Background:From the standpoint of pathology, the term pyloric stenosis is usually inaccurate at least in adult patients, since the site of obstruction is rarely situated at the pylorus itself but, is more often placed immediately proximal to the spinchter where the diagnosis of carcinoma is most probable or more distally in the duodenal bulb where the cause is almost invariably a duodenal ulcer. The aim was to study infantile hypertrophic pyloric stenosis, benign peptic ulcer and gastric carcinoma and evaluation of electrolyte abnormalities in gastric outlet obstruction, to study various modalities of treatment and to assess pertaining to recovery from paralytic ileus.  Methods: This was a clinical observational study comprising of 40 cases of gastric outlet obstruction. The patients for this study have been selected from Prathima Institute of Medical Sciences, Karimnagar, Telangana, India from December 2013- November 2015. The cases were selected who were willing to undergo surgery.Results:Congenital hypertrophic pyloric stenosis (CHPS) is more common among first born male infants. Parental consanguinity is associated with increased incidence of congenital hypertrophic pyloric stenosis. CHPS is common in the age group of first 3-6 weeks of life (average 4 weeks). Males are more commonly affected with gastric outlet obstructions in adults. Cicatrized duodenal ulcer is more common in the age group of 30-40 years, while carcinoma stomach is more common in age group of 50-60 years. Vomiting and visible gastric peristalsis are the most common and constant symptom and sign of gastric outlet obstruction, more so in cases of cicatrized duodenal ulcers.Conclusions:Ramstedt’s pyloromyotomy is the gold standard treatment for CHPS. Patients with gastric outlet obstruction due to cicatrized duodenal ulcer require truncal vagotomy with posterior gastrojejunostomy. Vagotomy is optional in view of better response with drugs for APD. Antral carcinoma cases require curative or palliative surgery depending on the stage of the disease.

Background:Diagnosing PAD is important in order to implement appropriate therapies for preventing cardiovascular morbidity and mortality, improving functional impairment, and preventing further functional decline. The objective was to study the pattern of clinical presentation and etiology of peripheral arterial occlusive disease.Methods: This was a cross sectional observational study of 50 cases diagnosed with peripheral arterial disease of the lower extremities. History was taken as soon as the patient was admitted. A thorough clinical examination was carried out personally to find out and establish clinically first, the presence of vascular obstruction. Detailed vascular system examination was done as per the proforma provided.Results:TAO and atherosclerosis are the etiologies for ischemia in these cases, with atherosclerosis being more common of the two. All the cases of PAD presented with ischemic claudication and rest pain as common symptoms, while gangrene (80% of cases) and ischemic ulcer (20% of cases) were the other predominant symptoms. Doppler findings correlated with the disease presentation, TAO having a more infra-popliteal obstruction and atherosclerosis showing more proximal obstruction. All the cases were managed with some form of surgery and majority of them had limb loss. The level of amputation was below knee in 42% and above knee in 58% cases. Improvement of rest pain noted in 62.5% of cases, healing of ulcer in 50% of cases and improvement in claudication pain in 37.5% of patients who underwent lumbar sympathectomy.Conclusions:Post operatively most of the patients recovered uneventfully and some patients required secondary suturing of the surgical site. Three patients required a revision amputation at a higher level. At first month follow-up, many patients were ambulatory with the use of crutches.

Background: Ventral hernias comprise the second most common hernial presentations in the surgical world. This study was undertaken to know the different clinical types, age incidence, predisposing factors for ventral hernia and also to study the post-operative results of different operative procedures.  objective of present study was to investigate clinical profile of patients with ventral hernia.Methods: Forty cases of abdominal wall hernia were studied during the period of 2 years. Informed consent was obtained. Detailed history, thorough clinical examination was carried out. Patients were operated with standard surgical procedure. They were followed for 3-18 more months to observe occurrence of complications among them. Data was analyzed using proportions and presented.Results: Sixty percentage were Incisional hernia following an operation and remaining contributed to 40%. 22.5% patients had presented with complications like irreducibility, obstruction and strangulation. The presence of associated diseases, large hernia, poor condition of local tissue (muscle), all make the surgical management of ventral hernia a complex problem. Each patient was evaluated separately and thoroughly, and his surgery planned so as to obtain satisfactory results. Different methods of surgical procedures were undertaken in this study. The post-operative complication rate was minimal that is 12.5% and the recurrence rate observed was 0% but the sample size and follow up period (3-18 months) was short, in view of which I am not able to give a definite.Conclusions: Good pre-operative evaluation and preparation; sound anatomical knowledge and meticulous attention to surgical detail are the most important factors for prevention of post-operative complications and recurrence of hernia.

Background: Inner lining of lobules or ducts of milk of breast tissue is the origin of the breast cancer. Among females, it constitutes 10.4% of cancer cases incidence all over the world. It thus is the fifth leading cause of mortality all over the world. As known, it is more common in females than males. The objective of this study was to study the clinical and epidemiological profile of breast cancer patients.Methods: A hospital based cross sectional study was carried out for a period of two and half years at M. G. M. Hospital, Warangal. Both males and females of 30 years and above were included in the study. Total number of carcinoma cases admitted during 2005 to 2007 for a period of two and half years were 1,428. Total number of carcinoma breast cases admitted during 2005 to 2007 for a period of two and half years were 242.Results: Maximum cases i.e. 44.6% belonged to stage III of breast cancer. Maximum cases were seen among Hindus i.e. 76.4%. As expected, only one case was reported by males which constituted only 0.42%. Highest number of cases i.e. 99 (40.9%) were reported during the age group of 40-50 years. Multi para women constituted more number of cases in 78.8%. Maximum number of cases of breast cancer i.e. 41.6% occurred among menstruating women. Most commonly affected quadrant was upper outer in 55.1% of cases. The most common type was Schirrous carcinoma in 39.6% of cases.Conclusions: Upper outer quadrant was most commonly affected. This indicates that the women in the reproductive age group should be directed to examine their breast daily with specific attention to upper outer quadrant.