Introduction: Typhoid enteric perforation is a communal acute emergency of abdomen in our hospital settings. Maximum patients in Pakistan come from rural zones and have a serious illness when presented in the laten final stages. Objective: To govern the importance of an ileostomy in cases of late presentation with enteric perforation. Study Design: A retrospective study. Place and Duration: In the surgical Department of Islam Medical College and Teaching Hospital Sialkot for one year duration from July 2020 to July 2021. Methods: 52 total patients of typhoid enteric perforation were included in our department. 5 to 32 years was the age range of patients with an average age of 16 years. Most of these patients have complaints of fever, abdominal pain, abdominal distension and vomiting Results: 52 patients with late presentation of typhoid perforation were alienated into 2 groups. All cases of group A underwent laparotomy and perforation exteriorization was done as loop ileostomy. In group A, when exteriorization was performed as the first procedure, fecal fistula was later developed in 12 cases. Ten of these cases had to be re-examined and the second perforation was found to be close to the original one. The mortality was observed in three cases. Conclusion: In a relatively normal-looking intestine, restoration of the margin, closure of the two layers of perforation, and ileostomy near the perforation are safer in the case of late onset of typhoid fever enteric perforation. Keywords: typhoid perforation, double-layer closure and ileostomy

Haemorrhoids are a clinical symptom of a change in the normal functional architecture of the inflamed and swollen veins known as the anal cushion. Numerous treatment opportunities are available for this communal issue, but Baron's Gum Ligation (RBL) is the utmost frequently used technique for second- and third-degree haemorrhoids because it treats hemorrhoidal disease without anaesthesia, hospitalization, minimal complications, and ooutpatient discharge is uneventful compared to conventional surgery. Purpose: We conducted this study to evaluate the effectiveness of rubber band ligation in the treatment of second- and third-degree haemorrhoids. Methodology: This prospective study was performed on 76 patients over a six-month period at the Department of General Surgery from January 2021 to June 2021 at Islam Medical College and Teaching Hospital Sialkot. Rubber rubber ligation was used in all patients. A maximum of two haemorrhoids in one session were banded, and third as needed in a check-up done two weeks later. At the end of the fourth week, post-banding assessments were made for the presence and absence of bleeding, pain, and haemorrhoidal prolapse. Results: Of the 76 patients, 60 (78.9%) were male and 16 (21.1%) were female. The M:F ratio was 5.0: 1.0. 37.85 years was the mean age of patients (range 15 to 68). The duration of symptoms in approximately 48 patients (63.2%) was less than one year old, and in 18 (23.7%) patients ranged from 1 to 3 years and 10 (13.2%) patients had symptoms for more than 4 years. Complications occurred in 23 patients, bleeding in three patients, pain in 18 patients, 2 patients have prolapsed. Conclusion: RBL is effective, safe and simple method of symptomatic treatment for 2nd and 3rd degree haemorrhoids in an outpatient setting.