Aim During the COVID-19 pandemic, emergency surgery was modified in line with Royal College guidance to accommodate the evolving climate. This study compared management of appendicitis before and during the pandemic by assessing disease presentation severity, modes of investigation, surgical management and patient outcomes. Outcomes assessed included length of stay, readmissions and rates of postoperative wound infections. Methods We collected data on appendicitis patients managed at a district general hospital over two distinct 8-week periods; 42 patients before and 36 patients during the COVID-19 pandemic respectively. The study included clinically or radiologically diagnosed appendicitis patients. Results Our study found patients during the COVID-19 pandemic had higher inflammatory markers (CRP 103 vs 53 mg/L; p = 0.03) and more severe disease on histological examination of the appendix than pre-pandemic. Patients were nearly twice as likely to undergo CT diagnosis of appendicitis during the pandemic than before. During the pandemic, only half of the cohort underwent laparoscopic appendicectomy in contrast with greater than 85% of the pre-COVID-19 cohort (p = 0.0005). Patients in the COVID-19 era cohort recorded shorter lengths of hospital stay (2.6 vs 3 days; p = 0.35); however, had higher reattendance rates (12 vs 25%; p = 0.15) and surgical site infections (p = 0.0443). Finally, the study reported shorter median time to theatre (0 vs 1 days) during the pandemic than before. Conclusion In addition to reiterating the benefits of laparoscopic versus open surgery and quicker diagnostic methods, this study also implies that though patients during COVID-19 era presented with more severe disease, their treatment was in a more efficient service.

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In our experience, prone ELAPE preceded by long-course chemoradiotherapy has been successfully used in the last 5 years to resect low rectal tumors. Perineal wound complications rates are similar to those presented in series using direct perineal closures. J. Surg. Oncol. 2016;114:86-90. © 2016 Wiley Periodicals, Inc.

Abstract:Vitiligo is an acquired multifactorial polygenic disorder with a complex pathogenesis, characterized by depigmented macules in skin. A clinical trial was conducted to evaluate the efficacy of oral mini pulse betamethasone in the treatment of vitiligo patients. The study was done in the department of Dermatology and Venereology, Faridpur Medical College Hospital (FMCH), Faridpur, Bangladesh from July 2014 to June 2015. Among thirty patients of vitiligo, most of the male patients (53.33%) and most of the female patients (40%) were between 20 to 25 years of age. Majority of patients (70%) had been suffering from vitiligo for less than 3 years and 50% patients had positive family history. Eighteen (60%) patients had acro-facial type of vitiligo and 20 (66.67%) cases were progressive in nature. In this study, response was slight in 36.67%, moderate in 33.33%, marked in 20% and excellent in 10% of cases after 12 weeks. Eight (26.66%) of total patients were seen to be with clinical side effects. Among the side effects, weight gain 4 (13.33%) was most prevalent, others include general weakness in 2 (6.66%) and acne in 2 (6.66%) patients. In conclusion, oral mini pulse betamethasone seems to be an effective treatment modality to arrest the progression of vitiligo and induction of repigmentation.