Liver abscesses, both amoebic and pyogenic, continue to be an important cause of morbidity and mortality in tropical countries. However, different modalities of treatment of liver abscess are conservative (medical management), percutaneous needle aspiration, percutaneous catheter drainage, surgical drainage and endoscopic drainage. The aim of the study is to evaluate the clinical presentation and the different management done for liver abscess. This is an observational prospective study for presentation of liver abscess and its management done in the department of general surgery, simmer hospital, Surat, Gujarat, India from 1 st January 2018 to 31 st December 2018. In this study, 35patients (23 males and 12 females; age range, 2-72 years; average age, 35 years) with liver abscesses (amebic 08; pyogenic 27) underwent either percutaneous needle aspiration, percutaneous catheter drainage, or surgical intervention along with appropriate antimicrobial therapy. In patients assigned to the needle aspiration group, an 18-gauge spinal needle under local anaesthesia was used to aspirate the abscess cavity. For catheter drainage, 8-to 12-French catheters were introduced into the abscess cavity using the Seldinger technique. Patients were followed up to assess the outcome of the treatment, length of hospital stay, and development of any complications. Sonography was performed every third day during hospitalization in cases of percutaneous needle aspiration and percutaneous catheter drainage. After discharge of the patient, periodic clinical and sonographic examinations were done until total resolution of abscesses was achieved. Improvement in clinical features, liver function tests, ultrasonic evidence of decrease in the size of abscess cavity was considered as criteria for successful treatment.

Background: In this ongoing era of 21st century, trauma is the leading cause of death in individuals between age 1 and 44. In trauma, also road traffic accidents (RTAs) are the major cause of death. Blunt abdominal trauma is a frequent emergency and is associated with significant morbidity and mortality.Methods: A prospective analysis of 50 patients of blunt abdominal trauma admitted in SMIMER hospital Surat within a span of 12 months was done. Unstable patients with initial resuscitation underwent focused assessment sonography for trauma (FAST). Failed resuscitation with free fluid in abdomen confirmed by FAST immediately shifted to operation theatre for laparotomy and proceed. Hemodynamically stable patients underwent computerized tomography of abdomen.Results: Most of the patients in our study were in the age group of 21-45 years with M:F ratio of 4:1. RTAs (62%) was the most common mechanism of injury. Spleen (38%) was the commonest organ injured and the most common surgery performed was splenectomy. In total non-operative management (NOM) was done in 58% of cases and surgical management was done in 42% of cases.Conclusions: Appropriate patient selection, early diagnosis and repeated clinical examination and use of appropriate investigations forms the key in management of blunt abdominal trauma. To conclude, initial resuscitation measures and correct diagnosis forms the most vital part of blunt abdominal trauma management.

Background: Intestinal obstruction is one the major cause that patients underwent emergency operations and which might lead to complications that could be turn fatal. Prompt evaluation and treatment prevents mortality and morbidity of post-operative patients. Methods: Prospective study conducted between 01 April 2020 to 31 March 2022 in 50 patients of intestinal obstruction operated in emergency according to inclusion criteria. Pre-operative, intraoperative, and post-operative assessment and recording of data done. Results: In 50 cases of intestinal obstruction, commonest age group is 41 to 60 years, pain and obstipation remains major presenting symptoms and tenderness, guarding and rigidity were most common signs. The commonest cause of intestinal obstruction in the adults in this study was postoperative adhesions (44%) followed by Koch’s abdomen (30%). Malignancy of the large bowel was seen in 6 cases constituting 12% of cases, obstructed hernia in 5 cases (10%), intussusception in 3 cases (6%) and gut malrotation in 1 case (2%). Comorbidity like hypertension and diabetes were main causes of post-operative complications. Conclusions: Maximum incidence of intestinal obstructions were reported in Age group 41-60 years with male predominance. Abdominal pain was the consistent symptoms followed by obstipation. Post-operative adhesion were the most common cause of the intestinal obstruction. Malignancy and multiple comorbidity remains the major risk factor for the post-operative complications and mortality.

Background: nowadays Urolithiasis is very common in general population. Due to the advent of newer lithotripsy techniques, endoscopic procedures are used in most of the cases and to promote stone clearance DJ stents are kept after all the endoscopic procedures. Methods: This is a prospective study conducted among indoor patients from January 2021 to May 2022 in 90 indoor patients of tertiary care hospital. Results: In our study go 90 patients, pre DJ insertion, IPSS score in group A was 10.22 and Group B was 9.64, Mean Quality of Life in Group A was 1.77 and group B was 1.37, Visual analogue scale in group A was 2.08 and group B was 2.24. On Day 1 Post DJ insertion, IPSS score in group A was 12.26 and Group B was 11.68, Mean Quality of Life in Group A was 1.44 and group B was 1.28, Visual analogue scale in group A was 2.55 and group B was 2.28. Conclusions: Use of combination of selective alpha 1a-1d blocker and M3 antagonist significantly reduces the DJ stent related morbidity after endoscopic treatment for urolithiasis.

Background: Most of the Ureteric surgery involves DJ stent Insertion to prevent post operative ureter related morbidity of the patients. This study aims towards the role of tamsulosin in relieving DJ stent related symptoms. Methods: Prospective study conducted between June 2018 to October 2020 in 58 patients randomised by random-number chart into two groups, group A (Non tamsulosin) group B (Tamsulosin). The international prostate symptom score (IPSS) questionnaire and quality of life (QoL) was assessed on admission as a baseline before patient underwent the surgery and reassessed when the patient came for stent removal. Results: The mean age of patients in group A (non-tamsulosin) was 39.38 years with range of 20 to 60 years. The mean age of patients in group B (tamsulosin) was 38.55 with range of 20 to 68 years. In group A consisted of 16 men and 13 women whereas group B had 13 men and 16 women. On comparing non tamsulosin and tamsulosin group, patients in which stent is removed at or <28 post operative day, mean IPSS+QoL component of questionnaire score is 14.1 (SD 3.8) and 11.8 (SD 4.1) respectively. While on comparing non tamsulosin and tamsulosin group, patients in which stent removed after 28th post operative day, mean IPSS+QoL component of questionnaire score is 18.9 (SD 1.0) and 6.4 (SD 1.1) respectively. Conclusions: Oral administration of tablet Tamsulosin 0.4 mg once a daily before sleep at night improves DJ stent related morbid symptoms.