Background: Inguinal hernia repair is a commonly performed general surgical procedure that constitute more than 95% of all groin hernia repairs. However, in developing countries, quite a considerable percentage of it is not repaired or delayed repaired and that lead to a higher incidence of morbidity and mortality. so, we planned to conduct this study to understand the clinic-epidemiologic profile of inguinal hernia in a tertiary care hospital of Bangladesh. Objective: To evaluate the clinical, epidemiological profile and associated risk factors for inguinal hernia. Methodology: This observational study was conducted among 100 patients during January 2018 to January 2019 who admitted in the surgery department of a tertiary care center for inguinal hernia surgery . All the study subjects were examined and their clinical and epidemiological profiles studied, tabulated and analyzed. Result: Among the 100 patients, most of them (94%) were men with a age of 57.02 ± 12.87, farmer (36%) by occupation.61% patients were in low saocio-ecenomic status. Most of the patients (60%) were in the age group of 40-60 years followed by less than 30 years (21%). On query regarding symptoms of inguinal hernia, all of them (100%) complaints of groin swelling. More than half of the patients complaints of groin pain and sensation of heaviness in groin. On clinical examination, right sided, left sided, bilateral hernias were found in 49%,45% and 6% study patients respectively. Direct hernias, indirect, pantaloons hernias were seen in57%,30%,7% study patient respectly. Most of hernias (81%) were reducible and were incomplete (88%). Most of the patients (75%) presented late to the health care center due to the lack of awareness of the disease and were initially treated by homeopath medicine. During query about risk factors for inguinal hernia,46% patients were more than 50 years of age and 26% patients were smoker. In this study, most common hernia repair procedure was Lichtenstein's procedure (63%) followed by modified Bassini's procedure (11%). Total open procedure were 93% and laparoscopic hernia repairs were done only in 7% patients.
Clinical examination revealed a swelling with normal appearing skin on the right side of the face localized to the maxilla. No cervical lymphadenopathy was noted and the mouth opening was normal. Oral examination revealed gross expansion of the right maxillary alveolar process and bulging of the hard palate. There was no tenderness on palpation. CT scan demonstrated a well-defined, mixeddensity mass filling the right maxillary sinus. The mass causing destruction of adjacent upper jaw, inferior orbital plate, medial and lateral wall of right maxilla. The clinical and radiological features were in favour of a fibroosseous lesion. So a diagnosis of right maxillary ossifying fibroma was made. Under general anaesthesia, a maxillary right buccal vestibular incision was made and surgical excision of the tumour was performed. The tumour (about 5x5 cm) was removed completely; a clear demarcation was evident between the tumour and healthy bone. Bony defects were filled with absorbable gelatin sponge. Histopathologically, excised specimen was identical with fibro-osseous lesion. IntroductionJuvenile ossifying fibroma (JOF) is a rare fibro osseous neoplasm that arises within the craniofacial bones in individuals under 15 years of age 1 . It is usually asymptomatic, achieving a large size and exhibiting aggressive behavior 2 . It affects both males and females equally. It has the potential for excessive growth, bone destruction, and recurrence. It is more aggressive than ossifying fibroma. Recurrence rate ranges from 30% to 58% 3,4 . Radiological changes are of a discrete mass with a distinct boundary and thinning of the cortical bone, resulting in an egg-shell appearance 3 . The lesion is non-encapsulated but well demarcated from surrounding bone. Microscopically, juvenile ossifying fibroma is highly cellular and contains trabeculae or spheroids of new bones. Juvenile ossifying fibroma has also been termed Juvenile aggressive ossifying fibroma, Juvenile active ossifying fibroma 4 .
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