Introduction Suture line disruption is an important cause of post-operative morbidity and mortality in patients who have undergone bowel surgery. Our aim was to study peri-operative factors causing anastomotic disruption in emergency surgeries and also morbidity and mortality associated with it. AfterMethodology obtaining ethical clearance from Institutional Ethical Committee, the present prospective study was conducted on 68 patients during the study period of two years (September 2017- August 2019) in a tertiary care hospital A total of 68 emergencyResults bowel anastomosis meeting the inclusion criteria were performed with 50 (73.5%) males patients. Anastomotic leak was present in 10 patients ((14.7%). The mean age of subjects in our series sustaining a leak was 62.60±6.95 years. Intra-operative hypotension, colo-colic anastomosis, post-operative vasopressor support, pre-operative hypoalbuminemia, hyponatremia and Intra-operative uid infused were signicantly associated with anastomosis leak. In our study majority of patients with anastomotic leak were of older age group. In anstomotic leak group chest infection, wound infection, septicemia and impaired renal function was present in 8, 10, 3, and 4 patients respectively. Among the 10 cases of anastomotic leak, four patients were managed conservatively and remaining six develop features of peritonitis, who were immediately taken for re-exploration. There were three deaths in the study, all of them were in leak group. Patients who have predisposing factors forConclusion leakage should ideally be considered for a temporary defunctioning stoma to tide the crisis over.

Background: Recovery after surgery for patients with colorectal disease has improved with the advent of minimal access surgery and standardized recovery protocols. Despite these advances, anastomotic leakage remains one of the most dreaded complications following colorectal surgery, with rates of 3-27 per cent depending on specific risk factors. The aim of the study was to assess sensitivity and specificity of systemic and peritoneal drain-fluid bio-markers in early prediction of anastomotic leak; and to co-relate rise in levels of biomarkers and severity of clinical symptoms in patients who have undergone colo-rectal surgeries.Methods: The present study was a prospective observational study conducted on 60 patients in the Postgraduate Department of Surgery, Government Medical College, Srinagar after obtaining due ethical clearance over a period of two years.Results: The mean age was 54.87±11.901 years with 44 patients (73.3%) were males. Among systemic makers: the mean CRP level was 2.7800±0.500 mg/L, the mean total leukocyte count was 10.783±0.940 thousands and the mean serum procalcitonin level was 0.365±0.1385 ng/ml. Among peritoneal fluid drain bio-makers, the mean IL-6 level was 3551.066±1311.965 pg/ml, the mean IL-10 level was 628.533±460.358 pg/ml and the mean TNF-a level was 16.391±6.736 pg/ml. The anastomotic leak after colo-rectal surgery was noted in 16 patients (26.7%). In our study significant co-relation was noted between the rise in levels of peritoneal drain fluid biomarkers and severity of clinical symptoms but no significant co-relation was noted between the rise in levels of systemic markers and severity of clinical symptoms in patients who have undergone colo-rectal surgeries.Conclusions: Systemic biomarkers are poor predictors of anastomotic leak after colorectal surgery. But sensitivity and specificity of peritoneal fluid drain biomarkers in predicting anastomotic leak was significantly high.

PURPOSE:- The objective of this study was to assess the effect of Totally extra-peritoneal inguinal hernia repair on testicular perfusion and testicular volume. METHODS: - After obtaining ethical clearance from institutional ethical committee, the present Prospective study was conducted on 48 male patients with unilateral inguinal hernia in a tertiary care hospital. RESULTS: - The study was conducted on 48 patients over a period of 2 years from august 2017 to august 2019 after meeting inclusion and exclusion criteria. Their mean age was 45.70 years (range 21-72 years). In our study comparison of preoperative and postoperative values at third and sixth month in the patients did not show any statistically signicant alteration in the variables studied like testicular volume (p-0.987) and blood ow perfusion parameters Peak systolic velocity (p-0.591); End Diastolic velocity (p-0.526); Resistance index (p-0.415). CONCLUSION: - No alteration in testicular volume and arterial ow over a six-month period was observed among patients who underwent laparoscopic extra-peritoneal surgical correction using polypropylene prosthesis for inguinal hernia

Gallstones are the stones developing in the gallbladder. Evolution of pathophysiology changes the trends of treatment of a disease. Laparoscopic revolution was only because of gallstones diseases. The shifting of food habits increased the incidence of diseases in developing countries. There are mainly three types of stones Cholesterol, pigment and brown stones. The pathophysiology of which is different for each type. Cholesterol stones being most common owing to the risk factors being prevalent in the developing and developed societies. Pigment stones being most common in blood disorder patients while brown stones are most common in common bile duct and are infected ones.

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