Emergency Basis Research Articles

To study the correlation between severe oligohydramnios with perinatal outcome along with histopathology of placenta

The aim: To study the correlation between severe oligohydramnios with perinatal outcome and the placenta's histopathology.
 Materials and methods: comprised of 100 patients with oligohydramnios diagnosed after 28 weeks of gestation, admitted on an emergency basis, both booked / unbooked, who were willing to cooperate, were chosen. All patients with oligohydramnios (AFI<5 %) were included in the study.
 Results: 3 cases came with intra-uterine death. All three were totally unbooked cases. 2 preterm babies died neonatal intensive care unit after 4 days due to meconium aspiration syndrome. Thus the perinatal mortality was 5 %. 44 % of neonates required admission into the neonatal intensive care unit. In our study, it was found that neonatal mortality and morbidity increased significantly when oligohydramnios was associated with complications like IUGR and pregnancy-induced hypertension in mothers. All the cases associated with these histopathological changes had adverse perinatal outcomes. Hence estimation of the amount of liquor is important in the antenatal period because oligohydramnios gives insight into the associated maternal complications or fetal anomalies and has a significant bearing on the perinatal outcome. The placental examination will illuminate all the conditions affecting the perinatal outcome. Without associated complications, oligohydramnios does not have adverse perinatal outcomes.
 Conclusions: Thus, in cases of oligohydramnios with no associated complications, expectant management can be tried for a better fetal outcome. Only oligohydramnios may be the first sign of placental insufficiency and an independent manifestation of the placental-related complications spectrum.

Peculiar penetrating oropharyngeal foreign body accident: a case report and review of literatures

BackgroundChildren are curious to learn and are always explorative. This exploration is sometimes by keeping things in the oral cavity resulting in cases of foreign body in the aerodigestive tract. Penetrating oropharyngeal foreign bodies can result in significant morbidity and mortality if not treated promptly. The usual objects implicated in children are pens, pipes and toys which are cylindrical. The injury commonly occurs when the child falls with foreign body in the mouth. Here, we present a case report of a peculiar penetrating oropharyngeal foreign body accident.Case presentationA 7-year-old boy was brought to the emergency room with an alleged history of foreign body insertion into the mouth while playing with a rigid metallic rod which was bent in the end. Following a forceful hit on the head of the child by his sibling from behind, the rod got impacted into the mouth. The screening X-ray revealed an impacted foreign body. Non-contrast computed tomography scan was done on an emergency basis. It revealed hook-shaped metallic foreign body in the oral cavity and penetrating the oropharynx at the tongue base region. The effective total length of FB was 30 cm with an embedded intraglossal component of 2.5 cm. To aid in intubation, the extraoral part of the foreign body was cut short preoperatively. C-MAC video laryngoscope was used to aid in intubation. A backup plan for emergency tracheostomy was made in case of failed intubation. The foreign body was held using Kocher’s artery forceps and removed completely under endoscopic visualisation without any significant bleeding from the site of entry.ConclusionThe unusual shape, the relatively narrow space in the patient and the tongue being a vascular structure were challenges in the removal of the foreign body. Due to the hook shape, it had to be withdrawn cephalad for removal. Penetrating oropharyngeal foreign body should not be pulled out either at primary care or in the emergency room but should be referred to experienced ENT surgeons. Critical teamwork between the ENT surgeon and the anaesthetist with well-defined preoperative plans for airway management is necessary. Awareness and ensuring safe play areas for children will prevent a great deal of penetrating oropharyngeal foreign body.

Patients Undergoing Systemic Anti-Cancer Therapy Who Require Surgical Intervention: What Surgeons Need to Know.

As part of routine cancer care, patients may undergo elective surgery with the aim of long-term cure. Some of these patients will receive systemic anti-cancer therapy (SACT) in the neoadjuvant and adjuvant settings. The majority of patients, usually with locally advanced or metastatic disease, will receive SACT with palliative intent. These treatment options are expanding beyond traditional chemotherapy to include targeted therapies, immunotherapy, hormone therapy, radionuclide therapy and gene therapy. During treatment, some patients will require surgical intervention on an urgent or emergency basis. This narrative review examined the evidence base for SACT-associated surgical risk and the precautions that a surgical team should consider in patients undergoing SACT.

