Background and Objectives: Antibiotic resistance is a growing concern worldwide. Laparoscopic cholecystectomy is a common surgical procedure where antibiotic prophylaxis is often used. Traditionally antibiotics have been advised pre and post operatively in surgery for gall bladder. The knowledge about usage of a single dose prophylactic preoperative antibiotic in comparison to conventional usage of perioperative antibiotics in laparoscopic Cholecystectomy is limited. Hence, this study focuses on comparing the efficacy of a single dose prophylactic antibiotic versus the usage of pre and postoperative antibiotics in laparoscopic Cholecystectomy. To assess the incidence of surgical site infections (SSIs) and antibiotic-resistant bacteria. To identify risk factors for SSIs and antibiotic resistance. Method: This is a prospective study conducted in the Department of General Surgery, at JNKTMCH, Madhepura. Study duration is Two years. Over 192 consecutive patients subjected for laparoscopic Cholecystectomy were included in study. They were divided in two groups (A&B) after applying exclusion. 74 patients in group A were given single dose of preoperative prophylactic antibiotic. No further post-operative antibiotics were given. 78 patients in group B were given both pre and postoperative antibiotics. Infective complications and cost constraints were compared between both the groups. Statistical analysis was done using chi-square test wherever necessary. Conclusion: Usage of single dose prophylactic preoperative antibiotics with no further post operative antibiotics would be sufficient to prevent surgical site infection in uncomplicated laparoscopic Cholecystectomy.

DOI: 10.5281/zenodo.

Background and Objectives: Secondary peritonitis is a severe and potentially life-threatening condition. Early prediction of mortality is crucial for optimizing treatment strategies. (1) To compare the predictive value of lactate clearance and base deficit for mortality in secondary peritonitis. (2) To evaluate the relationship between lactate clearance, base deficit, and severity of peritonitis. (3) To identify the optimal cutoff values for lactate clearance and base deficit for predicting mortality. Methods: Prospective cohort study. Lactate levels are normally maintained at less than 1.5 mmol/L using a delicate balance between production and clearance (by liver and kidneys). Hyperlactemia has shown correlation with higher mortality. In our study on 30 indoor patients of perforation peritonitis in JNKTMCH, Madhepura Bihar. we found that higher lactate level (> 4) is associated with higher ventilator need (80%) and hence higher mortality (60%).

DOI: 10.5281/zenodo.