Background: Acute abdomen poses a big challenge to the general surgeons in terms of both diagnosis and management. The aim of this study was to know in detail the clinical and postoperative outcome in non traumatic acute abdomen.Methods: Prospectively collected data of 326 patients with non traumatic acute abdomen admitted in PES institute of medical sciences and research, Kuppam from November 2016 to June 2018. All patients were subjected to clinical examination, relevant blood and imaging investigations, Intra and postoperative findings events were recorded.Results: Non traumatic acute abdominal pain was more common in 2nd to 5th decade of life. Males are more affected than females with a male to female ratio of 3.4:1. Acute appendicitis forms the commonest cause of acute abdomen (n=160=49%) followed by perforative peritonitis (n=85=26%). Most common surgical procedures done were laparoscopic/open appendectomy for acute appendicitis, exploratory laparotomy with Graham’s omentoplasty for perforative peritonitis.Conclusions: Systematic approach in history taking and a proper clinical examination with supportive imaging findings are most important in making an accurate diagnosis and need of appropriate surgical intervention in patients with non traumatic acute abdomen.

Background: Acute appendicitis is the most common acute surgical condition of the abdomen requiring early intervention. The diagnosis is often challenging and the decision to operate in an emergency setting is always debatable. Alvarado score for diagnosis of acute appendicitis is easy and additional tools like sonography results in accurate diagnosis. The aim was to evaluate accuracy of the clinical Alvarado scoring system, radiological findings and histopathological examination for the diagnosis of acute appendicitis.Methods: 100 cases of acute abdomen admitted in PES institute of medical sciences and research, Kuppam from December 2016 to June 2018 were included. Clinical examination was done and all patients were subjected to ultrasound abdomen examination and other relevant blood and imaging investigations.Results: Out of 100 patients 62 were males and 38 were Females. Most common symptom was pain in the right iliac fossa and patients with Alvarado Score 7 or > 7 subjected to USG followed by emergency appendectomy showed positive operative findings and histopathological findings. The overall specificity of abdominal USG in the diagnosis of acute appendicitis was 88.09% and sensitivity was 95.37%.Conclusions:The Alvarado scoring system combined with ultrasound can therefore be used as a cheap and less expensive useful, reliable and non invasive way of confirming acute appendicitis thus helps in reducing negative appendectomy rate. The overall accuracy of diagnosis of acute appendicitis goes up to 90% with positive histopathological findings.

Venous thromboembolism (VTE) is one of the common complications in surgical patients. Venous thromboembolism (VTE), which is manifested as deep vein thrombosis (DVT) and pulmonary embolism (PE), represents a significant cause of death, disability, and discomfort. With the various evidence based studies now we have a better understanding of the VTE/PE risk factors and preventive measures. However most of the hospitals and doctors fall short in implementing the knowledge while treating their patients. Hence the need for the present study to assess the practice pattern of VTE prophylaxis in surgical patients. MATERIALS AND METHODS: It's a retrospective study in which 100 patients were randomly selected from the operation theatre registry. Individual risk assessment was done and VTE prophylaxis given was recorded and then compared with the Caprini's VTE risk assessment model and suggested prophylaxis. RESULTS AND CONCLUSION: Appropriate VTE prophylaxis was given only in 42.03% of the postoperative patients (18.75% of low risk, 29.17% of moderate risk and 65.51% of high risk patients). The remaining 57.97% of patients were at increased risk of developing DVT and pulmonary embolism thus increasing the chances of morbidity and mortality. The prophylaxis was inadequate mainly in the moderate and low risk individuals. Hence there is a strong need for a standard hospital policy for VTE risk assessment and prophylaxis in surgical patients. KEYWORDS: Evaluation of practice pattern of VTE prophylaxis in postoperative patients. INTRODUCTION:Venous thromboembolism (VTE) is one of the common complications in surgical patients. 1 Venous thromboembolism (VTE), which is manifested as deep vein thrombosis (DVT) and pulmonary embolism (PE), represents a significant cause of death, disability, and discomfort. The risk for VTE in surgical patients depends both on patient related factors and the type of surgery. 1,2 The commonly used guidelines for VTE risk assessment and prophylaxis are Caprini's VTE risk assessment model and American College of Chest Physicians (ACCP) consensus guidelines for VTE prophylaxis. Use of LMWH, pneumatic compression stockings or graded compression stockings have greatly reduced the incidence of VTE and thereby reducing the morbidity and mortality. 2 Pulmonary embolism (PE) is now the most common cause of preventable death in surgical patients.With the various evidence based studies now, we have a better understanding of the VTE risk factors and preventive measures. The high incidence of postoperative VTE and the availability of effective methods of prevention mandate that thromboprophylaxis should be considered in every surgical patient. However most of the hospitals and doctors fall short in implementing the knowledge while treating their patients. 3,4,5 Hence the need for the present study to assess the practice pattern of VTE prophylaxis in surgical patients.

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Background: Acute appendicitis is the most common surgical emergency. An appendicectomy is considered the gold standard of treatment for acute appendicitis because of the potential risk of disease progression to perforation, gangrene and peritonitis. The aim of this study was to determine the incidence of complications in patients diagnosed with acute appendicitis.Methods: A total number of 70 patients were studied with various symptoms of acute appendicitis and their complications, all patients were presented to PESIMSR, Kuppam from December 2016 to June 2018. Clinical assessment , investigations like WBC counts, X-ray erect abdomen, USG abdomen and pelvis and management were recorded. The incidence of complications were studied. The cases of appendicular mass was treated conservatively, except for those who do not respond to antibiotics.Results: During this study period, among 70 patients aged between 5-45 years, male were 53 and female patients were 17 and 11 patients belong to pediatric age group and 59 patients aged more than 18 years. The commonest complication was postoperative surgical site infection (20%) found in perforated appendix patients in our study. Around 76% of the patients developed complications. Among the female patients diagnosed with acute appendicitis, appendicular perforation being the most common complication and it was the postoperative surgical site infections in males.Conclusions: Acute appendicitis is the most common surgical emergency. Open appendicectomy is the most commonly done procedure in our hospital. The commonest complication is postoperative surgical site infection (20%) found in perforated appendix patients in our study.

2. Chan JK. Mesenchymal tumors of the gastrointestinal tract: a paradise for acronyms (STUMP, GIST, GANT, and now GIPACT), implication of c-kit in genesis, and yet another of the many emerging roles of the interstitial cell of Cajal in the pathogenesis of gastrointestinal diseases?