Background: Surgical site infections (SSIs) is a major problem in both developed and developing countries. In developing countries like Bangladesh, infection in surgical patients has been appearing as a serious risk due to insurgence of drug resistance. Surgical site infections (SSIs) contribute significantly to increased health care costs in terms of prolonged hospital stay and lost working days. The problem was largely unexplored in Rangpur Medical College and Hospital, Rangpur. Objective: The aim of the study was to evaluate the bacteriological study on surgical site infections in Rangpur Medical College & Hospital. Methods: This cross-sectional observational study was conducted in the Department of Surgery at Rangpur Medical College Hospital. 72 patients of all ages, sex who developed surgical site infection were included through purposive sampling for observation and clinical follow up and wound swab was microbiologically evaluated. Results: Of the 72 cases, SSI developed 30.6% (22) following elective surgery and 69.4% (50) following emergency surgery. 7 cases were associated with co-morbid conditions like diabetes mellitus (2), malignancy (4) and tuberculosis (1). Most common organisms were Escherichia coli (30 /54) followed by Staphylococcous aureus (14/54), Pseudomonas (07/54) and Klebsiella (03/54).The antibiogram pattern of the organism isolated from wound swab of SSIs were analyzed with commonly used antibiotics. Resistance of Escherichia coli to Amoxycillin, Cotrimoxazole, Doxycycline and Nalidixic acid were 100%, 91.5%, 71.4% and 60.5% respectively. In case of, Staphylococcus aureus 87.5% were resistant to penicillin and Cotrimoxazole. Resistance of Pseudomonas spp. to Ciprofloxacin, Ceftazidime and Gentamicin were 31.2%. 6.3% and 50% respectively. In case of Klebsiella spp, it showed that 100% strains were resistant to Amoxycillin like Esch. coli but all strains were sensitive to both Ceftriaxon and Imipenem. Conclusion: The study emphasizes the need for the evidence-based infection control and antibiotic prescription policies in the hospital. J Rang Med Col. September 2022; Vol. 7, No. 2:12-19

Background: In order to remove the gall bladder, cholecystectomy, which may be performed laparoscopically, is one option. Before, acute cholecystitis was a barrier to laparoscopic treatment, but that limitation has been removed as the technique has evolved and become more refined. Objective: To see the outcome of laparoscopic cholecystectomy in acute gall bladder disease. Methods: This prospective observational research was undertaken from July 2021 to July 2022 at Rangpur Medical college Hospital. This research includes 52 acute cholecystitis patients. Age and gender didn't affect patient selection. Detailing routine and unusual clinical histories Blood, bilirubin Sugar, serum creatinine, CBC, SGPT, HBsAg, etc. Same surgical team performed all procedures. Post-op course and problems were noted. Everyone had four ports (Additional ports) Few individuals had 2-7-day cholecystectomy after acute attack. After attack conversion counseling, all patients had urgent Laparoscopic cholecystectomy. Results: Ultrasonographic findings (Table 2) showed that all the 52 patients had features of acute cholecystitis i.e. distended tense gallbladder with oedematous wall. In this series, 51patients had stones in the gall bladder and 1 patient had only features of acute cholecystitis. 27 patients had single stone. None of them had dilated biliary tree or stone in common bile duct. Most of the patients (41 patients, 78.85%) had leucocyte count (Table-3) between 11000- 13000/cmm, 4 (26.92%) had 13000-15000/cmm and rest seven patients had normal leucocyte count. Conclusion: Early surgery for acute calculous cholecystitis and acute biliary discomfort had a better prognosis than delayed treatment. Acute biliary pain patients benefit from early surgery to prevent read mission, however laparoscopic surgeries in the acute and elective context had a comparable conversion rate. Laparoscopic cholecystectomy is doable and useful provided the patient has the proper support and skill.