INTRODUCTIONIntestinal obstruction is a frequently seen entity in the Emergency Department that represents 25% of abdominal pain consultations. 1 The most frequent causes of intestinal obstruction are postoperative adhesions followed by neoplasms and hernias.2 The estimated rate of adhesions is around 94%-95% after laparotomy. It has recently been demonstrated that this rate is much lower in laparoscopic procedures, although the exact percentage is not known.3 Before the 1990s, the mortality rate associated with intestinal obstruction was 30%-50%, depending on the series. 4 Nowadays, the correct diagnosis of symptoms and adequate treatment can lower the mortality rate to 3%-5%. 4-6During the management of intestinal obstruction, the patient should initially be made to fast and intravenous therapy should be administered, in addition to intestinal decompression with a nasogastric tube. Most of the symptoms will respond to conservative treatment. The indication for surgery is clear when there are data to suspect ischemia or intestinal suffering: fever, tachycardia, abdominal pain, peritonitis and acidosis. The problem lies in knowing how much time should pass before we decide whether the patient is responding to ABSTRACT Background: Intestinal obstruction is a frequently seen entity in the Emergency Department that represents 25% of abdominal pain consultations. Methods: This prospective, randomized, and clinical trial study was designed to determine the value of gastrografin in adhesive small bowel obstruction. The primary end points were the evaluation of the operative rate reduction and shortening the hospital stay after the use of gastrografin. A total of 100 patients were randomized into two groups: the control group received conventional treatment, whereas the study group received in addition of 100 ml gastrografin meal. Patients were followed up within 4 days after admission, and clinical and radiological (if needed) improvements were evaluated. Results: Surgical procedure was performed in 10% of the gastrografin group for whom conservative treatment failed at the end of fourth day. In contrast, surgery was required in 28% of control group. These findings shows that gastrografin decreased the need for surgical management by 18%, but no statistically significant differences were observed. The length of hospital stay revealed a significant reduction from 4.60±1.14 days to 2.64±1.05 days for control and gastrografin groups, respectively. Conclusions: The use of gastrografin in adhesive small bowel obstruction is safe and reduces the length of hospital stay.

Background: Hernia is defined as abnormal protrusion of whole or a part of a viscus through the wall that contains it. Among all external abdominal hernias, inguinal hernia is one most commonly encountered. Many factors are responsible for the formation of the inguinal hernia but, what makes a few people more susceptible to this situation is still clearly not proved. The lowness of pubic tubercle is associated with narrow origin of internal oblique muscle from lateral inguinal ligament which fails to protect the deep inguinal ring consequently lead to inguinal hernia.Methods: The study was conducted in Sardar Patel Medical College and attached hospital, Bikaner for duration of 12 months from March 2018 to February 2019. It is a case-control study with 50 cases and 50 control meeting inclusion criteria. In all patients, following parameters SS line, ST line, height, weight was recorded and evaluated.Results: The mean value of ST line in our study group is 7.37±0.182 cm which is significantly greater (p=0.0001) than the controls the mean value being 7.01±0.262 cm. In our study, 98% of cases were having ST line >7.01 cm whereas 66% of controls were ST line under 7.01 cm.Conclusions: Group of people with low lying pubic tubercle are at high risk of developing inguinal hernia.

Background: Heparin is a multifaceted compound with uses not only as an anticoagulant, but also as an anti-inflammatory, anti-allergenic, anti-histaminic, anti-serotonin, anti-proteolytic and neoangiogenic agent. The aim of the study was to study the effect of topical heparin in the management of burns in terms of morbidity, mortality & safety. Subjects and Methods: A hospital based RCT with total duration of 16 months from June, 2018 to September, 2019 with 100 patients (age between 15-45 years, burns from 20-60%, with less than 48 hours duration), randomly enrolled into 2 groups, after initial resuscitative measures, 50 cases receiving Topical Heparin treatment, 50 controls receiving conventional treatment (1% silver sulphadiazine) with i.v. antibiotics, after explaining the study objectives and taking informed written consent. Data analysis was performed using Epi Info software. Results: Patients treated with topical heparin experienced statistically significant (p<0.05) improved pain relief, rapid healing, lesser complications and reduced duration of hospital stays. Conclusion: The current study demonstrates that topical heparin can improve clinical outcomes in the treatment of burn injury.

Today, Laparoscopic Cholecystectomy has become the gold standard treatment of gall stone disease. In the present era, where patient is more concerned about cosmesis (specially females), lesser morbidity and early postoperative recovery, many newer techniques like single incision laparoscopic cholecystectomy (SILC), natural orice transluminal endoscopic surgery (NOTES) has been developed with minimum scar to no scar on abdomen. The study was conducted on patients (n= 25) with calculous cholecystitis that underwent single incision laparoscopic cholecystectomy using conventional instruments during 2011-12 at S.P. Medical College, Bikaner. Maximum number of cases (n=24) had very satisfactory cosmetic outcome. It was concluded that single incision laparoscopic cholecystectomy (SILC) with conventional instruments and port is feasible, safe, cost effective with excellent cosmetic results.