Penetrating abdominal trauma forms an important component of surgical emergencies, most of the victims being young aged in the prime of their life. Over the past century, the diagnosis and management of this common problem has seen drastic changes, finally reaching the destination of . We present our experience in the management of this group of patients in the rural setup. This is a prospective observational study done at our hospital between 1 April 2013 and 31 March 2015 including patients who presented with penetrating abdominal injury. The clinical presentation, imaging features, diagnosis, management, and complications of all these patients are analyzed. The mean age was 33.5 years with majority being males. Homicidal stab injuries accounted for most of the injuries (62.5 %). Forty-eight patients underwent laparotomy, and among which, the procedure was therapeutic in 36 patients. Peritoneal penetration was the best predictor of a therapeutic laparotomy with a high sensitivity and positive predictive value (100 and 80 %, respectively). The small intestine was the most commonly injured organ. The mean postoperative stay was 8.25 days, and there was no mortality. Though the management of these patients should aim at minimizing the rate of negative laparotomies, this should not be done at the expense of delayed diagnosis and treatment. Diagnostic laparoscopy may avoid unnecessary laparotomies; however, it requires adequate skills in laparoendoscopy. Management is best tailor made for each individual based on the nature of injury, findings at presentation, and the organ injured.

Median arcuate ligament (MAL) syndrome is an uncommon condition caused by the external compression of the celiac trunk by the median arcuate ligament. In the current era of technological advancement, this syndrome may be corrected through the laparoscopic approach. We report two patients who were diagnosed as MAL syndrome and underwent laparoscopic division of MAL fibers at our institute. Both the patients improved symptomatically following the procedure and were discharged on the fourth post-operative day. Also, they remained symptom free during subsequent follow-up period of 1 year and 8 months, respectively. Laparoscopic approach to correct the MAL syndrome is feasible and safe. It may be the preferred modality of treatment in view of its superior visualization and lack of morbidity. However, adequate experience in advanced laparoscopic surgery is required before attempting this procedure.

Laparoscopic surgeries are advantageous over open surgeries in terms of minimal tissue handling, earlier return of bowel function, less postoperative pain, better cosmesis, lesser duration of hospital stay, earlier return to full activity and decreased overall cost. The incidence of bowel injuries is 0.13%, vascular injuries is 0.05-2% and abdominal wall vascular injuries 0.2-2%. Therefore, safe abdominal entry in laparoscopy is a major concern. Considering the fact that initial entry to abdominal cavity is a blind procedure, there is no ideal entry site. Various entry points used are Umbilicus, Palmar’s point, Jain point, Lee-Huang point, etc. The current study aimed to compare the better cosmetic outcome between trans umbilical and periumbilical incision for primary port insertion in cases of Laparoscopic Appendicectomy and Laparoscopic Cholecystectomy. This is a one year RCT done in Department of General Surgery, KLEs Dr.Prabhakar Kore Hospital and Medical Research Centre, Belagavi, from January 2022-December 2022. A total of 100 patients operated for laparoscopic appendectomy and laparoscopic cholecystectomy were studied. The patients were divided into Group A and Group B based on type of incision taken either periumbilical or transumbilical. Postoperative cosmetic outcome was analyzed using POSAS score on post op day 3,7 and 1-month follow up. The results are statistically significant (P<0.05). Between the two incisions during POD# 3 and 7 there is significant difference between variables such as induration, erythema, SSI. In our study 3 cases had SSI in both the groups. Transumbilical incision has better cosmetic satisfaction compared to Periumbilical incision.

PURPOSE: To evaluate changes in intraocular pressure in healthy eyes dilated with tropicamide 1% and phenylephrine 2.5% (itrop) versus those dilated with tropicamide 1% alone (appamide) using non-contact tonometer (NCT) MATERIALS AND METHODS: A prospective comparative study was conducted on 110 eyes and grouped into Group A & Group B with 55 eyes in each group respectively. Patients less than 40 years without any ocular or systemic illness were included in the study. In both groups baseline IOPwas recorded and one drop of combined phenylephrine 2.5% and Tropicamide 1% in Group Aand one drop of plain Tropicamide 1% in Group B were instilled, after 45 minutes IOPwas recorded. Data analysis was done using paired t test RESULTS: The mean IOP for Group A was 14.41mmHg at baseline and 15.25mmHg after dilation (P=0.0025).The mean IOP for Group B was 14.36mmHg at baseline and 14.35mmHg after dilation (P=0.0018). CONCLUSION: A signicant increase in IOP is observed in both groups,but the increase is more signicant in Group A(combined tropicamide 1% and phenylaphrine 2.5%) when compared to Group B ( Tropicamide 1% alone