Background: Intestinal stoma is an opening for fecal diversion. The purpose of the present study was to identify indications for emergency laparotomy, commonly performed intestinal stomas and to study complications related to it.Methods: This is a prospective study was carried out in a surgical unit of Saveetha Medical College & Hospital, Chennai, Tamilnadu, from August 2012 to August 2013. Data was collected by meticulous history taking including age, gender, indication, type of stoma, type of surgery, careful clinical examination, appropriate operative findings and follow up of the cases. The results were collected, analyzed and compared.Results: A total of 74 patients were evaluated age ranged between 16 to 78 years. Male to female ratio was 7:2. The most common type of stoma made was loop ileostomy (60%) followed by end ileostomy (30%) and loop colostomy (9%). Main indication for emergency laparotomy was intestinal obstruction (44%). The most common type of stoma performed was loop ileostomy (60%). The most dreaded complication of stomal closure is anastomotic leakage.Conclusions: Early referral to the tertiary hospital, early diagnosis, proper preoperative management like intravenous fluids, antibiotics, etc., early detection and prevention of hypotension, reduction of time duration for emergency laparotomy, close post-operative monitoring definitely reduce the morbidity and mortality of stomal closure, when intestinal stomas kept for emergency cases.

Background: Non-diabetic soft tissue infection is the infection of the soft tissue in a non-diabetic patient. It is rare, but results in high mortality. The aim of the study was to establish a scoring system to predict the outcome of a patient with non-diabetic soft tissue limb infection at the time of admission and to determine the factors which increase the morbidity of a patient with non-diabetic soft tissue limb infection as determined by number of days of hospital stay or limb loss or death of the patient.Methods: Clinical and laboratory details of 200 cases of non-diabetic soft tissue infections of the lower limb were retrospectively analyzed statistically, using pearson's chi square test for comparison of proportions with respect to mortality, fisher's exact test, logistic regression analysis were expressed using beta coefficient values, odds ratios. Statistical analysis was performed using SPSS software version 12.Results: Two hundred patients records were reviewed. 121 patients (60%) were males and 79 (40%) were females. Mean age was 52.5 years ranging from 14 to 91 years. Forty-six patients underwent conservative treatment, 111 patients underwent debridement and 43 patients underwent amputation. Increasing age were the risk factor associated with mortality in non-diabetic soft tissue infections that were statistically significant.Conclusions: Non-diabetic soft tissue infections still lead to high mortality and morbidity despite the use of appropriate conservative treatment, aggressive debridement, resuscitation and amputation. In this series, there is high mortality associated with increasing age.

Background: Abdominal tuberculosis is the sixth most common form of extrapulmonary site of infection after lymphatic, genitourinary, bone and joint, miliary and meningeal TB with a rising incidence in recent years. Tuberculosis can affect any part of the gastro-intestinal (GI) tract including anus, peritoneum and hepato-biliary system. The clinical manifestations of abdominal tuberculosis are non-specific and mimic various GI disorders and cause delay in diagnosis and management. The aim of this study is to study the incidence of abdominal tuberculosis, percentage of acute presentation, to study and analyse clinical presentation, various diagnostic modalities, role of surgery and to evaluate the spectrum of surgeries done for abdominal tuberculosisMethods: Study was done by analyzing 108 cases in our tertiary care hospital, Chennai, India, during the period of June 2015 to January 2016. All suspected and diagnosed cases of abdominal tuberculosis were included in the study. The relevant clinical information, laboratory results, microbiological and radiological investigations were recorded. Histopathological examination of all the resected or excised specimens was done to detect tuberculosis in all the cases.Results: Out of 108 cases with abdominal tuberculosis, the average age of presentation was between 21 and 40 years with a slight male predominance (male:female = 1.1:1). Abdominal pain (92%) was the most common presenting symptom followed by anorexia (70%), loss of weight (70%), and intestinal obstruction (13%). 29 cases underwent surgical management. All patients were put on anti-tubercular treatment and majority showed good response to therapy.Conclusions: Abdominal tuberculosis should be considered as a differential diagnosis in patients with vague GI symptoms. To diagnose abdominal tuberculosis, high degree of suspicion is needed, and its incidence being common in people with lower socioeconomic status. This study gives a basic outline of presentation, diagnosis and management of abdominal tuberculosis in developing country.

Background: Associations between breast cancer, benign breast tumours and thyroid disorders are reported in numerous studies. Relationship between thyroperoxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb), and breast cancer have been previously demonstrated. However, no analysis has been performed concerning an association between thyrotropin (TSH) receptor antibodies (TSHRAb) and breast cancer. The aim of the study was to evaluate the presence of TSH Receptor antibodies in women with breast cancer or benign breast tumours, and to analyze a possible relationship between TSH Receptor antibodies, and these two groups of breast diseases with emphasis to laboratory findings. Methods: Clinical and laboratory details of 87 women hospitalized were prospectively analyzed, using an Post hoc Tukey HSD for normally distributed continuous data, chi-square test for comparison. Results: TSH Receptor antibody levels in breast cancer was statistically significant. We observed TSHRAb more frequently in patients with breast cancer. We found that TSHRAb is the only variable possessing as a prognostic marker for breast cancer. Conclusions: The present study indicates that the serum levels of TSH Receptor Antibody are significant higher in patients with Breast cancer. These results have implications not only for the screening of patients but also for the development of new prognostic markers. Further high-quality prospective studies are needed to explore whether TSH Receptor Antibodies are potential prognostic markers for patients with Breast cancer.

Background: Diabetic foot ulcers are a prevalent and serious global health issue. Dressings form a key part of ulcer treatment. The purpose of the present study was to evaluate the outcome of various dressings in management of diabetic foot among the patients with diabetic foot ulcer.Methods: This is a prospective study carried out in a surgical unit of Saveetha Medical College & Hospital, Chennai, Tamilnadu, from February 2015 January 2017. All patients were allocated randomly into four groups – Group A, Group B, Group C and Group D which corresponded to saline, povidone-iodine, metronidazole and eusol dressing respectively. Data was collected by history taking, clinical examination, and follow up of the cases. All patients underwent daily surgical wound debridement and dressing. The results were collected, analyzed and compared.Results: total of 83 patients were evaluated age ranged between 20 to 80 years with maximal clustering between 51-60 years of age. Male to female ratio was 2:1. Poor glycemic control and diabetes for more than 5 – 10 years increase the risk of foot ulcer. Usage of Povidone Iodine, Eusol and Metronidazole did not offer any healing benefit when compared to normal saline dressing.Conclusions: Early diagnosis, proper management like bed rest, adequate surgical wound debridement and non-irritant dressing is the mainstay of treatment for diabetic foot ulcer without ischemia. Since diabetic foot has a multi factorial origin, multi-disciplinary approach forms the backbone for the management of diabetic foot.