Background: Human rabies continues to be endemic in India and according to recent estimate 20,000 persons die of this disease every year. Hence this study was conducted to know the prevalence and pattern of animal bites during last one year and to determine the rate of admission in Department of Surgery.Methods: This study was conducted in the casualty, Department of Community Medicine, Department of Surgery at M. K. C. G. Medical College, Odisha, India between 1st April 2016 - March 31st, 2017. It was a cross sectional study, where convenient sampling method was used. The sample size was 6242 subjects, above 1year age group selected randomly within last 1 year. The socio demographic characteristics, epidemiological and rate of admission in surgery department were studied.Results: It was found that during last one year, out of 6242 animal bite cases, majority of them were bitten by dogs 4785 (76.66%). It was found that 5617 (90%) are category III bite, 548 (8.78%) are category II bites, 77 (1.23%) are category I bite. Parts of body bitten by animals were limbs 5828 (93.37%), face 312 (5%), back 52 (0.83%). Out of 6242 cases, 348 (5.5%) cases were admitted in General Surgery Department.Conclusions: The prevalence of dog bite was found to be more and was of category III in nature and part of body affected were mostly limbs. Prevalence of bite was nearly equal among male and female. Around 5% of the total animal bite cases required admission in Department of Surgery.

IntroductionAn anal fissure is defined as a longitudinal split in the distal anoderm which extends from the anal verge to the dentate line. Fissures can be of primary or secondary type. The posterior midline is the most common location for primary fissures, while, anterior primary fissures, though rare, are more common in females. The cause of primary fissure is idiopathic. But secondary fissures are associated with other systemic diseases and can occur at an abnormal position anywhere in the anoderm. A high percentage of acute fissures heal spontaneously within three weeks with conservative medical management comprising of a high fiber diet, warm sitz bath, and topical analgesic with steroids. Secondary anal fissures will not heal in any form of treatment until the primary cause is addressed. These fissures often need surgical treatment. The lateral internal sphincterotomy (LIS) is one of the most practiced treatments for chronic anal fissure. Nonetheless, anal incontinence is one of the worrisome complications of LIS. Fissurectomy is one of the options among those techniques which address the issues with LIS. Some studies showed that patients with chronic fissures who are refractory to medical treatment responded well to fissurectomy. Hence, this study was conducted to compare the outcomes of fissurectomy and lateral internal sphincterotomy in the treatment of chronic anal fissure and compare recurrence and postoperative complications among both the procedures. MethodsAll consecutive patients attending the department of surgery with chronic fissure and age above 18 years were included in the study. All the included patients were randomized into two groups (fissurectomy and LIS) using the serially numbered opaque-sealed envelope (SNOSE) technique. The patients were discharged on the third day. The first visit was scheduled after two weeks and subsequent visits on the first and second months. Then the patients were followed up by telephonic conversation for the next six months. At the end of the follow-up, post-surgical complications were enquired, recorded, and interpreted. ResultsIn the present study, out of a total of 87 patients, 80 patients were included in the study. Among all the patients, 16 patients (20%) developed retention of urine. Four patients in the LIS group showed retention of urine whereas in the fissurectomy group it was twelve. The difference was not statistically significant (pvalue: 0.025). A total of 10 patients required catheterization postoperatively. More patients in the fissurectomy group developed incontinence to flatus (p-value: 0.02). Incontinence to liquid and solid was significantly higher in the fissurectomy group (p-value: 0.03 and 0.002, respectively). ConclusionIn the present study, it was found that LIS was a better treatment option for chronic anal fissure than Fissurectomy. The postoperative complications were less in LIS than in fissurectomy. But the recurrence was higher in the LIS group while there was no recurrence in the fissurectomy group.

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Acute sigmoid volvulus is defined as torsion of sigmoid colon around its mesenteric axis, if it is untreated it will leads to complication such as gangrene and bowel perforation. 1 Sigmoid volvulus, first described by von Rokitansky. 2 It is a very important cause of closed loop colonic obstruction in the world. 2,3 In some countries like Eastern Europe, India and Africa, it is almost 50% of large bowel obstruction. 4,5 Aetiology of the disease is multifactorial, high fiber and long sigmoid loop with a narrow mesentery leading to a predisposition to torsion, chronic constipation are the some of the causes. 6,7 Acute sigmoid volvulus mainly presented with abdominal distension, pain abdomen, no bowel movement, and vomiting. 8 On X-ray of abdomen showing typical omega sign. 9 Emergency operation is the only treatment of choice in complicated volvulus. 8 Various type of operation has been described in the management of acute sigmoid volvulus, the Hartmann's procedure is the treatment of ABSTRACT Background: Sigmoid volvulus is a common surgical emergency in many regions of the world, with significant morbidity and mortality. Volvulus occurs when an air-filled segment of the colon twists about its mesentery. In developing countries it is a major cause of colonic obstruction. The sigmoid colon is involved in up to 90% of cases. It can be present as acute, sub-acute or chronic. Emergency operation is needed in acute sigmoid volvulus. Various methods are used in the management. The purpose of our study was to evaluate the comparative study of single-stage resection and anastomosis with Hartmann's procedure for management of acute left-sided colonic obstruction due to acute sigmoid volvulus. Methods: This retrospective study was conducted in a consecutive series of 122 patients, admitted to M. K. C. G. Medical College in the department of general surgery, with acute sigmoid volvulus. Then laparotomy were carried out in all 122 patients, primary resection of the affected sigmoid colon with anastomosis were done in 87 patients and the surgical resection of the recto-sigmoid colon with closure of the rectal stump and formation of an end colostomy (Hartmann's procedure) in 35 patients were done in different groups. Outcome of the two procedures analyzed in terms of mortality, post-operative complications, and hospital stay. Results: This study clearly showed that there is no such statistically significant result compared to both groups. Except little bit longer hospital stay in resection and anastomosis group than Hartmann's group. Conclusions: This study demonstrated that outcome of two procedures are same. Resection and anastomosis should be done in uncomplicated acute sigmoid volvulus safely, but in case of complicated patients Hartmann's procedure is the choice of operation.

BACKGROUNDDiabetic foot ulcer is very common now a days. It ranges from 15% to 25%. Various methods and dressing agents have been tried for dressing. In this study, silver nitrate in solution form as a dressing agent has been tried. MATERIALS AND METHODSA prospective study was conducted at MKCG Medical College, Berhampur, Odisha. Here, a total of 100 number of patients having diabetic foot ulcer were studied and consent for various procedures were obtained from them. Data regarding granulation tissue formation, pus culture and sensitivity report, skin graft acceptance and hospital stay were analysed in tabular manner. RESULTSAmong 100 study subjects, 50 were taken as control group and 50 as study group. The granulation tissue formation on 14 th day was 95% in study group and 82% in control group. Successful skin graft uptake was 94% in study group and 80% in control group. Hospital stay in study group was 25.6 ± 3.4 days and 35.3 ± 7.2 days. Pus culture sensitivity test on day 14 was positive in 6 cases in study group and 12 cases in control group. CONCLUSIONFoot ulcer is a common problem worldwide, among which diabetic foot ulcer is the commonest one. Various modalities of dressing methods and materials are available, but in my study silver nitrate in the form of solution form is a better option as compared to others. KEYWORDSDiabetic Foot Ulcer, Silver Nitrate, Granulation Tissue, Skin Graft. HOW TO CITE THIS ARTICLE: Bara BK, Pattanayak SP, Malla TK, et al. A study of silver nitrate solution in dressing of diabetic foot ulcer. J. Evid. Based Med.