BACKGROUNDFournier's gangrene (FG) is a rare but life-threatening disease. Although originally thought to be an idiopathic process, FG has been shown to have a predilection for patients with diabetes as well as longterm alcohol misuse; however, it can also affect patients with non-obvious immune compromise. The nidus is usually located in the genitourinary tract, lower gastrointestinal tract, or skin. FG is a mixed infection caused by both aerobic and anaerobic bacterial flora. The development and progression of the gangrene is often fulminating and can rapidly cause multiple organ failure and death. Because of potential complications, it is important to diagnose the disease process as early as possible. Although antibiotics and aggressive debridement have been broadly accepted as the standard treatment, the death rate remains high. Aim -The purpose of this study is to highlight the aetiopathogenesis, risk factors and outcomes of Fournier's gangrene. MATERIALS AND METHODSA retrospective descriptive study was conducted on 288 patients of Fournier's gangrene (ICD-9 CM 608.83) from January 2013 to December 2016 at King George Hospital, Visakhapatnam, Andhra Pradesh, India. All cases who were found to have Fournier's gangrene at the time of admission were included in the study. RESULTSAmong the total 288 patients, 280 were male (97.23%) and 8 were female (2.77%). These cases represented less than 0.02% of hospital admissions. The overall incidence was 1.6/100,000 males, which peaked in males who were 50 to 79 years old (3.3/100,000). The overall case fatality rate was 22.91% (66). Primary underlying cause leading to Fournier's gangrene is not identified in 46 (15.97%) patients, which is referred as idiopathic variety. In remaining 242 (84.03%) cases, anorectal disease is leading cause (133, 46.18%) followed by genitourinary diseases (89, 30.90%) and other identifiable aetiology in 20 (6.94%) cases. The risk factors frequently associated with Fournier's gangrene are diabetes mellitus which is observed in 171 (59.37%), chronic alcoholism in 135 (46.87%), immunosuppression due to advanced malignancy 9 (3.12) and AIDS 5 (1.73%) and other unidentifiable risk factors in 44 (15.27%). Some patients have more than one risk factor like chronic alcoholism and diabetes mellitus 77 (26.73%). CONCLUSIONPatients with Fournier's gangrene are rarely treated at most hospitals because of lack of ICU facilities and unawareness of aetiopathogenesis. It is a very aggressive disease which needs prompt early diagnosis and aggressive management with broad spectrum antibiotics and thorough early debridement. Despite of aggressive management the mortality is still high.

BACKGROUND Thyroidectomy is a very common surgical procedure worldwide and is performed by surgeons with varied training. The outcome and complication rates are largely dependent on surgeon's skill and experience, the extent of surgery, indication of surgery and number of thyroid surgeries performed at that particular centre. The objective of this study is to determine the frequency of postoperative complications after thyroid surgery in a tertiary care hospital, Vishakhapatnam. The purpose of this study is to assess the early complications of total thyroidectomy and risk factors which leads to these complications. MATERIALS AND METHODS It was a retrospective descriptive study and was carried out over a period of 3 years from January 2014 to December 2017. A total of 179 patients of thyroid swelling, who underwent total thyroidectomy are assessed over a period of 3 years. All patients with thyroid swelling who underwent total thyroidectomy irrespective of cause of thyroid swelling were included in this study. Patient's biodata including age, sex, clinical status of thyroid, thyroid function tests, ultrasound, fine needle aspiration cytology and operative procedure, findings, post-operative complications and histopathology were recorded. RESULTS A total of 179 cases of thyroid swelling who underwent total thyroidectomy were assessed. The overall post-operative complication rate was 20.11% (36 cases). Post-operative hypocalcaemia was the most frequent complication observed in 33 cases. Most of the hypocalcaemia is transient in immediate post-operative period; permanent being observed in 4 cases. Recurrent laryngeal nerve (RLN) injury was noted in 10 (5.5%) patients. The complications like bleeding leading to haematoma formation was observed in one case for which immediate exploration was done; seroma formation in 15 cases. Tracheal and oesophageal injuries were identified in 5 and 2 cases respectively, which were due to extensive infiltration of these structures by malignant thyroid disease. Complications like wound infection, superior laryngeal nerve injury and sympathetic chain injury were not observed in our study. Many patients had more than one complication.

Background: Salivary gland neoplasms are rare and constitute 3 to 4% of head and neck neoplasms. Majority of them are benign and a small percentage of them constitute malignant tumors. A careful clinical examination and judicious investigations help us to plan for an optimal surgical management. The aim of the study was to study clinico-epidemiological pattern, histological subtypes, management & postoperative complications of salivary gland neoplasms.Methods: This retrospective study was conducted on 52 patients admitted into the surgical wards of DR. PSIMS and RF during the period between November 2017 and October 2020. All the patients were followed up until one year (October 2021) after surgery.Results: Data of 52 cases of salivary gland neoplasms were recorded, of which 20 were male and 32 were female, and the median age group was 41 to 50 years. Majority of the patients (47) presented with swelling in the parotid region of 1 to 2 years duration. 44 patients were diagnosed with pleomorphic adenoma of the parotid gland and 43 of them underwent superficial parotidectomy.Conclusions: The parotid gland is the most commonly involved gland with the majority of the cases being pleomorphic adenoma. Superficial parotidectomy was the most common surgery done with a minimal complication rate.