Comparing non-mesh and sutured inguinal hernia repairs in groin surgery: a randomized clinical trial

Mesh technique is the standard for inguinal hernia repair because of less recurrence, but it is inferior or equal to sutured technique in case of other post-operative complications such as chronic pain. This clinical trial set out to compare these two techniques. A total number of 322 cases of unilateral inguinal hernia in participants older than 18 years old were divided into 158 cases for mesh [Lichtenstein] and 164 for nonmesh [Bassini-McVay] hernia repair techniques. In order to compare the complications in the two groups, they were followed up from one to five years. During the study period, 12 and 7 participants were excluded from the mesh and non-mesh suture groups, leaving 146 and 157 participants in each group, respectively. The mean ages were 50.9 and 46.6 years old in mesh and sutured groups, respectively and mean follow up time was 2.9 years. Compared to mesh group, all complications were equal or less in non-mesh group, except for recurrence which had a statistically significant difference. Chronic post-operative pain, foreign body sensation, returning time to daily activities and costs were significantly less in non-meshed group [P = .0083]. Non-mesh suture technique still has its place in hernia repair. Mesh can be preserved for special conditions such as weak fascia wall, contralateral unsuccessful surgery, and recurrence, if suture technique is expensive or not easily available

[Evaluation of relationship between serum cholesterol and triglyceride level and gallstone incidence]

Cholecystectomy is one of the most common operations in the field of general surgery. It has higher cost in operations with complication and in these cases mortality and morbidity will increase. The main goal of this research is the study and compare of cholesterol and triglyceride serum level in gallstone group and control group. The role of Serum total cholesterol and triglyceride level in the etiology of gallstone disease was assessed in a case control study in Emam Reza hospital. Study include 37 cases [15 males and 22 females] with surgically or ultrasonographicaly confirmed cholecystolithiasis and 35 cases [16 males and 19 females] as control outpatient and hospital admitted patient without debilitating disease [such as umbilical and inguinal Hernia] over age of forty. Mean age in stone group was 54 years and in control group was 57 years. Serum cholesterol and triglyceride concentration in gallstone patient was 193 mg/dl and 135.9 mg/dl respectively were compared with control series with cholesterol and triglyceride levels 176 mg/dl and 121.8 mg/dl respectively [p=0.258 for cholesterol and p=0.368 for triglyceride]. Gallstone patient had higher serum cholesterol and triglyceride level than control group but these differences were not statistically significant

Using bipedicle abdominal flap to save left forearm and armfollowing a high-voltage electric burn

Electrical injury is daily compromise of our life and upper and lower extremities are common sites of injury. A 23 years old man who had suffered high voltage electrical injury referred to our center. He had severe left upper extremity burn and suffered from head and thoracic injuries due to falling down from high altitude. Fasciotomy of the left forearm was done. Muscle damageand myoglobinuria were managed. Early reconstruction was performedfor prevention of tendons and nerve necrosis. Because of circumferential burning of the left forearm, bipedicle abdominal flap at the skinof left lower thorax and the abdomen was done. Stillskin necrosis of the flap at the lateral epicondyle area of the bipedicle abdominal flap occurred. Latissimusdorsi muscle pedicle flap was used for coverage of the lateral epicondyle area. Local flap is an important complication of the bi-pedicle abdominal flap