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Background: The advent of mesh was a breakthrough in the field of hernia surgery. Mechanical methods of mesh fixation are hypothesized to cause more tissue trauma than nonmechanical methods. The present study was conducted to study the outcomes of mesh fixation using fibrin glue, a nonmechanical method versus tackers in totally extraperitoneal repair (TEP) of unilateral inguinal hernia. Methods: A randomized controlled single blinded study was conducted in India from June 2017 to March 2019. Patients diagnosed with unilateral uncomplicated inguinal hernia with a hernial sac of size not more than 5 cm were invited to participate in the study. Sample size was 60 patients randomized into groups just before mesh fixation. In group A mesh was fixed using tackers while in group B mesh was fixed using fibrin glue. Patients were followed‐up prospectively for 3 months. Results: There was no statistical difference between the two groups with respect to operating time. Average hospital stay and pain scores at all follow‐ups were better for fibrin glue group. There was no difference in the incidence of postoperative urinary retention, seroma formation and hematoma formation between the two groups. Patients of fibrin glue group had early restart of daily activities at 15 days follow‐up when compared to tacker group. Conclusion: Fibrin glue fixation technique should be advocated over tackers for mesh fixation in TEP considering the better outcomes and cost‐effectiveness of the technique. [ABSTRACT FROM AUTHOR]

Purpose: Analysis of complication profile after pterygium excision, in primary and recurrent pterygia.Methods: Retrospective analysis of all the patients who had undergone pterygium excision in a tertiary center in South India from 2010 to 2018 was analyzed. A total of 2356 eyes in 2028 patients were included in the study. Patients who had undergone conjunctival autografting for primary pterygium, conjunctival limbal autografting for recurrent pterygium, vertical split conjunctival autografting for double head pterygium were included in the study. In all the surgical procedures fibrin glue was used for fixation of the autograft. The follow-up period ranged from 6 months to 75 months, with an average of 17 months. Patients with less than 6 months of follow-up were excluded from the study.Results: The following postoperative complications were noted, Sub-conjunctival hemorrhage in 912 eyes (38.7%), edema of the graft in 522 cases (22.15%), graft loss in 22 cases (0.93%), graft retraction in 692 cases (29.37%) and sliding of the graft was seen in 9 cases (0.38%). Granuloma was seen in 4 cases (0.16%) at the host site and 5 cases (0.21%) at the donor site. Recurrence was seen in 34 patients (1.44%). Other severe complications like corneal melt were seen in only 1 case (0.04%) who was operated on for recurrent pterygium. In comparison between primary and recurrent pterygia; subconjunctival hemorrhage, edema of the graft, graft loss, and recurrence was significantly (P < 0.05%) higher in recurrent pterygia.Conclusion: Various complications can occur post pterygium surgery as listed above. Selecting a proper procedure for a particular type of pterygium with a proper graft fixation technique will improve the outcome with minimal complications. [ABSTRACT FROM AUTHOR]

Back ground: India has a huge resource of livestock and stands first globally in milk production, but reemergence of diseases like foot and mouth disease (FMD) causes a great concern and economic losses to the farmers. Three serotypes of FMD virus (O, A and Asia 1) are prevalent and serotype O was responsible for 80 per cent of confirmed outbreaks /cases in India. The highest incidence of the disease was seen in Southern region (31.5%) and during the month of September. Highest number of outbreaks (201) occurred in Tamil Nadu in the year 2007-08 caused by serotype O virus. FMD causes very high morbidity and mortality rate among young animals and the mortality rate is generally low in adult animals and seen with manifestation of infection limited to epithelial sites. However, In the present study an unusually high mortality among adult cattle due to FMD, complicated with Mannheimia hemolytica infection with specific myocardial lesions were discussed in several outbreaks of FMD in the state of Tamil Nadu, India. Methods: Outbreaks of FMD occurred in various districts of Tamil Nadu during the period of October to December in the year 2013 causing large scale mortality among adult cross bred (Jersey cross and Holstein Friesian cross) cows, heifers and calves and detailed disease investigations were carried out. Samples were collected from ailing animals and dead animals for laboratory confirmation of the disease. The collected samples were subjected to isolation of bacteria, serology and molecular confirmation of the virus. Result: Affected animals showed characteristic lesions of FMD with multiple, focal to coalescing ulcers and erosions covered with shreds of epithelium and fibrin on the dorsum and lateral margins of the tongue, dental pad, hard palate, mucosa of lips and gums. Samples of vesicular fluid, oral and tongue epithelium and heart confirmed the presence of FMD type 'O' virus based on sandwich ELISA and multiplex PCR. Cultural examination of bacteriological samples revealed presence of Mannheimia hemolytica which was further confirmed by multiplex PCR. Out of 83 serum sample collected, 45 sera were positive for FMD by LPB ELISA, while 32 serum samples were positive for FMD by DIVA test. The sudden deaths among adult cattle and heifers during the FMD outbreak might be attributed to the severe myocarditis and the disease was controlled by following appropriate treatment and preventive measures. [ABSTRACT FROM AUTHOR]

