Background The year 2019 marked the 50th anniversary of plastic surgery department of our institution. We present an audit to plot the changing clinical trends in our work in the past five decades. Methods A single-center retrospective cohort study based on the department demographics was performed and compared across the decades from 1969 to 2019. Results In 1969, the relative proportion of reconstructive versus cosmetic surgery procedures was 94.32% versus 5.68%; in 2019 this was 76.25% and 23.75%, respectively. An increase of 22 times increase in outpatient registrations, 13.1 times in total surgeries, 642 times in trauma reconstruction, 290 times for hand surgeries, and 323 times for skin tumor surgeries was noted. Male patients (64.9%) increased every decade more than females (35.1%), mostly for trauma surgery and gynecomastia correction. Proportion of pediatric cleft patients have markedly decreased. Spectrum of surgical procedures have widened. Top five reconstructive surgeries in 2019 were limb trauma reconstruction, skin tumor surgeries, hand surgeries, arterio-venous fistula (AV) creation, and oculoplasty. The most common surgery performed was cleft lip surgery in 1969 and hand surgery in 2019. The top five cosmetic surgeries performed in 2019 were scar revisions, nevus excision, liposuction and gynecomastia correction, rhinoplasty, and otoplasty. Conclusions Data collection and archiving and periodic audits help us study changing trends in our field compared with the global trends. Knowing societal demands will help to improve the resident training in teaching hospitals.

BACKGROUNDAcute Gastrointestinal (GI) haemorrhage is a common clinical problem with diverse manifestations. Patients may present with both haematemesis and melaena, an ageing patient population with an increased prevalence of associated medical comorbidities has kept the mortality figures largely unchanged for the past thirty years, despite technological advances in endoscopy and other minimally-invasive procedures, the hospital mortality rate has remained at about 10% in the past 30 years. MATERIALS AND METHODSProposed to study the clinical characters, accuracy of endoscopy in diagnosis and efficacy of endoscopic treatment in patients presenting with upper GI bleeding to Surgery Department in KIMS, Hubli, during the period of 2014-2016. The study was a prospective descriptive study among patients who presented with acute upper gastrointestinal bleeding. RESULTSThe male-to-female ratio was 3.9:1. Oesophageal varices were the leading cause of upper GI bleeding in both sexes. Other causes, duodenal ulcers, gastric ulcers and gastric cancer were commonly seen in males, whereas gastric erosions were seen equally in both sexes. Alcoholic liver disease is commonest cause of portal hypertension in upper GI bleeding followed by extrahepatic portal hypertension and noncirrhotic portal hypertension. CONCLUSIONUpper GI endoscopy serves as the mainstay in the diagnosis of upper gastrointestinal bleeding and its therapeutic applications are effective in all cases. It is therefore recommended that early endoscopy should be performed preferably within 24 hours of the onset of bleeding.

BACKGROUND Hernias are among the oldest known afflictions known to mankind and elective inguinal hernia repair is one of the most common operations performed by general surgeons. 1 Two thirds of these are indirect and the remainder are direct inguinal hernias. Femoral hernias comprise only 3% of all groin hernias. Men are 25 times more likely to have a groin hernia than women. An indirect inguinal hernia is the most common hernia, regardless of gender. 1,2 MATERIALS AND METHODS The study was a non-randomized controlled trial study conducted between October 2015 and November 2017 at a medical college hospital. Sample size was taken for convenience. RESULTS Both local & spinal anaesthesia can be used for hernia repair on short stay bases, but spinal anaesthesia has higher complication rates compared to local anaesthesia. There is significant increase in general complications like hypotension, urinary retention, & headache in spinal anaesthesia & local complications like seroma, hematoma, scrotal oedema & recurrence were similar in both groups. CONCLUSION Both local & spinal anaesthesia can be used for hernia repair on short stay bases, but spinal anaesthesia has higher complication rates compared to local anaesthesia. Local anaesthesia is with less immediate post-operative complication, best suitable for short stay surgery when compared to spinal anaesthesia.

Introduction COVID-19 has affected plastic surgeons like never before. We conducted an all-India survey to find how the practice was affected among public/private sector, reconstructive/aesthetic practice, and consultants/residents. We have proposed some solutions to the identified problems, which are supported by previous literature. Methods A survey framed in Google forms was circulated through WhatsApp and emails in August 2020. Closed and semiopen questions regarding changes in personal and professional lives, coping strategies adopted, and open questions for suggestions in improving practice, academics and measures to tackle the pandemic were included. Responses were collected in an Excel sheet and analysis done using SPSS software. Results A total of 220 consented responses were obtained. Public hospital practitioners had to bear the COVID-related administrative as well as executive works, especially residents, which led to anxiety, family concern, burnout, and concern about the loss of skills and academics. Patient interaction was also reduced. Aesthetic surgeons bore more financial loss. Conclusions Plastic surgeons in India faced decrease in caseload, financial loss, COVID-related duties, workload for residents, reduced academics, family and mental health problems, difficulty with personal protection equipment (PPE) during surgeries, and queries from patients. These can be solved by doing cases within the limits of protocols and safety, pooling public and private sector for COVID duties, rotating residents' groups to reduce workload, using telemedicine for academics and patient consultations, and providing social support groups to surgeons.