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The aim of this study is to assess the advantages of fibrin glue over Prolene suture in fixation of the mesh in open inguinal hernia repair. Sixty-four cases of inguinal hernia underwent hernia repair by the Lichtenstein method in the department of surgery in PGIMER & Dr. RML Hospital, New Delhi. The patients were randomized prospectively into group A (fibrin glue group) and group B (Prolene suture group). In group A, fibrin glue was used for mesh fixation, and in group B, Prolene suture was used for mesh fixation. The mean age of patients in group A was 44.5 years and that of group B patients was 44.2 years. There was a significant difference in the duration of surgery, with the mean duration in fibrin glue group being 30.6 min and that of the suture group was 43.3 min. The mean visual analogue pain score of postoperative pain at 1, 6, 12, and 24 h was significantly higher in the suture group than in the fibrin glue group (p<0.001). The mean total dose of analgesia in ampoules of tramadol was significantly less in the fibrin glue group (1.56 ampoules) than that in the suture group (4.125 ampoules) with p=0.000. At the end of the first month, 25 % of subjects in the suture group presented with mild groin pain (p value=0.0048). At the end of the second and third month, 22 % (p 68 value=0.0048) and 12.5 % (p value=0.1132) of subjects respectively presented with mild groin pain in the suture group. The present study demonstrates that the use of fibrin glue in place of Prolene suture for mesh fixation in open inguinal hernia repair can help decreasing the time required for surgery, reduce the intensity of postoperative pain, shorten the duration of hospital stay, and prevent the incidence of chronic groin pain.

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Aim-Background: The use of silver in the management of burn wounds is well known. This prospective study was undertaken to evaluate the efficacy of silver-impregnated dressing in patients with diabetic foot. Materials and methods:This study was conducted in the Department of Surgery at a tertiary care hospital in North India. It was a randomized case control study to compare the effectiveness of silver-impregnated dressings with conventional povidone iodine-based dressings in the healing of diabetic foot ulcers.Results: At the end of our study, we found that 19 (70.37%) patients whose wounds were dressed with silver-impregnated dressing had 100% granulation tissue while only 10 (34.48%) patients whose wounds had been dressed with povidone iodine-based dressing had 100% granulation tissue.Conclusion: Dressing diabetic foot ulcers with silver-based dressing is effective in controlling the microbiological burden of the wound and increasing the rate of granulation tissue formation.

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Caecal bascule is a variety of caecal volvulus which can present with features of intestinal obstruction and subsequent gangrene and perforation. This is a young male who presented with features suggestive of acute intestinal obstruction. On exploration caecum was found to be rotated over ascending colon in a flap valve like manner and was dilated with gangrenous changes. So, a right hemicolectomy with ileotransverse anastomosis was performed with uneventful postoperative recovery of the patient.

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