Background: Hemorrhoidectomy is the treatment of choice for patients with third-degree or fourth-degree haemorrhoids. This prospective randomized clinical study compared the outcome of surgical haemorrhoidectomy by open and closed techniques in terms of postoperative pain, wound healing, and morbidity.Methods: All consecutive patients with Grade III internal haemorrhoids or Grade IV haemorrhoids were randomly allocated to one of two groups. The entire wound was left open in the open group and completely closed using 2-0 chromic sutures in the closed group. Postoperative pain was assessed by a linear analog scale. Additional consumption of analgesics on the day of surgery and at defecation during the first week was recorded. Patients were followed up 1, 2, and 3 weeks after the procedure.Results: There were 30 patients in each group. No statistically significant differences were found between the two methods regarding complications, pain, or postoperative stay. There were four reoperations for bleeding, all after Milligan-Morgan operations. At follow-up after three weeks 78 percent of the Ferguson patients had completely healed wounds, and none had signs of infection. Of the Milligan-Morgan patients, only 26 percent had completely healed wounds, and symptoms of delayed wound healing were significantly more frequent.Conclusions: Both methods are fairly efficient treatment for third and fourth degree hemorrhoids, without serious drawbacks. The closed method has no advantage in postoperative pain reduction but is more advantageous with respect to faster wound healing.

Background: Patients with surgical jaundice need quick and precise diagnosis for the presence of an obstruction in the biliary tract, to establish the level and nature of the lesion. The importance of history and clinical examination in arriving at a correct pre-operative diagnosis needs to be emphasized. Present study attempts to determine the various causes, age and sex pattern in extra hepatic obstructive jaundice.Methods: 100 patients with surgical jaundice were studied at IMS and SUM Hospital, Bhubaneswar, India during the period from September 2015 to September 2017 who were diagnosed by investigation like ultrasonography and liver function test.Results: 76% of patients were between the age group of 50-80 years, there was a slight male predominance in 53.33%, malignant cause for surgical jaundice constituted in 66.67% with carcinoma head of pancreas the commonest cause in 33.33%, benign cause for surgical jaundice constituted in 33.33%, with choledocholithiasis the commonest cause in 23.33%.Conclusions: Most common age group seen in surgical jaundice was between 50-80 years. The sex ratio is near equalizing. Most common cause of surgical jaundice was carcinoma head of pancreas and choledocholithiasis.

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