Background: Pilonidal sinus is a chronic benign disease that mostly affects young adults. It is an acquired condition and commonly arises in the sacro-coccygeal region in the hair follicles of the deep natal cleft due to certain etiologic factors like hirsutism, deep natal cleft, obesity, local trauma, local irritation and smoking. Results: In this study 40 patients of single pilonidal sinus over the sacro-coccygeal region were studied. The Mean age was 29 years and out of 40 patients 12 were females. The mean hospital stay in patients treated with excision was 29 days, for Z plasty was 24 days and for Limberg flap was 15 days. When followed up for 26 months 2 out of 10 patients treated with Z plasty, 1 out of 5 patients treated with open technique followed up for recurrence, and no recurrence were noted in patients with Limberg flap. Conclusion: In our study we conclude Limberg flap was associated with lesser post operative complications, shorter hospital stay, increased patient satisfaction and lower recurrence rate.

Branchial cyst is a rare developmental disorder which is diagnosed rarely. Remnants of Branchial are present at birth but may become clinically significant later in life. We report a case of 14-year-old male patient with an asymptomatic branchial cyst over lateral side of neck. These cyst originate from remnants of branchial arches or branchial pouches. The definitive treatment of is complete surgical excision of the cyst. Complete surgical excision prevents recurrence or other complications.

Background: Perforation is one of the most important complications of a peptic ulcer. In spite of modern management, it is still a life threatening emergency. Operative method is still the treatment of choice and simple closure of perforation with Graham's patch is an established procedure of choice in our institution. Material and Methods: A prospective study was conducted on 30 diagnosed patients of perforated peptic ulcer at Dr. Vasantrao Pawar Medical College, Nashik to study the clinical profile and clinical outcome of peptic ulcer perforation patients post operatively from August 2014 to December 2016. Results: A total of 30 patients were included, majority of patients presented in the 4 th decade of life and 88.67% were males, 76.67% of the total patients had positive history suggestive of peptic ulcer disease and 36.66% patients had associated co morbidities, (36.67%) had severe dehydration, 10% patients presented with hypotension, with a systolic blood pressure of less than 90mmHg. In 23.33% of patients surgery was performed within 5 days of onset of acute abdominal pain and 16.67% presented with severe contamination of the peritoneal cavity, 33.33% presented with gastric perforation and 66.67% presented with duodenal perforation. 30% patients suffered from post operative wound infection and 30% patients suffered from post-operative respiratory infections. 16.67% patients presented with post operative sepsis. The mortality rate in this study was 10%. Conclusion: Perforated peptic ulcer is one of the most commonest acute abdominal emergencies. The outcome of the patient depends on the age of the patient, associated co morbidities, time interval between acute abdominal pain and surgery, timely resuscitation, contamination of the abdomen and post operative sepsis.

Background: Perforation is one of the most important complications of a peptic ulcer. In spite of modern management, it is still a life threatening emergency. Operative method is still the treatment of choice and simple closure of perforation with Graham's patch is an established procedure of choice in our institution. Material and Methods: A prospective study was conducted on 30 diagnosed patients of perforated peptic ulcer at Dr. Vasantrao Pawar Medical College, Nashik to study the clinical profile and clinical outcome of peptic ulcer perforation patients post operatively from August 2014 to December 2016. Results: A total of 30 patients were included, majority of patients presented in the 4 th decade of life and 88.67% were males, 76.67% of the total patients had positive history suggestive of peptic ulcer disease and 36.66% patients had associated co morbidities, (36.67%) had severe dehydration, 10% patients presented with hypotension, with a systolic blood pressure of less than 90mmHg. In 23.33% of patients surgery was performed within 5 days of onset of acute abdominal pain and 16.67% presented with severe contamination of the peritoneal cavity, 33.33% presented with gastric perforation and 66.67% presented with duodenal perforation. 30% patients suffered from post operative wound infection and 30% patients suffered from post-operative respiratory infections. 16.67% patients presented with post operative sepsis. The mortality rate in this study was 10%. Conclusion: Perforated peptic ulcer is one of the most commonest acute abdominal emergencies. The outcome of the patient depends on the age of the patient, associated co morbidities, time interval between acute abdominal pain and surgery, timely resuscitation, contamination of the abdomen and post operative sepsis.