Ventral and Inguinal Hernia Repair- Polyglactin - 910 better than Polypropylene?

Background: Mesh repair has been one of the most popular methods of hernia repair with the lowest recurrence rates as compared to other tissue repairs. With increasing incidence of incisional hernia which is only 2nd to inguinal hernia in incidence, number of surgeries performed for incisional hernia has increased considerably. The mesh fixation has traditionally been done with Polypropylene which are non-absorbable sutures. This study aims to compare the group of patients in which polyglactin-910 was used with patients in which polypropylene was used. Methods: The study is a prospective study conducted over a period of 4 years at the largest tertiary care hospital of Western India. 400 patients were included from which 256 patients had inguinal hernia and the rest 144 had ventral incisional hernias. Two groups were framed from these 400 patients – one in which polyglactin-910 was used (120 patients) and the other in which polypropylene (280 patients) was used. All the patients were followed up for at least 1 year and the complications were compared. Result: Out of 400 patients in 120 patients mesh repair was done with polglactin-910 and rest with poplypropylene, and study was conducted over a period of 4years with results showing incidence of pain 23% with poplypropylene against relatively low incidence with polyglactin-910 of 12%. Another observation was that incidence of sinus formation was 13% with polypropylene and only 0.8% with polyglactin-910. Conclusion: The study concluded that the association of pain and sinus formation was higher with polypropylene

Primary tuberculosis of thyroid gland – a case report.

Tuberculosis of the thyroid gland is very rare disease and isolated involvement of thyroid is even more rare. There are about 200 cases of thyroid gland tuberculosis had been reported worldwide .In India das et al repotred 21 cases thyroid tuberculosis . Almost all cases were secondary to some primary foci elsewhere in the body.The diagnosis is usually very difficult as the clinical presentation has no distinct characterstics. Clinically it may resemble thyroditis or goiter or some malignant etiology. On histo pathological evaluation, presence of necrotizing epitheloid cell granuloma along with langhan giant cells are diagnostic of thyroid tuberculosis. Further demonstration of acid fast bacilli in Z N staining confirms diagnosis.