Результаты оценки качества работы регионального сосудистого центра Оренбургской области (на примере оказания медицинской помощи пациентам с острым инфарктом миокарда)

Diseases of the circulatory system are an urgent medical and social problem. Cardiovascular disease is a common cause of death among more than half of all deaths in the Russian Federation, from 54,7 to 58,1 thousand people died from myocardial infarction every year in the last years. The regional vascular centers’ work is aimed at reducing the death rate of Russians from vascular accidents and improving their quality of life. The purpose of the study is the quality control of specialized medical care for patients with a acute myocardial infarction in Regional Vascular Center of the Orenburg region. Materials and methods. The study was conducted on the basis of the Orenburg Regional Clinical Hospital “Voynov”, where the Regional Vascular Center exists for 10 ten years. The assessment presents bed performance indicators and special indicators of the quality of work of vascular centers for the period 2018–2022. The work uses statistical and search methods of research. Results. It has been established that due to the pandemic of the new coronavirus infection Covid‑19, such an indicator of the activity of the Regional Vascular Center of the Orenburg Region as the work of a bed was found in the intensive care unit in 2021, is up to 285.8 days, in the cardiology department in 2020 is 253,6 days. The lethality rate of the arbitration department was maximum in 2018 and 2020, the composition of 9,9% each, storage – in 2021 (7,2%). At the same time, this indicator was lower than the target mortality rate from the acute infantry department in the Orenburg region, equal to 12,4%. With the exception of a period of decreasing coverage of patients with thrombolytic therapy, which is associated with an increase in percutaneous coronary lesions performed on an emergency basis, the maximum number of exercising cases was performed 862 patients in 2021. Among patients with coronary syndrome, an increase in the coverage of medical rehabilitation was revealed, so in 2022 the proportion of such cases reached 28,2%. Conclusions. Thus, the period of pandemic of a new coronavirus infection Covid‑19 seriously influenced the indicators of the Regional Vascular Orenburg Region, but at the same time, we can see the improvement in the quality of the work of the consumption center to global control.

It is time to revisit and re-evaluate Africa’s sub-par emergency surgical delivery

It is time to revisit and re-evaluate Africa’s sub-par emergency surgical delivery

Outcome of the elective or online radiofrequency ablation of typical atrial flutter.

Radiofrequency ablation of the cavotricuspid isthmus is currently the first-choice treatment of typical atrial flutter and usually it is performed electively. The purpose of this study was to see whether performing on-line ablation has similar clinical results compared to the conventional strategy. Consecutive patients (465) who underwent ablation of the cavotricuspid isthmus for typical atrial flutter (AFL) at our electrophysiology laboratory in the 2008-2017 decade were studied. We evaluated the acute and long-term clinical outcomes of those who were treated electively (337) compared to those who had online ablation (128), that is within 24 hours of presenting to the Department of Cardiology. In patients treated on an emergency basis, a transesophageal echocardiogram was performed to rule atrial thrombi when needed. No significant intraprocedural difference was observed between the 2 patient groups, with comparable acute electrophysiological success (99% vs. 98%) and serious complications. Even at the subsequent 4-year follow-up, there were no significant differences in the recurrence of typical AFL, onset of atrial fibrillation and other clinical events. Online ablation of typical atrial flutter performed at the time of the clinical presentation of the arrhythmia, was shown to be comparable in terms of procedural safety and clinical efficacy in the short and long term compared to an elective ablation strategy.

Study EDEN-12: Analysis of access to intensive care units of patients older than 65 years requiring emergency hospitalization

ObjectiveTo investigate the relationship between the age of an urgently hospitalized patient and his or her probability of admission to an intensive care unit (ICU). DesignObservational, retrospective, multicenter study. Setting42 Emergency Departments from Spain. Time-periodApril 1–7, 2019. PatientsPatients aged ≥65 years hospitalized from Spanish emergency departments. InterventionsNone. Main variables of interestICU admission, age sex, comorbidity, functional dependence and cognitive impairment. Results6120 patients were analyzed (median age: 76 years; males: 52%. 309 (5%) were admitted to ICU (186 from ED, 123 from hospitalization). Patients admitted to the ICU were younger, male, and with less comorbidity, dependence and cognitive impairment, but there were no differences between those admitted from the ED and from hospitalization. The OR for ICU-admission adjusted by sex, comorbidity, dependence and dementia reached statistical significance >83 years (OR: 0.67; 95%CI: 0.45−0.49). In patients admitted to the ICU from ED, the OR did not begin to decrease until 79 years, and was significant >85 years (OR: 0.56, 95%CI: 0.34−0.92); while in those admitted to ICU from hospitalization, the decrease began 65 years of age, and were significant from 85 years (OR: 0.55, 95%CI: 0.30−0.99). Sex, comorbidity, dependency and cognitive deterioration of the patient did not modify the association between age and ICU-admission (overall, from the ED or hospitalization). ConclusionsAfter taking into account other factors that influence admission to the ICU (comorbidity, dependence, dementia), the chances of admission to the ICU of older patients hospitalized on an emergency basis begin to decrease significantly after 83 years of age. There may be differences in the probability of admission to the ICU from the ED or from hospitalization according to age.

