ABSTRACT
Background: “Paraumbilical hernia” occurs through Linea Alba either above or below umbilicus. The current trend is to use a mesh forthe repair irrespective of the size. The conventional suture method of Mayo’s is also being practiced in various centers. An attempt ismade in this study to compare both the methods especially in relation to their post-operative complications in the long-term follow-up.Aim of the Study: The aim of the study to study and compare Mayo’s method and use of mesh technique in the surgicalmanagement of repair of paraumbilical hernias in relation to their post-operative complications.Materials and Methods: A cross-sectional prospective clinical study was conducted in the Department of General Surgeryof Malabar Medical College Hospital, Modakkallur. Atholi, Kozhikode, Kerala, wherein 58 patients undergoing surgery forparaumbilical hernia were included in the study. The patients were assigned to these groups using random numbers from www.randomizer.org. The patients belonging to Group A were subjected to Mayo’s operation and Group B were subjected to Meshtechnique. All the patients were asked thorough history taking followed by investigations of surgical profile before undertakingthe surgery. All the patients were followed up from day 1 postoperatively for 2 years.Observations and Results: A total of 58 patients with paraumbilical hernia were divided into 2 equal groups comprising of29 each. The mean age in Group A was 43.65 ± 4.10 years and in Group B was 44.60 ± 3.20 years. There were 18 femalesand 11 males in Group A and 17 females and 12 males in Group B. The patients belonging to the age group of 33–62 yearswere 21/29 (72.41%) in group A and 23/29 (79.31%) in Group B. There was no statistical significance in the incidence amongthe two groups as P = 0.153 (P taken significantly at <0.05). The male to female ratio in Group A was 1:1.63 and 1:1.41 inGroup B. Pain was complained in the post-operative period in 19/29 (65.51%) patients in Group A and 16/29 (55.17%) patientsin Group B. Hematoma was observed in 5/29 (17.24%) patients in Group A and 7/29 (24.13%) patients in Group B. Seromawas observed in 4/29 (13.79%) patients in Group A and 3/29 (10.34%) patients in Group B.Conclusions: In a follow-up of 2 months to years, among the procedures used classical Mayo’s repair had 4/29 recurrencesand 1/29 were noted in patients underwent mesh repair. Even though Mayo’s repair for paraumbilical has been the procedureof choice in many centers, but the tension-free mesh repair has an advantage of having no recurrences and can be used in thepresence of bigger defect and weaker abdominal muscle tone, thus showing a superior and favorable procedure than Mayo’s repair.
ABSTRACT
Background: Diabetes mellitus has become a global epidemic. Mortality and morbidity due to this is increasing in alarmingproportion. The financial burden to society by this is markedly increasing every year.Materials and Methods: This randomized control study included 72 patients of age group 44–75 (36 studies and 36 controlgroups). The study group is provided sildenafil 25 mg daily orally for 36 days. The phase of the healing process is comparedin both groups.Results: In the study group, all 36 patients showed complete healing in 22 days but in control group, only 6 patients hadcomplete healing on 36 days and other 30 patients are at various stage of healing. The difference was obvious statistically.Conclusion: Although the sildenafil is mainly used for erectile dysfunction syndrome and other medical conditions its role inthe management of diabetic foot ulcer is commendable.