BACKGROUNDTyphoid is a major cause for non-traumatic ileal perforation in developing and under developed countries. 1,2,3,4,5,6 Other causes of non-traumatic ileal perforations worldwide include intestinal tuberculosis, 11 Crohn's disease, Behcet's disease, radiation enteritis, adhesions, ischemic enteritis and nonspecific ulcer. The public health burden of enteric fever in India is huge. Typhoid burden in some states and union territories in India, like Kerala, Mizoram, Sikkim, Goa etc. are much lower than the national rate. 16 The objectives of this study were-(a) To find out the causes of non-traumatic ileal perforations for which surgery is undertaken in our institution (b) To estimate the frequency of typhoid fever among non-traumatic ileal perforations. (c) To analyse the various surgical treatments offered and (d) To analyze morbidity and mortality among patients operated. MATERIALS AND METHODSThis is a retrospective cohort study. During 2012 to 2017, a total of 62 patients with perforation peritonitis were identified as ileal perforations, at laparotomy. Data collected and analysed with the help of SPSS software Version 21.0. Basic statistical methods like percentage analysis were employed for the analysis of the data.

BACKGROUNDIt is a matter of controversy that whether deviated nasal septum is contributing to Eustachian tube dysfunction. In this study, the investigator observed a number of patients with deviated nasal septum (DNS) undergoing surgical correction and was interested to find out whether DNS was contributing to the development of Eustachian tube dysfunction (ETD) in these patients. Aims of this study-(i) To find the incidence of decrease in the negativity of middle ear pressure (MEP) in patients undergoing septoplasty for deviated nasal septum, and (ii) Among patients undergoing septoplasty, to study the relative proportion of decrease in the negativity of MEP in patients who are also having allergic rhinitis and chronic sinusitis. Settings & Design-This was a prospective analytical study done in a tertiary care centre in south India.

BACKGROUNDThe main post-operative complications of thyroidectomy are temporary hypocalcaemia (20%), permanent hypocalcaemia (4%), transient vocal cord palsy (1-2%) and permanent vocal cord palsy (0.5-1%). These complications are less with experienced surgeons using capsular dissection technique. The technique of capsular dissection can be done with the conventional technique or using other energy sources. Our study aims to find the outcome of capsular dissection using monopolar cautery. We wanted to study the outcome of capsular dissection technique, using monopolar cautery, during thyroid surgery, with regard to complications, bleeding and time taken for the procedure. METHODSThis is a retrospective study conducted in the Department of Surgery, Government Medical College, Thrissur. Details of patients undergoing thyroidectomy by capsular dissection technique, using monopolar cautery, during the period 2012 to 2015 were collected. Collected data was subjected to statistical analysis with the help of SPSS Ver. 21.0. Basic statistical methods like percentage analysis is used for analysis of data. RESULTS115 patients who underwent thyroidectomy for varying indications during the period and satisfying the inclusion criteria were included in the study. All patients were operated under general anaesthesia. All surgeries were done by the same surgeon, by capsular dissection technique using monopolar cautery. Average time duration was 79 minutes for total and 60 minutes for hemi-thyroidectomy. Blood loss was less than 30 ml. in all patients. There was no mortality. Overall complication rate was 5.2%. Transient hypocalcaemia was 3.4%, temporary hoarseness was 2.2% and wound haematoma was 0.8%. CONCLUSIONSCapsular dissection using monopolar cautery in thyroidectomy is safe and effective. This technique is less time consuming, causes only minimal bleeding and has lower complication rate.

BACKGROUND Gastric perforation is a common surgical emergency. Majority is due to benign ulcers, but rarely it may be cancer perforation. Usually it is on the anterior surface of the stomach. Only rarely we get perforation on the posterior surface. Pre-pyloric area is a common location of stomach perforation. Surgical options like primary closure or omental patch repair are favoured in the literature as these options carry good results as well as low mortality in an emergency setting. Traditionally it is said that gastric perforation carries high incidence of malignancy so should either be resected or at least a biopsy is essential before closure. The objectives of this study were-1. To identify the most common location of gastric perforations. 2. To identify the total incidence of malignancy. 3. To determine the rate of malignancy in different locations. 4. To evaluate the need for intraoperative biopsy. 5. To identify the best treatment options for these patients. MATERIALS AND METHODS This is a retrospective cohort study. Patients operated for gastric perforations during the period 2013-2016 were identified and details collected from data base. The collected data was subjected to statistical analysis with the help of SPSS Version 21.0. RESULTS Results of the analysis are presented in the form of tables and graphs. CONCLUSION Most common location of gastric perforation is pre-pyloric region. Incidence of malignancy is less in pre-pyloric perforation (1.3%). Malignancy incidence is more in other locations in stomach (24%). Intra operative biopsy is essential, since malignant perforation was detected in all locations, especially in locations other than pre-pyloric region of stomach. Gastrectomy in the setting of perforated stomach carries high mortality.

BACKGROUND Stomach cancer is the fourth most common malignancy in the world. 1 Except in countries where screening for stomach cancer is prevalent, most of the distal stomach tumours are diagnosed at advanced stage. Gastric outlet obstruction is usually believed to be a sign of locally-advanced disease. Complete surgical removal of the disease (R0) is the only potentially curative treatment for resectable gastric cancer. The aim of the study is to finda) The operability rate of gastric cancer in our institution and the incidence of Gastric Outlet Obstruction (GOO) in patients undergoing gastrectomy for distal gastric cancer. b) To compare the postoperative outcome in patients with gastric outlet obstruction and those without gastric outlet obstruction. c) To see if the histology of the tumour has any role in the development of GOO. MATERIALS AND METHODS This is a retrospective study. The study includes patients who were admitted with carcinoma stomach and underwent operative or nonoperative treatment in our institution during 2013 to 2015. RESULTS Overall operability rate was 45.8%. Operable patients in the GOO group were 47%. Operability in the no outlet obstruction group were 45%. Data shows a slightly increased predilection for GOO in diffuse and mixed type of tumours (statistically not significant). Intestinal tumours had significant rate of anaemia compared to diffuse tumours (p <0.005). Overall mortality was 6.7%. Mortality is higher in the GOO group (8.8%). CONCLUSION (a). Operability rate of distal gastric cancer in our institution is 45.8%. (b). Incidence of gastric outlet obstruction in patients undergoing gastrectomy is 38.2%. (c). Presence of gastric outlet obstruction does not influence operability rate (47% vs. 45%). (d). Morbidity and mortality after distal radical gastrectomy is comparable in both groups. (e). Both intestinal and diffuse histology have equal incidence of GOO. (f). Chronic blood loss and incidence of anaemia is more in intestinal type of tumours compared to diffuse histology.