Background: Fistula in ano is a track that connects deeply the anal canal or rectum to the skin around the anus. Fistula in ano most commonly follows an anorectal sepsis1. The main principles of management of anal fistula are closure of internal opening of fistula tract, drainage of infection or necrotic tissue, and eradication of fistulous tract with preservation of sphincter function. The objectives were to compare the various aspects like per operative complications, post-operative complications, mean hospital stay in the treatment of fistula in ano using various modalities like fistulotomy, fistulectomy, setons and lift procedure.Methods: This is a randomised, comparative, prospective study of 80 cases of fistula in ano, presenting at surgical opd of K.R. Hospital, Mysore attached to Mysore Medical College and research Institute. Out of which, 20 cases are treated by fistulectomy, 20 by seton, 20 by fistulotomy and the rest 20 cases by LIFT procedure by random selection method, during period of NOVEMBER 1, 2016 to 31st October 2017.Results: Most common age of presentation is 31-40 years and more common in males then females (M:F= 2.3:1 ). Per operative complications include bleeding seen more in patients undergoing fistulectomy. Per operative course of LIFT procedure patients was complication free. Postoperative pain seen more in patients undergoing setons procedure.Conclusions: we conclude that LIFT procedure and Fistulotomy were acceptable procedures for simple, uncomplicated low lying and high lying fistula.

Background: Vesical calculus are the most common manifestation of lower urinary tract stones accounting for approximately 5% of all urinary stone diseases. In pediatric population bladder stones are most commonly due to malnutrition and poor socioeconomic factors. In adults they are most commonly associated with bladder outlet obstruction. In this context we study the different etiological factors and pathogenesis in the causation of vesical calculus.Methods: This is a prospective study that included 40 patients admitted with clinical diagnosis of vesical calculus at KR Hospital, Mysore from June 2016 to May 2017.Results: Maximum patients belong to age group of 51-60 years (30%) and minimum numbers belongs to age group of 1-10, 11-20 and 81-90 years age group. Male to female ration in present study is 5:1. In present study patients with bore well as source of water were highest in number i.e., 22 patients. Maximum number of patients i.e., 22 patients (55%) presented with history of pain abdomen and 15 patients (37.5%) with dysuria. Twenty-four patients (60%) had alkaline urine. Urine albumin was positive in 10 patients (25%), urine sugar was present in 8 patients (20%), pus cells were found in urine of 28 patients (70%) and RBCs were present in 24 patients (60). Klebsiella was the commonest organism isolated from the urine of 22 patients (55%) and E. coli was isolated in 8 patients (20%). Ultrasonography of abdomen and pelvis detected associated other conditions such as hydroureteronephrosis in 8 patients (20%), cystitis in 10 patients (25%) and benign prostatic hyperplasia in 20 patients (50%).Conclusions: Bladder calculi are most common in people of old age group indicating obstruction could be the cause for stone formation. They are rarely formed spontaneously. There must be an inciting event namely bladder outlet obstruction or infection to promote the stone formation.

Background: Trauma remains the most common cause of death for all individuals between the ages of 1 and 44 years. 10% of these fatalities are attributable to abdominal injury. The Indian fatality rates for trauma are 20 times that for developed countries. The management of patients with blunt abdominal injury has evolved greatly over the last few decades from complete surgical management historically to present non operative management in most of the cases. In view of increasing number of road traffic accidents, rampant increase in construction work, accidental fall from height, this study is conducted to look into the causes of such incidents and also to strengthen the already established rules of non operative management in cases of blunt trauma abdomen.Methods: This is a prospective study of 53 patients who presented to K. R. Hospital, Mysuru, Karnataka, for management of blunt trauma abdomen over the period of January 2016 to June 2017. Unstable patients with initial resuscitation underwent Focused Assessment Sonography for Trauma. Failed resuscitation with free fluid in abdomen confirmed by FAST immediately shifted to operation theatre for laparotomy and proceed. Hemodynamically stable patients underwent computerized tomography of abdomen. Organ injuries were scaled according to the American Association for the Surgery of Trauma and these patients were managed conservatively after ruling out hollow viscus perforation.Results: Majority of the patients belonged to male sex (85%) and of the age group 21-40 years constituting 58.3% of patients. Road traffic accident was the most common mode of injury which included 35 patients (66%). A total of 19 cases had splenic injury out of which 13 (68.5%) underwent non operative management and 6 (31%) underwent emergency Splenectomy. liver injury was present in 15 patients and all were managed conservatively. In total non operative management was done in 73.5% of cases and surgical management was done in 26.5% of cases.Conclusions: The presence of free fluid with organ injury always does not mandate laparotomy. Patient selection, early diagnosis and repeated clinical examination and use of appropriate investigations forms the key in non operative management of blunt trauma abdomen. RTA being the most common mode of injury, adequate measures should be taken to prevent road traffic accidents by strict action and traffic norms and citizen education.

Background: Gall bladder perforation (GBP), is an uncommon complication of acute cholecystitis but it often remains a cause for diagnostic dilemma among surgeons while managing patients presenting with signs and symptoms of peritonitis. This study was undertaken to study the clinical profile of the patients diagnosed to have GBP which would aid in early diagnosis and surgical intervention thus improving the patient's outcome. Methods: A retrospective study from May 2013 to April 2018 with a sample size of 12 cases were studied. All cases were diagnosed either pre-operatively (based on radiological findings) or intra-operatively. Perforations of gall bladder caused due to trauma or iatrogenic reasons were excluded from the study. Intra-operative findings, postoperative sequelae and the outcome of the patient were evaluated. Results: The mean age of the patients was 66 and females were more affected than the males. USG done preoperatively could pick up only 1 out of 12 cases. Whereas CT showed gall bladder perforation in 3 out of 4 cases for whom CT was done giving it a sensitivity of 75%. Gall bladder perforation was commonly found to be located in the fundus followed by corpus and infundibulum. Conclusions: GBP is a rare complication of acute cholecystitis. It can present with full blown peritonitis features or vague abdominal symptoms. If promptly diagnosed and treated aggressively by laparotomy and cholecystectomy, the patient's outcomes are improved.