Tension-free open mesh repair of ventral hernias--Stoppa's technique.

Tension-free prosthetic mesh repair of giant, complex, or recurrent ventral hernias in the form of a modified Stoppa technique has been used in 60 cases. Complication rate has been comparable with other such studies. In obese patients with a pendulous anterior abdominal wall, limited panniculectomy was carried out while repairing the hernia through a low transverse abdominal incision. None of the patients required a progressive preoperative pneumoperitoneum. The incidence of wound infection was 5%. One patient had a wound hematoma that required evacuation; minor wound complications occurred in 11% cases. The hospital stay ranged from 1 to 6 weeks (mean, 10.3 days). One case required readmission for resuturing of the wound. None of the cases required removal of the mesh. There was no recurrence at follow-up (mean, 26 months) in 80% of the cases. This technique is an excellent but somewhat tedious procedure.

Comprehensive Evaluation of Drug De-addiction Centres (DDCs) in Punjab (Northern India).

BACKGROUND: Drug addiction is on the rise in Punjab,India. There are 15 DDCs which are supported by the Indian Red Cross Society. There is alleged mushrooming of private Drug De-addiction Centres (DDCs) in the smaller towns, villages and cities of Punjab. OBJECTIVE: This study aimed to evaluate DDCs in Punjab. MATERIALS AND METHODS: A total of 10 DDCs were included in the study and scheduled visits were made to collect data by using a pre-tested questionnaire. RESULTS: The duration of treatment was 1 month at the Red Cross DDCs and it was approximately 6 months at private DDCs. The staff at the private DDCs were inadequate. The major drugs which were abused by patients were Propoxyphene, Alcohol, Bhukki and Cannabis. Patients were usually referred to the DDCs either by family members (35.3%) or social workers (29.8%). About 72.5% of patients were married, 36.3% had passed 10th standard and 54.4% were employed. A majority dropped out of the DDCs due to personal reasons and lack of family support. On comparison, more patients were found to be treated at Red Cross centres (75.3%) than at private centres (65.8%). All DDCs had conducted regular sessions of individual, group and family counseling for patients. Red Cross DDCs ensured that ex-clients received follow-ups and home visits. More patients were satisfied with the services which were provided by the Red Cross DDCs. On the contrary, more patients at the private DDCs complained about harassment fromstaff personnel (p>0.05). CONCLUSION: It is recommended that all DDCs should be checked regularly, and that the private centres should be provided with additional support from the government, to help run them more efficiently.