BACKGROUNDThe fundamental in treatment of perforation peritonitis include resuscitation, treatment of septicemia, control of contaminating source and peritoneal toilet. Numerous studies have shown the role of different solutions such as normal saline, antibiotics and betadine as peritoneal lavage in reducing morbidity and mortality of perforation peritonitis. The objective of this study was to present our finding on the role of per-operative peritoneal lavage with super-oxidized solution in cases of perforation peritonitis and its effects on postoperative course and outcome compare to per operative lavage with saline. MATERIALS AND METHODSThe patients were randomized into two groups. In the control group after the definitive surgery for perforation peritonitis, the peritoneal cavity was lavaged with normal saline and closed after putting drain. In study group after definitive surgery the peritoneal cavity was lavaged with saline followed by 100ml of super-oxidized solution and drain were closed for 1h after abdominal closure. The patients were followed up for morbidity and mortality. RESULTIn present study, there was no statistically significance between super-oxidized solution and normal saline lavage group. When we compared it on the basis of postoperative wound infection, fever, burst abdomen and other complication, duration of hospital stay and morbidity and mortality. CONCLUSIONBy this study we concluded that peritoneal lavage by super-oxidized solution or normal saline alone did not make any difference on patient outcome. KEYWORDSSuper-oxidized solution 1; normal saline 2; perforation peritonitis 3. HOW TO CITE THIS ARTICLE:

Peritonitis (Peritoneal inflammation) may be primary, secondary or tertiary. Typhoid ileal perforation lead to secondary peritonitis that is a life threatening condition. Assessing the severity of peritonitis is important step in determining the proper treatment plan. AIM: This study is aimed to assess the ability of modified APACHE II (Acute Physiology and Chronic Health Evaluation II) score to correctly assess the severity of generalized peritonitis secondary to ileal perforation. MATERIALS AND METHODS: 100 patients of peritonitis secondary to ileal perforation were chosen in a one year period and were applied modified APACHE II score to assess the severity and outcome. RESULTS: Most of perforation occurred in 2nd and 3rd decade (65%). APACHE II score ranged from 1 to 21. Most of patients had < 9 score. Higher APACHE II score was associated with increased mortality. Morbidity was also accurately predicted by APACHE II score. CONCLUSION: Typhoid ileal perforation is still a common health problem causing high mortality (11%). Compared to mortality, morbidity was less accurately predicted by APACHE II score, and more number of the patients developed more complication in higher APACHE II score group. HOW TO CITE THIS ARTICLE:

Background: Appendix is a blind muscular tube derived from the midgut. During the embryogenic development, in the 6th week appendix and cecum appear as out pouching from midguts caudal limb. Acute appendicitis is one the most common diagnosis made whenever patient presents with right illac fossa pain and mostly encountered in young and middle-aged individuals. The diagnosis and management of acute appendicitis depend on clinical presentation, that is, clinical signs and symptoms. The most common presentations in these cases have abdominal pain along with fever, anorexia, nausea, and vomiting. Various Scoring systems are developed to diagnose acute appendicitis based mainly on the presenting signs and symptoms, but widely none of them are used as an uniform scoring system. Aims and Objectives: The purpose of this study was to assess effectiveness and comparison of modified Alvarado score and Tzanaki’s Score in the early diagnosis of acute appendicitis. Materials and Methods: A prospective observational study was done in department of General Surgery JLN Medical College Hospital, Ajmer which included 200 patients presenting with the signs and symptoms of acute appendicitis, clinically. During admission the patients were evaluated by Modified Alvarado score and Tzanaki’s Score and final surgical decision was taken by the treating surgeon. Finally, the scores were compared with the histopathological examination of the surgically operated specimen. Results: The sensitivity and specificity of Modified Alvarado Score was 84.26% and 72.7%, respectively, with a positive predictive value of 96.15% and negative predictive value of 36.3%. The sensitivity and specificity of Tzanaki’s score was 88.2% and 72.7%, respectively, with a positive predictive value of 96.31% and negative predictive value of 43.24%. The diagnostic accuracy of Alvarado score was 83% and that of Tzanaki’s score was 86.5%. Conclusions: Our study showed that Modified Alvarado scoring system is a simple tool with limited features for bedside diagnosis of acute appendicitis, but its effectiveness is not as good as that of Tzanaki’s scoring system.

INTRODUCTIONGall bladder cancer is 5 th most common cancer of GIT. It is associated with cholelithiasis in significant number of patients. Cholelithiasis is cause or effect of gall bladder cancer is still uncertain. There are many risk factors which are common to both gall stones and cancer. Preoperative diagnosis of gall bladder cancer is increased with better and new investigation facilities. AIMThe study was aimed to assess clinicopathological behaviour, sociodemography, diagnostic modalities and treatment of cancer gall bladder. MATERIAL AND METHODSIt was a type of prospective study which included 75 patients with clinical features suggestive of biliary disease. Various diagnostic modalities and treatment options were assessed along with sociodemography and clinical picture. RESULTCommon clinical features were pain abdomen, obstructive jaundice and lump. Nearly one third of the patients were having anaemia and abnormal liver function tests. Majority had gall bladder fossa mass with liver extension and gall stones. The most common histopathological variety of carcinoma Gallbladder was Adenocarcinoma. CONCLUSIONCarcinoma Gallbladder was found to affect predominantly the older female patients after the age of 40 years. Cholelithiasis was found in 69.3% patients of carcinoma Gallbladder. The most common clinical presentation was pain abdomen (90.7%). The most common histopathological variety of carcinoma Gallbladder was Adenocarcinoma. Majority of patients were treated with palliative measures.