Background: Incisional Hernias are common complication of andominal surgery. Depending on the risk factors Incisional Hernia can occure in 10 -20 % of patients subjected to abdominal operations. Aims and Objective: A clinical study on risk factors, clinical prentations, management and post oprattive complications in patient with Incisional Hernia. Setting: Department of Surgery of a Tertiary Health Care Centre with an attached medical college. Material and Methods: A total of 43 patients of Incisional Hernia were studied and postoperative complications were evaluated in our institute. Results: Incidence of incisional hernia is more common in females than males and the overall M:F ratio is 1:2, 55.9 % of patients presented with swelling and pain. Incisional hernia incidence is high in lower abdominal incisions. Conclusions: The use of midline incision should be restricted to operations in which unlimited access to the abdominal cavity is necessary. Use of suction drain reducess post-oparative complication

Introduction: Solitary nodule of thyroid has increased in incidence in the present day as compared to two decades before. Because of possibility of malignancy, some clinicians especially those in surgical subspecialties recommended that all nodules have to be removed. Material and Methods: Data collection by meticulous history taking and clinical examination, appropriate laboratory and radiological investigations, operative findings, histopathological report and follow-up of cases. Results: Study was conducted with 35 patients. The peak incidence of solitary thyroid nodule was observed in 3 rd to 4 th decade with four times more common in females as compared to male. The common causes of solitary thyroid nodule were colloid goitre (31.4%), Multinodular goitre (20%) and adenomatous goiter (17.1%), 94% of cases presented with euthyroid state. Incidence of malignancy in solitary thyroid nodule was 23%. The most common cause of malignancy was papillary carcinoma (14.3%). Conclusion: Solitary thyroid nodule is more common in 3 rd to 4 th decades. Solitary thyroid nodule is more common in females. Most of the patients presenting with solitary thyroid nodule are euthyroid and only a small percentage of patient with toxicity or hypothyroidism. USG can be accurately used to detect patients with multinodular goiter who clinically present as solitary thyroid nodule. Common causes of solitary thyroid nodule are colloid goitre, MNG, and adenomatous goiter. The most common cause of malignancy in solitary thyroid nodule is papillary carcinoma followed by follicular carcinoma.

Aims and Objective: The purpose of this study was to evaluate the clinical presentation of patient with extradural hematoma secondary to head injury and to decide upon the mode of management and also to study the results of the management and the outcome and the factors affecting morbidity and mortality. Materials and Methods: Data was collected through a prescribed proforma from the patients admitted in Surgery Department, Dr. Vasantrao Pawar Medical College and Hospital, Adgaon with extradural hematoma during the period of November 2014 to October 2016. The sample size of the study was 30 patients who completed the inclusion and exclusion criteria. All the patients with head injury on CT scan diagnosed to have EDH were included in the study. The management includes conservative measures and/or surgical intervention. The patients were followed for the results during the period of stay in hospital. Results: Temporo-Parietal (20%) and temporal region (20%) was the most common location of EDH. The most significant factors which influences surgical mode of management were higher age group, lower GCS and CT scan variables. Lower GCS was very significantly associated with unfavorable outcome along with CT scan variables irrespective of mode of management. Conclusion: From this study we concluded that neurological status of patient on presentation and the volumetric details of EDH are the most important factors in management and outcome of EDH. EDH patients were managed surgically and carried high number of unfavorable outcome previously. With early detection and treatment due to better connectivity of patients to hospitals, with the help of CT scan and good hospital care, we can expect a decrease in the number of unfavorable outcomes.

Background and Aims: Salmonella typhi causes an estimated 22 million cases of typhoid fever and 216000 deaths annually worldwide 1 and in developing countries, typhoid bowel perforation is an important surgical problem. The surgeon is faced with number of challenges during the management of these patients. The aims of this study are 1. To study the clinical profile of typhoid perforation of bowel in a tertiary care centre. 2. To study post operative outcome in patients with typhoid ulcer perforation. Methods and Methodology: A total of 45 patients diagnosed as having typhoid bowel perforation were included for the study after fulfilling the inclusion/ exclusion criteria. Results: Majority of patients were in the 2 nd and 3 rd decades (57.7%) with age ranging from 18 to 68 years. There were 28 (63.63%) males and 17 (37.7%) females. Fever with abdominal pain were the symptoms in all subjects followed by vomiting, distension of abdomen and constipation respectively. Most of the patients presented during 2 nd and 3 rd week of illness. 5 patients presented early i.e. within 24 hours and 40 patients presented late i.e., after 24 hours. Widal test was positive in 35 (79.45%) cases. Majority of patients (66.6%) group showed leucocytosis, while 7% showed leucopenia and 17% had normal WBC counts. Single perforation was found in 27 patients (60%), 2 perforations in 14 patients (31.1%) and more than 2 perforations were found in 4 patients (8.8%). Gas under diaphragm was present in all the patients. The most commonly done procedure in 33 cases (73.33% ) was simple closure of the perforation and resection and end to end ileo ileal anastomosis was done in 10 patients whereas ileo transverse anastomosis with ileostomy was done in 2 patients with multiple perforations. The most common post-operative complication was surgical site infection followed by respiratory infections, wound dehiscence. Enterocutaneous fistula was present in one case Mortality rate of 6.6 % was seen.

<p><strong>Aim:</strong> To study the applicability of the Mannheim's peritonitis index in predicting mortality in patients with perforative peritonitis.</p><p><strong>Methods:</strong> A total of 50 patients diagnosed as perforative peritonitis based on history, clinical examination, and plain skiagram abdomen erect antero-posterior view were studied. The Mannheim's peritonitis index was calculated at first laparotomy.</p><p><strong>Results:</strong> Overall post-operative mortality rate was 10%. Middle age population (35-55 years) was predominantly affected (48%) with male preponderance (75%). Peptic ulcer perforation was the most common cause of peritonitis. Malignant perforation of hollow viscus accounted for only 4% of cases. Mean MPI Score of survivors was 22.04, and that of non survivors was 33.2. Mortality rate was highest in patients with high MPI Score.</p><p><strong>Conclusion:</strong> Mannheim's peritonitis index is easy to use, with all variables easily available at first laparotomy, with reproducible results and is a reliable predictor of mortality.</p>