A 57 years old male who was a known case of type 2 diabetes presented with a swelling over the left lower abdomen and groin. The patient appeared toxic and local examination revealed discoloration of size 8x6 cm over the groin with a 1×0.5 cm sized ulcer over it accompanied by a seropurulent discharge. A clinical diagnosis of necrotizing fasciitis was made and investigations revealed an elevated blood sugar, white count and creatinine with cultures showing a poly-microbial growth. Emergency debridement under IV sedation was done and subsequently patient underwent daily debridement and dressing in addition to antibiotics and adequate glycemic control. This condition is a surgical emergency and early diagnosis is crucial for improved prognosis. Aggressive surgical debridement is the first line treatment followed by specific antibiotic therapy.

Background: Cancer breast is the leading cause of site-specific cancer-related death next to cancer cervix for women aged 20-59 years. Early diagnosis and treatment will reduce the morbidity and mortality of the disease and thus prolongs the survival of the patient. The patient usually present in the later stages of disease, due to the lack of awareness. This study aims at studying the various type of clinical and pathological patterns of presentation of operable carcinoma breast in a tertiary care centre.Methods: 50 patients with Carcinoma Breast, admitted in Government Royapettah Hospital were studied. It was a cross-sectional prospective study performed from January 2016 to October 2017.Results: The average age of occurrence of operable carcinoma breast is 48.54 years. One patient had a positive family history. Lump (100%) is the most commonest presentation. 98% of the study population had Infiltrating ductal carcinoma as HPE report. In my study population 56 % of had stage II disease. Patient with Early breast cancer underwent surgery followed by adjuvant chemotherapy, hormonal therapy, and radiotherapy. Patient with stage III disease undergoes neoadjuvant chemotherapy followed by surgery, then adjuvant chemotherapy, hormonal therapy, radiotherapy.Conclusions: The incidence of operable carcinoma breast is more common among middle-aged groups. The commonest presenting complaint is a lump and commonest histopathological type is infiltrating ductal carcinoma. Multimodality modality manage is the optimum treatment adopted. Routine screening mammography and by the health awareness programme carcinoma breast, nowadays, detected at an earlier stage.

A 48 years old man presented to the surgical OPD with a history of multiple painless swellings on his scrotum for 20 years. He had avoided all sexual relations with his wife due to potential embarrassment. A clinical diagnosis of scrotal epidermoid cysts was made. Both testes were normal on ultrasound. Upon surgery, the scrotal skin was thoroughly excised, and primary closure of skin was done. Postoperative period was uneventful. The patient engaged in intercourse with his partner two weeks after surgery. The man and his partner were referred to the psychiatry unit for appropriate counselling. Scrotal epidermoid cysts cause significant psychological handicap. In Asian countries, the taboo of seeking medical assistance for genital conditions still exists. The treatment of scrotal epidermoid cysts requires a team of surgeons, psychologists, and psychiatrists.

Background: Acute pancreatitis can be classified as mild and severe. Mild pancreatitis is explained by interstitial edema of the gland and it is usually a self-limiting form. Whereas in severe pancreatitis, there is pancreatic necrosis, severe systemic inflammatory response and multi-organ failure which may lead to mortality. To identify the most common etiological agent of acute pancreatitis in our institution.Methods: Patients diagnosed with acute pancreatitis in Institute of General Surgery, Rajiv Gandhi Govt. General Hospital. 50 of them are to be selected on the basis of nonprobability (purposive) sampling method. Data pertinent to the scoring systems will be recorded within 24 h of admission to the hospital.Results: 86% of patients had BISAP score less than 3 (mild) and 14% of patients had more or more than 3 (severe). The cases with mild, moderate and severe CTSI score were 76%, 20% and 4% respectively. Only two cases with BISAP score 3 or more had CTSI >6.Conclusions: Alcohol is the most common etiological factor for acute pancreatitis in this regional population. The morbidity rate is 26% and the mortality rate in patients with severe pancreatitis was 4%. The BISAP score is more accurate in predicting disease severity and significantly than CTSI in this study.

Background: Salivary gland tumors can arise from either the major salivary glands (parotid, submandibular and sublingual) or the minor salivary glands which are located throughout the submucosa of the upper aerodigestive tract. They can show a striking range of morphological diversity between different tumor types and sometimes within an individual tumor mass. Aim of the study was to study the role of fine needle aspiration cytology (FNAC) in the diagnosis of salivary gland tumors.Methods: This study was conducted comprising 34 patients attending the department of general surgery at Rajiv Gandhi government general hospital, MMC from January 2019 to December 2020 period of 24 months. A standard protocol was followed consisting of detailed history and physical examination, radiological evaluation followed by fine needle cytological examination. Histopathological examination was done in all the excised tumors for final diagnosis.Results: FNAC was done only in 20 out of 29 parotid tumors of which 12 were benign, 5 were malignant and 3 were inconclusive. In the present study superficial parotidectomy was done in 24 cases. Total parotidectomy was done in 3 out of 5 cases. Two patients refused surgery. Following surgery, 5 patients developed transient facial nerve paralysis and one patient developed permanent facial nerve paralysisConclusions: In tumors of the parotid gland, post-operative facial nerve palsy was rarely noticed. The best means of reducing iatrogenic facial nerve injury in parotid surgery remains an understanding of the anatomy coupled with a gentle technique.