COVID-19 pandemic has been widespread and devastating and has created unprecedented challenges for the whole medical fraternity. Mainly emergency surgeries were carried out during the pandemic, and data on postoperative outcomes of COVID-19 patients is limited [1,2]. Hence, this study was planned to find out post-operative outcome of RTPCR-positive COVID-19 patients who underwent emergency surgeries in a tertiary care institute. Retrospective data of those patients which included various parameters such as age, sex, COVID-19-related symptoms, comorbidities, surgical procedure done, length of hospital stay, postoperative complications, ICU admissions, and final outcome was collected and analysed.Twenty-three RT-PCR-positive patients who underwent emergency surgery during first and second wave of COVID-19 (1 March 2020 to 30 June 2021) were included in the study. A total of 6 and 17 were operated during 1st and 2nd wave of COVID-19, respectively. M:F ratio was 4:1 and mean age of the patients was 47 years. Before surgery, 18 were symptomatic for COVID-19, and 5 were asymptomatic. Fever was the main clinical symptom in 15 patients (65.2%), cough in 10 patients (43.4%), and dyspnoea in 3 patients (13%). Two patients were diabetic, 7 patients were hypertensive, and 2 patients had taken ATT in the past for pulmonary Koch's, whereas no comorbidities were recorded in 12 patients (52.1%). Fourteen patients underwent surgery for perforation peritonitis, 6 for acute appendicitis, 2 for blunt trauma abdomen, and 1 for absolute dysphagia. Seventeen patients were operated under general anaesthesia and 6 under spinal anaesthesia. Fourteen (60.8%) patients had postoperative complications among which 11 developed pulmonary complications, 2 had burst abdomen, and * Surender Verma

Background:Availability and advertising of caffeinated drinks is on the rise in Indian market. Excess caffeine intake may have deleterious effects on health.Objective:To estimate the daily consumption of caffeine among urban school-going adolescents from Delhi.Materials and Methods:A school-based survey was conducted to determine the amount and pattern of caffeine consumption among students of classes 9-12, using a self-administered questionnaire.Results:Of 300 participants (median age 15 year, 174 boys), 291 (97%) were consuming caffeine [mean (SD): 121.0 (98.2) mg/day]. Nineteen (6%) students were consuming more than 300 mg of caffeine per day. Tea/coffee contributed to more than 50% of the caffeine intake. The rest was derived from cola beverages, chocolates, and energy drinks.Conclusion:Average caffeine consumption among school-going adolescents from Delhi is high. The findings of this preliminary survey need to be confirmed in larger data sets.

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Tubular adenoma is a rare and benign tumor of breast occurring especially in young women of reproductive age. Grossly, they appear as solid circumscribed masses. Microscopically they are composed of tubular structures. We describe a case of this rare, benign tumor in a 26-year-old which was initially treated as fibroadenoma but later presented as fungating mass. Surgical excision was done and on histopathological examination confirmed features of tubular adenoma. Keeping a possibility of tubular adenomas in fungating masses of breast will help to go for more conservative approach rather than radical surgeries.

Background: Gastrointestinal perforation is one of the common surgical emergencies in developing countries. The diagnosis is mainly clinical and is aided by radiological investigations. This study was designed to highlight the spectrum of hollow viscus perforation peritonitis in terms of etiology, clinical presentations, site of perforation, surgical treatment, postoperative complications, and mortality.Methods: The study was a hospital‑based observational study and included 462 patients of perforation peritonitis (diffuse or localized) who were studied retrospectively in terms of cause, site of perforation, surgical treatment, complications, and mortality. Only those patients who underwent exploratory laparotomy for management of perforation peritonitis were included.Results: Overall stomach was the most common site of perforation (33%). Ileum (26%) was the second common site of perforation. Duodenal perforations were seen in 88 (19%) cases whereas appendicular perforations were seen in 46 (10%) cases. Colonic perforations were least common. Acid peptic disease was the most common etiology of stomach perforations. Enteric fever (63%) was the most common etiology of jejuno-ileal perforation. Other causes include tuberculosis (23%), trauma (8%), malignancy (3%) and idiopathic in rest. Males were six times more commonly affected than females. Peak incidence was noted in the 2nd and 3rd decades of life.Conclusions: Spectrum of perforation peritonitis cases in developing world is different from developed countries The Western literature suggests that foreign body, ischemia, radiotherapy, diverticula, and Crohn’s disease are the main causes of perforations. In contrast to this, infection is the most common cause for perforations in developing countries.