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

Frequency of duodenal ulcer perforation with radiological evidence of pneumoperitoneum

To determine the frequency of duodenal ulcer perforation with radiological evidence of gas under the diaphragm on X-ray chest. Descriptive. Department of Surgery Combined Military Hospital [CMH] and Military Hospital [MH], Rawalpindi, from Nov, 2005 to May 2006. Patients with acute abdomen presenting as emergency at CMH and MH Rawalpindi were evaluated. Preoperatively X-ray chest PA view, in standing posture, was done in all cases and presence or absence of pneumoperitoneum noted. The patients were then followed by laparotomy to confirm or otherwise a perforation of duodenum. Only 30 patients were included in the study where duodenal perforation was confirmed per-operatively. Pneumoperitoneum on X ray chest PA view was found in 25 [83.3%] out of 30 patients with duodenal ulcer perforation; The remaining 05 patients i.e. 16.67% did not show pneumoperitoneum. X-ray chest is a helpful tool in diagnosing majority of patients with a perforated duodenal ulcer. However there is a significant number of patients where the clinical acumen of the doctor would help in an early diagnosis and prompt treatment

Prevalence and sensitivity of different strains of bacteria; Special reference to MRSA in a surgical unit of MAYO Hospital Lahore

The correct registration, reporting and analysis of the resistance situation within a hospital is the first step in halting the emergence of antibiotic resistance, we therefore decided o analyze prevalence of bacteria and current trends of antibiotic resistance within our hospital. Orthopaedic ward of Mayo Hospital Lahore. Nov 2003 to Apr 2004. Isolates were taken from 157 patients admitted in Orthopaedic ward of Mayo Hospital Lahore during 6 months period randomly. The samples were collected from patient's wounds, the patients were not given any antibiotics 48 hours prior to collection of the specimen. Isolates were also taken from the environment [Rooms, AC ducts, corridors of the wards, operation theatre] and OT instruments. Isolates were inoculated on standard media in optimum environment and standard internationally accepted methods were applied for identification of bacteria. We found out that the most prevalent bacterium to be staphylococcus aureus 33 [1 8.75%] and seven were MRSA susceptible to Amikacin only. Where as the other bacteria pseudomonas auregenosa 38 [21.59%], E. Coli 19 [10.79%]. Proteus 14 [7.95%]. Streptococcus pyogenes 10 [5.68%], enterobacter 8 [4.55%], Klebsiella 5 [2.84%] more or less showed sensitivity to Amikacin. No growth was seen in 36 cases From among the 50 evironmental isolates, Bacillus 18 [36%] Staphylococcus in combination with bacillus 23 [46%] and No growth in 9 [18%]

Epidemiology of trauma victims

The data on relative incidence of trauma was collected and analysed into different groups, to plan out an effective control programme for the prevention and better management of this Epidemic [i.e. trauma]. Out of 1,83,091 [total] cases presenting in the year 1991, 40,280 [22%] were trauma victims. The very obvious picture of a trauma victim which emerged from this study is that of a male [79% chances], below 30 years of age [72% chances], is injured by R.T.A., fall or violence [77% chances] and will not get an ambulance service for transportation [95% chances]. From this study the lack of recognition of risk factors and poor management of trauma is very evident