Background: Supraglottic airway devices offer several advantages over endotracheal tube with regards to ease of insertion, hemodynamic stability, decreased airway morbidity, reduced requirement of drugs and smoother emergence from anesthesia.  Objective was to compare two supraglottic airway devices, Igel and proseal LMA, with respect to ease of insertion, number of insertion attempts, time taken for placement of device and hemodynamic changes.Methods: This prospective, randomized observational study was conducted in a tertiary care hospital in India after obtaining approval from the ethical committee of the institute. Sample size consisted of 80 patients who were randomized into two groups with each group having 40 patients.Results: In our study it was found that Igel was easier to insert in 95% of the patients as compared to proseal laryngeal mask airway, whose insertion was found easy in 77.5% of the patients. There was higher success rate in first attempt insertion for Igel as compared to proseal laryngeal mask airway. 95% of the patients had successful device insertion in single attempt in group Igel and 77.5% of the patients had successful device insertion in single attempt in proseal laryngeal mask airway group. Time taken to insert Igel was significantly less (15.2 seconds) as compared to proseal laryngeal mask airway (26.1 seconds).Conclusions: The ease of insertion of Igel is better as compared to insertion of proseal laryngeal mask airway. The success rate in first attempt insertion for Igel is higher as compared to proseal laryngeal mask airway. Time taken to insert Igel was significantly less as compared to proseal laryngeal mask airway. However, there was no difference in hemodynamic parameters and oxygen saturation between the two groups.

Background. Postpartum hemorrhage (PPH) is a major cause of serious maternal morbidity and mortality worldwide. To avoid the same, it is essential to find out avoidable factors and to reduce their consequences. So, the present study is taken to see the incidence, management and outcome of primary PPH in a tertiary care centre. Objective of current study was to study the incidence, management and outcome of primary PPH in a tertiary care hospital.Methods: This observational cross-sectional study was conducted in a tertiary care hospital over a period of one year. A total of 200 patients developing primary PPH after delivery were divided into two groups-Group A: Patients with primary atonic PPH and Group B: Patients with traumatic PPH.Results: The incidence of primary PPH in our study came out to be 8.3%. Most of the cases were in the age group of 26 -30 years. 84% of the patients belonged to rural areas. 72.5% of patients had hemoglobin levels below 9g%. The main cause of PPH in our study was uterine atony with an incidence of 73% followed by traumatic PPH in 24% cases. Cesarean sections constitute about 55% cases whereas spontaneous vaginal delivery constitutes 45% cases. Primary PPH was noted in 60% cases that underwent induction of labor followed by 28.9% having augmented labor and 11.1% had spontaneous onset of labor. Conclusions: Every pregnancy should culminate in a healthy mother and healthy baby and for that we should make sure that every woman should have access to top quality essential and emergency obstetric services to cut back maternal mortality. Finally, the surest prophylaxis of PPH is that the correct management of all stages of labor should be done.

Background: Inguinal hernia repair is one of the most commonly performed surgery in surgical practice and has evolved through various techniques. However, which technique is gold standard is still a topic of debate and the clinical studies are not adequate to show clear benefits of one technique over another. Objective was to compare the outcome of transabdominal preperitoneal repair (TAPP) versus open Lichtenstein tension free mesh repair in primary inguinal hernia.Methods: This retrospective cohort study was conducted in a tertiary care hospital with sample size of 80 patients (40 cases in each group) and these patients were compared in terms of operative time, complications, duration of hospital stay, postoperative recovery, postoperative pain and timing of return to normal activity and work.Results: On comparing the results of our study we found that in unilateral cases the operating time was greater in the TAPP group than the Lichtenstein group; however, in the bilateral cases, the operating time was significantly greater in the Lichtenstein repair group than the laparoscopic TAPP group. The incidence of post operative complications was lower in TAPP group (8.2%) then in open hernia repair group (21.6%). The time to return to normal activity was also lower for laparoscopic group in both unilateral and bilateral cases.Conclusions: It can be concluded that laparoscopic TAPP repair offers significant advantage over open tension free mesh hernioplasty in terms of lesser post operative pain, lesser complications and early return to normal activity, better cosmetic outcomes, and less persisting pain but it is associated with a higher operative time depending on surgeon’s expertise, more costly for the patient and there is no significant difference in early post operative complications.

Background: The COVID-19 pandemic has greatly affected surgical practice in all parts of the world because the safety of minimal access surgery (MAS) was questioned during the COVID-19 pandemic due to increased concern with regard to disease spread. This study assessed the available evidence on the safety of laparoscopy as compared to open surgery during the COVID-19, explored the possible precautions to be taken to prevent exposure of the operating team to the viral infection. The objective of this study was to access the clinical safety of laparoscopy as compared to open surgery during the COVID-19 pandemic.Methods: This study was a retrospective study conducted during the COVID-19 pandemic in the Department of Surgery, GMC, India, from January 2020 to January 2021. The various outcomes assessed included: burden of covid-19 infection among the patients, deaths due to COVID-19, infection acquired by staff, length of hospital stay and post-discharge symptomatology among patients.Results: There was no statistically significant difference in terms of median age of patients (p=0.853), gender (p=0.835), American Society of Anesthesiologists (ASA) status (p=0.876), urgency of operation (p=0.074), total time in theatre complex (p=0.163) or total number of theatre staff involved (p=0.831). The length of stay in the hospital was significantly shorter in the laparoscopic as compared the open group (3.5 versus 9 days; p=0.011).Conclusions: Based on our review, we concluded that if recommended guidelines are followed and proper precautions are taken, laparoscopic surgery is safe for patients and theatre staff during the COVID-19 pandemic. Only on the basis of COVID-19, laparoscopy should not be replaced by laparotomy. If laparoscopy is strongly indicated in patients, it can be used with precautions because of its benefits over open surgery.

Background: Surgical audit is defined as a systematic, critical analysis of the quality of surgical care that is reviewed by peers against explicit criteria or recognized standards, and then used to further inform and improve surgical practice with the ultimate goal of improving the quality of care for patients. Aims and objectives were to study the profile of patients who died due to trauma and to identify factors involved in both pre-hospital and hospital care.Methods: This study was conducted in the department of surgery, GMC Jammu during over a period of one year. The profile of all traumatic deaths was studied to evaluate the various causes of trauma related mortality, age and sex relationship, mortality rate, prognostic indicators and also to identify factors involved in both pre-hospital and hospital care.Results: A total of 414 deaths occurred due to trauma. Out of these 317 patients were males and 97 patients were females comprising male to female ratio of 3.3:1. Road traffic accidents accounted for majority of the deaths (57%) followed by falls (35.5%), assaults (5.07%) and miscellaneous causes (2.43%). In children less than 15 years of age, traumatic deaths were more due to falls, whereas in adults it was more due to road traffic accidents. In our study there was steady rise of fatalities during weekend days with a peak on Saturday. Cranio-cerebral injuries were responsible for majority of the traumatic deaths (85.9%) followed by limb injuries including fractures (38.4%), thoracic injuries (27.7%), abdominal injuries (24.6%), pelvic injuries (20.7%) and spine injuries (14.2%).Conclusions: This study can be the impetus to motivate committed professionals in the trauma specialty to help in the organization of available facilities and to upgrade existing facilities for a better response to injury, which should not be different from other public health responses.