A basic insight into COVID-19 vaccines: an overview

Atypical serious respiratory illnesses were reported in December 2019 from Wuhan, a city of China, which later spread to other places rapidly and became a global pandemic. Soon it was discovered to be caused by a novel corona virus, named as the severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) and the disease caused by it as corona virus disease-19 (COVID-19). Since COVID-19 is a new viral disease, world is still struggling to find out a permanent remedy to overcome this serious health problem. Developing safe and effective vaccine against SARS-CoV-2 has become the only way forward to tackle it. Various vaccines have been developed and are approved for mass vaccination on emergency basis. Both classical and next generation vaccine platforms are being used to develop COVID-19 vaccine. It seems interesting to have a look on the various types of vaccines and get an insight into them so that we can get familiarize with the COVID-19 vaccination.

Evolution of Ivorian Popular Front in the Political System of Côte d’Ivoire

The matter of political leadership in West African countries affected by conflicts and instability is significant in terms of its institutionalisation through political parties and organisations. The article seeks to examine the extent to which the formal political structure and functioning of a party reflect the actual political organisation mechanisms enacted in the fragile institutional environment in the context of civil wars, interethnic violence based on the case of Côte d’Ivoire, especially in the wake of the Ivorian Civil War of 2002-2011. A particular political organisation under examination is the Ivorian Popular Front, created by the former Ivorian President Laurent Gbagbo and the ruling party in Côte d’Ivoire in 2000-2011. A special attention in the framework of this analysis is drawn to the issue of the ethnic and tribal basis of the political party emergence and the significance of this ethnic (religious, regional or any other identity-based) agenda for further development of the political force and its practical operations. Further analysis is devoted to the role of a leader, in this case, Laurent Gbagbo, and the formal and informal patronage networks that emerge surrounding him, the way his political choices reflect identity-based agenda or his personalised interests. Limitations imposed by a political force in a conflict-ridden West African environment are examined both in conditions of control of power over the state and after its loss. A separate question addressed is the matter of a party’s ability to exist without being a dominant political force and a strong connection to the person of its founder and is there an opportunity for a political force that suffered a severe military defeat to return to prominence.

Analysis of Factors Affecting Outcome of Acute Extradural Hematoma—Our Observation in Dhaka Medical College and Hospital

Abstract Background Extradural hematoma (EDH) is a leading cause of death in young population. Timely intervention gives dramatic recovery but often fatal if not treated in time. The surgical outcome of EDH depends on many variables that strongly affect the prognosis of the disease, which are preoperative Glasgow coma scale (GCS), overlying skull fracture, time interval between injury and surgery, other associated intracranial injuries (like cerebral contusion, subdural hematoma, or intracerebral hematoma), pupillary abnormalities (anisocoria), and hematoma volume. But no correlation was found between surgical outcome of EDH and age, sex, etiology, and site of hematoma. Objective We want to identify the factors affecting the surgical outcome of EDH that will help us in preoperative prioritization of the cases for intervention, adequate resuscitation, and counselling the attendant regarding the outcome. Our ultimate goal was to reduce the mortality and morbidity from this disease. Methods This study was conducted on the patients admitted through neuroemergency and diagnosed as EDH by computed tomography scan of head, in the department of Neurosurgery of Dhaka medical college and hospital from January 1, 2017 to December 31, 2019. This is three-year prospective interventional study where all the patients underwent surgical evacuation of EDH on emergency basis and outcome was measured by Glasgow outcome scale (GOS) after 48 hours of admission and at discharge. Results Outcome was divided into good (GOS 4,5) and poor (GOS 1–3) groups. Pre-operative GCS, overlying skull fracture, time interval between injury and surgery, associated intracranial injuries, anisocoria and hematoma volume were the factors affecting the surgical outcome significantly. Conclusion Good surgical outcome is associated with EDH volume less than 40cc, preoperative GCS more than 8, absence of anisocoria, overlying skull fracture, no associated intracranial injury and surgery within 12 hours of injury. But age, sex and site of EDH has no definite correlation with outcome.

