Background: Dengue is found in tropical and subtropical regions around the world, predominantly in urban and semi-urban areas. Dengue mortality can be reduced by implementing early case detection and referral systems for patients; managing severe cases with appropriate treatment; reorienting health services to cope with dengue outbreaks; and training health personnel at all levels of the health system. Many studies that focus on the difference between the frequency of clinical findings in DHF and dengue shock syndrome (DSS) with respect to classical DF has been published. The objectives of the study were to assess signs and symptoms of dengue among patients with severe dengue and patients with dengue fever and to evaluate laboratory and radiological profile among dengue patients.Methods: This Hospital based cross sectional study was conducted on 70 seropositive cases, admitted in the Paediatrics Department of Gandhi hospital during the period of July to December 2017 for 6months. Data was analyzed by using SPPS Version 17 and student t test was used for inferential statistics.Results: Out of 70 cases 38 were presented with severe dengue and 32 presented with dengue fever. Average age of presentation is 7.24 years among severe dengue group, 5.52 years among dengue fever group. In group of severe dengue, 60.5% of the cases were female, which was insignificantly more as compared to 40.6% of the cases from group of dengue fever.Conclusions: All levels of health personnel must be aware of clinical signs and symptoms of all dengue types. Careful monitoring of unusual presentations early recognition severe manifestation and timely intervention can reduce disease specific mortality rate.

(a) Laparoscopic cholecystectomy is a widely performed surgery in India and across the world for a wide range of indications. It is one of the most commonly performed surgeries, and hence a study based on outcomes of Laparoscopic cholecystectomy in the elderly would go a long way in determining the safety and success of Laparoscopic cholecystectomy in the elderly, and could help in timing surgery more effectively to avoid complications and difculties. (b) Materials and methods: Out of 250 patients who underwent Laparoscopic Cholecystectomy at JSS Hospital in the period starting January 2019 onwards who were selected by randomization, 65 patients t the criteria (age > 60 years) while 185 patients were aged <60. Data regarding comorbidities, duration of surgery, duration of hospital stay, conversion to open cholecystectomy was compiled and studied. (c) Results: A signicant number of the patients in the elderly age group had associated comorbidities. Duration of surgery was prolonged by a mean duration of 9.5 minutes in the elderly. Duration of hospital stay was increased by a mean of 2.2 days in the elderly. Incidence of conversion to open cholecystectomy was also higher in the elderly. (d) Conclusions: Laparoscopic cholecystectomy is a relatively safe and easy surgery with few complications. However, one may experience difculties while operating on the elderly, viz. Adhesions, contracted gall bladder with hepatic adhesions etc., Which may result in longer duration of surgery and higher rates of conversion to open cholecystectomy.

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Perianal abscess is a common surgical emergency in India, representing a spectrum of clinical infectious conditions across age groups and gender. [1][2][3] It is associated with signicant morbidity and prolonged postoperative recovery period. Etiology is multifactorial, and several organisms have been isolated from cultures, the most common being Gram negative organisms. With misuse of antibiotics, several microorganisms have now [4][5] become resistant to what were earlier the gold standard and rst line of treatment. A retrospective study on 100 patients with perianal abscess who underwent surgery in the form of Incision and Drainage at JSS Hospital, Mysuru was done. Patients were studied for clinical and microbiological data, viz. Age, gender, presenting complaints, culture and sensitivity reports, organism isolated, resistance etc. Results showed a signicant number of patients with perianal abscess had underlying comorbidities such as Type II Diabetes Mellitus and Hypertension. Majority of the organisms isolated were Gram negative bacilli, with signicant levels of resistance to cephalosporins. However, no signicant difference in resistance levels were seen in patients with and those without comorbidities. Perianal abscess is an infectious pathology of the perianal region, causing signicant morbidity. The most common organisms isolated are gram negative bacilli, with signicant levels of resistance to lower generation of antibiotics. Empirically starting higher generation antibiotics, while at the same time judicious use of antibiotics in patients who present early, may help in enhanced recovery postoperatively, and may help to reduce levels of resistance in the future.