BACKGROUND Air in the peritoneal cavity is called as Pneumoperitoneum. Not all the cases of pneumoperitoneum are due to hollow viscus perforation. Most common cause of pneumoperitoneum is due to hollow viscus perforation in 90% cases, mostly due to duodenal ulcer perforation or gastric perforation. In 10% of the cases, the pneumoperitoneum does not indicate the perforation nor warranted the surgery. Pneumoperitoneum that is non-iatrogenic that does not need surgery is called as spontaneous pneumoperitoneum. MATERIALS AND METHODSThis study analyses the spontaneous/non-surgical causes of pneumoperitoneum and our experience in our institute for the past 5 years that is from June 2011 to May 2016 and also aims to create awareness about the non-surgical causes of pneumoperitoneum, identifying cases for which negative laparotomy can be avoided. RESULTSIn this period 11 patients were identified with nonsurgical causes of pneumoperitoneum, from that 2 patients underwent emergency laparotomy which was negative and 9 patients were managed conservatively. CONCLUSIONIn our study totally 11 patients were presented with pneumoperitoneum, out of which 9 patients were managed conservatively and 2 patients underwent negative laparotomy. Most common cause of spontaneous pneumoperitoneum in our study is thoracic cause.

BACKGROUNDBurn Injuries are one of the leading causes of death in all medicolegal cases in developing countries like India. Burn Injuries are the most common mode of death in dowry deaths. MATERIALS AND METHODSThe study was conducted as a retrospective study. The study includes all burn injury patients who got admitted in our tertiary care centre. The details were analysed. RESULTSTotally 1016 patients were included in this study. Among them, patients aged between 21 to 30 years and 31 to 40 years constitute the major portion of burn injury patients in both sexes. In this study, 41-50% burns diagnosis made in maximum number of patients. Almost 89% burns patients had varying depth of burns. Most of the burn injury occurs in home around 82%. Most common nature is accidental, followed by suicidal. Most common cause of burns was due to fire. 50.19% of burns patients suffered from >40% of burns. Most number of deaths occurred because most of them suffered >40% of burns due to its severity. CONCLUSIONThis study helps to improve the burns safety regulations, creating awareness among the public and improve the burns care unit facilities.

BACKGROUNDIndia is becoming the world capital of diabetes mellitus. Diabetes mellitus has many number of complications. Patients with diabetes mellitus seek medical attention for their foot problems more often. Among those who developed diabetic foot problems, 15% underwent some type of toe to foot amputations.Aim of this study is to assess the efficiency of topical phenytoin on diabetic foot ulcers, Meggitt's grade 1 and 2.

BACKGROUND Metastatic malignant tumours of the Liver are common in clinical practice, ranking second only to cirrhosis as a cause of fatal liver disease. At autopsy, 30-50% of all patients dying from malignant diseases reveal hepatic secondaries. MATERIALS AND METHODS Liver metastases are 7 times commoner due to gastrointestinal primary cancers than other tumours. Patients with Liver metastasis due to GI Tract malignancies included in this study, so extra gastrointestinal causes have been excluded from this study. RESULTS 60% of liver metastases in this study is secondary to colorectal primary cancers. 96% of liver metastases are Adenocarcinomatous origin form GI tract. 2% i.e., one case of squamous cell carcinoma of oesophagus and 2% i.e., one case of NHL from small intestine. Female sex predominates as 60% of overall cases with liver secondaries. Average duration of illness before presentation and diagnosis is more in females than males. 96% of these metastases are exclusively from adenocarcinomas. CONCLUSION The surgical management of patients with hepatic metastases involves sorting through many variables and choosing an optimal course of action and utilizing technological advances which will continue to improve the outcome for these unfortunate patients with previously hopeless condition

BACKGROUNDRoad traffic accidents are the leading cause of death in all injuries and tenth leading cause of death globally, RTA are increasing alarmingly worldwide and causes the increased morbidity and mortality. Patients presenting with RTA has different pattern of injuries, different modes of accident and with or without intoxication with alcohol or drug use.