Background: Ventral hernia repair is one of the most common surgical operations performed all over the world. Onlay and sublay mesh repairs are the commonly performed techniques for the same. However, the debate still continues about the superiority of both techniques over each other. The aim of this study was to compare the outcome of the onlay versus sublay mesh repair for ventral hernia.Methods: A total of 100 patients with paraumbilical, epigastric, supraumbilical and incisional hernias (with defect size ≤4 inches) were divided into main two groups; A: onlay mesh repair and B: sublay mesh repair. Patients with uncontrolled diabetes and recurrent ventral hernia were excluded. Randomization was done using computer generated software. Patients were evaluated for operating time, postoperative seroma formation, wound infection, drain duration, post-op hospital stay and recurrence of symptoms. Ethical approval for this study was granted by the ethical review committee of Mysore Medical College, Mysore, Karnataka, India.Results: The incidence of post-operative seroma and wound infection was 6.52% and 4.35% in sublay group compared to 21.30% and 19.20% in onlay group which was statistically significant (p<0.05). Mean operating time was found to be more in sublay group than onlay group which was also statistically significant (72.3+9.23 vs. 65.25+10.58 minutes, p<0.05). Mean drainage duration (4.22+0.99 days vs. 5.97+1.24 days) and post-op hospital stay (4.8+1.51 days vs. 6.68+1.46 days) was low in sublay group compared to onlay group which was statistically significant (p<0.05). Recurrence in sublay group was 4.35% compared to 8.51% in onlay group which was not statistically significant (p>0.05).Conclusions: Even though operating time is longer, placement of mesh in sublay position is a better option than onlay placement in open ventral hernia repair because of lower complication rate and post-op morbidity.

Background: Though colonoscopy is widely performed, the statistical data regarding its indications, findings, and the diagnostic yield are not widely documented especially in developing countries. This study is an attempt to determine such data in a group of patients who underwent colonoscopy at our hospital.Methods: This was a hospital‑based retrospective study carried out at the Department of General Surgery, MMC&RI, Mysore. The subjects were a total of 286 patients who underwent colonoscopies in the year 2017. The relevant data from colonoscopy register were recorded and tabulated.Results: The major indications in our study group were bleeding per rectum (25%), unexplained diarrhoea or dysentery (16%), pain abdomen (15%) and suspected malignancy (13%). Other indications included suspected inflammatory bowel disease (IBD), subacute intestinal obstruction, anaemia, mass per abdomen and suspected irritable bowel syndrome (IBS). More than one third (35%) had normal colonoscopic studies. The most common pathology found was malignancy (24%) followed by the spectrum of proctocolitis (20%). The indications which produced high diagnostic yields included suspected carcinoma (97%), bleeding per rectum (82%) and suspected IBD (80%). Significant number of patients with per rectal bleeding was diagnosed with malignancy (21%). The indications which produced low yields included subacute intestinal obstruction (31%), anaemia (45%), non-specific pain abdomen (50%) and suspected irritable bowel syndrome (18%).Conclusions: Colonoscopy is highly rewarding among patients who are being evaluated for suspected malignancies, lower gastrointestinal bleeding and suspected IBD. As such, certain indications produce a higher diagnostic yield than others, suggesting that a stricter patient selection criterion may be employed for performing colonoscopy especially in resource poor settings.

Introduction: Wound cleansing plays a vital role in wound management. Although various solutions have been recommended for cleansing wounds, normal saline is favoured as it is an isotonic solution and is not thought to interfere with the normal healing process. Cooled boiled water is commonly used in community settings for cleansing wounds because it is easily accessible, efcient and cost-effective; however, there is an unresolved debate about its use. The aim of the study was to test whether there are differences in wound infection and w Aims And Objectives: ound healing rates when wounds are irrigated with cooled boiled water compared to sterile normal saline. Can this approach be used in a community environment without risk? Subjects were randomly assigned to wound cleansing with cooled Method: boiled water (experimental group) or sterile normal saline (control group). Wound assessment was conducted at each hospital visit, and an assessment of wound size was conducted once a week. The main outcome measures, occurrence of a wound infection and wound healing, were assessed over a period of 6 weeks. Study ndings indicate that cooled b Conclusion: oiled water is a safe alternative to sterile normal saline for wound cleansing and this method can be safely applied to community setting.