Pediatric inguinal hernia: controversies and decision making.

The pediatric inguinal hernia is the commonest defect the surgeon performs surgery on and is usually indirect. It is believed that these hernias rarely go away, and therefore, virtually all should be repaired. Much has been written about this condition, but the controversy on different aspects of it still exists. This article aims to address the controversies and decision making in pediatric inguinal hernias.

Reduction of length of hospital stay after transurethral resection of prostate by early catheter removal: a retrospective analysis.

The aim of this study was to determine whether early catheter removal after transurethral resection of prostate significantly reduces the length of hospital stay. Fifty two consecutive patients who underwent transurethral resection of prostate (TURP) for benign prostatic hyperplasia (BPH) were reviewed retrospectively. Patient's profile and all relevant data were noted from charts. The length of hospital stay was registered in days. These patients were divided into two group; Group I (n=20) includes patients whose catheter was removed within 2 days of operation and group II (n=32) includes beyond 2 days. Various parameters were analyzed in between the groups using statistical package for social sciences (SPSS) for Windows. The demographics of the patients, pre-operative morbidities and immediate post-operative complications in both groups were comparable. There was statistically significant difference noted in duration of resection, weight of resected prostatic tissue, catheter removal and length of hospital stay between group I and group II. Length of hospital stay strongly correlates with days on which catheter was removed. Further, correlation was found between the catheter removal and the weight of resected prostatic tissue; but not with duration of resection. In conclusion, early catheter removal significantly shortens the length of hospital stay, which not only helps the authorities for efficient bed management, but also saves cost. The weight of resected prostatic chips and duration of resection are few peri-operative factors which can guide for effective catheter management after TURP.

Current concepts and controversies in undescended testes.

Cryptorchidism, or undescended testis, is the most common genital anomaly identified at birth in males that continues to challenge the pediatric specialist. The last two decades have seen rapid improvements in understanding the complex mechanisms underlying the genesis of cryptorchidism. Yet, despite years of study, answers to questions relating to controversies surrounding undescended testes remain elusive. This article presents an overview of the controversies and current understanding of this challenging problem.

Perception of final-year medical students about skills attainment in a new medical school of Nepal.

The competence of clinical and procedural skills possessed by medical students on graduation have received considerable importance in recent years. This questionnaire-based study was conducted at B.P. Koirala Institute of Health Sciences, Dharan, Nepal with an aim to assess the perception about clinical and procedural skills attainment by final-year medical students in a new medical school of Nepal. Fifty-nine final year MBBS students were interviewed using a set of questionnaire related to the experience gained by the students in relations eight clinical and twenty procedural skills. The perception about the level of attainment was good for most of the clinical skills and for few procedural skills, for example, using an auroscope and ophthalmoscope. The level of attainment was very poor in inserting the flatus tube, aspirating pleural and ascitic fluids, performing lumbar puncture, administering enema and giving subcutaneous injection. The perceived confidence in giving intravenous injection, inserting venflons, catheterizing urinary bladder, performing ambu bag and mask ventilation, proctoscopy and suturing of superficial wound was greater than the level of practical experience. The practical experience was more in doing venesection but the perceived confidence was poor in it. The final year medical students had mastered most of the clinical skills but not all procedural skills equally. Those skills in which they are not competent must be acquired during internship. Training in these skills needs to be reinforced by establishing a skill laboratory.

Inflammatory fibroid polyp of the jejunum presenting as intussusception.

Inflammatory fibroid polyp (IFP) of jejunnum is a rare nonneoplastic lesion of gastrointestinal tract. We report a case of a 45-year-old man presenting with small bowel obstruction due to jejuno-jejunal intussusception of an inflammatory fibroid polyp. To the best of our knowledges, this is the eighth reported case with such a presentation in English medical literature. Segmental resection of the jejunum was performed and histopathology confirmed the diagnosis.