Surgical emphysema, also widely known as subcutaneous emphysema, is defined as a clinical state in which air gets trapped subcutaneously. The etiology may be traumatic or atraumatic, and multiple causes in each are present. Case report. A 63-year-old female patient presented to the emergency room with a facial soft tissue injury following road traffic accident and developed surgical emphysema later on with no evidence of rib fractures or pneumothorax. Infectious etiology was ruled out. Due to the respiratory embarrassment, the patient was electively intubated. Conservative management was provided. Emphysema resolved within 24 hours after the accident. Discussion. Various theories have been outlined in literature, like Mackler effect, Crampton theory and ballvalve mechanism. In our case, it was difficult to apply any of these theories to confirm the diagnosis. Conservative management is still used in the treatment of surgical emphysema. Conclusion. Surgical emphysema is a common encounter in trauma practice, and its identification is essential to rule out any emergency causes which may lead to respiratory distress.

Phlebosclerosis is defined as the fibrous degeneration of the venous wall, though in history, it has been defined from endophlebitis to hyalinzation of the intima of the venous wall, the actual pathology is obscure. We present a case series of three different cases from three different decades of life, 5th, 6th, 7th respectively with varied co-morbidities, in which we encountered phlebosclerosis, while harvesting GSV for coronary artery bypass grafting (CABG). To authors’ knowledge, this is the first ever indigenous study on phlebosclerosis of GSV, the study would give an excerpt into the continuum on the natural history of the disease. The literature is reviewed and the case is presented.

Background: Helicobacter pylori infections have proven to be associated with gastritis and peptic ulcer, adenocarcinoma, gastric lymphoma. But its association with peptic ulcer perforations has not been completely proved. This study is intended to find out the association and give clarity of the pathology. The objective of the study was to observe the presence or absence of H. pylori in perforated peptic ulcer disease by obtaining biopsy from ulcer margin for rapid urease test, giemsa staining as well as serological method (antibodies IgA and IgG)Methods: This is an observational non-blinded study carried out in all cases of perforated peptic ulcer reporting in surgical wards, Emergency Department of the medical college during 2016-2018. Biopsy was taken from the ulcer margin and the tissue was subjected to histo-pathological examination, rapid urease test and blood sample was sent for serological examination.Results: Of the 46 patients participated in our study, 41 (89.1%) happened to be male, 5 (10.9%) were female. Only 2.2% of the patients were positive for H. pylori and remaining 95.7% were negative for H. pylori. The difference in the age group and H. pylori infection was found to be not statistically significant (p>0.05).Conclusions: In our study, frequency of H. pylori in perforated peptic ulcer cases was found to be only 2.2% which proves that there may be other contributing factors in perforated peptic ulcer cases, which need to be further evaluated.

Background: The incidence of self-inflicted anger related upper extremity injuries due to punching glass, involving dominant hand has increased in recent years even in our rural population of less than 1.5 million in District of Kolar, Karnataka, India. Although hospital stay is short, these patients require long term follow up, physiotherapy and occupational rehabilitation.Methods: This study is a case series involving a a retrospective analysis from June 1, 2015, to July 31, 2017.  Our study involved only glass cut injury following an angry intention.Results: This study included 9 eligible patients who were all young male aged between 18 to 28 years (median age: 23.4 years) who had triggering factor before punching the glass pane. All patients had tendon injuries, flexors (n=4), extensor (n=3), both (n=2), muscle injuries (n=1), median nerve (n=2), radial artery (n=3). All injuries required operative intervention. Mean hospital stay was 5.2 days. Mean rehabilitation period was 5.2 months.Conclusions: These types of injuries can be prevented by regular counseling for stress/anger management as a part of rehabilitation to prevent further recurrences.