"Quality of life is impaired in children with chronic pancreatitis: A multicenter study".

BACKGROUND AND OBJECTIVES: The impact of chronic pancreatitis (CP) on quality of life (QOL) of children is not well established. Our objective was to evaluate the QOL, identify contributing factors, and determine the prevalence of anxiety and depression in children with CP in India. METHODS: Children (8-18y old) with CP were prospectively enrolled across three pediatric gastroenterology centres in India. QOL was assessed using the pediatric QOL inventory (PedsQL 4.0) scale, administered to both children and their parents. Anxiety and depression was studied using the Revised Children's Anxiety and Depression Scale (RCADS 25). Contributing factors were identified using binary logistic regression analysis. The data was compared against published QOL data in healthy Indian children. RESULTS: 121 children with CP (boys-57.9 %, age at QOL-14 ± 3.2years) were enrolled. A majority (82.7 %) had pain and advanced disease (Cambridge grade IV- 63.6 %). Children with CP had poorer QOL compared to controls (total score 74.6 ± 16 vs. 87.5 ± 11.1, p < 0.0001). QOL scores were similar across centres. Older children were similar to younger ones, except for a poorer emotional QOL. Taking QOL < -2 standard deviation (SD) of controls, ∼35 % had poor physical (50.9 ± 11.9) and 20 % had poor psychosocial (PS) QOL score (52.1 ± 7.2). On analysis, presence of pain and lower socio-economic status (SES) adversely affected both physical and PS-QOL. Additionally, girls had poorer PS-QOL than boys (Odds ratio 3.1, 95%CI:1.23-7.31). Anxiety and depression were uncommon (2,1.6 %). CONCLUSIONS: Patients with CP had impaired physical and psycho-social QOL. Presence of pain and lower SES adversely affected QOL. Psychiatric comorbidities were uncommon.

Prediction of mortality in secondary peritonitis: a prospective study comparing p-POSSUM, Mannheim Peritonitis Index, and Jabalpur Peritonitis Index.

BACKGROUND: Risk scoring systems are required to allow accurate prognostication, compare outcomes of surgery, and allow patients to make informed decisions about their health. This prospective study compares the p-POSSUM (Portsmouth Modification to Physiological and Operative Severity Score for Enumeration of Mortality), Mannheim Peritonitis Index, and Jabalpur Peritonitis Index for their utility in predicting mortality in patients with peritonitis. METHODS: Perioperative data was collected from 235 patients with secondary peritonitis and used to calculate p-POSSUM, MPI, and JPI scores. The accuracy of the 3 scores was compared using receiver operator characteristic curves. RESULTS: p-POSSUM and Mannheim Peritonitis Index were similar in their accuracy with area under the curve (AUC) values of 0.756 and 0.757. Jabalpur Peritonitis Index had an AUC of 0.665. CONCLUSION: p-POSSUM and Mannheim Peritonitis Index can be used to predict mortality in patients with secondary peritonitis. Jabalpur Peritonitis Index is not suited for this purpose. Further studies are required to improve the diagnostic performance of p-POSSUM and MPI in patients with secondary peritonitis.

Use of secukinumab in erythrodermic psoriasis: A single center experience.

Background: Erythrodermic psoriasis is an acute inflammatory condition presenting as erythema and scaling involving more than 90% of body surface area in patients with a history of psoriasis vulgaris. If not treated promptly, metabolic complications and infections due to acute skin failure can cause significant morbidity and mortality in this condition. Interleukin-17 (IL-17) is considered to be the key player in initiating the inflammatory cascade in psoriasis. IL-17 blockers have been successfully used in the management of psoriasis vulgaris. However, its use in unstable erythrodermic psoriasis is limited to isolated case reports. Methods: We hereby report an observational study of nine patients of unstable psoriatic erythroderma successfully managed with injection secukinumab and followed up over the next 24 months. Results: Nine patients were managed during the study period, and a successful outcome was noted in all the patients. The Psoriasis Area and Severity Index response rate improved by at least 75% from baseline in 33.3% (3/9) at week 4 and improved to 88.9% (8/9) at week 12. None of the patients had a recurrence of erythroderma till 24 months of followup. Conclusion: The study concluded that secukinumab is quick, safe, and efficient in psoriatic erythroderma, and there was no relapse of erythroderma in any of the patients in the 24 months of followup.

TCF7L2 gene associated postprandial triglyceride dysmetabolism- a novel mechanism for diabetes risk among Asian Indians.

