Facial nerve palsy after ear surgery is a troublesome postoperative complication for both patient and the surgeon. Though most of the palsies occur in the immediate post-operative period, in rare instances patients may develop facial nerve palsy anywhere from several hours to several days after ear surgery. We hereby present a case of delayed facial nerve palsy, after 5 days following surgery, in 48 year old women operated for tubotympanic type of chronic suppurative otitis media. Patient recovered well with oral steroid therapy. Delayed facial nerve palsy is a very rare complication of ear surgery. Reactivation of virus is the probable etiology. KEY WORDS: Facial nerve palsy, Delayed, Tympanomastoidectomy. INTRODUCTION:Facial nerve palsy is troublesome post-operative complication for both the patient and the surgeon. Delayed facial nerve palsy is a rare complication of ear surgeries. It is reported only after tympano-mastoidectomy, stapes surgery, cochlear implant and endolymphatic surgery. However it is not reported after myringoplasty or myringotomy. Herein, we report a case of delayed facial nerve palsy after tympano-mastoidectomy.

Background: Rational use of antibiotic is important as injudicious use can adversely affect the patient, cause emergence of antibiotic resistance and increase the cost of health care. The efficacy of antibiotic prophylaxis in preventing surgical site infection in patients undergoing Lichtenstein tension free inguinal hernia repair still remains controversial.Methods: A randomized controlled trial was conducted in patients undergoing lichtenstein tension free inguinal hernia repair between January 2015 to June 2016, and the results were compared with the control group in whom, conventional antibiotics were given for 7 days . All patients in study group undergoing surgery were given 400 mg parenteral ciprofloxacin 30 min prior to surgery. In the control group, the patients were given 2 days parenteral ciprofloxacin 400 mg twice a day and the next 5 days the same antibiotics were given in oral route, after surgery. Total 100 patients were randomized to 50 each group. The outcome in terms of duration of surgery, surgical site infection, cost and antibiotic side effects were then compared.Results: The duration of the hospital stay, cost and side effects are significantly higher in the control group patients. Antibiotic side effects (P < 0.05) were high for control group. The infection rate was same in both the groups. There was no significant difference in terms of infection rate among two groups.Conclusions: This study concludes that prophylactic single-dose antibiotic is effective in preventing surgical site infection and is cost-effective in patients undergoing lichtenstein tension free mesh repair.

Background: One of the most common complication post modified radical mastectomy is the formation of seroma. Seroma formation in-turn delays wound healing, increases susceptibility to infection, skin flap necrosis, persistent pain and thus prolongs convalescence. For this, several techniques have been tried and trialed to improve primary healing and decrease the formation of seroma.Methods: Between Aug 2014 and July 2016, 60 patients with carcinoma of the breast, posted for modified radical mastectomy at KR Hospital, Mysuru, Karnataka, India were randomly divided into 2 groups, the study group (30) and the control group (30). In the study group; the mastectomy flap quilting sutures were put between the flap and the pectoral fascia and muscle at different parts of the flap and at the flap edge with absorbable sutures (polyglactin 3-0). In the control group; the flaps were approximated by the conventional method at the edges. Closed suction drains were placed in both the groups. Patients, tumour characteristics and operative related factors were documented. The volume and colour of the fluid drained was recorded everyday. The drains were removed when the amount became less than 30 cc in a 24 hour period. The total volume and duration (number of days) of fluid drained and the complications were recorded and compared.Results: In the study group, the drain was removed much earlier when compared to the control group (p < 0.001). The total amount of fluid drained was much lower in the study group (p < 0.001). The study group showed a much lower frequency of seroma formation when compared to the control group.Conclusions: The mastectomy quilting suture technique is an effective procedure that considerably reduces the incidence of seroma formation in patients undergoing modified radical mastectomy.

Background: Ultrasound-guided foam sclerotherapy (UGFS) is becoming an accepted standard of treatment varicose veins. It is a relatively safe, effective inexpensive method in limited, small varicose veins.This study aims to assess the safety and efficacy of UGFS using sodium tetradecyl sulphate (setrol) in patients presenting with minor varicosities and residual varicosities of lower limb.Methods: 78 patients with minor varicosities or residual varicosities post-surgery who presented between January2015 and June2016 at KR hospital attached to Mysore Medical College and Research Institute, Mysuru, underwent ultrasound-guided foam sclerotherapy with 0.5ml (at a single session) setrol prepared as a foam by Tessari technique. The efficacy criterion was the disappearance of the varicosities and improvement in symptoms and signs: 1 week, and 1, 3, 6 and 12 months after the treatment. Complications of sclerotherapy were reported during follow-up.Results: Decrease or withdrawal of complaints was reported in 96% of cases (74 patients). Disappearance or decrease of varicose veins was observed in all patients (100%). Phlebitis and pigmentation as a complication was noted in 5 (7%) and 9 (11.5%) cases respectively. Major complications, such as deep vein thrombosis, pulmonary embolism, dyspnoea, anaphylaxis, or neurological abnormalities, were not reported.Conclusions: Ultrasound-guided foam sclerotherapy for minor varicosities and residual varicosities with sodium tetra decyl sulphate is a safe and satisfactory method of treatment of minor and residual varicosities.