IntroductionOne of the core indicators of monitoring universal access to safe, affordable surgical care is access to timely, essential surgery. Analysing the waiting time for elective operations is one way to determine access to surgical services in a country. Aims of this study were to determine the access to surgical services in a urology unit of Sri Lanka by analysing waiting time for elective surgical operations and to determine whether waiting time is related to income categories and social classes.

Objectives: To observe the outcome of various surgical procedures opted in patients presenting with peritonitis, following typhoid perforation. Study Design: Prospective observational study. Setting: Single surgical unit, Dr. Ruth K.M.Pfau, Civil Hospital, Karachi. Period: 37 months from December 2014 to December 2017. Material and Methods: 25 patients who were admitted from emergency department with the clinical diagnosis of peritonitis following typhoid perforation. The diagnosis of typhoid peritonitis was confirmed on histopathology with the finding of chronic inflammation not associated with granuloma/ giant cell and malignant cells. Results: Out of 25 patients there were 19(76%) male and 6(24%) female patients. The mean age± standard deviation (SD) was 29.52±15 years. Fever and abdominal pain was present in all patient. Generalized peritonitis was present in 23(92%), single perforation at terminal ileum was found in 23(92%). Whereas, loop ileostomy was the commonest procedure performed 14(56%) of patients. En masse abdominal wall closure was performed in 22(88%), however, skin closure was only possible in 11(44%) of the patients.  Wound infection was common complication noted 21(84%), whereas 2(8%) patients died during treatment. Conclusion: With reference to morbidities and mortality loop ileostomy seems to be have a good outcome.