Perinatal Outcome: A Comparative Study between Emergency and Elective Caesarean Section at A Tertiary Care Hospital

Introduction: Caesarean delivery is the most commonly performed lifesaving procedure in obstetrics. Caesarean section can be done in emergency and elective basis. There has been rising trend of caesarean section over the last few decades. Both the caesarean sections are associated with fetal risks than vaginal delivery.
 Objectives: To assess and compare the perinatal outcomes of emergency and elective caesarean sections.
 Methods: It was a cross-sectional comparative study done in Civil Service Hospital of Nepal over the period of one year starting from January 2021 to December 2021. All the patients who underwent caesarean section during the study period were taken into study. Data regarding perinatal outcomes were analysed by SPSS software.
 Results: During the study period, there were 1349 total deliveries. Caesarean sections accounted for 52.2% (n=705) of all deliveries. There were a total of 373 (52.9%) emergency CS and 332 (47.1%) elective CS. Most common indications of emergency and elective caesarean section were fetal distress and previous caesarean section respectively.Out of 713 new-born’s, 26 (6.9%) were preterm in emergency CS, 4 (2.1%) in elective group which was statistically significant (X2 <0.001). Regarding APGAR score, need of resuscitation, nursery admission, respiratory distress syndrome, and neonatal intensive care unit transfer, neonates delivered by emergency basis had more number of babies than elective. However, there was no significant difference. There was one early neonatal death in the study period.
 Conclusion: Caesarean section is in rising trend of late. However, timely decision making skills can certainly lead to better perinatal outcome in caesarean sections.

Trocar site incisional hernias

Objective: to analyse the incidence of trocar site hernias among patients admitted to the surgical clinic on an emergency basis with a diagnosis of an incarcerated hernia. Materials and methods. The retrospective and prospective study; the follow-up period is 10 years. A statistical analysis of patients with incarcerated hernias had been performed. A total of 1,448 subjects was selected for the study. Of these, 825 (57.0%) patients were diagnosed with incarcerated hernias of various localizations. The diagnosis of incarceration among 623 (43.0%) subjects proved to be false, and the hernias of these patients were classified as “reducible” and “irreducible” hernias. Results. An analysis of the operations revealed 34 patients with trocar site hernias, representing 2.34% of the total number of patients admitted to hospital with hernias and 4.93% of those operated on an emergency basis. Conclusion. The rare, partial incarceration of the omentum and small intestine, the so-called Richter’s hernia, after using 5-mm-diameter trocars was revealed in 4 people operated on previously (3 to 5 years). Moreover, the hernial orifice (abdominal wall defect) at the time of our operation turned out to be significantly larger than after puncture with a 5-mm trocar. A direct correlation was found between the incidence of trocar site hernia and the degree of obesity, body mass index.

Surgical treatment of spleen injuries

Objective. To conduct a clinical analysis of the surgical treatment of patients with spleen injuries in the Astrakhan region. Materials and methods. The data of 110 patients with spleen injuries of different sex and age who were hospitalized on an emergency basis in hospitals of the Astrakhan region and were in surgical departments from August 2017 to December 2022 were analyzed. Results. An analysis was made of 110 clinical cases of spleen injury in the Astrakhan region for the period from 08.2017 to December 2022. The distribution of patients by sex and age was carried out, the nature of spleen injuries, the localization of spleen wounds, the time of admission of patients from the moment of injury, the features of clinical manifestations, the choice of diagnostic method and surgical intervention were studied. Postoperative complications and causes of mortality after spleen injury, the number of bed-days spent in the hospital, depending on the type of surgical intervention, were analyzed. Conclusion. The use of hemostatic sutures for isolated splenic injuries makes it possible to increase the number of organ-preserving operations. In case of total ruptures, multiple wounds and damage to the vascular pedicle, it is recommended to perform splenectomy with autotransplantation of splenic tissue.

Rate of various access sites for temporary transvenous pacing and different outcomes at Lady Reading Hospital, Peshawar Pakistan.

