Tropical vaginal hydroceles: are they all filarial in origin?

Hydrocele of the tunica vaginalis testis has been conventionally used as an absolute indicator of filarial disease in most clinical surveys. The prevalence of filarial etiology in 100 consecutive hydroceles was studied using clinical, parasitological, histopathological and immunological parameters. Filarial etiology could be proved in 57% of hydrocele cases using major criteria: presence of microfilaria in hydrocele fluid, presence of chyle in hydrocele fluid, demonstration of adult worm in tunica, ratio of fluid antibody titer to serum antibody titer more than 2 and presence of filarial antigen in hydrocele fluid. The results of other tests in these 57 cases were used to define the minor criteria. In the other 43 cases, based on the minor criteria, 12 hydroceles could be classified as likely to be due to filariasis and the rest were probably non-filarial. Thus only 69% of hydroceles were definitely or probably filarial.

Results of the Smead-Jones technique of closure of vertical midline incisions for emergency laparotomies--a prospective study of 403 patients.

The early and late results of the Smead-Jones (SJ) technique of closure of emergency vertical midline laparotomies was compared with other conventional methods of closure such as anatomical repair (AR), mass closure (MC) and single layer (SL) closure. Four Hundred and Three patients who underwent emergency laparotomy were studied prospectively. The results of SJ closure of laparotomy in them were compared with other techniques of abdominal closure. Ninety percent of patients with SJ were in wound class IV and at high risk of wound complications. It was seen that the overall infection rate for SJ at 12.4% was significantly less than all other types of closure. The wound dehiscence rate for SJ at 3.0% was the lowest. This protective effect of SJ against dehiscence was also seen in the presence of post operative chest infection and abdominal distension. The incisional hernia rate for SJ was also lowest (4%). The appearance of the scar was comparable to the other techniques of follow up. The present study concluded that the Smead-Jones techniques of laparotomy closure had very low incidence of early and late complications and was superior to other conventional methods of closure.