Reviewer's report 
 Outcome following emergency surgery for refractory severe ulcerative colitis in a tertiary care Title: 
centre in India 
 2  7 July 2005 Version: Date: 
 Neil H Hyman Reviewer: 
Reviewer's report: 
General 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can 
be reached) 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the 
author can be trusted to correct) 
--------none----------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
I enjoyed this paper. Clearly the management was state of the art and I agree with the management 
principles. However,I really think the conclusion needs to be reassessed. The pts who had surgery 
more than 5 days were delayed owing to medical comrbidities(eg heart disease) or because of a 
delay in transfer from an outlying hospital. These selection factors are far more likely to cause the 
poorer outcomes than the delay itself-note that all 10 pts with perforation survived. As such, early 
surgery seemed to be a marker for a healthier patient with fewer comorbidities. 
 Accept after minor essential revisions What next?: 
 An article of limited interest Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I have no competing interests 
Reviewer's report 
 Outcome following emergency surgery for refractory severe ulcerative colitis in a tertiary care Title: 
centre in India 
 2  7 July 2005 Version: Date: 
 Neil H Hyman Reviewer: 
Reviewer's report: 
General 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can 
be reached) 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the 
author can be trusted to correct) 
--------none----------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
I enjoyed this paper. Clearly the management was state of the art and I agree with the management 
principles. However,I really think the conclusion needs to be reassessed. The pts who had surgery 
more than 5 days were delayed owing to medical comrbidities(eg heart disease) or because of a 
delay in transfer from an outlying hospital. These selection factors are far more likely to cause the 
poorer outcomes than the delay itself-note that all 10 pts with perforation survived. As such, early 
surgery seemed to be a marker for a healthier patient with fewer comorbidities. 
 Accept after minor essential revisions What next?: 
 An article of limited interest Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I have no competing interests 
Please review this paper.
user
Reviewer's report 
 Outcome following emergency surgery for refractory severe ulcerative colitis in a tertiary care Title: 
centre in India 
 2  7 July 2005 Version: Date: 
 Neil H Hyman Reviewer: 
Reviewer's report: 
General 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can 
be reached) 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the 
author can be trusted to correct) 
--------none----------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
I enjoyed this paper. Clearly the management was state of the art and I agree with the management 
principles. However,I really think the conclusion needs to be reassessed. The pts who had surgery 
more than 5 days were delayed owing to medical comrbidities(eg heart disease) or because of a 
delay in transfer from an outlying hospital. These selection factors are far more likely to cause the 
poorer outcomes than the delay itself-note that all 10 pts with perforation survived. As such, early 
surgery seemed to be a marker for a healthier patient with fewer comorbidities. 
 Accept after minor essential revisions What next?: 
 An article of limited interest Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I have no competing interests 
assistant