Aim: TCF7L2 gene is believed to increase the risk of T2DM by its effects on insulin secretion. However, the exact mechanism of this enhanced risk is not clearly known. While TCF7L2 gene has been shown to affect lipid metabolism, these effects have remained largely unexplored in the context of diabetes risk. Methods: Postprandial lipid responses to a standardized fat challenge test were performed in 620 Asian Indian subjects (310 with NGT and 310 with T2DM/prediabetes) and compared between the risk and wild genotypes of the rs7903146 TCF7L2 gene. In 30 subjects scheduled to undergo abdominal surgery (10 each with NGT, Prediabetes and T2DM), adipocyte TCF7L2 gene expression was also performed by real time qPCR and confirmed by protein expression in western blot. Results: T allele of rs7903146 TCF7L2 gene was confirmed as the risk allele for T2DM (OR=1.8(1.2-2.74), p=0.005). TT+CT genotypes of rs7903146 TCF7L2 gene showed significantly higher 4hrTg (p<0.01), TgAUC (p<0.01), peakTg (p<0.01) as well as higher postprandial plasma glucose (p=.006) levels and HOMA-IR (p=0.03) and significantly lower adiponectin levels (p=0.02) as compared to CC genotype. The expression of TCF7L2 gene in VAT was 11-fold higher in prediabetes group as compared to NGT (P<0.01) and 5.7-fold higher in T2DM group as compared to NGT group(P=0.003) and was significantly associated with PPTg and glucose levels. Conclusion: There is significant PPTg dysmetabolism associated with the risk allele of rs7903146 polymorphism as well as adipocyte expression of TCF7L2 gene. Significant upregulation of TCF7L2 gene expression in VAT that correlates with PPTg and glycaemia is also seen in Asian Indians with glucose intolerance. Modulation of PPTg metabolism by TCF7L2 gene and the resultant PPHTg may be a novel mechanism that contributes to its diabetes risk in them.

Association of Organochlorine Pesticides With Genetic Markers of Endoplasmic Reticulum Stress in Type 2 Diabetes Mellitus: A Case-Control Study Among the North-Indian Population.

Background: Organochlorine pesticides (OCPs) have been long linked to type 2 diabetes mellitus (T2DM); however, this relation at the molecular level has not been explored yet. Endoplasmic reticulum (ER) stress and pro-inflammatory pathways are considered vital ones in the pathogenesis of T2DM. We aimed to investigate the existence of any association between OCPs, ER stress, and pro-inflammatory pathways in subjects with known T2DM. Methods: Seventy subjects each with T2DM and normal glucose tolerance were recruited from the surgery department. Their visceral adipose tissue was collected intraoperatively. OCP concentration, ER stress, and pro-inflammatory markers were analyzed and compared between two study groups. Results: We found 18 OCPs and their metabolites in visceral adipose tissue samples of study participants. The levels of δ-HCH, heptachlor, endrin, and p,p'DDT were significantly higher in the T2DM group and were also positively correlated with fasting and postprandial plasma glucose levels (p < 0.01). We observed a positive association of δ-HCH (p < 0.01), heptachlor (p < 0.05), and endrin (p < 0.05) with central adiposity and ER stress markers. However, we failed to establish the correlation of OCPs with any of the pro-inflammatory markers. Conclusion: The existence and simultaneous complex correlation of OCPs with ER stress may explain their role in the pathogenesis of T2DM, revealing the persistence of the gene-environment interaction in the etiology of T2DM.

Correlation of serum ST2 levels with severity of diastolic dysfunction on echocardiography and findings on cardiac MRI in patients with heart failure with preserved ejection fraction.

