RESUMO
Background: Hernioplasty, in which a mesh is used to strengthen a weakness or defect in the inguinal wall, has replaced simple tissue repair. As it is associated with low recurrence, it is considered the gold standard and is one of the most common general surgical procedures. The ideal repair should be rapid, safe and simple to do, requires minimal dissection to create sufficient space, be cost-effective and be accompanied by a brief hospital stay, reduced pain, and fewer recurrences. The aim of the present study was to compare the efficacy of 3-stitch mesh fixation with that of traditional Lichtenstein mesh fixation of inguinal hernia repair. Materials and Methods: Between July 2018 and December 2019, 59 cases of primary, uncomplicated inguinal hernias were surgically treated. Both the classical Lichtenstein technique (group A, n = 30) and the Lichtenstein technique with the three-stitch fixation method (group B, n = 29) were used on patients with inguinal hernias. Between the two groups, the mean operative times, post-surgical pain scores, average hospital stays and postoperative complications including recurrence rates were compared. Results: With a P-value of 0.001, the 3-point fixation group (group B) took 3.41 ± 0.58 min less time to fix the mesh than the Lichtenstein group (group A, 5.52 ± 0.59 min). The pain after surgery was much less for participants who had 3-point mesh fixation than for those who had conventional mesh fixation in the early (1, 3, 7 and 15 days after surgery) and late (1 month and 3 months) postoperative periods, with a P-value of 0.0001. When compared to the classical mesh fixation group, the 3-point mesh fixation group had less urinary retention, seroma and swelling. Both groups had the same number of other complications. Conclusions: The three-point hernioplasty is a simple procedure that is easier to adopt, less time-consuming, causes less trauma and has a lower risk of postoperative discomfort including chronic groin pain.
RESUMO
Epichlorohydrin is an organochlorine compound and a epoxide. It is a colourless liquid with a pungent, garlic like odour, moderately soluble in water, but miscible with most polar organic solvents. It is used in the production of glycerol, plastics, epoxy glues and resins, epoxy diluents and elastomers. Epichlorohydrin is a common chemical used in industry and Accidental exposure to Epichlorohydrin can occur in workers working in glycerol, plastics, epoxy glues and resins, epoxy diluents and elastomer factories. AIMS AND OBJECTIVES: To study the clinical profile of patients with Acute Epichlorohydrin Poisoning And identify the frequency and nature of lung involvement. MATERIALS AND METHOD: 30 patients of age 18 and above with Acute Epichlorohydrin poisoning were included in the study. Symptomatology and History, ABG, chest Xray and Hrct chest findings were included in the clinical profile. Distribution of responses were examined using frequencies and percentages and cross tabulation were done between various subgroups. OBSERVATION AND RESULTS: All the patients had accidental direct exposure to Epichlorohydrin. All the patients presented with acute onset respiratory distress and dry cough. Burning sensation and redness and watering from eyes with watering from nose were present in all the patients. Burning sensation in the throat was present in two third of the patient. Two third of the patients developed ARDS and of them 60 % developed moderate to severe ARDS. Two thirds of the patient required ICU admission and out of them 60 % required NIV support and rest 40% were managed by Oxygen via Facemask. Rest one third patient required admission in general ward. All the patients show heterogenous opacities in chest Xray. All the patients show patchy areas of consolidation with Ground Glass changes in HRCT Chest. Two third of the patients show pleural effusion in both Chest Xray and HRCT Chest and out of them 80 % patients show bilateral pleural effusion. CONCLUSION: ARDS of varying degree with mucosal irritation is the most common presenting feature of patients with ACUTE EPICHLOROHYDRIN POISONING. Pneumonia with HRCT chest showing Ground Glass Opacities are common.