Background: Inguinal neuralgia is one of the important complications of hernia repair which occurs due to entrapment, neuroma or fibrotic reactions involving the ilioinguinal nerve. Hence the excision of ilioinguinal nerve should theoretically eliminate the possibility of inguinal neuralgia. But routine ilioinguinal neurectomy is still controversial and is not widely accepted. Hence a study was conducted to evaluate the effect of prophylactic ilioinguinal neurectomy in open inguinal hernia repair.Methods: A prospective study was conducted in the General Surgery Department in a tertiary center for a period of 20 months, from December 2011 to July 2013. The patients were randomly allocated to either group A or group B by block randomized technique. Group ‘A’ patients underwent neurectomy of ilioinguinal nerve whereas the ilioinguinal nerve in group ‘B’ patients was safeguarded.Results: A total of 60 patients were studied with 30 patients each in group A and group B. During vigorous activities, more group B patients had pain compared to group A patients at 4-month [15 (50%) vs. five (17%); p=0.006; Chi-square test] and 8-month follow-up [15 (50%) vs. five (17%); p=0.006; Chi-square test].Conclusions: Inguinal neuralgia is a significant and debilitating complication following hernia repair. The prophylactic neurectomy can be an appropriate solution in the prevention of chronic groin pain following inguinal hernia repair and can be considered as an ideal inclusion into the standard hernia repair procedures.

Aim: To compare the outcomes in children who underwent emergency surgery and those who underwent percutaneous drainage for appendicular abscess. Materials and Methods: In this prospective study, 45 children of appendicular abscess detected on ultrasonogram (USG) were included in the study. The following characteristics were registered: age, gender, the time from onset of symptoms to seeking care, pain, vomiting, fever and general peritonitis; white blood cell count. The size, location of the abscess was noted on USG. After the diagnosis, we divided the patients into two groups based on the type of management. Patients who underwent emergency surgery and appendectomy (Group 1) which composed of twenty patients (14 males and six females) with their ages ranged from 3 to 18 years, and patients treated with ultrasound-guided percutaneous drainage and interval appendectomy (Group 2) which composed of 25 patients, (15 males and ten females) with their ages ranged from 2 to 18 years. Results: Group 1 included twenty patients and Group 2 included 25 patients. In Group 1, on USG the average size of the abscess was 7.2 ± 2.5 cm. After the surgery regained their functional recovery during a mean period of 3.2 ± 1 days. In Group 2, on USG average abscess size was 6.8 ± 2.4 cm. After the procedure regained their functional recovery on the second day. No major complications were noted in Group 2. On the contrary, 12 patients (60%) of Group 1 show complications in the form of wound infection in eight children and wound dehiscence in four children. Conclusions: USG-guided percutaneous drainage was safe and effective way of management of appendicular abscess.

BACKGROUND: Fourniers gangrene is a fatal necrotising fasciitis of the perineal region which requires aggressive medical or prompt surgical treatment. AIM: Aim of the study is to study its risk and predisposing factors along with the clinical course and management techniques. Predictive values of Fournier Gangrene Severity Index Score was calculated. MATERIALS AND METHODS: In a prospective case review between july2012 to July 2014, predisposing factors, clinical course and FGSI score for all cases of Fourniers gangrene was evaluated. RESULTS: Commonest affected age group was 40-60 years with an average of 50 years and. The disease more commonly affects in lower socioeconomic group. Diabetes and alcoholism were significantly associated with the disease and association of co-morbidities gravely influences the prognosis. Average time before referral for treatment was 6.4days in the survival group and 31.66 days in the non-survival group. FGSI ˂7 had a better outcome, however FGSI˃9 had high mortality rate (20%). CONCLUSION: Older age group patients ˃50 years had significant morbidity and mortality. FGSI is an effective score for mortality assessment with a high predictive value. Early detection of patients followed by adequate surgical debridement and proper antibiotic cover, yields good results.

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Mucoceles are benign lesions of the oral cavity that develop as a result of retention or extravasation of mucous material from minor salivary glands. Congenital mucoceles are very rare. Mucocele involving the ventral surface of the tongue in neonates is further rare with sporadic cases reported in the world literature accounting to 2-8 of oral mucoceles. This report describes a 5-day male neonate with large congenital mucocele involving the ventral surface of the tongue with associated difficulty in breast feeding. An en block excision of the cystic swelling with removal of entire cyst wall was done.