The diaphragmatic surface of the liver is normally smooth but may be grooved occasionally. Such grooves could be 'cough furrows' or due to a 'corset liver'. Accessory sulci have also been described and may confuse the inexperienced surgeon. We describe one such case of an accessory sulcus found incidentally at laparotomy.

Accessory parotid glands are a common clinical occurrence and usually drain into the main Stenson's duct by small ductules and thereby, into the buccal cavity. Presence of an accessory parotid gland with an ectopic fistulous duct is a rare occurrence. Clinical findings, imaging studies, biochemical tests, histopathological examination are needed for appropriate surgical management. It is extremely rare case with ectopic fistulous duct in an accessory parotid gland managed surgically by internalization of the duct to open into the buccal mucosa and excision of pre-aural appendages. Further to this, we give a comprehensive review of literature on accessory parotid gland and duct anomalies.

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Background: Surgical hemorrhoidectomy is usual method for management in hemorrhoid grade III and IV. It is generally associated with postoperative pain, long hospital stay and a longer convalescence. Stapled hemorrhoidopexy is a newer minimally invasive alternative for the treatment of hemorrhoids. Aims: In this study, the above two methods were compared with respect to short term outcomes. Settings and Design: This was a prospective and randomized study. Methods: 60 patients having grade 3 or 4 hemorrhoids and who fullled the criteria were included in the study. Thirty patients underwent stapled hemorrhoidopexy and other thirty underwent open hemorrhoidectomy. All patients were reviewed immediately after surgery and at 1, 3 and6 weeks post-operatively. The two groups were compared in terms of duration of surgery, hospital stay, return to work and post-operative level of satisfaction . Statistical Analysis: The statistical analysis was done using SPSS (Statistical Package for Social Sciences) Version 15.0 statistical Analysis Software. Signicance was assessed at 5% level of signicance. Student t-test was used to nd the signicance of study parameters on continuous scale in parametric condition between two groups (inter group analysis) and Mann Whitney U test was used to nd the signicance of study parameters on continuous scale in non-parametric condition within each group. Chi-square/ Fisher Exact test were used to nd the signicance of study parameters on categorical scale between two groups. Results: The overall mean age of patients in our study was 41.35 ± 12.80. The majority of patients in the study were males (78.3%) and had grade 3 haemorrhoids (93.3%). Stapled hemorrhoidopexy group had shorter duration of surgery, less postoperative pain and need for analgesia, shorter duration of hospital stay and earlier return to work and a high patient satisfaction as compared with open hemorrhoidectomy group. Conclusions: Stapled hemorrhoidopexy is a minimally invasive, better and safer alternative to open hemorrhoidectomy with many short-term benets.

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Background- Appendicitis is a perception that urgent operation is essential to prevent the increased morbidity and mortality of peritonitis. In our study, laparoscopic appendectomy was done via conventional method except Harmonic Scalpel was used to coagulate the mesoappendix. Base of the appendix was sealed via harmonic scalpel in a stepwise manner at the setting of minimum just to occlude the lumen and just distil to previous site till the appendix is divided. The purpose of this study was to test the efcacy of harmonic scalpel in laparoscopic appendectomy for sealing the base of appendix. Total 54 appendectomies were performed by harmonic during this period out Methodology- of which 44 were done as elective and 10 were done as emergencies case. Statistical analysis was done by Chi-square test with Yates correction. The mean age and standard Resultsdeviation (SD) were 31.22SD13.35 years. Maximum number of patients belonged to age group 21-40 years. Mean operative time for 54 appendectomies by harmonics was 28.463SD7.19 min and maximum and minimum time taken was 48 min and 17 minute. ConclusionTechniques of the appendicular stump closure by harmonic scalpel is effective and safe. Postoperative complications following appendicectomy are relatively uncommon and it is recommended as the approach of choice in the management of appendicitis. There was no mortality occurred in this study

Background: Surgical site infections are associated with substantial morbidity and mortality, increase in hospital stay and enhanced cost of health care. Objective of present study is to identify the etiological pathogens and their antimicrobial susceptibility, resistance and risk factors for development SSIs. Methods: It is observational study carried out at Department of General Surgery at GSVM Medical College, Kanpur, India for a period of one year. It is a tertiary care centre and a teaching hospital. A predesigned and pretested proforma was used to collect data. Surgical sites were examined and culture with sensitivity was done for infected wounds. Results: The most commonly isolated bacteria were: Klebsiella, E. coli and Staphylococcus aureus. Increasing age and associated diabetes showed signicantly higher rates of infection compared to their counterparts. Universal resistance was present to ampicillin, cefoxitin, ceftriaxone and tetracycline, while organism were sensitive to Imipenam, Meropenam and Piperacillin. Conclusions: Post-operative abdominal wound infection represents a substantial burden of disease both for the patients and the healthcare services in terms of the morbidity, mortality and economic costs.