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Background: Seroma, a recognized complication of modified radical mastectomy (MRM) delays the administration of adjuvant therapy and also effects adverse events. Aims and Objectives: This study was conducted to study the sociodemographic and clinical profile of patients developing seroma post MRM and compare the effectiveness of different modalities of seroma prevention since there is a dearth of literature on this matter in our sub-Himalayan region. Materials and Methods: This was an observational study conducted from February 2021 to August 2022 on 60 women with carcinoma breast who underwent MRM. They were studied for sociodemographic profile, cancer characteristics, and seroma prevention techniques and followed up during the study period. Preventive modalities used were quilting, octreotide therapy, suction drains with early drain removal, passive low suction drains, sharp dissection technique, and sclerotherapy. The results were analyzed using the Statistical Package for the Social Sciences version 22. Results: The mean age was 49.7±9.4 years, 18.3% had hypertension and 10.0% diabetes mellitus, and 58.3% presented with breast lump. Overall incidence of seroma was 23.3%; the highest was observed in sclerotherapy (50%), and the lowest was in quilting (7.1%) (P=0.235). The presence of hypertension (P=0.026) and the non-administration of neoadjuvant chemotherapy (P=0.010) was significantly associated with developing seroma. Sharp dissection was associated with wound infection (33.3%), sclerotherapy with flap necrosis (50%), and quilting with shoulder stiffness (21.4%). Conclusion: The lowest incidence of seroma was in quilting and the highest in sclerotherapy. Adverse events such as wound infection, shoulder stiffness, and flap necrosis were the lowest among patients discharged with passive drains and highest in sclerotherapy. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer (Ca Cx) the 4th common cancer has a high mortality rate. Human Papilloma Virus (HPV) is chiefly responsible for a long latent period to progress from preinvasive to invasive Ca Cx. So it can be prevented by screening procedures such as visual inspection with acetic acid (VIA), conventional cervical PAP smear (CP), liquid-based cytology (LBC), and high-risk (HPV-hr) detection along with vaccination. Aims and Objectives: The study aims to determine the socio-demographic profile of Ca Cx and the most appropriate costeffective community screening method. Materials and Methods: A prospective observational study with 80 symptomatic women of reproductive and peri/postmenopausal age groups attending the Gynecology Department who underwent VIA, CP, and LBC and thereby detected positive along with screened negative but clinically suspicious women were tested for HPV-hr detection. Results were tabulated into an Excel sheet and screening methods were compared using Chi-square test, gold standard being cervical histopathology (P<0.5 significant). Statistical software used - Graphpad Prism 9 (San Diego, CA). Results: The mean age was 43.3 years. Multiparity and early marriage were seen in 80% and 45% respectively. Inflammatory lesions were best diagnosed by CP but epithelial cell abnormality and more satisfactory smears by LBC (P<0.05). Sensitivity was highest (93.75%) in VIA, positive predictive value, and specificity in CP (91.66%, 75%). negative predictive value was highest in VIA and HPV-hr DNA (50%). Conclusion: VIA with CP/LBC is an economically viable and effective screening method for Ca Cx in developing countries along with HPV vaccination. [ABSTRACT FROM AUTHOR]

Meckel's diverticulum (MD), first documented by Wilhelm Fabricius Hildanus in 1598 as a small bowel diverticulum and later detailed by Johann Friedrich Meckel in 1809, is a remnant of the vitellointestinal duct connecting the fetal gut with the yolk sac. It is a true diverticulum, comprising of all the layers of the bowel wall. The commonly cited "rule of 2s" regarding the diverticulum is: Occurs in 2% of the population, has a 2:1 male-to-female ratio, usually discovered by 2 years of age, located 2 feet from the ileocecal valve, and commonly 2 cm in diameter and 2 inches long. Most Meckel diverticula are benign and are incidentally discovered during autopsy, laparotomy, or barium studies. Vitellointestinal duct lining cell being pluripotent, heterotopic tissues such as gastric, pancreatic followed by others might be found. Common clinical presentation in symptomatic cases is gastrointestinal hemorrhages followed by intestinal obstruction, diverticulitis, cystic abdominal mass, patent umbilical fistula, and neoplasm. Clinical signs and symptoms are non-specific simulating other abdominal emergencies and routine radiology is unable to detect the anomaly in rural peripheral centers. Hence, prompt surgical intervention may be needed in emergency cases. Diverticulectomy or ileal segment resection with end-to-end anastomosis is done. Due to the difficulty of diagnosing a pathologic MD pre-operatively, many surgeons recommend prophylactic diverticulectomy in those found incidentally. [ABSTRACT FROM AUTHOR]

