Background: One of the most prevalent abdominal crises is acute appendicitis. Many efforts have been directed towards early diagnosis and intervention. Delay in diagnosis leads to increase morbidity and costs. Present study was aimed to evaluate the correlation of CRP and PCT with perioperative ndings in suspected cases of acute appendicitis and to nd whether they can aid in the diagnosis of acute appendicitis. Material and Methods: Present study was hospital based screening test study, conducted patients of age > 18 years, either gender, who presented with right iliac fossa pain lasting < 48 hours and were tentatively diagnosed with acute appendicitis, underwent surgery. Results: Among 115 patients with acute appendicitis, most of patients belong to age group of 21 to 30 years (45.2 %) followed by 31 to 40 and 10 to 20 years (18.3 %). Out of 115 patients 40 (34.8%) patients were females and 75 (65.2%) patients were males. CRP was positive in 84 (73.04%) and procalcitonin was positive in 66 (57.39%) patients with acute appendicitis. CRP had a sensitivity of 72.82%, a specicity of 25%, a positive predictive value of 89.29%, and a negative predictive value of 9.68 %. Procalcitonin had a sensitivity of 57.28 %, a specicity of 41.67 %, a positive predictive value of 89.39 %, and a negative predictive value of 10.20%. Conclusion: Elevation in CRP as well as procalcitonin levels only cannot be used for nal diagnosis of acute appendicitis, but it can act as an adjunct when evaluating the available clinical and laboratory

Background: Per anal diseases and the pain management in such cases have always been a problematic solution for surgeons. There are various pain management methods for per anal cases, however we wanted a cheaper yet effective way and patient friendly method for pain management where no expertise would be required, hence we opted to see results of diclofenac suppositories which were easily available, patient could insert it without anyone’s help or assistance and hence need not be hospitalized for any intravenous analgesics.Methods: A study was conducted over 2000 cases over a span of 6 years in a tertiary centre. A control group A of 1000 patients was made where, oral (tablet diclofenac) plus local analgesics (xylocaine gel) were opted for whereas the other group B of 1000 patients was treated with diclofenac suppository 100 mg twice a day with glycerin as lubricant at anal verge. The pain score was noted in both the groups. All acute fissure in ano cases, we included in this study.Results: The pain score of the group B cases was much lower than the group A cases, and also the duration of results acquired was much lesser than group A.Conclusions: Diclofenac suppository 100 mg twice a day proved to be an excellent pain management method for acute fissure in ano cases in outpatient department care.

Background: Per anal and perianal surgeries are one of the bread and butter surgeries in a surgeons life, and satisfaction of patient matters a lot. Early miraculous recovery has always been patient’s expectations hence we decided to study standard IV method of diclofenac as analgesic with diclofenac suppository and compared their effects on patients with the help of pain scale of 0 to 10.Methods: 200 common per anal surgeries were considered in the study, and were divided in two groups group A post operatively IV diclofenac was given 12 hourly and in group B cases diclofenac suppository 100 mg was started daily twice and the pain score was noted for a week.Results: Diclofenac suppositories resulted in early pain relief and thus early discharges of these patients. The pain score had decreased to a larger extent by day 3 and was almost negligible by day 5 and a few cases to day 7. The hospital stay reduced as patient could manage suppository at home by themselves. IV site complications like thrombophlebitis leading to pain and fever could be easily avoided.Conclusions: Thus diclofenac suppositories proved to be an effective way to give a pain free satisfaction compared to intravenous painful analgesics, thus decreased their hospital stay and also it was a patient friendly.

Background: Breast cancer is frequently associated with activation of the hemostatic system and the extent of this activation correlates with a more advanced tumor stage. D-dimer is a biomarker that indicates the activation of hemostasis and fibrinolysis.Methods: This is a prospective, observational, analytical study in which we compare plasma D-dimer levels among three groups’ i.e., healthy subjects, benign patients and breast cancer patients. We have also evaluated plasma D-dimer levels in patients with lymphadenopathy and in those patients who did not have palpable lymph nodes. Plasma D-dimer levels were further characterized based on TNM classification in breast cancer patients where quantitative D-dimer levels were correlated with clinical stage grouping.Results: Through our study we have observed that D-dimer level is inexpensive and a convenient method for diagnosis and prognosis of breast cancer. We have used a control group so as to evaluate a more accurate result. Comparison between benign and malignant lesions was made and we have achieved a significant p value, which proved our study positive for raised D-dimer levels in cancer breast.Conclusions: D-dimer proves to be a safe, convenient and easily available biomarker which can be combined with conventional sentinel node biopsy in clinically node negative breast cancer to assess metastatic disease in axilla and reduce false negative results. Plasma D-dimer level was positively correlated with clinical stage of solid cancers.

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