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Background: A fistula-in-ano is an abnormal hollow tract or cavity that is lined with granulation tissue and that connects a primary opening inside the anal canal to a secondary opening in the perianal skin; secondary tracts may be multiple and can extend from the same primary opening.Methods: All cases of clinically diagnosed fistulae-in-ano admitted in various surgical units in Index Medical College Hospital, Indore during the study period January 1, 2015 to December 31, 2017. A Preformed set of questionnaires will be prepared and tested and the same proforma will be used for the study of selected clinically diagnosed cases of Fistula-in-ano. Clinical history was obtained in all the patients. Clinical examination including per rectal and proctoscopic was done in required patients.Results: Total 44 cases of fistula in ano were selected randomly using closed envelope method and studied in detail the following results were obtained. In this present series, 56.81% of patients were in the age group of 31-60 years followed by 34.09% of patients were in the age group of 11-30 years. Only 9.09% of patients were in the age group above 60 years. About major clinical features were noted perianal discharge, pain, swelling and peri anal irritation were 75%, 65.91%, 43.18% and 11.36% respectively.Conclusions: Early diagnosis and appropriate management is the key to success. Fistula-in-ano forms a good majority of treatable benign lesions of rectum and anal canal. 90%or so of these cases are end results of cryptoglandular infections.

Background: Many people have complications after surgery; some transient, others serious, but all are important to patients. The likelihood of postoperative complications is influenced by the type of surgery, the patients pre-existing comorbid state and perioperative management. Anaesthesia result in a variety of metabolic and endocrine responses, but conventional wisdom maintains that anaesthetic technique has little long-term effect on patient outcomes. There is accumulating evidence that, on contrary, anaesthetic management may in fact exert a number of longer-term effects in postoperative outcome.Methods: A prospective study of early post-operative complication in 100 patients’, who underwent major surgery, was done in the Department of Surgery in a tertiary care teaching hospital, Indore. Therefore, the present study was carried out prospectively to study the incidence of postoperative complications in relation to age, sex and other factors which influence them and correlation of post-operative complications with the nature of anaesthesia, duration of operation, type of surgery and in surgery above diaphragm or below diaphragm.Results: The incidence of post-operative complications was more in patients operated with general anaesthesia (48.38% and 12.9% respectively) the morbidity and mortality in patients who were operated under spinal anaesthesia was lower than general anaesthesia, but morbidity was higher in patients who were operated under epidural anaesthesia, but mortality was lower than epidural.Conclusions: There is accumulating evidence that anaesthetic management may indeed exert a number of influences on longer term postoperative outcomes. Further prospective, randomized, large scale, human trials with long- term follow-up are required to clarify the association between anaesthesia technique and postoperative outcome.

Objective:(1)To audit cases of abdominal hysterectomy performed by post graduate tainees. (2) Toevaluate mortality and morbidity rate. Study Design: An observational Study. Setting: Department of Obstetrics andgynaecology, Allied Hospital Faisalabad. Period: From 01-01-2005 to 30-06-2006. Material & Methods:120 casesof abdominal hysterectomies done for non obstetric and benign gynaecological conditions were selected for study.Results: The most common indications for hysterectomy was DUB (43.3%). Overall intra operative complicationsdeveloped in 5 patients (4.1%). Post operative complications developed in 9 patients (7.5%). The mean duration ofhospital stay was 5.5 days. No case of death was recorded in the study. Conclusion: This study demonstrates thatabdominal hysterectomy can be safely done even during the learning curve of the post graduate trainees with the lowcomplication rate, shorter hospital stay and without significant mortality.

Objective: To assess the control of gestational diabetes with metformin and to study maternal and fetal outcome in patients using metformin. Study Design: Cross Sectional study. Setting: Department of Obs & Gynae, Independent University Hospital. Period: September 2019 to July 2021. Material & Methods: Eighty six patient diagnosed as having gestational diabetes mellitus by oral glucose tolerance test included in study and Metformin used as first line therapy along with diet for control of blood sugar levels. While patients with insulin dependent diabetes and type 2 DM were excluded from study. Results: It was observed in study, that with metformin use glycemic control was excellent in 70 (81.3%) of patients. Maternal outcome like risk of maternal weight gain>10kg, preeclampsia, and premature births were low in patient usung metformin in pregnancy and as well as neonatal risk of macrosomia, prematurity, neonatal hypoglycemia and need for hospital admission were low with the use of metformin in patients suffering from gestational diabetes. Conclusion: GDM associated adverse outcome for mother like maternal weight gain, pregnancy induced hypertension operative delivery and neonate like macrosomia, birth trauma, neonatal hypoglycemia are well controlled by the use of life style modification and metformin use in almost >80 % of cases only in few cases there is additional need of insulin therapy. Maternal and fetal outcome found to be satisfactory with the use of metformin. Further studies are required to build a more confidence.