Introduction:Androgen insensitivity syndrome is a form of male pseudohermaphrodite where the phenotype female has male gonads and is genotypically male.Case report: We report a case of complete androgen insensitivity syndrome in a 22-year-old who underwent laparoscopic gonadectomy.Discussion: Androgen insensitivity syndrome is the most common cause of male pseudohermaphroditism and third most common cause of primary amenorrhea. Conclusion:Laparoscopy is an effective method in androgen insensitivity syndrome treatment, mainly due to the increased risk of malignant transformation of the testes. Psychosexual needs should be addressed along with low-dose hormonal therapy to maximize long-term success.

Background: Acute pancreatitis (AP) is as an inflammation of the pancreas with varied range of complication like peri-pancreatic collection, pancreatic necrosis, renal failure, multi-organ dysfunction syndrome which increases mortality rate and morbidity. Majority of AP cases are mild but severe cases of AP are associated with increased complication and mortality. BISAP is simple bedside prognostic scoring system for predicting severity of AP. BISAP is a collection of simple routine investigation and scores are quantified at 24hours of onset of AP. This study aims to assess prognosis of AP cases at ESIC Medical college and Post Graduate Institute of Medical Science and Research, Bangalore, Karnataka, India.Methods: A prospective study of 60 Patients who were diagnosed as AP according to RAC. All patients were admitted in high dependency unit with close observation of vital parameters and investigations were done at 24 hours of onset of AP. BISAP score >3 was considered as Severe Acute Pancreatitis, its correlation with local complications, organ failure, ICU stay and Mortality was studied. Statistical analysis done using Chi-square test and Fisher Exact test for local complications and organ failure using xL Stat and SPSS v.21.0, a p-value <0.05 was considered to be significant.Results: Of the 60 patients, BISAP score was >3 and <3 in 15 and 45 patients respectively. Alcohol was the most common cause of acute pancreatitis, accounting for 53.33%. In current study 12 (20%) patients developed organ failure and among them 9 (75%) had transient organ failure and 3 (25%) had persistent organ failure. Total 8 (13%) patients had developed pancreatic necrosis and among them 6 had BISAP >3. Mortality rate in this study was 2%.Conclusions: The BISAP score is a simple and fairly accurate method for the early identification of patients at increased risk for in hospital mortality and to identify patients at risk of the development of intermediate markers of severity and organ failure within 24 hours of presentation.

Background: Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a ruptured appendix include widespread, painful inflammation of the inner lining of the abdominal wall and sepsis. The main objective is to compare C-reactive levels in diagnosis of acute appendicitis.Methods: In this study patients coming to General Surgery Department of ESIC Medical college, Rajajinagar, Bengaluru, from January 2017 to December 2017, who are diagnosed clinically as to have acute appendicitis form the source of study.Results: In the present study, maximum number of cases belongs to 21-30 year age group (22 cases) and male female ratio is 1.07:1. Most common site of pain being right iliac fossa (52 cases), vomiting as presenting complaint was seen in 51 cases, fever as a presenting complaint was present in 31 cases, Mc-Burneys point tenderness noted in 49 cases, rebound tenderness noted in 46 cases. In present series 53 patients had elevated serum CRP level (>2.5 mg/dl) which is 89% of total study group. In these patients only one patient had high serum CRP level in spite of normal appendix.Conclusions: An elevated serum CRP level supports the surgeon’s diagnosis and hence avoids chances of error in diagnosis, due to atypical presentations. Similarly a normal preoperative serum CRP level in patients with suspected acute appendicitis is most likely to be associated with a normal appendix on histo-pathological examination.

Background: Although traditional surgery is the gold standard treatment for hemorrhoids, stapled hemorrhoidopexy (SH) is an alternative surgical technique. However, this technique has concerns of recurrence. We conducted this study to assess the clinical outcomes and complications of SH in patients visiting our institution Methods: A prospective study was conducted on 115 patients from 2010 to 2012 who underwent SH with PPH03 kit under spinal anesthesia. Clinical outcomes assessed included the operation time, hospital stay and rate of post-operative pain. Results: SH had lower operative procedural time (30 minutes), post-operative pain and hospital stay (1.8 days) along with minimal procedural complications and were comparable to the previous reports. Conclusions: Stapled hemorrhoidopexy is an effective alternative to traditional surgical technique in treating 3rd and 4th degree hemorrhoids, in terms of lesser operative procedural time, post-operative pain, use of analgesics and hospital stay along with reduced procedure related complication.

To assess the expression of VEGF-A in breast cancer patient and to find an association between VEGF-A overexpression and the clinicopathologic features. Materials and Methods: The study was conducted from January 2010 through 2016. Formalin-fixed, paraffin-embedded blocks from 64 patients with breast cancer were included in this study. S treptavidinbiotin method was employed for immunohistochemical detection of VEGF. Results: The detection rate of VEGF was 93.5%. There was a significant difference in the immunoexpression of VEGF A between the different histological types of carcinoma. However, no significant differen ces were noted among age groups, tumor sizes, perineural invasion and overall survival. Conclusion: In our study, VEGF overexpression was positiv ely associated with only the histological type of breast cancer. Further studies involving patients with advanced diseases are required to establish an association between the VEGF-A over expression and survival outcomes and to use it as a prognostic biomarker.