Background: Closure of wound depends on the location, length of the wound and the age of the patient. Ideally, wound closure device should be easy to enable rapid closure, painless and provide excellent cosmetic appearance and it should be cost effective. Optimal closure technique is necessary for cosmesis and avoiding infection, scarring and adequate wound healing. Proper evasion of wound edges, minimal suture marks, adequate tensile strength and optimal approximation of skin edges should be learnt. Materials and Methods: The present study is a randomized study conducted at Sir Sayajirao General Hospital and Medical College, Vadodara from June 2017 to October 2018 on 100 patients with a follow up period of 1 month. Patients were evaluated postoperatively with respect to closure time, pain, cosmesis and complications like seroma, infection, wound dehiscence, etc.Results: Adhesive tape is better in terms of short closure time, post-operative pain and price as compare to suture material for closure of surgical site incisions but more number of randomized control trials and multicenter trials need to be undertaken with long term follow up for scar assessment.

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Background: Aim of the study was to find out various proportion of diseases responsible for bleeding per rectum in adults and to find out diagnostic utility of anoproctoscopy, rigid sigmoidoscopy and colonoscopy for patients with bleeding per rectum. It also aims to find out the usefulness of other investigations like upper GI scopy, computed tomography etc., in undiagnosed cases.Methods: A total no of 129 patients with complaint of bleeding per rectum were included in the study. All cases were subjected to anoproctoscopy and rigid sigmoidoscopy. Colonoscopy was done in cases with severe or recurrent bleeding which were undiagnosed by sigmoidoscopy. If colonoscopy does not reveal the diagnosis upper GI scopy or computerized tomography (CT) angiography was done.Results: At the end of evaluation of 129 cases with bleeding per rectum, the cause for bleeding identified in 101 cases (78.3%). 28 cases (21.7%) remain undiagnosed.Conclusions: Large bowel endoscopy increases the diagnostic yield in patients with bleeding per rectum. Rigid sigmoidoscopy is a safe OPD based procedure, recommended in all patients presenting with bleeding per rectum and if the cause for bleeding per rectum cannot be diagnosed by rigid sigmoidoscopy, then colonoscopy is indicated. Even colonoscopy is not diagnostic, then the other investigations like upper GI scopy and CT angiography can be done to identify the source of bleeding.

Background: The aim of study was to formulate a scoring system to predict difficult laparoscopic cholecystectomy (LC) pre-operatively; depending on the specific parameters of an individual patient.Methods: We have included 100 patients who underwent LC from July 2010 to December 2012. Conversion to open cholecystectomy in relation with age, sex, attack of acute cholecystitis, fever, abdominal tenderness, serum amylase and LDH level, status of GB and GB wall thickness, number of stone, leukocyte count and CBD diameter were assessed.Results: The most important reason for conversion was adhesions at Calot's triangle (60%), followed by contracted gall bladder (15%). The other reasons of conversion were empyema of the gall bladder (15%), stone at Hartmann's pouch (10%), bleeding during dissection (5%).Conclusions: This study will surely help the surgical fraternity in the future to plan the particular patients for appropriate mode of surgery, pre-operative preparation, patient counselling and most importantly to predict the score for the difficult interval Laparoscopic Cholecystectomy.

Background: The aim of study was to evaluate the patients with bleeding per rectum by rigid sigmoidoscopy and to know the various causes of bleeding per rectum in our OPD population and to select the best approach to treat the underlying pathology.Methods: A total 63 patients with bleeding per rectum in whom cause could not be ascertained by routine methods like proctoscopy were considered from outpatient department form January 2017 to June 2018 for the study. Out of 63 patients, rigid sigmoidoscopy done in 31 patients and results were documented. All 31 patients were undergone for complete clinical examination and rigid sigmoidoscopic examination in the surgical OPD and routine blood, urine and stool investigations were also done.Results: Out of 31 cases in which sigmoidoscopic examination has been done, definitive source of bleeding is identified in 22 cases (70.97%) and in 9 cases (29.03%), the source of bleeding could not be detected by rigid sigmoidoscope.Conclusions: Rigid sigmoidoscopy has a very high diagnostic yield (approximately 71% in this study) in patients with bleeding per rectum which could not be detected by routine ano proctoscopy. Hence rigid sigmoidoscopy would be recommended in the workup of patients presenting with bleeding per rectum and it also serves an equally important function in excluding serious colonic lesions like malignancy and enables us to reassure the patient.