Background: Self-medication in urban population seems to increase but the available information is scarce. It is essential to generate evidence regarding the burden and determinants to plan for a public health intervention to address this problem. Our study is an attempt to ascertain the research may show the prevalence and determinants of self-medication among adults population of urban Tamil Nadu. Methods: A community-based cross sectional study was conducted among 408 adults residing in a sub urban areas near Chennai, Tamil Nadu. Probability proportionate to size of sampling technique (PPS) was used to decide the number of adults to be included in the study. House to house interview was done using a predesigned, pretested questionnaire. Informed written consent was obtained from the participants. Results: Around 132 out of 406 of our study population (32.5%, 95% CI: 27.9, 37.06) reported that they are using self-medication at least once in the past 6 months. It was found that males are 1.5 times more likely to use self-medication than females (OR: 1.58, 95% CI: 1.05, 2.39, P value: 0.036) and younger adults (age <30 years) are 55% less likely to use self-medication than the adults greater than 30 years (OR: 0.45, 95% CI: 0.28, 0.72, P value: 0.001). Conclusion: Increasing prevalence of self-medication use qualifies it to be considered as the public health problem. Gender discrimination and lack of prioritizing geriatric heath care needs in a routine health system are some of the other problems identified. These problems have to be addressed by the public health planners and policy makers to provide equitable and quality health care.

Introduction: Stoma could be a surgically created opening within the abdominal wall. The main purpose of the stoma is to divert the excreta off from the distal intestinal loops to relieve an obstruction or protect anastomosis. The indications for stoma creation are intestinal obstruction due to benign or malignant tumors, perforation peritonitis, inflammatory bowel disease, colorectal malignancies, and anorectal malformations. Aim of the study: The study aimed to identify the patterns, indications, and complications that occur following the creation of enteric stomas. Materials and Methods: It is a prospective observational study conducted from May 2012 to October 2015 on a hundred patients, who were admitted in the department of general surgery, surgical gastroenterology, and pediatric surgery, Government Stanley Medical College and Hospital. The sampling method followed here is the non-probability convenience sampling technique. The data is collected from all the patients who come under the inclusion criteria. Results: Of 100 patients, the majority of the patients belonged to 26–35 years and 46–55 years ( n = 25). Based on the study, loop colostomy is more common with age less than one year and loop ileostomy is more common in 26–55 years. The foremost common indication of an enteric stoma is a gastrointestinal malignancy (25%) followed by abdominal trauma (22%). In our study, an ileostomy (80%) is the most common type of stoma created followed by colostomy. Within the ileostomy, loop ileostomy is the more common (60%) followed by end ileostomy (20%). Among the complications related to an enteric stoma, skin excoriation (54.4%) is most common followed by surgical site infections (8.5%). Conclusion: Our study shows stoma creation is higher in the adult and old age group, mostly done as an emergency procedure compared to an elective procedure. So, better preoperative planning in both emergency and elective settings can reduce the number of stoma and its related complications. The duration of hospital stay is higher in stoma patients. So, the reduction in stoma creation leads to a reduction in complication, duration of hospital stays and indirectly reduces expenditure related to it. In our study, most of the stoma is created for obstruction in malignancy and perforation in trauma patients. From our study, we can observe early diagnosis of intestinal malignancy with a well-planned elective procedure or bride procedure like colonic stenting in malignant obstruction can reduce the number of stoma creation. Skin excoriation is the most complication followed by surgical site infections. These complications can be reduced by better postoperative stoma care and early reversal of stoma.

Fat necrosis is an inflammatory process of fat folloing an insult to the adipose tissue. It is more common in the body region here there is high adipose tissue. It can present ith cellulitis, skin necrosis, discharging ounds, and mass. Carcinoma is one of the differential diagnoses of fat necrosis. Our case is presented ith a gluteal mass hich as diagnosed as a hydatid cyst, based on the imaging. Sometimes, imaging fails to identify traumatic fat necrosis, particularly if it is associated ith a capsule ith multiple fat lobules. Postoperative history confirms the encapsulated type of fat necrosis ith fat lobules. Encapsulated traumatic fat necrosis should be considered one of the differential diagnoses of hydatid cyst.

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