Gastrojejuno appendicular fistula is a rare condition. To our knowledge it has not been reported previously in the literature. We report the first case of a gastrojejuno appendicular fistula occurring in a patient who had previous gastroenterostomy for ulcer disease. He presented to us with recurrent episodes of abdominal pain and bilious vomiting. An endoscopy revealed intense gastritis with bile reflux. He was diagnosed as alkaline gastritis and put on medication. As there was no relief of his symptoms; it was decided to do a biliary diversion. At laparotomy there were extensive adhesions which was gently separated. Patient had an anticolic anastomosis and a long tubular structure was seen fistulating to the stoma site. It was traced and found to be the appendix. The gastrojejunal stoma was opened and the fistulous mouth was identified and cannulated following, which a retrograde appendicectomy was performed and a cuff of intestine around the fistula was excised. The Stoma was closed in a single layer. A Braun's enteroenterostomy was done to correct the alkaline reflux. The patient is symptomatically better and is gaining weight. The pathogenesis of alkaline gastritis. appendicular fistula and gastrojejunocolic fistula is discussed.

Background: Hypocalcemia is a common post-operative complication of Thyroidectomy. This study is aimed to evaluate and treat hypocalcemia after total thyroidectomy procedure with routine administration of oral calcium and vitamin D supplements. The aim of this study was to evaluate the clinical effectiveness of oral calcium and vitamin D administration in preventing hypocalcemia post-thyroidectomy. Subjects and Methods: This was a prospective randomized controlled study conducted on 50 patients undergoing total or near total thyroidectomy for benign or malignant disease over the period of one year from February 2017 to January 2018 at Department of General Surgery, Bhaskar Medical College, Yenkapally, Moinabad, Ranga Reddy District, Telangana, India. All the participants were randomly assigned to routinely receive or not receive oral calcium (3 g/d) and vitamin D (1 µg/d) for 2 weeks. Hypocalcemia symptoms and signs and total serum calcium levels were monitored and compared between the 2 groups. Data were presented in the form of statistical tables and charts. SPSS software version 20 was used for statistical analysis. Results: The hypocalcemic symptoms were minimal in the supplement group but more severe in the group not receiving the supplement. Serum calcium levels decreased in both groups after surgery but recovered earlier in the supplement group. Conclusion: In reducing the incidence and severity of hypocalcemia after total thyroidectomy, routine administration of supplements containing oral calcium and vitamin D has been effective.

Background: Single or multiple-dose regimens of antibiotics may rely on the patient’s medical situation and the patient’s susceptibility to infection. The present study was therefore planned to evaluate the effectiveness and outcomes of the single dose of antibiotics in patients undergoing laparoscopic appendicectomy. A simple, safe, and non-toxic drug is used for avoiding or eradicating contamination with a certain microorganism. Materials and Methods: The retrospective case study was conducted in Department of General Surgery, Bhaskar Medical College, Yenkapally, Moinabad, Ranga Reddy Dist., Telangana, India from March 2017 -February 2018 among 50 patients scheduled for laparoscopic appendicectomy. Laparoscopic appendicectomy patients were divided into two groups, one group of 30 patients received single dose pre-operative antibiotics and the other group of 20 patients received multiple doses of antibiotics. Results: Out of 50 patients, majority 84% were males and 16% were females. Out of 50 patients, 8 patients had SSI. Out of 50 patients, the majority 76% of the patients reported on day 2 and only 24% reported on day 1 of appendicectomy. 29 patients were discharged after a day stay in the hospital, 93% belonged to the single-dose group and 5% belonged to the multiple-dose group. The remaining 21 patients were discharged on day 2. The majority 95% belonging to the multiple-dose group were discharged on day 2 and 7% belonging to the single-dose group were discharged on day 2 as they have been kept under observation for infection. Conclusion: For basic, uncomplicated acute appendicitis, single dose of prophylactic antibiotics will help in cases of laparoscopic appendicectomy. There is no necessity for the post-operative administration of antibiotics.