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BACKGROUND: Perforation peritonitis constitutes one of the commonest surgical emergency operation encountered by surgeons all over world as well as in India.There is no single,easily available laboratory test that predicts severity or prognosis in patients with perforation peritonitis. The aim of this study is to study prognostic factors in perforation peritonitis and evaluating the outcome of patients with perforation peritonitis using Mannhein Peritonitis Index. MATERIALS AND METHOD:The study was a prospective analytical study done in the Department of General Surgery, JNIMS,Imphal from 1st September 2017 to 31st august 2019 comprising of 100 consecutive patients in which diagnosis of perforation peritonitis were established by operative findings or surgical interventions during management were included in the study as per the inclusion and exclusion criteria. RESULTS: Among the various prognostic factors of the scoring system, age >50 years, nature of peritoneal fluid exudates and presence of organ failure had a significant role in predicting the eventual outcome of the patients.Colonic origin of sepsis was associated with worse outcome probably due to presence of faecal exudates which is commonly associated with colonic origin of sepsis. MPI < 21 was associated wih complications in 25% of patients whereas complications increases as MPI score increases with 34.5% of patients having complication in MPI ranging from 21-29. CONCLUSION: MPI is disease specific, easy scoring system for predicting outcomes in patients with perforation peritonitis

Malignant peripheral nerve sheath tumour (MPNST) are rare, aggressive sarcomatous tumours of peripheral nerve sheaths which can arise from preexisting neurofibroma or de novo.Sporadic origin accounts for nearly half of all MPNST cases,while other cases occur in association with neurofibromatosis type 1 (NF1).The most common site is nerve trunks of extremities like sciatic nerve. On literature search only four case reports of MPNST of radial nerve are published till date.We report a case of 50 years old lady presenting with a large,firm,ovoid swelling measuring 7 cm x 8 cm over her right arm with symptoms of neuropathy.The fine needle aspiration cytology report was a benign neurogenenic tumour. MRI reported as a radial nerve sheath tumour. Core biopsy shows features of neurofibroma(NF).She was subjected to treatment as a benign pathology but the final histopathological report was a low grade - malignant peripheral nerve sheath tumour.

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