BACKGROUND Around 4 million people are affected by peptic ulcer diseases worldwide annually. The incidence of around 1.5 % to 3 % has been estimated. Peptic ulcer perforation presents with an overall mortality of 10 %. The management is also associated with significant post-operative morbidity and mortality regardless of whether laparoscopic or open repair is performed. In this study, we wanted to find out the incidence of peptic ulcer perforation and its management. METHODS Our study was a prospective observational study conducted in post graduate Department of Surgery, Government Medical College Srinagar, from October 2018 to November 2020. All patients were evaluated properly with all baseline investigations followed by X-ray chest and abdomen and ultrasonography (USG). RESULTS In our study, 136 patients were diagnosed as cases of peptic ulcer perforation. The maximum number of patients were in age group of 41 - 50 years (27.20 %). The male : female ratio was 14.1 : 1. Abdominal pain was present in all patients as presenting symptom followed by abdominal distension. In this study, 124 patients (91.2 %) had perforation in first part of duodenum, 9 patients (6.6 %) had perforation in prepyloric region and 3 (2.2 %) patients had perforation in body of stomach. Graham’s Patch repair was done in 133 patients, 1 patient underwent primary closure, and 2 patients underwent distal gastrectomy with gastrojejunostomy. CONCLUSIONS Our study shows that young people with perforated peptic ulcer have fewer coexisting medical illness, a lower complication rate and a more favorable outcome as compared to elderly patients with perforated peptic ulcer. A majority of such perforations are in 1st part of duodenum with male preponderance. A plain chest radiograph is sufficient to make diagnosis in the classic case of sudden onset epigastric pain. KEYWORDS Perforation Peritonitis, Management of Peptic Ulcer Perforation, Graham’s Repair, Clinical Presentation of Peptic Ulcer Perforation

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Introduction: Laparoscopic cholecystectomy is the most commonly performed surgical procedure of digestive tract. It has replaced open cholecystectomy as gold standard treatment for cholelithiasis and inflammation of gallbladder.  It is estimated that approximately 90% of cholecystectomies in the  United States are performed using a laparoscopic approach.  The aim of this study was to evaluate the outcome of Laparoscopic cholecystectomy in context to its complications, morbidity and mortality in a tertiary care hospital.  Methods: This retrospective study was conducted on 1200 patients, who underwent laparoscopic cholecystectomies, during the period from January 2019 to December 2019, at Government Medical College Jammu J & K, India and necessary data was collected and reviewed. Results: In our study, a total of 1200 patients were studied including 216 males (18%) and 984 females (82%). The mean age of the patients was 43.35±8.61. The mean operative time in our study was 55.5±10.60 minutes with range of 45 – 90 minutes. Conversion rate was 2.6%. 2 patients were re-explored. Bile duct injury was found in 6 patients (0.5%).  Conclusions: Gallstone disease is a global health problem. Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first choice of treatment for gallstones. Gall stone diseases is most frequently encountered in female population. The risk factors for conversion to open cholecystectomy include male gender, previous abdominal surgery, acute cholecystitis, dense adhesions and fibrosis in Calot’ s triangle, anatomical variations, advanced age, comorbidity, obesity, suspicion of common bile duct stones, jaundice, and decreased surgeon experience. The incidence of surgical site infection has significantly decreased in laparoscopic cholecystectomy compared to open cholecystectomy. In our study we could not find any case of surgical site infection.

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Introduction: Hydatid disease is a disease that has been known since antiquity and was described by Hippocrates with the particular term Liver filled with water followed by famous Arabian physician Al-rhazes who wrote on hydatid cyst of liver about 1000 years ago. Hydatid disease commonly known as Cystic Echinococcosis (CE) is a parasitic infestation caused by flatworm Echinococcus granulosus. Hydatid disease is characterized by cystic lesions occurring in different parts of body most commonly liver (65%), lungs (15%). Unusual sites of involvement include muscles (5%), bones (5%),kidney (3%), spleen (2%), diaphragm (1%), ovary (0.2%).The peritoneal cavity, thyroid, breast, gall bladder, omentum are rarely involved. Methods: Our study was a prospective observational study conducted in Postgraduate Department of General Surgery, Government Medical College, Srinagar, J&K for a period of 2 years. This study included 30 patients after fulfilment of inclusion and exclusion criteria. Ethical clearance was obtained from institutional Ethical Committee. Results: In this study 30 cases of hydatid disease were studied, the most common age group involved in this disease was 21-30 years. . Most of our patients were females 18 cases (60%) and males 12 cases (40%). Male: Female ratio of our study is 1:1.5. Majority of patients presented with abdominal pain 24 cases (80%) followed by vomiting in 5 cases (16.7%), palpable mass was found in 1 case (3.3%) and Jaundice in 1 case (3.3%). Laparoscopic hydatid cystectomy for hydatid liver was done in 10 cases (33.3%). Open hydatid cystectomy was done in 17 cases (56.7%). Conclusion: Hydatid disease can occur in any age group but is seen most commonly in middle age , females, patients belonging to low socioeconomic status and involved in farming. Low socioeconomic status, agricultural activities and association with dogs or cattle were risk factors for the disease. Absence of history of contact with cattle or dogs doesnt rule out the possibility of disease.