 had gynaecomastia, 2 had breast abscess, 5 Infiltrating duct carcinoma and 1 each of mastitis, eczema of nipple, sebaceous cyst of areola and primary breast sarcoma. Out of 44 patients, 12 patients underwent surgery for benign and malignant breast diseases, 24 patients of gynaecomastia were managed by reassurance, 5 males with infiltrating ductal carcinoma were managed by modified radical mastectomy and 3 patients by medical therapy. Conclusion: It was concluded that benign male breast diseases were more common and ultrasound together with mammography should be used to differentiate characteristics of benign and malignant male breast lesions.