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BACKGROUND Acute appendicitis is the most common intra-abdominal condition requiring emergency surgery. Past reports have shown that up to 30% of appendices have been removed after clinical diagnosis of acute appendicitis, which may be normal on histopathological examination. In spite of advanced technology and vast knowledge about the condition, it remains a difficult task for clinicia ns to diagnose it cent percent accurately. Emergency appendicectomy is performed to prevent morbidity and mortality due to perforation and gangrenous changes. In such situations, a certain percentage of normal appendices are found to be removed due to misdiagnosis. There is general agreement that highly competent surgeons make false positive diagnosis of acute appendicitis and remove normal appendices about 20% to 25%. The discomfort and risks associated with an exploratory laparotomy and discovering "no disease" are far outweighed by the morbidity and mortality (about 2%) associated with perforation (Singhal R et al, 2007). 1 MATERIALS AND METHODS This study was a prospective study conducted in Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India from April 2010 to March 2017. 1000 cases of appendicectomy specimens were examined histopathologically to confirm for acute appendicitis. Detailed history was taken, physical examination and relevant laboratory investigations were performed during the clinical encounter. The diagnosis of acute appendicitis was made clinically and was confirmed after histopathological examination of the removed appendix. RESULTS Out of 1000 appendix specimens sent for histopathological examination, 440 (44%) showed simple appendicitis, 240 (24%) showed gangrenous appendicitis, 200 (20%) showed perforated appendicitis and 120 (12%) showed no appendicitis.

ABSTRACT:To study the causes and outcome of perforation peritonitis in a newly established Medical College for a period of three years. MATERIALS AND METHODS: Three hundred cases of Perforation Peritonitis admitted in the General Surgery ward of JN Institute of Medical Sciences Hospital, Porompat, Imphal from January 2011 up to December 2013 who underwent exploratory laparotomy were studied. Preoperative diagnosis was done by clinical examination and investigations like Chest X ray erect, USG whole abdomen. In select doubtful cases, CECT abdomen was done. After initial resuscitation and confirmation of diagnosis, exploratory laparotomy was done. RESULTS:The most common site of perforation was Duodenal followed by Appendicular, Ileal, Jejunal, Gastric, Multiple site and Colorectal perforations. Primary closure of the perforation site was the commonest procedure followed by appendicectomy, resection anastomosis of bowel and colostomy. The overall mortality was 5%. CONCLUSION: Perforation peritonitis continues to be one of the most common surgical emergencies in India, inspite of advances in diagnosis and treatment. Early diagnosis and prompt management is the key to reduce morbidity and mortality.

BACKGROUNDBenign breast diseases encompass a wide range of clinical and pathologic entities and globally they are the most common lesions accounting for 90% of the clinical presentation related to breast, but much concern is given to malignant lesions of the breast. The clinician must differentiate between them and give appropriate treatment for each case and avoid unnecessary longterm followup.The objective is to study the pattern of presentation of breast disease in different age groups attending surgical outpatient clinic. MATERIALS AND METHODSThis is a descriptive study of 302 females with breast symptoms who presented in surgical outpatient clinic at a state medical college located in the capital city of a north eastern state of India from 1 st April 2015 to 31 st March 2017. RESULTSOut of 302 cases, 210 (69.54 %) were benign followed by 75 (24.83%) inflammatory and 9 (2.98%) cases of malignant lesions. The overall mean age of patients with breast lesion was 32 ± 11.29 SD. Fibroadenoma was the most common condition in benign breast disease with 82 (27.15 %) cases and with mean age of 29.25 ± 9.74 years. CONCLUSIONThe commonest benign breast lesion encountered in surgical practice is fibroadenoma and the peak age of presentation is the second decade of life. The commonest mode of presentation in patients with breast disease is the palpable breast lump followed by mastalgia. Triple assessment plays a significant role in diagnosis and evaluation of breast disease. KEYWORDS BACKGROUNDThe breast is an appendage of skin and is a modified sweat gland. It is composed of glandular tissue, fibrous or supporting tissue and fat, which lies between the skin and the pectoral fascia, to which it is loosely attached. It extends from the clavicle superiorly down on to the abdominal wall, where it extends over the rectus abdominis, external oblique and serratus anterior muscles. The lifecycle of the breast consists of three main periods: development (early reproductive life), mature reproductive life and involution. 1 Breast problems for which patients consult doctors are breast pain, nipple discharge and palpable masses. Breast diseases include benign, inflammatory and malignant conditions. Benign breast diseases encompass a wide range of clinical and pathologic entities and globally they are the most common lesions accounting for 90% of the clinical presentation related to breast. 2,3

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