OBJECTIVE: The aim of the present study was to find a correlation of serum Suppression of tumorigenicity 2 (ST2) levels with severity of diastolic dysfunction on echocardiography and cardiac magnetic resonance imaging (CMRI) in heart failure with preserved ejection fraction (HFpEF) patients. METHODS: Fifty patients aged ≥18 years fulfilling diagnostic criteria for HFpEF were included. ST2 levels, 2D echocardiography and CMRI were performed. Left ventricular ejection fraction, E/A, Septal E/E', left atrial volume index (LAVI), tricuspid regurgitation (TR), assessment of diastolic dysfunction, T1 mapping in milliseconds and late gadolinium enhancement (LGE) in percentage were noted. The primary outcome measure was to study correlation of ST2 levels with severity of diastolic dysfunction, whereas the secondary outcome measures were to study correlation of ST2 levels with native T1 mapping and LGE on CMRI. RESULTS: ST2 levels showed statistically significant and positive correlation with E/E' (r = 0.837), peak TR velocity (r = 0.373), LAVI (r = 0.74), E/A (r = 0.420), and T1 values in milliseconds (r = 0.619). There was no statistically significant correlation between ST2 level and LGE in % (r = 0.145). The median ST2 levels in patients with E/E' > 14 and E/E' ≤ 14 were 110.8 and 36.1 respectively (p-value < 0.05). The mean ST2 levels were significantly higher in patients who had diastolic dysfunction grade III (126.4) and New York Heart Association class IV (133.3). CONCLUSIONS: Evaluation of ST2 adds important information to support the diagnosis of left ventricular diastolic dysfunction in patients with HFpEF.

Detection of deltamethrin, cypermethrin and flumethrin efficacy against buffalo lice-Haematopinus tuberculatus.

The cattle and buffalo farm practices have been adopted differently by farmers in India but the infestation of ectoparasites including louse has been advocated in high population of animals across the country. The aim of this study was to identify the louse morphologically and determine the in vitro efficacy of the insecticides deltamethrin, cypermethrin and flumethrin against the buffalo louse, Haematopinus tuberculatus. The present research work was conducted using lice collected from organized buffalo dairy farms of Mhow block, Indore district of Madhya Pradesh, India. The adult's lice were collected from heavily infested regions of the body and tail of buffaloes. Some of the collected adult's lice were preserved for morphological identification in 70% alcohol. Briefly, in vitro treated surface bioassay utilizing a cloth rectangle that allows lice to move freely has been used. The concentrations were prepared as 30, 60, 90 and 120 ppm for deltamethrin and flumethrin, whereas for cypermethrin, 100, 200, 300 and 400 ppm concentrations were prepared in distilled water. The 600 µl of each concentration was spread evenly over a cloth rectangle held in the bottom of a Petri plate. Ten adult lice were used for each concentration in triplicate (n = 30) and the same is maintained for control. The vitality of the louse was assessed at various intervals: 30, 60, 120, 180 and 240 min. The lousicidal efficacy was determined by using in vitro bioassays with deltamethrin, cypermethrin and flumethrin. It is observed that as the concentration of insecticides increases with exposure time, mortality of lice is also increased. The current study reveals that cypermethrin and flumethrin were effective in their recommended doses but in the case of deltamethrin, the lice showed a low level of resistance. Furthermore, this type of study on buffalo louse has not conducted in Mhow region of Madhya Pradesh where heavy infestation of lice occurs on buffalo.

A Rare Case of Complex Hernia Causing Urethral Obstruction.

Abdominal wall hernias rarely cause obstruction of the urinary tract. We present the case of a patient undergoing regular smooth dilatations for urethral stricture since 8 years who developed right inguinoscrotal swelling and narrowing of urinary stream since 2 years of age. There was a growing difficulty in dilatation due to path distortion of urethra by the hernia. He had a history of open suprapubic cystostomy (SPC) 8 years ago. The patient refused surgery till he landed with an inability to pass dilators and difficulty in passing urine. He was taken up for right inguinal exploration with internal optic urethrotomy (IOU). Intraoperatively, he was found to have right inguinal hernia with incisional hernia at the site of SPC which was repaired and a cystoscopy revealed urethral deviation with anterior urethral stricture for which IOU was done. Postoperatively, the patient's urethral tract straightened and his urinary complaints resolved. A complex hernia can cause urethral deviation and obstruction due to pressure effects of its contents and should be repaired at an early stage.

Retro-Odontoid Pseudotumor Without Radiographic Instability with Congenital C1 Assimilation and C2-C3 Fusion: A Case Report.

CASE: The authors present a case of retro-odontoid pseudotumor (ROP) with congenital C1 assimilation and C2-C3 block vertebra without radiological instability who presented with cervical myelopathy with spastic quadriparesis. The patient was managed with occipitocervical fusion and C1 laminectomy. She had rapid neurological recovery in 3 months postoperatively and at 2 years had complete resolution of the retro-odontoid mass. CONCLUSION: C1 assimilation without apparent radiographic instability as a cause of ROP is underappreciated. This case report and review of literature highlight that C1 assimilation and C2-C3 fusion can lead to ROP even in the absence of apparent radiographic instability with posterior atlantoaxial fusion alone providing good results.

