Background: There are several methods of circumcision with its own merits and demerits. Dorsal slit technique is practised all over the world most commonly. The sleeve technique introduced later on which helps in preventing common complications of open technique. Aim: To compare complications of sleeve technique versus conventional dorsal slit technique for circumcision in children. Material and Methods: Total 64 patients were studied by doing comparison of complications between sleeve technique and dorsal slit technique of circumcision allocated randomly. Post-operative pain was evaluated by Visual Analogue Scale (VAS) at 1, 3, 6 and 24 hour. Blood loss, healing time were assessed. Patient was examined on follow up at 1, 2 and 6 week. Results: For Dorsal slit technique, the mean of gauze pieces used was 2.12 pieces and for sleeve technique, the mean of gauze pieces used was 1.71 pieces. For Dorsal slit technique, the mean VAS score was 2.90 and for sleeve technique, the mean VAS score was 2.40. For dorsal slit technique, the mean of healing time was 16 days and for sleeve technique, the mean of healing time was 15.43 days. Post-operatively, 14 and 9 patients of dorsal slit technique and sleeve technique had edema at local site, respectively. Conclusion: Sleeve technique produces a good postoperative result, less bleeding and less postoperative pain as compared to dorsal slit technique. Hence, sleeve technique is recommended for circumcision as compared to dorsal slit technique.

Introduction: India being a developing country has a high incidence of thermal burns. Severe burn injury is followed by a state of hypermetabolism, which causes increased cardiac workload and increased resting energy expenditure causing muscle wasting, leading to increased morbidity. The aim of this study is to test the effect of propranolol in modulating the state of hypermetabolism in the acute post burn phase using various clinical and laboratory parameters. Patients and Methods: This is a prospective randomized control study which includes 84 patients of burns with total burn surface area 20-40% conducted at Department of surgery ,SSG Hospital, Baroda over a period of 1.5 year. The patients were divided into test (propanolol) and control groups. Similar burn treatment was continued in both groups and change in the laboratory, and clinical parameters were noted. Results were compared within the groups using paired t-test and in between the groups using unpaired t-test. Result: This study shows a significant reduction of 25% in the heart rate and 26% in the sleeping pulse rate with 2 weeks of propranolol therapy (P < 0.001). There was a 3.33% increase in the weight along with 2.5% increase in mid-arm circumference. There was a 5.7% increase in total serum albumin concentration and C-reactive protein was found to be reduced by 8.2%. Conclusion: The results prove propranolol as an effective modulator of hypermetabolism by counteracting the effect of catecholamine, reducing infection and inflammation hence improving the overall outcome of severe burn patients.

Background: The surgical treatment of inguinal hernias has evolved through several stage, history of groin hernia is the history of surgery itself. But, chronic pain is still a major irritating post-operative complain of the patient. The objective of the present study was to compare post-operative outcomes of mesh fixation with monofilament non-absorbable v/s monofilament absorbable suture material in terms of postoperative pain, chronic groin pain, seroma formation, wound infection and recurrence in Lichtenstein hernioplasty. Methods: This is a single centre, prospective randomized controlled study of 152 cases of inguinal hernia comparing post-operative outcomes of mesh fixation with monofilament non-absorbable v/s monofilament absorbable suture material in Lichtenstein hernioplasty at Baroda Medical College and S.S.G. Hospital, between 1st December 2017 to 30th November 2018. Results: Total 152 patients of unilateral or bilateral inguinal hernia were studied 76 in each group. Chronic groin pain mean visual analogue scale score at 3 months was higher in group with non-absorbable suture compared to monofilament absorbable group (1.3±0.9 v/s 0.95±0.8 p value <0.05). Conclusions: Monofilament absorbable suture is associated with less chronic groin pain and compared to monofilament non-absorbable sutures.

Multiple epidermoid cyst is relatively rare condition now a day. They are asymptomatic, but cosmetically unaccepted. Once infected cause fatal complication like Fournier`s gangrene and septicemia. They are successfully managed surgically by complete excision with good cosmetic result and minimum morbidity. Here we report a case of 44 years old male patient with symptom of multiple epidermoid cyst over scrotum for last 10 years.In this case complete excision of scrotal wall with cyst followed by mobilizing scrotal skin and primary suturing was done.