Context:The surgical management of fistula-in-ano is still debatable and no clear recommendations have been made available until now. The present study analyses the results of ligation of intersphincteric fistula tract (LIFT) technique in treating fistula-in-ano in particular with recurrence, healing time, and continence status.Aims:LIFT in the management of patients of fistula-in-ano of cryptoglandular origin.Settings and Design:Prospective study.Materials and Methods:This is a prospective study of 52 patients admitted from September 2012 to August 2014. Patients were managed with LIFT technique and results of LIFT technique were compared with other studies in terms of recurrence rate, incontinence rate, and other postoperative complications.Results:A total of 52 patients were studied. Median follow-up was 24 weeks. Primary healing was achieved in 32 (71.11%) patients. Thirteen patients (28.88%) had a recurrence. No patient reported any subjective decrease incontinence after the procedure.Conclusions:LIFT technique is simple and easy to learn. With this method fistula-in-ano could be easily treated even at primary health care level. LIFT technique is a simple and novel modified approach for the treatment of fistula-in-ano with rapid healing rate and without any resultant incontinence.

Small bowel injuries in general are uncommon after blunt abdominal trauma and are usually due to high-energy deceleration injuries, often in relation to motor vehicle accidents and affect fixed segments such as duodenum, duodeno-jejunal (DJ) flexure, proximal jejunum and terminal ileum. High morbidity and mortality are associated with this type of injury when the diagnosis is delayed. Untimely management of such injuries, especially transection of the DJ flexure, results in high-output entero-cutaneous fistula. In total, eight cases of DJ flexure transection with/without associated multiple injuries were reviewed retrospectively. For DJ flexure transection in all cases, the flexure was adequately mobilised, and end-to-end duodenojejunostomy performed with two-layer interrupted sutures. A large calibre nasojejunal tube was placed through the anastomotic site before completion to protect the anastomotic area from the proteolytic action of large volumes of upper gastrointestinal secretions. In case of associated injuries, appropriate procedures were done. In DJ flexure transection, a timely management by end-to-end anastomosis with administration of nasojejunal tube beyond the site of anastomosis is an alternate, simple and safe procedure in comparison to difficult procedures such as pyloric exclusion and gastrojejunostomy in patients with delayed presentation.

: Multiple scoring systems have been addressed to identify those patients who need emergency appendicectomy as the risk of delay could be avoided. Of these, the consideration of both sore related to the Alvarado and Tzanakis is essential for the study to understand the effective diagnose of acute appendicitis. The study aims to compare and evaluate Alvarado and Tzanakis score for diagnosing the acute appendicitis. This study was conducted in the department of General Surgery associated with the M.K.C.G, Medical College and Hospital, Berhampur from August, 2018 to July, 2020. A total of 96 patients were being considered for carrying out a systematic study after carefully verifying a variety of the inclusion and exclusion criteria. To conduct the study in a systematic manner, the doctor has analyzed and given the score of Alvarado and Tzanakis. On the basis of score of these two approaches, the medical team has provided the treatment to these patients. The proper identification of score has helped to select the method of operation and surgery. In addition to this, the comparison of score focusing on the NPV and PPV has also allowed for identifying the sensitivity. The Alvarado and Tzanakis score was found to have sensitivity along with the specificity of 94.44% and 83.33% respectively. However, the PPV and NPV was found to be 98.84% and 50.00% respectively as compared to Alvarado score where sensitivity, specificity, PPV and NPV was found out to be 77.77%, 66.66%, 97.22% and 16.66% respectively. From the study, it has carried out that the Tzanakis scoring system has been addressed a more reliable for analyzing the condition of patients and offering the treatment. Diagnostic. Alvarado score, with the former achieving higher sensitivity and PPV.

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The fistula in ano is commonly encountered problem in surgery and the treatment of complex fistula in ano poses a nightmare for the surgeons as there is no single technique appropriate for its treatment. The objective of this study was to determine the effectiveness of various surgical treatments in terms of recurrence and in continence. In this prospective study, total 35 patients of complex fistula in ano were treated with different surgical techniques from June 2011 to July 2013 and recorded incidence of recurrence and incontinence as follows. There was no recurrence in the patients treated with fistulotomy and cutting seton alone. But recurrence rate of 25%, 10%and 8.33% were recorded in fistulectomy, staged fistulotomy and fistulectomy with cutting seton respectively. The major and minor incontinence also occurred as follows, in fistulotomy 14.29% & 42.87%, in fistulectomy 25% & 50%, staged fistulotomy 0% & 30%, fistulectomy with cutting seton 8.33% & 16.66% but patients treated with cutting seton alone developed no incontinence.