Mesh versus non-mesh repair of ventral abdominal hernias

To investigate the relative effectiveness of mesh and suture repair of ventral abdominal hernias in terms of clinical outcome, quality of life and rate of recurrence in both the techniques. This is a retrospective descriptive analysis of 236 patients with mesh and non-mesh repair of primary ventral hernias performed between January 2000 to December 2004 at Surgery Department, Liaquat University of Medical and Health Sciences, Jamshoro. The record sheets of the patients were analyzed and data retrieved to compare the results of both techniques for short-term and long-term results. The data retrieved is statistically analyzed on SPSS version 11. There were 43 [18.22%] males and 193 [81.77%] females with a mean age of 51.79 years and a range of 59 [81-22]. Para-umbilical hernia was the commonest of ventral hernia and accounted for 49.8% [n=118] of the total study population followed by incisional hernia comprising 24% [n=57] of the total number. There was a significant difference in the recurrent rate at 3 years interval with 23/101 [22.77%] recurrences in suture-repaired subjects compared to 10/135 [7.40%] in mesh repair group. Chronic pain lasting up to 1-2 years was noted in 14 patients with suture repair. Wound infection is comparatively more common [8.14%] in mesh group. The other variables such as operative and postoperative complications, total hospital stay and quality of life is also discussed. Mesh repair of ventral hernia is much superior to non-mesh suture repair in terms of recurrence and overall outcome

Problems faced by edtiors of peer reviewed medical journals

Forty-six medical and dental journals are published from Pakistan of which only 29 are currently recognized by the Pakistan Medical and Dental Council. Only a few are peer reviewed. Six are indexed in Medline while EMBASE Excerpta Medica and World Health Organization Index Medicus for Eastern Mediterranean Region cover others. Editors of the peer reviewed medical journals are faced with numerous problems, which relate to the authors. Some of these are: shortage of quality of manuscripts, poor quality of reviewers, problems with indexation in international indexing services particularly Medline, duplicate submission and authorship and lastly, financial problems. Patronage from the Pharma industry is the major source of revenue which itself has serious implications. Editing a medical journal is a very stressful job and the editors have to work under too many pressures. A lot of useful data is presented at medical conferences, but a vast majority of it remains unpublished for various reasons, which adversely affects the citation rate from scientists from the developing third world countries in the world of medical literature. A few lectures on medical writing and research methodology to final year medical students will expose them to the art of medical writing. Specialty organizations can be persuaded to have a session on medical writing at their conferences, which will be extremely helpful not only to the potential new authors but also others, thereby improving the quality of their manuscripts. In addition to regular seminars, workshops for authors, reviewers and training courses for editors, subscribing to local medical journals by healthcare professionals and libraries are some of the measures that will help improve the situation to a great extent