A comparative study of Desarda's technique with Lichtenstein mesh repair in treatment of inguinal hernia: A prospective cohort study.

BACKGROUND: The Desarda repair technique of inguinal hernia repair introduced in 2001 is still not considered standard tissue based hernia repair technique. We compared the tissue based Desarda technique with standard Lichtenstein repair in treatment of primary inguinal hernia. METHODS: 187 cases were allocated into 2 groups. Desarda (D Group) had 92 and Lichtenstein (L Group) had 95 patients. Primary outcome factor was early (<1 year) recurrence of inguinal hernia. Secondary outcome factors included operative time measured from skin incision to skin closure. Postoperative pain scores was assessed on day 1, 3, 7, 30 and 90 using Visual analogue scale. Time taken to return to basic and home activities was calculated. Cord oedema, groin discomfort, seroma, fever, surgical site infections, chronic pain, etc. were evaluated as postoperative complications. RESULTS: After a 15-month mean follow up period 1 recurrence is noted in each arm (P = 1). Operative time was 73.89 ± 12.63 min in Lichtenstein and 72.60 ± 13.89 min in desarda repair (P = 0.508). Postoperative pain was significantly less in the first 7 post-operative days in Desarda group (P = 0.09) compared to Lichtenstein group. Time taken to return to basic and home activities was significantly less in Desarda group (P = 0.001). There was no statistical difference in rates of post-operative complications among the two arms of the study. CONCLUSION: The results of inguinal hernia treatment with the Desarda technique are similar to the results after standard Lichtenstein operations. Desarda technique does not use a mesh. Patients after Desarda's operative procedure get ambulatory sooner as compared to the standard Lichtenstein mesh repair. Less Postoperative pain, complications similar to standardised technique. Desarda technique has the potential to enlarge the number of tissue based methods available to treat groin hernias.

Skeletal remains of mummified foetus for 36 years in mother's abdomen.

Lithopedion is a rare event that occurs in 0.0054% of all gestations.(1) According to one report there are only about 330 known cases of stone baby in the world (Gang sung, Min Lee et al., 2010). About 1.5-1.8% of the abdominal babies develop into lithopedion. We report a 60-year-old female with pain and lump in lower abdomen since 2 months. Possibility of tumour was on evaluation. Eventually a mass containing foetal skeleton was found in her abdomen which was traced to her pregnancy 36 years back.

Hyperbilirubinemia as a Diagnostic Tool for the Prediction of Appendicular Perforation: A Prospective Study.

BACKGROUND: The certainty of diagnosing acute appendicitis in patients presenting with right iliac fossa pain still remains a mystery though acute appendicitis being the commonest surgical procedure done in emergency. In acute appendicitis, serum bilirubin levels are raised due to hepatocellular damage as a result of direct insult caused by Gram-negative bacterial endotoxemia. The need for the study is to conclude whether the serum bilirubin can be considered as a new laboratory marker to aid in the diagnosis of acute appendicitis and if so, does it have the predictive capacity to warn us about appendicular perforation. MATERIALS AND METHODS: This is a prospective study carried out at rural tertiary healthcare center and includes 213 patients clinically diagnosed as acute appendicitis. RESULTS: Out of 213 patients, raised serum bilirubin ≥1.2 mg/dl was present in 195 (91.5%) patients, out of which 194 (99.4%) patients had histopathologically inflamed appendix and this difference was statistically highly significant with p-value < 0.0001. In this study, 32 patients had perforated appendix. Out of those, 30 patients had bilirubin ≥ 4 mg/dl and 2 patients had bilirubin level between 1.2 and < 4 mg/dl. Raised serum bilirubin (≥4 mg/dl) was present in 35 (17.9%) patients, out of which 30 (87.7%) patients had perforated appendix. HOW TO CITE THIS ARTICLE: Saxena D, Tandon M, Shah Y, Gedam BS. Hyperbilirubinemia as a Diagnostic Tool for the Prediction of Appendicular Perforation: A Prospective Study. Euroasian J Hepato-Gastroenterol 2015;5(2):87-89.

Herpes Zoster Infection Presenting with Urinary Retention and Constipation.

Herpes zoster is a sporadic disease that results from the reactivation of latent Varicella zoster virus infection (VZV) from the dorsal root ganglion. We report a case of herpes zoste of lumbosacral region presenting as acute retention of urine and constipation, an uncommon presentation.

Primary gastric inflammatory myofibroblastic tumor in an adult-case report with brief review.

The term inflammatory myofibroblastic tumor more commonly referred to as "pseudostumor ", denotes a pseudosarcomatous inflammatory lesion that contains spindle cells, myofibroblasts, plasma cells, lymphocytes and histiocytes. It exhibits a variable biological behavior that ranges from frequently benign lesions to more aggressive variants. Inflammatory myofibroblastic tumor (IMT) of the stomach is extremely rare and its prognosis is unpredictable. We present a 45-year-old diabetic man with a gastric Inflammatory myofibroblastic tumor. The histopathological and immunohistochemical analysis was the key to reach diagnosis.

A Case of Emphysematous Pyelonephritis.

Emphysematous pyelonephritis is a rare but dangerous condition in patients with D.M. and urinary tract infection. We report a case of emphysematous pyelonephritis who presented to us with acute abdomen and sepsis. Her CT abdomen showed air in the collecting system of left kidney. She was managed with, I. V. fluids, antibiotics, insulin, and percutaneous nephrostomy. But she died on the 3rd day of hospitalisation due to Multiorgan failure with sepsis.

Abdominal cocoon: an unusual cause of subacute intestinal obstruction.

We report an unusual cause of subacute intestinal obstruction in a young adolescent girl, which is a nontubercular abdominal cocoon. Barium meal follow-through revealed "cauliflower"-like appearance of small bowel. The patient underwent an exploratory laparotomy showing thick fibrous-like coverings which were encasing the small bowel loops to form an abdominal cocoon. Fibrocollagenous membrane was excised after adhesiolysis. Histopathological examination of membrane revealed fibrocollagenous membrane with hyaline deposition of nontubercular origin.