Largest Intracranial Calcified Hydatid Cyst: A Case Report with Review of Literature.

Cerebral hydatid disease is a peculiar manifestation of echinococcosis, an infection acquired from Echinococcus tapeworm, in its larval stage. It symbolizes only 2% of all the cerebral space occupying lesions. It is frequently observed in children and young adults. In this paper, we report an exceptional case of intracranial solitary calcified hydatid cyst in a 25 year old male, shepherd by occupation, presenting with history of difficulty in walking and convulsions for the last 20 years. Craniotomy was carried out and an intact calcified mass weighing around 300 grams was excised. It is the largest intracranial calcified hydatid cyst excised till date and is first of its kind.

Spinal Epidural Lipomatosis with Osteoporotic Vertebral Fractures Presenting as Acute Thoracic Myelopathy in a 33-Year-Old Man with Cushing Disease.

BACKGROUND: Steroid-related spinal epidural lipomatosis (SEL) is a well-known condition most commonly encountered in patients taking chronic steroid medications. Endogenous Cushing syndrome is a rare cause of SEL. The authors report an unusual presentation of acute thoracic myelopathy due to SEL with osteoporotic vertebral compression fractures in a patient with Cushing disease. CASE DESCRIPTION: A 33-year-old man presented with thoracic myelopathy due to SEL and multiple vertebral compression fractures. He had Cushingoid clinical features, and investigations revealed a pituitary microadenoma as the cause of hypercortisolism. The diagnosis was missed on multiple occasions before the onset of paraparesis. The patient was treated with urgent thoracic laminoplasty followed by transsphenoidal surgery on the same day. Although normalization of the serum cortisol levels was delayed by 6 months, he had a complete neurologic recovery and remains symptom free at 2 years follow-up. CONCLUSIONS: This is a rare presentation of Cushing disease and has been reported only twice before in the 1990s. This case highlights the need to keep a high degree of suspicion for development of thoracic myelopathy in a patient with Cushing syndrome who develops thoracic compression fractures associated with SEL. Early recognition of this clinical association and addressing the primary endocrine problem urgently could have prevented spinal cord involvement and the subsequent spine surgery. This scenario is also documented in previous published case reports of this association where the diagnosis of Cushing syndrome has been revealed retrospectively after the development of neurologic symptoms.

Assessment of posterior urethra in benign prostatic hyperplasia and after its surgery.

INTRODUCTION: Surgical management of benign prostatic hyperplasia (BPH) primarily consists of transurethral resection of the prostate (TURP). Due to BPH and after surgical intervention, anatomic variations in the posterior urethra are expected. Due to the paucity of information regarding posterior urethral anatomic variations in these conditions and its aftermath, this study was undertaken to evaluate the anatomic variations in the posterior urethra after TURP. MATERIALS AND METHODS: This prospective observational study was conducted over 2 years at the Department of Surgery and Radiodiagnosis, University College of Medical Sciences, Delhi. All consenting patients undergoing TURP for BPH were included in the study. We assessed the posterior urethral changes in BPH before and 3 months after the procedure. Diagnostic modalities used were urethrocystoscopy, micturating cystourethrogram, and retrograde urethrogram. Furthermore, the prostate volume and postvoid residual volume of urine were compared before and after its surgery using ultrasonography. Urodynamic studies were used to calculate total voided volume (TVV), peak flow rate (PFR), voiding time (VT), and hesitancy. RESULTS: Mean age of the patients was 68.12 ± 7.83 years. Lengthening in posterior urethra was seen in BPH patients with a mean of 4.24 ± 1.012 cm. Postprocedure, there was a mean reduction of 2.6 ± 1.225 cm in length of the posterior urethra (P < 0.0001). Prostatic urethral angle was increased in patients suffering from BPH, and it decreased after undergoing surgical management (P < 0.679). All patients enrolled in our study had prostatic lobes enlargement, and after surgery, this enlargement was reduced in most of the patients with 21 having no prostatic enlargement, and in four patients, bilateral lateral lobe was not completely reduced (P = 1.000). Stricture in prostatic urethra was observed in 2 out of 25 (8%) patients operated for BPH. Evaluation of various parameters of urodynamic studies revealed the net improvement in the TVV of 157.746 ± 120.999 ml, as before the procedure, this value was 176.715 ± 72.272 ml, and after surgery, it was 334.46 ± 78.588 ml (P < 0.001). VT taken by patients before surgery was 57.377 ± 16.858 s, and postprocedure, this value was 33.31 ± 8.807 s. This net reduction of 24.069 ± 14.88 s was statistically significant (P < 0.0001). PFR before the procedure was 6.177 ± 3.5067, and postprocedure, this value was 26.43 ± 7.112 ml/s with a net improvement of 20.253 ± 9.226 ml/s (P < 0.0001). Hesitancy in BPH patients before the procedure was 23.908 ± 15.521 s. Postprocedure, hesitancy decreased to a value of 6.79 ± 4.435 s with a net reduction of mean 17.115 ± 15.817 s (P < 0.002). CONCLUSION: By our findings, we conclude that BPH is associated with anatomic variations in posterior urethra such as lengthening of the length of the posterior urethra and increased posterior urethral elevation, which is measured by an increase in posterior urethral angle (PUA). Whereas post-TURP, there is a shortening of posterior urethra, decrease in PUA, decrease in prostatic volume, postvoid residual urine volume, and improvement in uroflowmetric parameters.