Although laparoscopic repair offers a quick and less morbid way of treating hernias, complications like hematoma, seroma, neuralgia, recurrence, mesh infection, hydrocele, etc. are known. The present study was undertaken to compare various clinical outcomes between mesh fixation using fibrin glue and mesh fixation with tacker in a 3-months follow-up. One hundred patients aged 18 to 60 years having inguinal hernia admitted in Poona Hospital and Research Centre, Pune, between October 2012 and November 2014 for laparoscopic hernia surgery and ready to participate in this study were included. All of them underwent laparoscopic repair of hernia by total extra peritoneal (TEP) method following sample surgical protocol in all of them except for method of mesh fixation. Mean time calculated from insertion of the first trocar to beginning of skin suturing was 54.9 min in tacker group and 50.3 min in fibrin glue group with no statistically significant difference between the two. The incidence of urinary retention was significantly higher in tacker (34 %) as compared to fibrin glue (12 %) group. Incidence of hematoma was significantly higher in tacker group in 15-day follow-up, but there was no significant difference in hematoma formation at hernial sites in both groups after 15 days of follow-up. The incidence of neuralgia was significantly higher in the tacker group (24 %) compared with the fibrin glue group (2 %). Significantly, more number of people in the fibrin glue group 68 and 90 %, respectively, returned to work during 15 and 30 days follow-up as compared to the tacker group 46 and 64 %. Fibrin glue can be considered as an alternative to tacker for mesh fixation. [ABSTRACT FROM AUTHOR]

Aim: To analyse the technical challenges, clinical success, and associated complications of endovascular and percutaneous embolisation of pancreatitis-related pseudoaneurysms.Materials and Methods: A retrospective study of patients referred for embolisation of pancreatitis-related pseudoaneurysms between January 2014 and March 2019 was conducted. Computed tomography angiography (CTA) was performed to assess the morphology of the aneurysms prior to any intervention. Percutaneous or endovascular embolisation was performed. Details of CTA and methods of embolisation were recorded. Technical success, clinical success, and complications were reported.Results: A total of 80 patients (mean age, 40.69 ± 13.41 years, 73 male) underwent embolisation during the study period. Pseudoaneurysms were related to chronic pancreatitis (CP) in 44 (55%) patients and acute pancreatitis (AP) in 36 (45%) patients. Pseudoaneurysms were detected in 65 (81.2%) patients on CTA. The most common site of pseudoaneurysms was gastroduodenal artery (GDA) followed by splenic artery. Seven patients were treated with percutaneous thrombin injection and five were treated with percutaneous glue injection under ultrasound/fluoroscopy guidance. The remaining patients (n=68) underwent catheter angiography with endovascular embolisation. Technical success was achieved in 4/7 (57%) percutaneous thrombin cases and in all the cases (5/5, 100%) with percutaneous glue or endovascular (68/68,100%) embolisation.Conclusion: Endovascular or percutaneous embolisation of pseudoaneurysms has high technical success with an excellent safety profile. [ABSTRACT FROM AUTHOR]

Purpose: To assess the long-term (6-12 years) results and complications of glued transscleral-fixated intraocular lens (IOL)., Setting: Dr. Agarwal's Eye Center, Chennai, India., Design: Retrospective case series., Methods: Eyes with glued IOL of more than 5-year follow-up were evaluated. Visual acuity (logarithm of the minimum angle of resolution [logMAR]), IOL tilt, corneal topography, corneal endothelial cell density, intraocular pressure, central corneal thickness, central foveal thickness, and ocular residual astigmatism (ORA) were evaluated., Results: Overall, 91 eyes (63 patients) with mean postoperative 8.2 ± 2.3 years were analyzed. The duration was 10 to 12 years in 31 eyes (34%), 9 years in 14 eyes (15.3%), and 6 to 9 years in 46 eyes (50.5%). No subscleral haptic was visible in 50% eyes. Mild, moderate, and severe grade of haptic visibility was noted in 33.5%, 9.4%, and 7%, respectively. The corrected distance visual acuity (CDVA) was 0.50 ± 0.50 logMAR. Clinically, no tilt was seen in 87 eyes (95.6%), whereas detectable tilt was seen in 4 eyes (4.3%). The optical coherence tomography microtilt was 0.8 ± 1.7 and 0.4 ± 1.2 degrees in 90- and 180-degree axes, respectively. The mean iris vault was 0.45 mm, and the mean ORA was 1.10 ± 1.00 diopter. Complications were glaucoma (7.6%), IOL luxation (4.4%), retinal detachment (3.2%), macular edema (4.3%), corneal decompensation (3.2%), uveitis (2.1%), and uveitis-glaucoma-hyphema syndrome (1%). Haptic reposition (3.2%), retinal detachment surgery (3.2%) keratoplasty (1%), pupilloplasty (2.1%), and IOL explantation (1%) were the second surgeries performed., Conclusions: Glued IOL has shown good anatomical and functional stability with minimal incidence of vision-threatening complications on long-term., (Copyright © 2020 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)