Background: A thyroid enlargement whether diffuses or in the form of nodules have to be investigated to rule out neoplasm. FNAC is the first line of investigation. USG and TFT are also used. The cases which are at high risk are considered for surgery. Aims and objectives of the study was the clinical presentation of thyroid swellings, incidence of various thyroid swelling, benign versus malignant lesion and to correlate the clinical diagnosis with that of pathological diagnosis.Methods: A case series study of 60 patients attending surgical OPD IPD with symptoms of thyroid in SNMRC and HSK hospital Bagalkot between 1-1-2015 to 30-6-2016. After detailed history thorough, clinical examination was carried out all the patients underwent routine investigations TFT FNAC USG neck. Few patients underwent surgery and all the thyroid specimens were sent for HPE and the clinical diagnosis is correlated with that of pathological diagnosis.Results: Of 60 cases female to male ratio was 9:1. The age group involved is between 31-40 years (31.67%). Duration of goiter is less than one year in 60% of cases. The chief complaint was swelling in front of the neck 100%. Duration of swelling ranged from 15 days to 15 years. Toxic features were present in 18.33% of cases, but after TFT the toxic cases were only 6.67%. Most of the patient showed colloid goiter (43.33%) on FNAC. Out of 60 cases only 22 cases did undergo surgery histopathological specimen were colloid versus nodular goiter in 81.88% out of 22 cases only.Conclusions: Thyroid swellings are common in females they occur in 3rd and 4th decade most commonly. FNAC is very useful in the diagnosis. The main indications of surgery are cosmetic problems, pressure effect symptoms are suspicion of malignancy.

Background: Incisional hernia (IH) remains a very frequent postoperative complication and common hernias in middle aged population more commonly in females. The two techniques most frequently used are the onlay repair and sublay repair. Various studies have been conducted to compare the advantages and disadvantages of sublay and onlay mesh repair in incisional hernia and the superiority of sublay mesh repair. These studies whether they hold good for the population is a pertinent question. In view of this, author need to study the appropriate surgical techniques sublay versus onlay repair in the set up.Methods: Author conducted randomized comparative study of 100 patients having incisional hernia admitted to various surgical units of SNMC and HSK Hospital, Bagalkot during the period December 2014 to June 2016.Results: In present study of 100 cases, females have more incidence of incisional hernias than males. In onlay technique seroma formation was found in 72% of patients postoperatively and 4% in sublay technique. Surgical site infection (SSIN) was noticed in 8% of sublay technique whereas 12% in onlay technique. There is no recurrence in sublay group whereas onlay had 12% recurrence.Conclusions: Sublay technique is superior to onlay concerning the hospital stay, complications and recurrence.

INTRODUCTIONAbdomen is like Pandora's Box. Diseases of the abdomen constitute a topic full of curiosity. A meticulous examination of the abdomen is one of the most rewarding diagnostic procedures available to the doctor, especially the surgeon. As it had been said by Bailey, "A correct diagnosis is the hand maiden of successful operation" Despite the advancements in the fields of diagnosis the surprises never caese.1 Acute appendicitis is the most common acute surgical condition of the abdomen. 2 ABSTRACTBackground: Now a day there is a trend to rely more on high-tech investigations rather than taking thorough history and clinical examination of the patients in the diagnosis of acute pain abdomen. Commonest cause of acute abdomen in the surgical practice is appendicitis. Delay in the diagnosis and treatment of acute appendicitis, leads to complications. Objective of this study was to evaluate the accuracy of clinical diagnosis versus sensitivity and specificity of ultrasound examination and histopathological examination of the resected specimen of appendix. This study also assesses the incidence of negative appendectomies in a medical college hospital of North Karnataka. Methods: This study included one hundred and fifty patients with history of pain abdomen where clinical diagnosis of acute appendicitis was made. The study period was of 18 months between February 2014 to July 2015. Routine blood investigations and abdominal ultrasonography were done in all cases. All ultrasound positive cases were subjected to surgery. Some ultrasound negative cases were also taken to surgery on the high suspicion of diagnosis of acute appendicitis depending upon thorough history taking and clinical examination. The diagnosis made depending on the ultrasound findings were compared with clinical findings, operative findings and histopathological examination reports. Results: Out of 150 patients, 104 were male and 46 were female. The common symptoms were pain in the RIF (100%) and anorexia (80%).The overall sensitivity and specificity of clinical diagnosis was 96.9% and 90.48% respectively. The same for ultrasound was 86.99% and 33.33% respectively. The present study shows negative appendectomy rate 6.66% in females and 7.33% in males. Conclusions: The diagnostic accuracy of ultrasound was 84.87% whereas clinical diagnosis was 96%. Thus, detailed history taking, and thorough clinical examination still holds good in the diagnosis of acute appendicitis and should be stressed in the clinical teaching.

Background: Necrotizing fasciitis, is a spectrum of diseases where necrosis of deeper soft tissue is by an infective microorganism. It is a life-threatening infectious disease with mortality rate ranging from 17% to 34%. Understanding patho-physiology plays an important role in providing better medical or surgical care. Aim of the present study was to find out the most common microorganisms causing Necrotizing Fasciitis, sensitivity pattern of the isolated organisms and effective antibiotic therapy.Methods: This is a prospective observational study done in HSK Hospital, Bagalkot comprising 150 patients for a period of 8 months. The study group consisted of the patients admitted with clinical diagnosis of necrotizing fasciitis by different surgeons during this period.Results: Out of 150 patients with necrotizing fasciitis, 121 (80.67%) were male and 29 (19.33%) were females. The maximum number of patients 45 (30%) were found in the age group of 61 to 70 years. 62 patients had Type II Diabetes Mellitus,13 patients were on steroids, 7 patients had liver disease. The culture and sensitivity reports from these 150 patients was positive for growth in 136(90.66 %). The most common Gram positive bacterial isolate was Staphylococcus aureus 48 (45.28 %) and Gram negative bacterial isolate was Pseudomonas aeruginosa 46 (38.33%). The antibiotic administration was a combination of Cefperazone-sulbactum (or), piprecallin-tazobactum (or), aminoglycosides for gram negative coverage and clindamycin (or) trimethoprim-sulphamethoxazole for gram positive coverage. Anaerobic coverage was with metronidazole/tinidazole. The mortality rate was 11.33% and the common isolate in these patients from wound swab was Acetinobacter with sensitivity only to colistin and tigicycline followed by klebsiella.Conclusions: Males with age more than 60 years having diabetes mellitus were more prone to necrotizing fasciitis. Most common Gram positive bacterial isolate was Staphylococcus aureus and Gram negative bacterial isolate was Pseudomonas aeruginosa.