Background: Normal anal canal contains cushion of submucosa with vascular tissues. When cushions become abnormal , cause symptoms. This clinical condition is known as haemorrhoids. Haemorrhoidectomy is surgery for haemorrhoids, which can be performed by Milligan-Morgan (open technique) or Ferguson (close technique) methods. This study is conducted to compare different surgical modalities of treatment for haemorrhoids.Methods: In total, 232 patients suffering from haemorrhoids with or without fissures were included in the study. Patients were categorized into two groups. Patients undergoing open technique were designated as open group, similarly patients undergoing close technique were designated as close group. In both groups for few patients internal sphincterotomy (I.S.) was performed. Post-operative pain was assessed by visual analogue scale in all groups, per operative haemorrhage was assessed by number of swabs used during surgery and VAS estimation, operating time and post-operative hospital stay were recorded.Results: 136 patients were suffering from haemorrhoids with fissures. Of these 84 patients were operated by open technique and 52 patients by close technique. In all 136 patients, internal sphincterotomy was performed. Remaining 96 patients were suffering from only haemorrhoids. Of these 30 patients were treated by open technique with I.S., 30 patients were treated by close technique only. 25 patients were treated by close technique with I.S. and 10 patients were treated by close technique without I.S. Close group and open group with I.S. experienced less pain compared to without I.S. in both groups. Per operative haemorrhage and hospital stay in close group was less . Operative time in open group was less compared to close group.Conclusions: Ferguson procedure is found to cause less post-operative discomfort. Addition of internal sphincterotomy is having a positive effect in reducing post-operative pain.

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Background: Cholecystectomy is one of the most common surgeries done worldwide. Most common indication is biliary colic due to cholelithiasis. Presently most cholecystectomies are done by laparoscopic approach, however conversion to open cholecystectomy is needed in few circumstances and there are some absolute indications for open cholecystectomy where laparoscopic procedure can’t be done.Methods: This is a prospective observational study of 50 open cholecystectomies operated during March 2017 to Feb 2019 in our medical college. Various data including demographic data of patients, different indications, post-operative complications were documented and analyzed.Results: Mean age of the patients was 40.58 (16-65) years. Female patients were more in number 32 (64%) when compared with males. Maximum patients were in the age group 31-40 years accounting to 17 (34%) of study population. Pain abdomen 24 (48%) was the chief presenting complaint. Cholelithiasis 38 (76%) was the major indication for surgery. Complications like bile leak, bleeding, subphrenic abscess and infection occurred in 04 (08%) patients. Total four cases of laparoscopic cholecystectomy were converted to open cholecystectomy. Mean hospital stay was 7.48 (5-14) days.Conclusions: Even though laparoscopic cholecystectomy is the gold standard in the present era, it is important that the surgeon is also competent in doing open cholecystectomy. Certain conditions require planned open cholecystectomy as the standard procedure. In difficult laparoscopic cases, the surgeon must take timely decision to convert to the open technique. Surgeons experience and proper clinical judgment skills are important in difficult cases.

Kidney stones develop as a result of various metabolic disorders which affect various elements in the body especially calcium. Study was done to record the metabolic evaluation of kidney stone patients and to identify metabolic abnormality, and treating the same. Material and Methods: A prospective observational study, of hundred patients with the history of pain in flanks radiating to front and analyzing them for any metabolic abnormality. Results: Out of the 100 patients, 70 were males and 30 were females. Patients underwent metabolic evaluation, in which 55 male, 15 female patients had a metabolic abnormality remaining male and female patients had no abnormality. The common abnormality found was hyperuricosuria, followed by hypercalciuria. Conclusion: Metabolic evaluation is a must which greatly help to diagnose kidney stone and reduce the risk of stone recurrence