Tuberculosis: A Common Infection with Rare Presentation, Isolated Sellar Tuberculoma with Panhypopituitarism.

Isolated sellar tuberculoma is a very rare condition and usually presents with headache and decreased vision. It can present with panhypopituitarism with 3rd nerve palsy. Tuberculoma mimics pituitary adenoma clinically as well as radiologically and requires endoscopic transsphenoidal surgery and histopathological examination for the final diagnosis. We present a rare case of a 40-year-old female presented with headache, decreased vision, and unilateral 3rd nerve palsy with panhypopituitarism.

Undiagnosed spontaneous oesophageal rupture presenting as right hydropneumothorax.

Spontaneous oesophageal rupture has been a known ailment with a high morbidity and mortality. Various factors contribute to its predisposition such as preexisting oesophageal diseases, increased intraluminal pressure, neurogenic causes, and iatrogenic-commonest being instrumentation. We present the case of a 26-year-old male with features of right hydropneumothorax for which an intercostal chest drain (ICD) was inserted that yielded turbid fluid with suspicion of it being gastric contents. With a diagnosis of diaphragmatic hernia and gut/bowel injury caused due to intercostal drain, the patient underwent emergency exploratory laparotomy. No abnormality was detected and possibility of oesophageal injury/rupture was contemplated though ruled out on investigations. The patient improved with medical treatment of empyema and discharged. The patient was lost to follow-up until after a year the patient reported to surgery OPD with complaints of dysphagia. A barium swallow revealed thoracic oesophageal benign stricture thus confirming our suspicion of spontaneous oesophageal rupture that had occurred a year ago. Knowledge about atypical presentations of oesophageal rupture is important so as to be more aware of this possibility.

Scrotal abscess consequent on syphilitic epididymo-orchitis.

Syphilis is notorious and a great imitator of all diseases. It is a chronic bacterial infection, caused by the sexually transmitted spirochete, Treponema pallidum. Though it has drastically reduced in prevalence, its recent resurgence (especially with HIV disease) is worrying. Without treatment, the disease can progress over years through a series of clinical stages and lead to irreversible neurological or cardiovascular complications. The disease may occur in any organ, including the testis, and is commonly mistaken for malignancy. We report a case of scrotal abscess consequent on epididymo-orchitis, confirmed by histopathological examination to be syphilitic in origin, in an immunocompromised HIV-positive patient.

Endoluminal Shuntscope-Guided Ventricular Catheter Placement: Early Experience.

BACKGROUND: Placement of ventricular catheter (VC) in an optimal position is the most important factor in determining the outcome of shunt surgery. VC obstruction due to shunt tube placement in brain parenchyma, across the septa, tangled in the choroid plexuses and clogging of VC due to brain matter or other debris are common reasons resulting in shunt complete or partial dysfunction. To resolve these hurdles, many technical advancements have been made including navigation, stereotaxy, sonography, and ventriculoscope-guided VC placement. OBJECTIVE: To report early experience, technique, and result of placing VC with shuntscope. METHODS: We are publishing our experience of shuntscope-guided ventriculoperitoneal shunt in 9 cases done from June 2015 to April 2016. Shuntscope is a 1 mm outer diameter semi-rigid scope from Karl Storz with 10000 pixel of magnification. It has a fiber optic lens system with camera and light source attachment away from the scope to make it light weight and easily maneuverable. RESULTS: In all cases, VC was placed in the ipsilateral frontal horn away from choroid plexuses, septae, or membranes. Septum pellucidum perforation and placement to opposite side of ventricle was identified with shunt scope assistance and corrected. CONCLUSION: Although our initial results are encouraging, larger case series would be helpful. Complications and cost due to shunt dysfunction can thus be reduced to a great extent with shuntscope.

