Background and objectives In high-risk populations, the efficacy of mesh placement in incisional hernia (IH) prevention after elective abdominal surgeries has been supported by many published studies. This meta-analysis aimed at providing comprehensive and updated clinical implications of prophylactic mesh placement (PMP) for the prevention of IH as compared to primary suture closure (PSC).

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Actinomycosis is a chronic granulomatous infection caused by opportunistic bacteria, Actinomyces. These bacteria lack virulence and cause disease when there is a breach in the integrity of the mucosa. Diagnosis of Actinomycosis is challenging and less than 10% of abdominopelvic cases are diagnosed preoperatively. The treatment involves prolonged course of antibiotics with or without removal of tissue. In this case report we will present a case of hepatobiliary actinomycosis which was managed by a combination of both surgical and medical treatment.

Background The technical competence of oesophagogastroduodenoscopy (OGD) is rapidly acquired but to support the practice of complete examination, the British Society of Gastroenterology (BSG) and Association of Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS) strongly recommend photo-documentation of 8 standardized set stations in an OGD. Photo-documentation ensures complete examination, opportunity to inspect area of interest and serves as a legal record of adequate procedure. Methods Retrospective single center study involving review of randomly selected 100 OGD reports from 1/1/2018 till 31/3/2020 from the Endorad system. The reports on online Endorad system were reviewed for photo-documentation of 8 set stations and was also used to collect data on age, sex and the endoscopist. Microsoft Excel was used for data entry and analysis. Results Out of the 100 OGDs reviewed, 58% were males and 42% females. The mean age being 62.7 +/- 13.5. 60% of OGDs were done by surgeons, 25% by gastroenterologist and 15% by Advanced Nurse Practioner. No report had photo-documentation of all 8 stations. Most (40%) had photos of 5 stations, most common was photo evidence at retroflexion (95%) followed by photographic evidence of intubation to D2 (84%). Conclusions OGD is the gold standard test for the investigation of upper gastrointestinal symptoms, the importance lies in the early detection of cancers which maybe amenable to endoscopic treatment. For this reason its important to adhere to guidelines to improve quality in OGD

Aims The technical competence of Oesophago-Gastro-Duodenoscopy (OGD) is rapidly acquired but to support the practice of complete examination, the British Society of Gastroenterology (BSG) and Association of Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS) recommend documentation of 8 anatomical stations. Photo-documentation ensures a complete examination, gives an opportunity to inspect area of interest and serves as legal record of an adequate procedure. Our Aim was to assess the hospitals practice of photo-documentation against the BSG and AUGIS guidelines and to improve practice by conducting teaching sessions and designing a poster for the endoscopy rooms. Methods 1st Cycle: 100 OGD reports were randomly selected from 1/1/2018 to 31/3/2020 and were reviewed on the hospitals electronic reporting system (Endorad). Data on patients demographics, speciality of Endoscopist and the documented stations was collected. Data was presented at the departments meeting and a simultaneous teaching session was conducted. A poster was designed and displayed outside the endoscopy rooms. 2nd Cycle: 100 OGD reports were selected from 1st January to 30th June 2021 and re audited. Results 66% of the OGD reports had photo-documentation of all 8 stations and 81% of reports had 7 documented stations which was a significant improvement in practice as the first audit had no report with photographic documentation of all the stations. The highest number of stations documented in the first audit were 5 and that too in only 40% of the cases. Conclusions The audit cycle showed significant improvement in photo-documentation of all the stations, highlighting the benefit of the process.