Background: Peritonitis is defined as inflammation of the serosal membrane that lines the abdominal cavity and the organs contained therein. Peritonitis is often caused by the introduction of infection into the otherwise sterile peritoneal environment through the perforation of the bowel, such as the ruptured appendix or colonic diverticulum. The disease may also be caused by the introduction of a chemically irritating material, such as gastric acid from a perforated ulcer. Peritonitis secondary to perforation of the gastrointestinal tract, a common occurrence in this country, requires emergency surgical intervention and is associated with significant morbidity and mortality rates.Methods: This was a comparative prospective cohort study in which 150 patients presenting with symptoms peritonitis secondary to hollow viscus perforation in general surgery department, Sri Venktaeshwara Medical College, Tiruapti from March 2017 to November 2018 were taken for the study.Results: Jabalpur prognostic scoring system has a slightly higher area under the curve of 96% when compared with the Mannheims peritonitis index score with 95%. So this shows that the Jabalpur prognostic scoring system has slightly greater indices than, that of Mannheims peritonitis index scoring system in predicting the prognosis of perforative peritonitis.Conclusions: In patients with perforation peritonitis, Jabalpur prognostic scoring system is an easy and reliable predictor in evaluating prognosis. In developing countries like India, where in resources are limited, Jabalpur prognostic scoring system will greatly help in predicting prognosis in patients with perforarion peritonitis. Because of its cost effectiveness, availability and ease of use, it is recommended as a part in the holistic approach of treatment of perforation peritonitis.

Background: Acute pancreatitis is a common condition associated with morbidity and mortality. The incidence of acute pancreatitis (AP) has been increasing worldwide. Recent advances in diagnostic and therapeutic management in acute pancreatitis (AP) remarkably decreased the mortality rate. Assessing severity of acute pancreatitis at an early stage will further decrease the mortality rate and will help to initiate appropriate treatment as early as possible to prevent mortality. Many clinical, laboratory, and radiological factors and scoring systems are used to predict severity and prognosis of AP, but none is ideal. In low resource setting, costly laboratory tests are not readily available.  Platelet to lymphocyte ratio (PLR) is an easily derivable, cost effective and applicable blood test. Platelet to lymphocyte ratio (PLR) is a relatively novel inflammatory marker and can predict severity in various diseases. In this study, we evaluated the value of PLR as prognostic factor in acute pancreatitis (AP).Methods: This prospective study was conducted on 256 patients admitted to S.V.R.R.G.G. Hospital, with the diagnosis of acute pancreatitis, from April 2017 to September 2018. Patients with Acute Pancreatitis were divided into tertiles based on the values of PLR at admission, a PLR of less than 150 as 1st tertile, a PLR of 150-300 as 2nd tertile and a PLR of more than 300 as 3rd tertile. The outcomes assessed were intensive care unit (ICU) admission, length of stay (LOS) in the hospital and death.Results: According to PLR tertiles, patients in the 3rd tertile (PLR>300) had significantly more ICU admissions, 59 (71%) and longer average Length of Hospital Stay (LOS) of survivors,18+/-5 days and higher mortality, 24 (28.9%), compared with those in the 1st tertile (PLR<150).Conclusions: PLR is an easily derivable, cost effective prognostic factor which can predict the outcome of acute pancreatitis. In this study, we established that high PLR value is associated with very bad prognosis and poor outcome or death in Acute pancreatitis.

Breast carcinoma is the most common malignant tumor and the leading cause of death, in women, worldwide. It accounts for 15 % of all cancer deaths. Various protocols are in use for the assessment of prognosis, and also to assist in planningfurther management of these cases. Of various parameters, expression of Estrogen receptors (ER) is significant. The literature includes several studies showing association between the presence of estrogen receptors apart from other indicators of good prognosis like small tumor size, low histological grade, low nuclear grade and low mitotic activity. It is also a powerful predictive factor for the likelihood of benefit from adjuvant hormonal therapy including aromatase inhibitors (Anastrozole, letrozole) and Tamoxifen, an oral selective estrogen receptor modulator. All cases of Carcinoma breast presenting to S.V.R.R.G.G. Hospital, are evaluated for Estrogen Receptor status using immunochemistry, indirectly assessing the prognosis of individuals presenting to the Hospital and in turn the prognosis of the disease in the region.

Diverticulosis of small intestine is an uncommon disease, with variable clinical presentation. Among the small bowel diverticulae, distal jejunal diverticulae form the most common subset. Diverticulosis of proximal jejunum represents an uncommon pathology of the small bowel. The condition is usually asymptomatic and should be taken into consideration in cases of unexplained malabsorption, anemia, chronic abdominal pain or discomfort. Complications such as diverticulitis, perforation, bleeding or intestinal obstruction appear in 10-30% of the patients increasing morbidity and mortality rates. We herein report a case of a 45 year-old man, who presented at the emergency department with acute abdominal pain, vomiting and abdominal distension. Preoperative radiological examination followed by laparotomy revealed multiple proximal jejunal diverticulae, filled with food, adherent to and compressing upon the terminal ileum, causing intestinal obstruction.