Background: Approximately 1.2 million people per year are affected by pneumonia in the United States. In paediatric patients, thoracis empyema complicates pneumonia 36% to 57% of the time with a range of incidence between 0.4 and 6.0 cases per 1000 paediatric admissions. Many retrospective case series have suggested that children who experience failure of conventional chest tube therapy exhibit improvement after thoracotomy or video assisted thoracoscopic surgery (VATS), especially if the procedure is performed early, based on these reports, many paediatric surgeons have come to consider primary VATS a better approach for children suffering from thoracis empyema, A recent meta-analysis suggested that primary surgical intervention for paediatric thoracis empyema effusions was best which was prospective, randomized study done by Waite et al in adults.Methods: The present prospective study was conducted in a large teaching hospital that is a tertiary centre, department of surgery pediatric surgery unit, Pt. J. N. M. medical college & Dr. B.R Ambedkar hospital, Raipur (C.G.), India, in the year 2010. Using a random number method, patients were assigned either to a primary conventional thoracostomy arm or to a VATS arm. Those randomly assigned to the conventional thoracostomy arm had chest rube placement within 24 hours of empyema detection. If the chest radiograph obtained within 24 hours of the procedure showed significant clearing, then the thoracostomy tube was left in place until it drained <1 mL/per day for >24 hours. If there was incomplete resolution of the effusion on the follow-up chest radiograph [obvious locations] and the patient was not clinically improving, then the patient was evaluated for rescue VATS or open thoracotomy. A sample size of 30 was chosen to have an 80% power to detect a predicted deference of 4 days in the mean length of hospitalization. Results: In this study, 30 patients included between 0 to 18 years of age youngest patient was 1 year and the oldest was 14 years. Six patients (20%) were between 2 to 3 years of age. In this study, 20 (67%) were male and 10 (30%) patients were females. Out of all 30 patients, in this study 20 (67%) were male and 10 (30%) patients were females.[Sixteen (53.3%) patients had right sided disease and fourteen (46.6%) had left sided disease, no patient was found having bilateral disease. All the thirty patients were empyema Thoracis. Using a random number method, patients were assigned either to a primary conventional thoracostomy arm or to a VATS arm. Conclusions: In the present study we found that empyema thoracis can be successfully treated by thoracoscopic decortications if encountered in early phase of the disease process. To conclude early intervention of empyema thoracis with thoracoscopic decortications seems to be the worldwide accepted modality of choice.

Background: Incisional hernia is the second most common type of hernia after inguinal hernia. It is a complication of abdominal surgery, reported in up to 11% of patients generally and in up to 20% of those who developed post operative wound infection. The list of predictive factors associated with development of incisional hernia is obesity, diabetes mellitus, steroid, smoking, old age, malnutrition, COPD and type of incision.Methods: This was a hospital based cross sectional observational study carried out from February 2018 - October 2019 in surgery department of Dr. B.R.A.M. Hospital Raipur C.G, with diagnosis of incisional hernia. Total 100 patients were included in the study.Results: In present study the mean age of study subjects was 47.27±13.16 years. Around two-third 64% were females. 40% of perforation and 35% of LSCS cases later develop to Incisional hernia.  Risk factors profile showed that 31% were alcoholic, 27% smokers, 48% pre-obese and 5% were obese. 36% were hypertensive, 48% diabetic, and 12% had constipation. 25% had prolonged cough, 35% had surgical site infection, 45% had anemia. Clinical presentation of study subjects showed that 63% had swelling, 33% had swelling and pain and 4% had obstruction.Conclusions: Incisional hernia is more common in female than males and in cases above the age of 45 years. It is more common in patients who underwent the previous surgery on an emergency basis especially in perforation and obstruction and LSCS cases. Risk factors associated with incisional hernia are smoker, alcoholic, obesity, hypertension, diabetes, constipation, prolong cough and anemia.

