Of 113 methyl isocyanate (MIC)-exposed subjects studied initially at Bhopal, India, 79, 56, 68, and 87 were followed with clinical, lung function, radiographic, and immunologic tests at 3, 6, 12, 18, and 24 months. Though our cohort consisted of subjects at all ages showing a varied severity of initial illness, fewer females and young subjects were seen. Initially all had eye problems, but dominant symptoms were exertional dyspnea, cough, chest pain, sputum, and muscle weakness. A large number showed persistent depression mixed with anxiety, with disturbances of personality parameters. The early radiographic changes were lung edema, overinflation, enlarged heart, pleural scars, and consolidation. The persistent changes seen were interstitial deposits. Lung functions showed mainly restrictive changes with small airway obstruction; there was impairment of oxygen exchange. Oxygen exchange improved at 3-6 months, and spirometry improved at 12 months, only to decline later. The expiratory flow rates pertaining to large and medium airway function improved, but those for small airways remained low. There were changes of alveolitis in bronchoalveolar lavage fluid on fiber optic bronchoscopy, and in 11 cases positive MIC-specific antibodies to IgM, IgG, and IgE were demonstrated. On follow up, only 48% of the subjects were clinically stable, while 50% showed fluctuations. Thirty-two percent of the subjects had lung function fluctuations. Detailed sequential behavior over 2-4 years was predicted for dyspnea, forced vital capacity, maximum expiratory flow rate (0.25-0.75), peak expiratory flow rate, VO2, and depression score. A model for clinical behavior explained a total variance of 52.4% by using the factors of cough, PCO2 and X-ray zones in addition to above five parameters. The behavior of the railway colony group (1640 patients) revealed a similar pattern of illness. When this observed pattern of changes was transferred to the affected Bhopal city sections (with an equitable age-sex distribution), our model results were again validated. Thus the picture of MIC-induced disease seems similar despite the differences for age-sex and initial severity of illness in our cohort and in the population of Bhopal city as predicted by our model.ImagesFIGURE 1.FIGURE 2.

Background: Hernia is one of the oldest maladies known and suffered by humans. It has been known since ages and will be known for centuries to come as long as human beings prompt to stand and walk. Lichtenstein hernia repair is the most common procedure followed surgery but with some devastating complications such as chronic groin pain (CGP). The search for the most appropriate method to fix mesh and to reduce complications is still on and this study aims for the same.Methods: A comparative prospective study conducted in Department of General Surgery, Bangalore medical college & Research institute from November-2016 to May-2018. 100 patients falling into inclusion criteria were taken to study with randomization, 50 in each group (prolene vs Fibrin-glue). Postoperatively patient was assessed for complications, recovery time and Data collected was statistically analyzed using appropriate statistical test and p<0.05 was taken significant.Results: Most common age group presenting with hernia was from 41-50 years (29%) with M: F ration 5.6:1. Laterality being right: left: bilateral:: 58%: 36% :6% respectively. Type of hernia being Indirect: Direct:: 66%: 34% respectively. Duration of surgery, recovery to ADL and postoperative complications like seroma, chronic groin pain, foreign-body sensation was significantly less with fibrin glue compared to prolene group. Postoperative Haematoma, local numbness and recurrence were comparable and the difference in the result was statistically insignificant.Conclusions: Through our study from the above-mentioned benefits, it can be concluded that use of fibrin Glue in mesh fixation is a safe and acceptable method and can be used as a better alternative for prolene suture for mesh fixation in Liechtenstein’s hernioplasty.

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