Desmoid tumors (also called desmoids fibromatosis) are rare slow growing benign and musculoaponeurotic tumors. Although these tumors have a propensity to invade surrounding tissues, they are not malignant. These tumors are associated with women of fertile age, especially during and after pregnancy. We report a young female patient with a giant desmoid tumor of the anterior abdominal wall who underwent primary resection. The patient had no history of an earlier abdominal surgery. Preoperative evaluation included abdominal ultrasound, computed tomography, and magnetic resonance imaging. The histology revealed a desmoid tumor. Primary surgical resection with immediate reconstruction of abdominal defect is the best management of this rarity. To the best of our knowledge and PubMed search, this is the first case ever reported in the medical literature of such a giant desmoid tumor arising from anterior abdominal wall weighing 6.5 kg treated surgically with successful outcome.

We report a case of neglected, strangulated, inguinal hernia in a middle-aged male, which presented as a scrotal fecal fistula. This is the first such case reported in an adult. The patient was treated by resection and anastamosis of the ileum, local debridement of the scrotum and Shouldice repair for the inguinal defect.

Background: In the current era, the laparoscopic procedure such as laparoscopic cholecystectomy, laparoscopic hepatobiliary surgery and other open procedures such as open cholecystectomy, biliary stricture surgery, are performed regularly throughout the world and extrahepatic biliary tract is one of the most common sites of the surgical procedures. The incidence of biliary tract injury by laparoscopic cholecystectomy has been found to be higher than open cholecystectomy. Apart from various other causes of biliary injuries aberrant anatomical course of extrahepatic biliary system is a well established fact of iatrogenic ductal injury. Thus, an adequate recognition and awareness of anatomical abnormalities of extra hepatic biliary tree with its vessel, can decrease the morbidity and mortality related to the surgery. Methods: Study was done in Department of Surgery, Gandhi Medical College and Hamidia Hospital Bhopal, India on 100 cases, during period of Aug 2014 to Nov 2015, and dissection was carried out in department of Forensic Medicine and Toxicology after taking permission from ethical committee. Results: In 100 cases of study 72 were male and 28 were female in which 16% male and 10.7% female showed variations in their anatomy. The most common variation which we observed in our study was short cystic duct in 8 cases, and second most common variations was cystic artery origin, from left hepatic artery in 3 cases and from proper hepatic artery in 1 case, other variations were floating gall bladder in 1 case, intrahepatic union of left hepatic duct and right hepatic duct in 3 cases, low insertion of cystic duct in 3 cases, high insertion of cystic duct to common hepatic duct in 1 case,and in one case cystic artery passing anterior to common hepatic duct. Conclusion: There was a significant variations seen in extrahepatic biliary apparatus and its related arterial supply in our study, and these variations observed could definintely be useful to hepatobiliary, laparoscopic surgeons and radiologist. And will further contribute to literature available on variations of extrahepatic biliary system.

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Background: Hernias of the abdominal wall constitute an important public health problem. Laparoscopic inguinal hernia repair (TEP) is a minimal access surgical procedure as compared to open hernia repair. The objective of the study was to compare open and laparoscopic hernia repair in terms of safety, complications, morbidity, recurrence, post-op pain and hospital stay.Methods: This was a prospective observational comparative study. Total 50 patients were taken in this study; out of them 25 patients subjected to group A (open repair of inguinal hernia) and 25 patients subjected to group B (laparoscopic repair of inguinal hernia). Postoperatively patients were observed for any complications and followed up one year.Results: Present study shows high incidence of inguinal hernia in males. Mean operative time for open hernia repair group was less than laparoscopic hernia repair group. Time to return to normal work, duration of hospital stay and postoperative pain were less in laparoscopic hernia repair group than open hernia repair group. Out of 25 patients in laparoscopic hernia repair (TEP) 1 patient had recurrence but in open hernia repair group there was no recurrence.Conclusions: Laparoscopic hernia repair is quite safe; it has definite advantages in bilateral and recurrent cases, postoperative pain, early return to normal activities, less postoperative hospital stay and better cosmetic results although it has its own disadvantages in terms of recurrence rate, operative time and cost effectiveness.

Background: Sucralfate is a basic aluminum salt of sucrose octasulphate which was orally taken for prevention and treatment of several gastrointestinal diseases. This study primarily aims to analyze whether sucralfate accelerates wound healing process in burn patients. The incidence of infection & relieve in pain in burn patients was also compared.Methods: This is an observational study carried out in the Department of General Surgery, Hamidia Hospital Bhopal on 50 patients divided into group 1 (sucralfate)and group 2 [a-sucralfate; b-silver sulfadiazine (SSD)]. Demographics, history, physical, and systemic examinations of the patients were recorded.Results: It was observed that sucralfate augments the formation of granulation tissue (in 6-17 days) as compared to SSD (14-22 days). It was noticed that faster healing by re-epithelialization was present in sucralfate group (11-22 days) as compared with SSD group (15-30 days). By the end of 3rd week 50-75% of wound was healed in sucralfate group as compared with 35-50% in SSD group. Incidence of secondary infection was less when topical sucralfate was used (group 1 = 25%; group 2a = 16.6%; group 2b = 66.66%). There was a marked relief in pain and discomfort after sucralfate application as compared to SSD.Conclusions: Using topical sucralfate expedite the burn wound healing process, significantly decreases pain with no local or systemic adverse reactions to the topical application therefore it can be used as an adjunctive or alternative agent in the future. However, multicentric trials with larger sample size are needed to insure the concept.

All unidentified / unaccompanied & unknown TBI patients admitted in department of neurosurgery, Gandhi Medical College Bhopal from June 2016 to May 2019 were enrolled in this study. Management of unidentified and unaccompanied patients is difficult in any health care setup due to challenges in managing their day to day care. Traumatic brain injury is the most common cause of death in trauma patients.  We analyzed demography, mode of injury, clinical presentation & condition at admission, treatment given, hospital stay, outcome & factors affecting outcome of the patients. Very few studies in world literature are available on this subgroup of patients. We analyzed data pertaining to 100 consecutive patients at our hospital. Aim and Objectives: The aim and objective of this study is to determine the outcome of traumatic Brain Injury in patients who were admitted in trauma unit/ Neurosurgery unit of Gandhi medical College Bhopal India from June 2016 to May 2019. As unaccompanied / unknown/ unidentified. In this study we collected the data of unknown/ unidentified patients of TBI to analyze the outcome. Material and Methods: It was a prospective study of all unaccompanied/ unknown patients who were admitted in the trauma unit/ Neurosurgery unit of surgery department of Gandhi Medical College & Associated Hamidia Hospital Bhopal India from June 2016 to May 2019 a total number of 100 unidentified /unaccompanied patients were admitted whose data were collected and analyzed Departmental staff, social workers, police and media persons help were take in for relocation of unknown patients to their home or non government organization shelter homes . Results: There were total 100 consecutive patient enrolment in this study, 87% of the patients were male. Most common age group was 40-59 years, 48% patients falls in this age group. Most common cause of trauma was road traffic accident (48%), followed by Cause Unknown (36%). Overall mortality was 39%. Others clinical characteristic and type of lesion in traumatic brain injury of unidentified and unaccompanied patients is given in detail in. Out of 100 patients, 43 (43%) patients were managed conservatively based on CT head findings and neurological status & 57 (57%) were operated. Decompressive Craniectomy was most common operative procedure depending on the clinical & neurological status. Overall complication rate during hospital stay was 26%. Keywords: TBI, Unidentified Patient & Unaccompanied & Decompressive Craniectomy, Rehabilitation.