To evaluate the various temporary transvenous pacemaker (TPM) access sites, its indications, procedural complications, and outcomes of patients. This prospective study conducted in a tertiary care hospital of Peshawar, included 100 patients, who underwent TPM for any reasons, via the trans jugular, subclavian, or trans-femoral route. The duration of the study was from October 1st, 2021 to March 31st, 2022. The demographic, procedure -related complications, causes of complete heart block and in hospital outcomes were recorded. Of the 100 patients who underwent temporary transvenous pacing, 56%were males and 44% were females, with an age range of 46-80 years. In majority of the patients, (N =54) internal jugular vein was used as the venous access site followed by the subclavian vein. (N=24). Coronary artery disease was prevalent in 42% of the patients. 50% had complete AV block, 19% had symptomatic second-degree block, and 10% had sinus nodal diseases. Seventy three percent of the patients needed TPM implantation on an emergency basis, which is statistically significant (p=0.009). Almost 40% of the patient ultimately underwent a permanent pacemaker. Out of 100 patients, 16 patients expired. The major procedure related complications were bleeding 16% overall at the puncture site and 14.8% in the internal jugular group. Other complications were local infection 13% at the insertion site followed by hemopericardium 3%, in the internal jugular group. Atrioventricular block is the commonest indication for temporary pacing in our study. The average time the TPM remained in place was significantly higher in the trans jugular approach group along with a higher complication rate in this group.

523 Retrospective Application of Guidelines for Referral to Palliative Care for Persons Who Have Been Burned

Abstract Introduction Palliative Care (PC) is a limited resource, requiring allocation to those most likely to benefit. One currently underserved population is persons sustaining burns, as these injuries may severely limit quality of life, psychosocial and physical health. Additionally, treatment decisions must frequently be made on an emergent basis on behalf of someone unable to participate in decision making. PC services could benefit patients and caregivers substantially, yet only 2% of persons who have been burned are referred to PC. We developed empirically-derived referral criteria; the purpose of this study was to quantify the sensitivity, specificity, and predictive value of the criteria when retrospectively applied. Methods Retrospective review of regional burn center admissions (1/1/2019-1/31/2022) to determine adherence to criteria indicating referral to PC should be made or considered. Descriptive statistics characterizing the sample and criteria performance were calculated. Results N=388 admissions occurred study period (29.9% female; mean(SD) age=39.9 (24.1) years. N=28 persons were referred to PC; n=27 met consult criteria, and n=1 met consider criteria. Criteria for PC consultation indicated referral for n=62, and had 0.96 sensitivity, 0.90 specificity, 0.44 positive predictive value, 1.00 negative predictive value, 0.91 total accuracy. Criteria for considering PC consultation were indicated for n=181 and had 1.00 sensitivity, 0.45 specificity, 0.01 positive predictive value, 1.00 negative predictive value, 0.45 total accuracy. Conclusions Criteria for PC consultation were sensitive and specific, though the positive predictive value was low. Criteria for consideration show low values; however, documentation did not reveal whether referral was considered or not. Presence of comorbidities was the most commonly-met criterion for referral consideration. Despite the robust sample size, data from a single site may have limited generalizability. Criteria have promising characteristics, may be used as basis for quality improvement efforts, and merit ongoing study and revision to improve predictive ability. Applicability of Research to Practice These criteria advance clinical practice by providing guidance on identifying persons most likely to benefit from specialist PC.

Extracellular vesicles: A promising therapy against SARS-CoV-2 infection

Extracellular vesicles: A promising therapy against SARS-CoV-2 infection

Assessment of severity of peritonitis due to hollow viscous perforation- using APACHE II score

: Acute widespread peritonitis caused by a perforated hollow viscus is a potentially fatal illness. It's a common surgical emergency in many developing-country general surgical departments, and it's often associated with substantial morbidity and mortality. Grading the severity of acute peritonitis has greatly aided decision-making and improved the therapeutic success in the management of critically ill patients. Empirically based risk assessment for major clinical events has proven to be tremendously valuable in evaluating new medicines, monitoring resource utilisation, and improving care quality. A hospital based prospective observational study was conducted on patients operated on emergency basis for hollow viscus perforation admitted to the hospital, the study was conducted from OCT 2014 – SEP 2016 at Kamineni institute Medical sciences & hospital, Narketpally, Telengana. A series of 100 cases was compiled for this study during this period. The accuracy in outcome prediction of APACHE–II system was assessed by means of receiver operating characteristic curve and Pearson correlation coefficient. The Analytical data obtained was compared and discussed with the data available in the literature. A total of 100 patients were studied. Out of which there were 86(86%) survivors and 14(14%) non-survivors. Mean APACHE–II score of the study population was 9.80 with a range of 1-30. The predicted death rate for the study population was 16% and observed death rate was 14%. Mean APACHE–II score in survivors was 8.03 where as in non-survivors it was 20.64. The area under the curve using receiver operating characteristic curve analysis was found to be 0.985. The association between the APACHE-II score and the predicted death rate was flawless, with r = 0.99 and P0.001. In patients with peritonitis caused by hollow viscus perforation, an APACHE-II score of 11-20 was found to be a stronger predictor of mortality risk. In patient groups with APACHE-II scores of 0-10 and scores > 20, predicted death did not match observed mortality. APACHI-II scoring system can be used for assessment of group out come in patients with peritonitis due to hollow viscus perforation. However, it does not provide sufficient confidence for outcome prediction in individual patient.

