Objective: Comparison of the efficacy of absorbable versus non-absorbable sutures after Lichtenstein mesh hernioplasty. Methodology: We planned this Randomized Control Trial consisting of 200 cases, from Surgical outdoor booked for hernioplasty. All patients were examined in a comfortable environment. All the information was kept confidential. The patients were not aware of the randomization arm and selected via lottery method. All patients underwent Lichtenstein mesh hernioplasty under local anesthesia. Before surgery, a course of prophylactic antibiotics consisting of 1 g of IV cefazolin was administered to each patient. All procedures were done by skilled post graduate general surgical residents under consultant supervision. Predictable bias and confounding factors were controlled by restriction (inclusion and exclusion criteria) and randomization. Rest was addressed during final analysis through stratification. GROUP A patients undergo mesh fixation using Prolene 1. (non-absorbable) GROUP B patients undergo mesh fixation using Vicryl 0. (absorbable). For all treatments, a conventional tension-free uniformed surgical method was adopted. Patients were evaluated at 3 months followup to record the efficacy. Results: Mean age was calculated as 44.7+9.45, mean pain score on VAS was calculated as 2.04+0.72 in Group-A and 1.54+0.76 in Group-B,p-value=0.018. Comparison of efficacy of absorbable versus non-absorbable sutures after Lichtenstein mesh Hernioplasty shows that 83(n=83%) in Group-A and 94(n=94) in Group-B had efficacy while, p value 0.014 showing a significant difference. Conclusion: Our findings indicate that, following Lichtenstein mesh hernioplasty, absorbable suture is more effective than non-absorbable suture regarding post operative pain. Keywords: Inguinal hernia, hernioplasty, absorbable versus non-absorbable sutures, efficacy

Objective: To evaluate the outcome of laparoscopic Intra-abdominal Ventral Hernia Repair with Tissue Separating Mesh. Methodology: Patients aged 18-60 years old with documented ASA grade I or II, ventral hernias >5 cm in size (clinically assessed by palpable expansile cough impulse and as abdominal wall defect on ultrasound), and no general contraindications to laparoscopy (such as bleeding disorders, low platelet counts, or prolonged clotting times) were excluded. Patients' permission was obtained after they were fully informed of the risks and benefits. Name, age, gender, and contact details were also recorded. After that, laparoscopic ventral hernia repair was performed. These surgeries were performed under general anaesthesia by a single surgical team led by a senior doctor with at least three years of expertise in laparoscopic surgery. The moment of incision served as the starting point. Tissue-separating mesh was inserted intraoperatively, and the operational time was recorded once again during closure. The patients were sent to the ward for further observation. Discharge documentation revealed a patient's postoperative hospital stay. Results: Mean age of the patients was calculated as 37.03+11.32 years. The gender breakdown reveals that men as majority, with 51 (51%) compared to 49 (49%) females. The outcome of laparoscopic intra-abdominal ventral hernia repair using tissue Separating Mesh showed that the mean operation time was 116.21+8.27 minutes, and the length of hospital stay was documented as 2.4+0.38 days. Conclusion: We concluded that outcome of laparoscopic Intra-abdominal Ventral Hernia Repair with Tissue Separating Mesh with regards to duration of operation and post operative hospital stay is feasible in our population Keywords: Intra-abdominal Ventral Hernia Repair, Tissue Separating Mesh, outcome, post-operative hospital stay, duration of operation

Amongst the most frequent illnesses in civilised nations of West is chronic venous insufficiency (CVI). It is believed that 40-50 percent of all individuals have superficial venous insufficiency of the leg, which manifests primarily as varicose veins. Individuals with varicose veins typically complain of leg pain at the conclusion of the day following extended walking. Ankle edoema, itch, hemorrhage, superficial thrombophelibitis, dermatitis, lipodermatosclerosis, and open wounds are some of the additional manifestations. Methods: In this cross sectional study, conducted at the surgical floor, Mayo Hospital, Lahore. Varicose veins were defined as dilated, tortuous, subcutaneous veins usually seen in upright posture. Any case of suspected chronic venous insufficiency was assessed on clinical examination by unbiased consultant surgeon. The severity of varicose vein was assessed by clinical grading from CEAP (Clinical-Etiological-Anatomical-Pathophysiological) system in which there are six classes. Results: Patients in our study were mostly males; male to female ratio of patients of varicose veins is 3:1, most of the male patients had class 2 or class 5; Association of class of varicose veins and gender was also insignificant (p-value calculated for the class of varicose veins and gender was 0.25). Conclusion: In our study population, male patients suffered worse than female patients. The occurrence rate was comparable between people of different ages. There was a higher prevalence of varicose veins in classes 2 and 3. To further understand the causes of varicose veins, larger-scale studies focusing on female gender-related risk factors and occupation-related risk factors are needed. Additional measures, such as patient education, can aid in lowering the frequency of varicose veins. Keywords: Varicose Veins, DVTs, Ankle edema, Thrombophelibitis, lipodermatosclerosis