Combined fascia and mesh closure of large incisional hernias.

Large incisional hernias of the abdominal wall represent substantial defects of supportive tissues. The repair of these requires the mobilization of fascia or the use of a prosthetic mesh. A method for closing large midline incisional hernias using both the fascia and a mesh was described in 1979. This repair was used for six midline hernias and four large incisional hernias in the right subcostal region. No wound complications and no recurrences (median follow-up 1 year 5 months) were seen. The combined fascia and mesh repair can be successfully used for large incisional hernias of the anterior abdominal wall in areas other than the midline.

General surgery with a special interest in vascular surgery: changing patterns of workload.

Prospective surveys of workload were carried out during 1989, 1990 and 1995. Analysis of outpatient referrals, inpatients and operations performed over periods of 3 months was undertaken and the changing patterns of general surgical and vascular surgical workload noted. The number of outpatient referrals rose throughout the study period because of a significant increase in the number of patients with both varicose veins and other vascular problems. There was an increase in the number of emergency admissions for vascular disease. The number of patients having general surgical operations fell; there was a corresponding increase in the number for arterial and venous disease. The general surgical component of a general surgical unit with a vascular interest is gradually declining, as increased numbers of patients with vascular problems are being referred and managed.

Changing patterns in aortoiliac reconstruction: a 7-year audit.

A prospective vascular audit was performed in this hospital between 1988 and 1994. There was a substantial increase in the number of vascular reconstructions (78 in 1988; 141 in 1994). Aortobifemoral grafts for occlusive disease comprised 18 per cent of the operations in 1988 and 0.7 per cent in 1994 (95 per cent confidence interval 0.086-0.259). There was a corresponding increase in the number of extra-anatomic grafts (from 3 to 20.6 per cent). There was a threefold increase in the number of percutaneous angioplasties performed for iliac occlusive lesions (14 in 1988; 41 plus 13 iliac stent procedures in 1994). This had no impact on the total rate of surgical intervention for aortoiliac disease, although it probably aided the shift to extra-anatomic reconstruction by dilatation of the donor side. To investigate whether this change is national, rather than local, graft sales figures were obtained from two vascular graft companies; these confirmed a national trend away from aortobifemoral grafting and provide some evidence to support an increase in extra-anatomic bypass grafting.

Effect of thyroxine on experimental bronchospasm in guinea pigs.

Effect of Thyroxine was studied in histamine induced bronchospasm in guinea pigs. Chronic treatment with the drug significantly protected against experimental bronchospasm. Thyroxine also potentiated salbutamol evoked bronchodilation in this experimental model. Up-regulation of beta-2 adrenoceptors in bronchial smooth muscle may be the probable mechanism of action of thyroxine.

Frusemide-induced diabetes mellitus in insulin pretreated rabbits as an experimental model.

Single dose of frusemide 0.1 mg/kg orally was administered in 10 rabbits pretreated with soluble insulin 4 IU intravenously. Induction of diabetes after 24 h was confirmed by an increase in blood sugar and glucosylated haemoglobin and a decrease in serum insulin levels. Ten diabetic rabbits which received only frusemide without insulin pretreatment were used as controls, whereas equal number of insulin-pretreated rabbits receiving hydrochlorothiazide 250 mg/kg orally served as the positive control group. All biochemical parameters remained unaltered in the frusemide-treated test group as well as the positive control group after two weeks. The pancreatotoxic effect of frusemide may induce a stable hyperglycaemic state in rabbits which could lead to a useful diabetic model.

Effects of trichloroethylene anaesthesia on salivary paracetamol elimination.

The effect of trichloroethylene (Trielene) anaesthesia was studied in 10 young male patients undergoing short surgical procedures. Equal number of males operated upon for the same indication under epidural anaesthesia, served as a control group. Paracetamol concentrations in saliva were measured at hourly intervals on the day before and after surgery. Paracetamol half life (t1/2) significantly decreased (from 2.5 to 0.84 h) and clearance rate (CL) significantly increased (from 8.0 to 14.0 ml/min/kg) as compared to preoperative values. The control also showed significant but smaller alterations in these parameters. Our result suggests that trielene exposure may accelerate the hepatic metabolism of paracetamol.

Ocimum sanctum Linn--a study on gastric ulceration and gastric secretion in rats.

The antiulcerogenic property of Ocimum sanctum Linn (Tulsi) was studied in pyloric ligated and pyloric ligated & aspirin treated rats. The extract of OSL reduced the ulcer index, free & total acidity on acute and chronic administration. Seven days pretreatment with the drug increased the mucous secretion also. It may be concluded that OSL extract has antiulcerogenic property against experimental ulcers, and it is due to its ability to reduce acid secretion and increase mucous secretion.