Impact of Bedside Balloon Atrial Septostomy in Neonates with Transposition of the Great Arteries in a Neonatal Intensive Care Unit in Romania.

(1) Background: Transposition of the great arteries (TGA) is the most common congenital heart disease, accounting for 5-7% of all cardiac anomalies, with a prevalence of 0.2-0.3 per 1000 live births. (2) Aim: Our main objectives were to evaluate the clinical safety of balloon atrial septostomy in neonates and the possible complications. Furthermore, we tried to establish whether the procedure should be performed in all TGA patients with small atrial septal defects, regardless of oxygen saturation, within a center where corrective surgery cannot be performed on an emergency basis due to the lack of a permanent cardiac surgery team for arterial switch surgery. (2) Methods: We conducted an observational, retrospective, single tertiary-care center study between January 2008 and April 2022, which included 92 neonates with TGA transferred to our institution for specialized treatment. (3) Results: The median age at the time of the Rashkind procedure was four days. The rate of immediate complications after balloon atrial septostomy (BAS) was high (34.3%), but most were transient (metabolic acidosis and arterial hypotension-21.8%). Twenty patients with TGA managed in our hospital underwent definitive and corrective surgical intervention (arterial switch operation) at a median age of 13 days. Most patients (82.6%) were term neonates, but 16 were born preterm. (4) Conclusions: Urgent balloon atrial septostomy is often the only solution to restore adequate systemic perfusion. Bedside balloon atrial septostomy is a safe, effective, and initial palliative intervention in neonates with TGA, which can be performed in the neonatal unit.

Questionable effect of collagen cross-linking for keratoconus in a pregnant female

We report a rare case of keratoconus (KC) progressing to advanced stage in a pregnant female with previously stable KC managed with collagen cross-linking 7 years back. A 26-year-old female first visited during the second month of her pregnancy with stable KC managed with collagen cross-linking 7 years back. She was found to have corneal melt with haze and was advised to undergo keratoplasty surgery. However, the patient was not willing for that, and the surgery was deferred. After 4 months, the patient came with similar complaints. On examination, the corneal melt was advanced and the patient was suggested surgery again. However, she again deferred the surgery. At the eighth month of pregnancy, the patient came with advanced melt with well-epithelized descemetocele, which was then successfully operated on an emergency basis with full-thickness penetrating keratoplasty.

How Efficient Are Isolation Protocols? Outcome of Isolation Protocol in Surgery during COVID-19 Pandemic: A Single Institute Experience.

The timing of screening for SARS-CoV-2 preoperatively by RT-PCR/CBNAAT, isolation protocols in preoperative wards, operation theatres, and postoperative wards are not well established. Evaluating the effectiveness of maintaining three pathways of two COVID-19 negative pathways (1) immediate testing pathway (2) isolation, or quarantine for five days and testing prior to surgery pathway, and (3) the tested COVID-19-positive pathway, was the aim of the study. The primary objective was to assess the utility and outcome of the two COVID-19 negative pathways adopted before surgery in terms of infectivity (seroconversion; COVID-19 positivity rate before surgery and symptomatic COVID-19 disease after surgery). The secondary objective was to derive a practical protocol for isolation or quarantine for emergency and elective surgery. Enrolled patients were grouped based on the need for surgery; Group-1 emergency basis, Group-2 urgent basis, and Group-3 COVID-19 positive and the three channels were kept separate with separate dedicated healthcare staff for each channel. There were 199 (4.56%) COVID-19-positive patients, of whom 80 (40%) were operated. COVID-19 positivity rate was low in Group 2 (3% vs. Group 1, 11%). There was no seroconversion from negative to positive in our patients during the peri-operative period. COVID-19 positivity rate in Group-2 was significantly less. None of the COVID-19-negative patients turned symptomatic and the probability of seroconversion from COVID-19-negative was less during the peri-operative period. The isolation protocol of non-COVID-19 positive patients with the separate channel is effective.