Background Colorectal cancer often presents with obstruction needing urgent, potentially life-saving decompression. The comparative efficacy and safety of endoluminal stenting versus emergency surgery as initial treatment for such patients is uncertain. Methods Patients with left-sided colonic obstruction and radiological features of carcinoma were randomized to endoluminal stenting using a combined endoscopic/fluoroscopic technique followed by elective surgery 1–4 weeks later, or surgical decompression with or without tumour resection. Treatment allocation was via a central randomization service using a minimization procedure stratified by curative intent, primary tumour site, and severity score (Acute Physiology And Chronic Health Evaluation). Co-primary outcome measures were duration of hospital stay and 30-day mortality. Secondary outcomes were stoma formation, stenting completion and complication rates, perioperative morbidity, 6-month survival, 3-year recurrence, resource use, adherence to chemotherapy, and quality of life. Analyses were undertaken by intention to treat. Results Between 23 April 2009 and 22 December 2014, 245 patients from 39 hospitals were randomized. Stenting was attempted in 119 of 123 allocated patients (96.7 per cent), achieving relief of obstruction in 98 of 119 (82.4 per cent). For the 89 per cent treated with curative intent, there were no significant differences in 30-day postoperative mortality (3.6 per cent (4 of 110) versus 5.6 per cent (6 of 107); P = 0.48), or duration of hospital stay (median 19 (i.q.r. 11–34) versus 18 (10–28) days; P = 0.94) between stenting followed by delayed elective surgery and emergency surgery. Among patients undergoing potentially curative treatment, stoma formation occurred less frequently in those allocated to stenting than those allocated to immediate surgery (47 of 99 (47.5 per cent) versus 72 of 106 (67.9 per cent); P = 0.003). There were no significant differences in perioperative morbidity, critical care use, quality of life, 3-year recurrence or mortality between treatment groups. Conclusion Stenting as a bridge to surgery reduces stoma formation without detrimental effects. Registration number: ISRCTN13846816 (http://www.controlled-trials.com).

Background: Surgical site infections (SSI) are one of the most common hospital-acquired infections worldwide. SSI are known to increase morbidity, mortality, length of stay in hospital as well as the cost of treatment to the patients. The incidence varies from 1% to 20% among developed countries to as high as 40% in developing world. Aims: To find the incidence and risk factors, bacteriological profile, and antibiogram for SSI in General Surgery department of a tertiary care hospital in Western Rajasthan. Methods: Culture and sensitivity of wounds of all the clinically suspected cases of SSI were taken. Bacterial identification and antimicrobial susceptibility were performed according to standard CLSI guidelines. Statistical analysis was done using Microsoft Excel, SPSS 13 software. Results: Among total 609 patients, 102 were clinically suspected SSI and 88 were culture positive. Incidence of SSI was 14.45%. The most common organism was Staphylococcus aureus followed by Klebsiella pneumoniae . Most of the Gram-positive isolates were resistant to penicillin and cephalosporin antibiotics and were moderately susceptible to fluoroquinolones and aminoglycosides. Gram-negative isolates were resistant to beta-lactam and beta-lactam/beta-lactamase inhibitor combination also but were susceptible to fluoroquinolones, aminoglycosides, and carbapenems. Results: Among total 609 patients, 102 were clinically suspected SSI and 88 were culture positive. Incidence of SSI was 14.45%. The most common organism was Staphylococcus aureus followed by Klebsiella pneumoniae. Most of the Gram-positive isolates were resistant to penicillin and cephalosporin antibiotics and were moderately susceptible to fluoroquinolones and aminoglycosides. Gram-negative isolates were resistant to beta-lactam and beta-lactam/beta-lactamase inhibitor combination also but were susceptible to fluoroquinolones, aminoglycosides, and carbapenems. Conclusion: High incidence rate of SSI in our setup emphasizes the need of quality surgical care which takes into consideration all the three important factors, i.e. host, environmental, and microorganism characteristics before doing any surgery. Increasing resistance to commonly used antibiotics warrants the judicious use of antibiotics and establishment of antibiotic policy in the hospital.

Introduction: Owing to the poor socioeconomic conditions and lack of sanitary hygiene, a large number of population in developing countries remain under constant threat of different parasitic infections causing severe morbidity and mortality. Enough measures to prevent and reduce the disease burden are still to be undertaken.Aim: Aim of the study was to determine the spectrum of parasitic infections in patients with complaints of diarrhoea and other gastrointestinal symptoms attending a tertiary care hospital in Western Rajasthan, India. Results: Out of 968 cases, 158 (16.3%) were found to be infected with either a parasite or a commensal or both. A maximum number of isolates (21.1%) were from the age group of 31-40 years. Overall, protozoans (95.38%) were detected in excess of helminths (4.62%). The most common protozoa isolated was Entamoeba histolytica (37.57%) followed by Giardia lamblia (23.12%), and the most common helminth isolated was Hymenolepis nana (2.9%) followed by Ascaris lumbricoides (1.15%). Out of 17 stool samples, where modified ZN staining was performed, Cryptosporidium spp., Isospora belli, and Cyclospora spp. were detected in one sample each.Conclusion: Intestinal protozoal infections are more prevalent as compared to helminthic infections in this study group.

Background: COVID-19, a disease caused by SARS-CoV-2 has become a public health emergency of worldwide concern. Originated in Wuhan District of China, it has spread globally at a very rapid rate causing millions of deaths worldwide. Aims and Objectives: To summarize findings from all the current literature available from different databases regarding the epidemiological, clinical characteristics, laboratory diagnosis, treatment, prevention and control of the SARS-CoV-2. This will help out the reader to have a fine gist of all the data available on SARS-CoV-2 in an effective manner. Methods: All the research literature from Jan-March 2020 and available on the following online databases: bio-Rxiv, PubMed, Google Scholar, Embase as well as CNKI and Wang Fang data were included in the review. The keywords used for data search were “coronavirus,” “nCoV,” “2019-nCoV,” and “COVID-19.” Conclusion: After undergoing extensive literature search, it can be concluded that it mainly effects elderly male population. Mode of transmission is droplet transmission and human to human transmission is present. The main diagnostic modality remains molecular assays though several rapid testing methods are on the way. Due to lack of specific treatment guidelines, Infection control and supportive treatment remain the mainstay. Plethora of experiments are under trails for development of effective vaccine which can be a ray of hope in future.