INTRODUCTION :- Laparoscopic cholecystectomy is very commonly performed surgery for symptomatic cholelithiasis. There is very low risk of infective complications in elective Laparoscopic cholecystectomy and hence standard guideline doesn't recommend prophylactic antibiotic usage for low risk cases. However it is very commonly practicised in dosage and duration inconsistent among various surgeons. This study is being done to assess the efcacy of single dose antibiotic prophylaxis over multiple dose in the prevention of surgical site infection in patients undergoing elective laparoscopic cholecystectomy to avoid antibiotic resistance and overuse of it . METHODS: The study included 60 patients admitted for elective Laparoscopic cholecystectomy. First 30 patients received injectable ceftriaxone 1 gram intravenous peri-operatively, rst dose twelve hour before surgery and second dose half hour before surgical incision and then followed by injection (conventional dose) ceftriaxone 1 gram/day iv twice daily for the rst 5-7 days post-operatively. Next 30 was dened as the single dose (post-operative) antibiotic patients , this group were given only single dosage of injectable ceftriaxone 1 gram intravenous post-operatively.operation-room anesthetic assistant administered prophylactic antibiotics at induction of anaesthesia to all the patients. On the third, fth, tenth and fteenth days post operatively, based on Southampton scoring system the wound was seen and grading of the infection was done RESULT: The post-operative surgical site infection rate in group receiving single dose was 7.76 % and that in multiple dose group was found to be 6.67% . Chi- square test was used to analyse the data and the difference in the rate of SSI in both the groups was found to be statistically insignicant. CONCLUSION: There is no signicant difference in the outcome of elective laparoscopic cholecystectomy in terms of post operative surgical site infection in single dose and multiple dose group. Also single dose of antibiotics are more patient compliant, cost effective, have less adverse effects and reduce the incidence of antibiotic resistance

Background: Gallstones are one of the widely occurring digestive/hepatobiliary disorders. Chronic cholecystitis, cholelithiasis or symptomatic gallbladder is a prolonged mechanical or functional disorder of abnormal gallbladder emptying.  Nearly eighty percent of the gallstones are cholesterol gallstones, and 20% are pigmented stones consisting of bilirubin and calcium, the two components present in the bile. The diagnosis is established by a variety of diagnostic tools like ultrasonography, CT scan, ERCP, liver function tests and pancreatic enzyme studies. The hypothesis of the presence of H. pylori in the biliary epithelium of the patients with hepatobiliary ailments has been sporadically investigated. Helicobacter pylori (H. pylori) is a spiral, microaerophilic, gram-negative bacterium. There are many suggestive evidences that the DNA components of H. pylori is found in the bile, gallbladder tissue and/or cholesterol gallstones. The association of gallstones with Helicobacter pylori has been investigated by many authors, but not clearly established. Methods: The present study is aimed to identify the Helicobacter pylori infection as a risk factor for gallstone disease. The histopathological samples of gall bladder mucosa were examined by staining with modified giemsa stain, haematoxylin, and eosin. Results: Our study showed the presence of H. pylori in only one case which is not statistically significant. Moreover, the present study was based on H and E stains only and they should have been substantiated with immunohistochemistry and PCR studies. Thus, further studies are required to establish a causal relationship between the Helicobactor pylori infection and gallstone formation. Conclusions: Helicobacter pylori as a risk factor for gallstones is yet to be proven.

INTRODUCTION: Gallstone disease is a common clinical condition affecting the adult population of both sexes. Iron deciency was found to be a new parameter in aetiology of gallstones[5, 6,7]. Iron deciency has been shown to alter the activity of several hepatic enzymes, leading to increased gallbladder cholesterol saturation and promotion of cholesterol crystal formation[8, 9]. Iron acts as a coenzyme for nitric oxide synthetase (NOS), which synthesizes nitric oxide (NO) important for the maintenance of gallbladder tone and normal relaxation [10, 11]. METHOD: Prospective case control study was conducted In Dr.B.R.A.M. Hospital, Raipur On January 2020 to December 2020. sample size was for case is 60 and for control 60 taken On the basis of inclusion and exclusion criteria . patient sonological conrmed and estimate the serum iron and ferritin level . Data are analyzed with descriptive statistical principals RESULT: 31.67% patient of cholelithiasis have serum iron level below normal value .In control group 21.67% participants have normal serum iron level ( P value = 0.21) 33.33% cases have serum ferritin level below normal range and18.33% of control group have serum ferritin level below normal range ( P value = 0.06 ) CONCLUSION: gallstone are more prevalent in female population than males . low serum iron was not signicantly found in both case and control group with relation to cholelithiasis. low serum ferritin level not signicantly found both in case and control group