Introduction: Surgical Site Infections (SSIs) are very common and the most frequently studied Hospital-Acquired Infection (HAI) in developing countries. Up to 5% of patients undergoing surgery develop SSIs, which can cause significant morbidity and, in some cases, be fatal. Aim: To determine the prevalence of SSI and compare the factors related to its development between clean and clean-contaminated surgeries. Materials and Methods: This longitudinal study was conducted at a rural tertiary care centre in the Department of General Surgery from May 2020 to April 2021. A total of 1,020 patients who underwent clean and clean-contaminated surgeries were clinically examined, investigated, and provided standard treatment modalities. Dirty and contaminated cases were excluded from the study. Clean and clean-contaminated surgeries were defined according to the guidelines provided by the Centres for Disease Control and Prevention (CDC). Demographic and risk factors, such as sex, age, nature of surgery, wound irrigation, American Society of Anaesthesiologists (ASA) score, smoking, preoperative stay, duration of surgery, hair removal, drains, immunosuppression, Diabetes Mellitus (DM), and Hemoglobin (Hb) levels, were observed and compared between the two groups. The development of SSI was diagnosed based on CDC guidelines. SSI cases were followed up longitudinally in both groups. Continuous variables were analysed using an unpaired t-test, while categorical variables were analysed using a chi-square test. A p-value of <0.05 was considered statistically significant. Results: Out of the 1,020 patients, a total of 93 (9.11%) developed SSI. Among the males (573, 56.17%), 39 (6.8%) developed SSI, while among the females (447, 43.83%), 54 (12.08%) developed SSI. The study found that 24 (3.46%) clean operations and 69 (21.1%) clean-contaminated surgeries developed SSI (p-value<0.0001). There was a significant association between SSI and risk factors such as ASA <2 (p-value<0.01), smoking (p-value< 0.01), DM (p-value< 0.01), Hb <8 gm% (p-value<0.01), shorter preoperative stay (p-value<0.01), prolonged surgery (p-value<0.01), use of drains (p-value<0.01), and immunosuppression (p-value<0.01). The majority of SSIs were caused by Staphylococcus aureus (24 cases, 25.8%), followed by Pseudomonas aeruginosa (18 cases, 19.3%) and Escherichia coli (12 cases, 12.9%). Patients who developed SSI had a mean postoperative stay of 32.35 days, compared to 7.19 days for those who did not develop SSI. Conclusion: The study concluded that SSI was significantly more common in clean-contaminated surgeries compared to clean surgeries. Proper surveillance can help document SSI even after hospital discharge. Prompt identification of organisms can facilitate clinical recovery. [ABSTRACT FROM AUTHOR]

Background: Wounds are a major source of morbidity and sometimes, mortality and there are several ways to treat them. Negative pressure wound therapy (NPWT) is one way, and this involves the use of a suction device to aspirate and remove fluids, debris, and infectious materials from the wound bed to promote the formation of granulation tissue and wound healing. Another way is with the use of conventional wound dressings. Aims and Objectives: The aim was to compare NPWT and conventional wound dressings for the poor in a rural setting. Materials and Methods: Sixty consecutive cases clinically presenting with wounds between March 2018 and August 2019 were examined and divided into NPWT or conventional wound dressing groups. Outcome was measured by recording wound scores on day 7 or thereafter. Cases and controls were studied from admission until complete healing. Outcome and complications of NPWT and conventional wound dressings were noted. Results were tabulated in MS excel and evaluated using Graphpad Prism 9 software (San Diego, CA, USA). Results: Many patients (33.33%) were in the 5th and 6th decades of life and most (77%) were male. Many wounds were located on the foot (40%). Those patients younger than 40 years of age with a wound <10 days old had a better median wound score in both the groups. The majority of wounds (43.33%) were traumatic. Wound healing was better in non-diabetics and non-smokers. There was a considerable reduction in the organism load in the NPWT group (P=0.0078). Complications were minor. The NPWT group had a significantly shorter mean hospital stay (P=0.0001). Conclusion: NPWT enhanced granulation tissue formation leading to earlier wound healing and faster recovery compared to conventional wound dressings. [ABSTRACT FROM AUTHOR]