Clinical, radiological, cytological, and microbiological assessment of painful extratesticular lesions.

INTRODUCTION: Most of the painful extratesticular scrotal lesions are erroneously diagnosed and treated in our clinical practice. Therefore, this study was undertaken to analyze the usefulness of a combination of clinical, radiological, cytological, and microbiological assessment in establishing the accurate diagnosis of this lesion. AIM: To study the Clinical, Radiological, Cytological and Microbiological assessment of painful extra-testicular lesions and their correlation with each other in establishing the accurate diagnosis of these lesions. OBJECTIVES: The objectives of the study were to assess the diagnostic significance of clinical, radiological, cytological, and microbiological methods and their correlation in establishing the accurate diagnosis of painful extratesticular lesions. MATERIALS AND METHODS: This cross-sectional study was carried out in Departments of Surgery, Radiology, Pathology, and Microbiology, University College of Medical Sciences and GTB Hospital over the period of 2 years. During this period, we were able to accommodate 75 patients in the study, who presented with pain and swelling in the scrotum and clinically found to have extratesticular swellings. Radiological assessment was done on the 1st day of visit, using Grayscale ultrasonography along with Color Doppler of these lesions. For cytological assessment, ultrasound-guided fine-needle aspiration cytology and microbiological assessment were done from the aspirate remaining after making cytology slide. STATISTICAL ANALYSIS: Data analysis was done using SPSS statistical software. Kappa statistics were used to find the degree of agreement or concordance between clinical, radiological, cytological, and microbiological findings. RESULTS: Clinically 71 patients were found to have tender extratesticular swellings, whereas in four patients, these swellings were nontender on clinical examination. Radiologically, epididymitis was found in 32 patients. Only in 37 patients out of 75, a definite diagnosis could be made on cytology. The microbiological examination did not give any positive results. CONCLUSION: Painful extratesticular scrotal lesion often poses a diagnostic dilemma in the mind of treating physician. Clinical findings of these lesions may be corroborated through radiological, cytological, and microbiological assessment in an endeavor to arrive at a definitive diagnosis with a defined etiology.

Metaplastic breast carcinoma presenting as benign breast lump.

A 38-year-old female presented with the left breast lump for 6 months. Physical examination revealed 11 cm × 7 cm mobile lump in the left breast without any axillary or supraclavicular lymphadenopathy. Mammographically it appeared as benign breast lump (breast imaging reporting and Data System-II). Fine needle aspiration cytology and Tru-cut biopsy were not able to differentiate between benign or malignant nature of this breast lump. For better characterization of this lesion, lumpectomy was performed, which revealed malignant tumor with squamous differentiation along with areas of ductal carcinoma in situ and the inferior margin was not free. For proper locoregional control, left modified radical mastectomy was performed. Postoperative period was uneventful. Final biopsy report of the mastectomy specimen was negative for any residual tumor, and axillary lymph nodes were not involved.

Wound Outcome Following Primary and Delayed Primary Skin Closure Techniques After Laparotomy for Non-Traumatic Ileal Perforation: a Randomized Clinical Trial.

To study the effect of primary and delayed primary closure of skin incision on wound outcome in patients with non-traumatic ileal perforation, 68 patients of ileal perforation were studied in a prospective randomized clinical trial. Patients fulfilling inclusion criteria were divided into ileostomy and non-ileostomy groups, both of which were then randomized into two subgroups each depending on whether skin was closed primarily or in a delayed primary manner. Wound infection and dehiscence were the main outcome parameters studied. The data collected was analyzed using appropriate statistical tools taking significant p value at 5 %. Most patients were 21-30 years of age. Male:female ratio was 3.2:1. The overall incidence of wound infection was 63 %. Wound infection was strongly associated with the incidence of superficial wound dehiscence and total wound dehiscence that were 11.76 and 47 %, respectively. Mortality was 10.3 %. Methodology of wound closure has no significant impact on incidence of wound infection, wound dehiscence, and mortality, although the onset of wound complications is significantly delayed with delayed primary closure of the skin.