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The objectives of this study were to study the total cost and operative time required for suture and staple Repairs, to study the effect on wound healing and infection rate with the use of Sutures and staples, to study the cosmetic results of these two techniques and to study the degree of patient's acceptance with the two techniques. MATERIALS AND METHODS: Source of Data: The study was conducted on 100 patients who undergoing elective surgery from January 2010 to March 2014 in BLDE UNIVERSITY, Shri B M Patil medical college Bijapur. The patients were randomly selected to receive either suture or staple repair. METHOD OF COLLECTION OF DATA: DURING OPERATION-from operating surgeon. Post operatively: from patient's input. Supply of Suture and Staples: from pharmacy. FOLLOW UP OF PATIENTS: Patients came for follow up to outpatient Department After discharge. INCLUSION CRITERIA: Patients undergoing elective abdominal surgery, with clean wound. EXCLUSION CRITERIA: Patients having lacerated wounds with skin loss. RESULT: The study groups included 100 patients who underwent wound closure by staplers and 100 patients who underwent the silk suturing. The youngest patient was aged 2 year and the oldest was 75 years old. The commonest region of the surgical wounds in this study was inguinal, 20 in staplers and 20 in suture group. The time taken for wound closure using staplers showed statistically significant difference over silk suture closure. It took the stapler four times less duration to perform wound closure. The appearance of the scar among the staple groups was good in 90% of those who returned for follow up at one month, 10% had average scar. The average cost of using staple was higher than silk suture. Patient acceptance was better in the staple group with less pain during removal as compared to suture group. There were four complications in the staple group in the form of wound infection and ten cases of postoperative wound infection in the suture group. Average VAS of patients in staple group at the end of one month was 71.88 (±5.50) while the average for suture group was 64.44(±6.17). P value calculated using Student's Unpaired 'T' test. P value was <0.0001 which was highly significant.

Characteristics of high-risk population; 1 Elderly, Co morbid conditions,Needing emergency surgery (no time for optimisation). Life expectancy and the geriatric population have increased steadily in recent decades. By 2030, people more than 65 years of age will account for 20% of overall population. 2,3 Our society is continuing to age and with luck, fortunately this trend is continuing. Advances in healthcare systems have enabled people to live longer and to remain healthy for a significantly greater amount of time. Today, major surgical operations are offered to increasing numbers of geriatric patients. As in other surgical specialties, the frequency of digestive operations performed in elderly patients, and even in subgroups of older patients (i.e. ≥80 or ≥85 years) has increased. 3 Senescence or physiological ageing is decreased functional reserve of critical organ systems resulting in decreased ability in coping with operative stress. 3 Patients >65 years old account for approximately 50% of all emergent operations and 75% of operative mortality. 3 Geriatric patients are often viewed as highrisk surgical candidates. Consequently, elective surgery may not be performed, with the result that a potentially treatable disease process may develop into an acute catastrophic event. 2,3 Surgery in geriatrics poses unique ABSTRACT Background: Geriatric population is a special subgroup of population undergoing emergency abdominal surgeries. Both higher age group and emergency surgical procedure are considered as high risk factors. In this study, we study the most common cause for geriatric population to undergo an emergency abdominal surgery and the therapeutic outcomes. Methods: All the patients aged more than 60 years coming to surgical department, BLDEU's hospital with acute abdominal conditions. Study period was from Jan 2010 to Jan 2013. All patients aged more than 60 years old admitted with abdominal emergency conditions in department of surgery. Geriatric patients coming with blunt trauma of abdomen also included. Exclusion criteria were immunocompromised patients. Results: 128 patients aged 60 years or more who presented with abdominal emergency surgical conditions were studied. Most common cause for emergency abdominal surgery was perforated peptic ulcer (38%) followed by intestinal obstruction (17%). The most common post-operative complication was surgical site infection (29%). Mortality rate was 17%. Most common cause of death was septic shock with multi organ dysfunction. Conclusion: Geriatric population is an important subgroup of population undergoing emergency abdominal surgeries. Most common cause is peptic ulcer perforation followed by intestinal obstruction due to adhesions. More than the age per say, the delay in presentation may be the cause for mortality in this age group. The therapeutic outcome in patients with co morbid factors like hypertension and diabetes mellitus in control, were similar to other patients.

Actinomycosis of breast is a rare disease; only 20 cases have been reported. But majority are secondary in presentation. But this study represents the rarest report of primary actinomycosis in postmenopausal woman in India and in the world. A 55 year old presented with a lump, clinically simulating malignancy, in the right breast. Fine needle aspiration was inconclusive. Mammography showed features of malignancy. Modified radical mastectomy was done, histological diagnosis of ACTINOMYCOSIS was made, rare interesting case discussed.