Comparative efficacy of prolene and prolene-vicryl composite mesh for experimental ventral hernia repair in dogs

In this study, efficacy of two hernia mesh implants viz. conventional Prolene and a novel Prolene-Vicryl composite mesh was assessed for experimental ventral hernia repair in dogs. Twelve healthy mongrel dogs were selected and randomly divided into three groups, A, Band C [n=4]. In all groups, an experimental laparotomy was performed; thereafter, the posterior rectus sheath and peritoneum were sutured together, while, a 5 × 5 cm defect was created in the rectus muscle belly and anterior rectus sheath. For sublay hernioplasty, the hernia mesh [Prolene: group A; Prolene-Vicryl composite mesh: group B], was implanted over the posterior rectus sheath. In group C [control], mesh was not implanted; instead the laparotomy incision was closed after a herniorrhaphy. Postoperative pain, mesh shrinkage and adhesion formation were assessed as short term complications. Post-operatively, pain at surgical site was significantly less [P<0.001] in group B [composite mesh]; mesh shrinkage was also significantly less in group B [21.42%, P<0.05] than in group A [Prolene mesh shrinkage: 58.18%]. Group B [composite mesh] also depicted less than 25% adhesions [Mean +/- SE: 0.75 +/- 0.50 scores, P

Complications of repair of incisional hernia using polypropylene mesh

To find out frequency and type of complications after repair of incisional hernia using polypropylene mesh. It is a descriptive type of study. This study was conducted in surgical Unit-I and Surgical Unit II Nishtar Hospital Multan from March 2003 to February 2005. After admission of the patient a detailed history, thorough physical examination was done and a proforma filled containing information about previous operation. Investigations like complete blood examination, complete Urine examination, random blood sugar level, X-ray chest, ultrasound were performed and patients put on the operation list. Polypropylene mesh placed in retromuscular plane and patients were observed for complications. Male to female ratio was 1:1.85. Age varied from 14-70 years. 32 patients [80%] were between the age of 31-60 years. 6 patients [15%] were between the age of 20-30 years 2 patients [5%] were between the age of 61-70 years. The approximate time interval between the initial operation and appearance of hernia, predominantly in all 40 patients was within first year following surgery, in fact 27 patients developed incisional hernia within first 3 months, incidence decreased gradually over subsequent years. The most common presentation was protusion of abdomen in all patients [100%] followed by vague abdominal discomfort in 36 patients [90%] and dragging pain at hernia site in 16 patients [40%]. All patients underwent repair of incisional hernia using polypropylene mesh which was placed in retromuscular preperitoneal position. Complications occurred were wound infection in 4 patients [10%], serum collection in 2 patients [5%], prolonged ileus in 2 patients [5%], sinus formation in only 1 [2.5%], hernia recurrence in 1 patient [2.5%]. There was no mortality in study. Patients were followed up at 3 weeks, 6 weeks, 3 months, 6 months and 12 months. Mesh repair was found very effective method of dealing with incisional hernia

Frequency of benign breast diseases in female patients presenting with breast lumps - a study at sir Ganga Ram Hospital, Lahore

To determine the frequency of benign breast diseases in female patients in our setup. Prospective descriptive study. The study was carried on female patients presenting at surgical out door of Sir Ganga Ram Hospital, Lahore during one year i.e. January 2001 to January 2002. Two hundred female patients presenting with breast lumps at surgical out door of Sir Ganga Ram Hospital, Lahore during one year were studied. All the patients were examined clinically with special emphasis on breast, axilla and supra clavicular fossae. Basic laboratory investigations including blood complete examination, urine complete examination and chest X -ray were done for all the patients. Breast imaging and FNAC of lumps were also done. Final diagnosis was based upon histological examination of the tissues biopsied from the lump. After collecting data, written in proforma, window SPSS software was used to analyze the results. This study shows a high f requency of fibroadenoma [45%] in Pakistani females. Fibrocystic disease is second in frequency and accounts for 36% patients.8% patients had intraductal papilloma and three percent suffered from duct ectasia.5% patients had other conditions related to breast including two patients presenting with pre histological diagnosis of fibrocystic disease who turned out to be malignant after histopathology. Most of the patients had age range of 20-29 years. Fibroadenoma is the commonest of all benign breast diseases in Pakistani women. Fibrocystic change is the second in this regard. Benign lesions of the breast can resemble its carcinoma on clinical examination

Sentinel node localization in breast carcinoma

To determine the success rate of sentinel node dissection and the sensitivity of sentinel node to determine the presence of axillary node metastasis in women with clinically node negative breast cancer. Case series. Place and Duration of Study: The study was conducted at Department of General Surgery Pakistan Institute of Medical Sciences, Islamabad [PIMS] and Nuclear Oncology and Radiotherapy Institute, Islamabad [NORI] from January 2002 to December 2003. A total of 15 patients of early carcinoma breast were recruited in the study. Five patients were injected with radiocolloid and later with isosulfan blue in the subareolar region. Ten patients were given isosulfan blue only. All the patients were subjected to standard axillary clearance after sentinel node biopsy through separate incisions. Sentinel node was examined by intra-operative frozen section and all of the dissected lymph nodes were examined histopathologically for tumour deposits. Sentinel lymph node was successfully excised in all the cases 15/15 [100%]. In 14 of the patients the sentinel node pathology was truly predictive of axillary nodal status. Sensitivity of the test was 93.33% and the positive predictive value was 100%. Sentinel node biopsy should be followed by standard axillary lymph adenectomy until the results of multiple prospective randomized trials define the role of this technique in the management of carcinoma breast

Pattern of dynamic intestinal obstruction in adults

To evaluate the causes of dynamic intestinal obstruction at PIMS Islamabad. Material and This was a prospective study of 75 consecutive cases of dynamic intestinal obstruction, conducted in department of surgery at Pakistan Institute of Medical Sciences, Islamabad from 1st August 1998 to 31st December 1999. Those patients who improved with conservative treatment and did not undergo laparatomy were excluded from the study. All patients who underwent laparatomy for management of their disease were included. Laparatomy findings were recorded and where necessary specimen was taken for histopathology for confirmation of final diagnosis. In this study of 75 cases, 100% patients presented with pain and distension of abdomen, other symptoms were less in frequency. Males were 38 and females were 37 with male to female ratio of 1.01:1. Tuberculosis was the leading cause of [36%] dynamic intestinal obstruction followed by carcinoma of the large gut and postoperative adhesions. Only two patients had small bowl malignancy and intessusception, and one patient was with meckle's diverticulum. Tuberculosis is emerging as a leading cause of dynamic intestinal obstruction. Therefore it is time to run more efficiently the tuberculosis control programme in Pakistan, before it is too late