Background: Fissure-in-ano is a common yet troublesome condition; if acute, the severity of patient discomfort and extent of disability far exceed that would be expected from a seemingly trivial lesion. The present study was carried out to study the effectiveness of conservative management in symptom relief in acute fissure in ano.Methods: The study was conducted in 165 patients with acute fissure in ano attending Surgery OPD and/or admitted in surgical wards of Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa during the period from 1st August 2015 to 31st July 2016. It was a prospective clinical study. All the study subjects underwent extensive clinical examination and were prescribed conservative treatment regime. Follow up was done at the end of 2 weeks, 4 weeks and 6 weeks and the data was analyzed. 165 patients diagnosed as having acute fissure in ano. The outcome was assessed based on the following parameters; symptomatic relief, pain relief based on visual analogue scale and healing of ulcer.Results: Most of the patients were young adults with a slight female dominance. Pain during defecation and bleeding per rectum were the major presenting complaints. 73.94% of patients achieved symptom relief within 2 weeks of conservative treatment. At 6 weeks follow up after giving conservative line of management, 97.58% achieved symptom relief with healing of ulcer. Mean pain score was reduced from 9.5±0.71 at the start of therapy to 1.33±0.69 at the end of 6 weeks of conservative therapy.Conclusions: Acute fissure in ano can be easily cured with systematic usage of conservative treatment regime. A proper follow up along with patient education can help to achieve good remission and avoid unnecessary surgical intervention.

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Background: Trauma is a critical and urgent surgical condition that we encounter on a regular basis. Blunt trauma mechanisms account for 78.9–95.6% of all injuries, with the abdomen being affected in 6.0–14.9% of all traumatic injuries. Diagnostic laparoscopy (DL) for blunt abdominal trauma (BAT) is safe and feasible. Prerequisites are the hemodynamic stability of the patient and surgical expertise in advanced laparoscopy. Aims and Objectives: To find out the role of DL in the diagnosis and management of abdominal trauma patients. Effect on the length of hospital stay and rate of reduction of non-therapeutic laparotomy in the patients with trauma abdomen. Materials and Methods: This cross-sectional study was conducted with 50 patients of abdominal trauma with pre-structured pro forma and Written informed consent. A contrast-enhanced computed tomography (CECT) scan of the abdomen was done in hemodynamically stable patient and injury was noted. Patients meeting the inclusion criteria underwent DL. Results: The duration of hospital stay was lower in laparoscopically managed patients than in laparotomy patients. Most of the patients were managed conservatively 37 (74%) and thus by reducing non-therapeutic laparotomy. Overall recovery was 86% which signifies the reduction in mortality rate with the use of DL. In this study, clear diagnosis was obtained in 88% of the cases, so the efficacy is 88%. Conclusion: Laparoscopy and CECT abdomen has an effective diagnostic and management role in patients with BAT. The therapeutic value of DL is also accepted, well appreciated, and it cannot be underestimated.