Background: Pilonidal sinus is a common disease of young adult usually caused by insertion of fallen hair into skin (Gluteal cleft). Wide excision surgery is a common practice but due to high recurrence and long duration of healing there are more simple alternatives. Our experience with transposition of Rhomboid flap in the treatment of pilonidal sinus are described. The conventional way of treatment of pilonidal sinus is block excision and lay open of the sinus result in 5-14 days hospital stay healing time of 6-10 weeks. In our study all patients hospital stay was 2-3 days, healing time was less than two weeks with minimum complication. The aim of the study is to do rhomboid flap for the treatment of pilonidal sinus, so to avoid complications and recurrence, to shorten hospital stay and to give better outcome. Methods: Total 6 patients of 18-40 years of age after doing all investigations and clinical examinations, excision of pilonidal sinus was done and repaired by rhomboid transposition flap in the same setting. All the patients were followed up post operatively for 3 months to see any discharging sinus. Results: All 6 patients were discharged on 3 rd post operative day and stitches were removed on 8 th post operative day and approximate time to resume their work is 14 days. Conclusion: Pilonidal sinus surgery is a challenging operation for the surgeon because of recurrence and complication. Rhomboid flap technique has become familial because of its advantage of early healing, less hospital stay and very low recurrence rate.

Background: One of the common cause of admission in surgical ward with acute abdomen in Asian subcontinent is Biliary Ascariasis.The causative agent, Ascarias lumbricoides is distributed throughout the tropics & subtropics & mostly prevent is developing country due to unhygienic livelihood. This study deals with management of Biliary Ascariasis demonstrating the effectiveness of only conservative management in acute condition. Materials and methods: This was an analytical study where 47 patients diagnosed as a case of Biliary Ascariasis were observed & managed accordingly. Complete history, diagnostic tool, complication of Ascarisis & treatment modality were analysed. Result: Here we documented 47 patients throughout the period October-2018 to September -2019 age limit is 13 yrs to 70 yers. Out of which female patient was 78.72% where male was 21.27%. Among female patient 10.63% were pregnant at the time of presentation. 100% patient present with biliary colic, 57.44% had associated nausea & vomiting 38.99% patient present as a case of cholecystitis. Cholangitis developed was 8.5% patient, 8.5% had obstructive jaundices, 4.2% developed liver abscess, 6.38% pancreatitis, 10.63% got cholelithiasis & 8.51% develop chololadocholithiasis &/ or hepaticolithiasis. USG & CBC was advised for all patient as standard diagnostic tool. During conservative treatment endoscopy was advised to all, only 63.82% was able to do this & successful extraction of worm was possible in 26.02%.70% improved by conservative treatment & ERCP required in 10.63%.Surgery for exploring CBD was done in 1 patient (2.1%). 34.02% patient had H/O recurrent attack. 17.02% patient underwent previous endoscopic procedure & 8.51% ERCP procedure. Before discharge review USG found in 68.08% patient with evidence of clear CBD & then discharged with advice of taking Antihelmintic therapy in 2 months interval. Conclusion: Maintenance of hygienic & regular anthelmintic therapy is all prevention of occurance & complication. only conservative management with or without minimal invasive endoscopic retrieval of worm is very much effective for improvement of symptoms. JCMCTA 2019 ; 31 (1) : 9-12