The major complications of peptic ulcer are hemorrhage, perforation and

Background: Inguinal hernia is a one of common diagnosis which is frequently encountered in routine clinical practice. The Lichtenstein technique (tension free mesh repair) is currently the gold standard in open inguinal hernia repair. Currently chronic groin pain (Inguinodynia) is one of the common complications after hernia repair and it may affect quality of life and it has been reported in 16% to 62% of the patients.Methods: This prospective, randomized study was conducted in the department of general surgery in S.M.S. Medical College and attached group of hospitals, Jaipur from May 2014 to December 2015. All patients of 18-80 years old, who were admitted for elective inguinal hernia repair, were included for the study. Patients with bilateral, recurrent, irreducible or incarcerated hernia, pregnant patients and patients with co morbid conditions, were excluded from the study.Results: Mean age was 46.5 years in absorbable group and 45.4 years in non absorbable group. Male to female ratio was 142:13 in absorbable group and 143:12 in non absorbable group. Post operative pain was measured by VAS score. Mean postoperative pain (VAS score) was lower in absorbable sutures group as compared to non absorbable group at 3 months (0.92±0.879 vs. 1.23±1.2; p=0.013) and at 6 months (0.48±0.57 vs. 0.77±0.65; p≤0.001), which was significant.Conclusions: Patients with absorbable suture for mesh fixation has less groin pain as compared to non-absorbable suture in hernia repair during 6 months follow up period.

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Blunt traumatic abdominal wall disruptions associated with evisceration (abdominal wall injury grade type VI) are very rare. We describe a case of large traumatic abdominal wall disruption with bowel evisceration and complete transection of jejunum and sigmoid colon that occurred after a 30-year-old male sustained run over injury to abdomen. Abdominal exploration and primary end to end jejuno-jejunal and colo-colic anastomosis were done. Staged management of giant abdominal wall defect was performed without any plastic reconstruction with good clinical outcome.

Introduction: Enteric perforation is a serious complication of typhoid fever and the condition has a high morbidity and mortality in many developing countries including India. No consensus exists concerning the best procedure to be performed in these cases. Aim: The purpose of this study was to analyse our clinical experience in surgical management of enteric perforation and to determine the prognostic factors associated with morbidity and mortality. Methods: It was a prospective study of patients who underwent surgery for typhoid intestinal perforation at SMS Medical College and Hospital, Jaipur, India, between April 2012 and October 2013. Laparotomy was performed by a midline incision. Management of perforation was based on the intraoperative findings and the procedure to be performed was decided by the operating surgeon. Results: 88 patients were studied with a male to female ratio of 6.3:1. The mean age was 36.4 years. The peak incidence was between 21 to 30 years. All the patients presented with abdominal pain and distension. More than 90% patients showed free gas under diaphragm. 71% patients had a single perforation and 97% patients had perforations confined to ileum. Debridement with double layered closure was performed in about 58% patients, ileostomy in 25% and resection anastomosis in 18% of patients. Overall complication rate was 44.3% with surgical site infection being the most common morbidity. The mortality rate was 17.1% which was significantly affected by perforation-admission interval of more than 48 hours, number of perforations and occurrence of postoperative complications. Conclusion: Typhoid fever leading to development of intestinal perforation continues to be a significant health problem with a high morbidity and mortality especially in rural India. The management of the disease requires an early and appropriate surgical intervention.

<p class="abstract"><strong>Background:</strong> A retrospective case series study was done on forearm diaphyseal fracture in adolescents treated with TENS (titanium elastic nailing system). Purpose of the study was analysis of functional outcome of TENS in forearm diaphyseal fractures in children between 12-18 year age group.</p><p class="abstract"><strong>Methods:</strong> We retrospectively evaluated 30 patients operated by same senior surgeon during the period from March 2014 to February 2015 with closed diaphyseal forearm fractures in age group 12–18 years treated with TENS in whom closed reduction could not be achieved. Nail diameter taken as 33-40% of narrowest diameter of diaphysys were introduced proximally in ulna and distally in radius under image intensifier in closed manner. Postoperatively, patients encouraged for active shoulder, elbow and finger movements and suture removal done after 2 weeks. Patients were followed up for minimum period of one year.  </p><p class="abstract"><strong>Results:</strong> In terms of union and range of motion using Anderson et al criteria 24 patients had excellent results, 4 patients had satisfactory results and one patient had poor result having non-union of ulna. Two patients had superficial infection at the nail entry site which eventually resolved. One patient lost for follow up.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that TENS in both bone forearm fractures in adolescent age group in terms of union and range of motion is a minimally invasive and effective method of fixation.</p>

Background: Blunt trauma to the abdomen leading to bowel injury is one of the major causes of death in the society. The most important problem associated with gastrointestinal perforation following blunt abdominal trauma is that they frequently remain undetected or are diagnosed too late despite advances in medical imaging.