Aims and objectives: Surgical site infections (SSIs) are one of the most important causes of health care-associated infections. Understanding SSI reduces the social and economic burden of a hospital and society. In this context, we evaluated the various aspects of SSI in our institution, Rohilkhand Medical College & Hospital (RMCH), which is a tertiary care teaching hospital in rural Uttar Pradesh in North India. Materials and methods:This prospective study was conducted in the Department of General Surgery, RMCH, Bareilly, Uttar Pradesh, India. A total number of 1,498 patients admitted for surgical procedures with effect from November 1, 2016 to December 31, 2016, formed the subjects of the present study. All operated cases during the above period, including major and minor, emergency and elective, laparoscopic and open procedures were included in the present study. Data so obtained were analyzed statistically. The Centers for Disease Control and Prevention, USA criteria were used for defining the wound. Sample swabs were collected from the first dressing and up to 2 to 4 weeks postoperatively. Samples were processed for aerobic and anaerobic flora, and the antibiotic sensitivity of the isolates was also performed. Results and discussion:The SSI rate in the present study was 8.67%. Significantly higher incidence of SSI was detected with increasing age. The SSI rate in case of emergency surgeries was more (27.7%) as compared with routine/elective surgeries (6.3%). The higher incidence (18.75%) of SSI was detected in patients having preoperative hospital stay of more than 7 days, and the maximum incidence (15.7%) was observed in patients having longer postoperative hospital stay of more than 10 days. Dirty wounds had the highest incidence of SSI (53.45%). The incidence of SSI increased with duration of surgery, order of surgery, and with the increasing duration of postoperative drains. Staphylococcus aureus was the commonest isolate (32.30%) followed by Escherichia coli (39%). Conclusion:Though the incidence of SSI in the present study was slightly low as compared with similar reports from other institutions of the country, more rational antibiotic policy and more stringent infection control measures are needed.

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Background: Perforation of the small intestine causing peritonitis is the most common abdominal surgical emergency encountered in study region. Late presentations with sepsis and septic shock makes evaluation and management of these patients a formidable surgical challenge. The aim of this study was to identify the etiologies, clinical presentation, diagnostic dilemmas and modalities of treatment of the small bowel perforation of diverse etiology in this study region. Objective was to study the demography, etiology, pathology, clinical presentation and various surgical procedures in treatment of small bowel perforation in hospital.Methods: This study was a prospective observational study conducted in the department of general surgery Rohilkhand medical college Bareilly, Uttar Pradesh, India from November 2015 to December 2016. 90 patients admitted in the emergency of this hospital who eventually turned out to be those of small bowel perforation were included in this study and an analysis of the demographic data, clinical presentations, radiological findings, site of perforation, surgical procedure performed, surgical complications and duration of hospital stay was done.Results: Duodenal perforation was the commonest cause of small bowel perforation, contributing to 51 (56.66%) patients. Peptic ulcer disease accounted for 49 (96.07%) patients and blunt trauma abdomen for 2 (3.9%) of these patients.  Jejunal perforations accounted for 9 (10%) patients and ileal perforations for 30 (33.34%) patients. Typhoid fever was the commonest cause of ileal perforation in 24 (80%) patients Blunt trauma abdomen was the commonest cause in 5 (55.55%) patients of jejunal perforations.Conclusions: Indiscriminate use of NSAIDS/Steroids accounted for most of the peptic ulcer perforation in our region. The other additive factors include alcohol consumption and smoking.

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly prescribed drugs for pain and inflammation all over the world by medical practitioners. Long-term overuse of these drugs leads to severe gastrointestinal complications such as peptic ulcers and erosions. Aim of study is to evaluate the incidence of NSAIDS related peptic ulcer perforation in our region and to know the role of NSAIDS in the causation of duodenal perforation. Methods: This was retrospective study conducted in the Department of General Surgery Rohilkhand Medical College and Hospital on 51 patients of duodenal perforations to know its causation with NSAIDS. The results obtained were compiled in a tabulated form. Mean ± Standard Deviation (SD) were analyzed using with Statistical Package for Social Sciences (SPSS 23.0). The level P < 0.05 was considered as the cutoff value for significance. Results: The Mean age of all patients was 43.86±11.05 years. In majority of 28 (54.90%) patients NSAIDS was responsible either alone or concomitantly associated with excessive smoking and alcohol in 20(71.42%) patients and NSAIDS alone in 8(28.57%) patients. Conclusion: Excessive high dose intake of these drugs and intake of the combination of two NSAIDS instead of single NSAIDS therapy has resulted in increased chances of peptic ulcer perforation. So indiscriminate use of NSAIDS should be avoided.