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Objective: To analyze the outcomes of mesh infection management following inguinal hernia repair. Study Design: Retrospective Cohort study. Setting: Department of Surgery, Khyber Medical University Institute of Medical Sciences DHQ Teaching Hospital Kohat. Period: January 2022 to December 2022. Material & Methods: Patients who had mesh implants for the correction of inguinal hernias were the subjects of this study. The hospital notes of these patients were retrospectively evaluated, and data concerning the patients' presentations, types of prior hernia repairs, types of mesh used, operative findings, and complications following mesh infection repair. Results: During the study period, 40 patients reported with mesh related infections among patients with history of inguinal hernia repair. Out of these 40 patients, 37 (92.5%) were male and 3 (7.5%) female. The mean age was reported to be 52.8±6.4 years. The mean duration of inguinal hernia repair was 10.8±4.2 months. All patients were examined for possible causes for the mesh infection and it was found that unincorporated polypropylene was the commonest possible factor behind mesh infection and reported in 18 (45.0%) cases. Follow up record of patients for at least 6 months was evaluated following mesh infection management and 32 (90.0%) patients reported no complications. Conclusion: Outcomes of mesh infection management following inguinal hernia repair were good. Clinical judgment is necessary to determine the extent of mesh removal.

Objective: To investigate the early complications, associated comorbidities and risk factors associated with modified radical mastectomy in patients suffering from breast cancer. Study Design: Prospective Cohort study. Setting: Department of Surgery, Khyber Medical University, Institute of Medical Sciences, District Headquarter Hospital, Kohat. Period: January 2021 to December 2022. Material & Methods: A total of 65 patients diagnosed with breast cancer who were planned to undergone through radical mastectomy during the study period were analyzed. Demographical and clinical characteristics of all patients were noted. Early complications, associated comorbidities and related risk factors were recorded. Results: In a total of 65 patients, the mean age was 47±13 years (ranging 50-65 years). At the time of enrollment, 25 (38.5%) patients had painful lump in their breasts while remaining 40 (47.7%) patients reported that they were had swelling in their axillary region. There were 30 (46.2%) patients who had had stage-III breast cancer whereas other 34 (52.3%) were suffering from stage-II breast cancer. Formation of seroma was most commonly associated complication reported in 30 (46.2%) patients whereas 10 (15.4%) patients reported infections of wound. Twenty (30.8%) patients reported that they were having pain on the site of surgery along with paresthesia on the medial side of arm. Five (7.7%) patients had associated diabetes while 8 (12.3%) patients were overweight with their body mass index (BMI) value between 25-29.9 kg/m2. Nine 9 (13.8%) patients were hypertensive. Conclusion: Most common early complications associated with modified radical mastectomy included infection of the surgical site, paresthesia and pain.

Objective: To compare the outcomes of prosthetic repair and tissue repair in the emergency management of acutely incarcerated para-umbilical hernia (PUH). Study Design: Randomized Clinical Trial. Setting: Department of Surgery, DHQ Hospital KDA Kohat, Pakistan. Period: July 2021 to December 2022. Material & Methods: A total of 40 patients (20 in each group) of either gender aged above 18 years with acutely incarcerated PUH undergoing emergency management were randomized in to either mesh repair or tissue repair. The length of the procedure, the hospital stay following the procedure, and any postoperative issues were noted up till 6 months post-operatively. Results: In a total of 40 patients, 35 (87.5%) were female. The difference in the mean operating times for prosthetic repair group and tissue repair group were significantly different (97.2±15.2 minutes vs. 66.2±15.2 minutes, p<0.0001). Duration of incarceration and characteristics of the defect were statistically similar (p>0.05). Postoperative complications were encountered in 6 (30.0%) patients in prosthetic repair groups versus (25.0%) in tissue repair groups while the difference between various complications were found to be statistically insignificant (p>0.05). Throughout the course of the trial, there were no permanent difficulties caused by the mesh and none of the mesh had to be taken out. Conclusion: The use of prosthetic repair for emergency management of incarcerated PUH was safer and resulted in better outcomes as compared to conventional tissue repair.