Background: Postoperative pain after open mesh repair of inguinal hernia is an important challenge. Such type of pain sometimes does not respond to medical treatment including non-steroidal anti-inflammatory drugs and opiates. The objective of the present study was to evaluate the effect of preservation or division of the Ilioinguinal nerve on pain and post-operative symptoms, after open mesh repair of inguinal hernia.Methods: All patients undergoing surgery for tension free Lichtenstein mesh repair over a period of 1 year were included. Patients below the age of 18 years and patients with bilateral or recurrent hernias were excluded.Results: In present study of 42 patients, early mean postoperative pain at day 1 was 1.8 on VAS scale in ilioinguinal neurectomised patient compared to 1.5 in nerve preserved group (P=0.1408). Postoperative pain at week 1 was 1.25 in neurectomised patients compared to 1.32 in nerve preserved group (P=0.7161). Late Postoperative pain and chronic groin pain was 0.6 and 0.25 at 1 and 3 months respectively in ilioinguinal neurectomised patients as compared to 1.05 and 0.77 at 1 and 3 months respectively in nerve preserved group (P=0.0184 at 1month and P=0.0335 at 3 months).Conclusions: The difference in postoperative pain at day 1 and at week 1 was not significant and both groups had equal pain. Late postoperative pain (at 1 month) and chronic groin pain (at 3 months) was significantly low in ilioinguinal neurectomised patient compared to nerve preserved group.

Outcome following ultrasound guided foam sclerotherapy treatment for varicose veins in a tertiary care centre. International

Background: Mastalgia is a common problem and 60-70% women encounter it at least once in their lifetime. Many drugs have been used and are been used with varying response, like Tamoxifen, Danazol, primrose oil, topical analgesics and recently Centchroman. The objective of the present study was to compare the three most commonly used drugs in the treatment of mastalgia, namely Centchroman, Tamoxifen and Danazol with a placebo.Methods: All consecutive female patients more than 25 years of age with history of mastalgia for more than 3 months were taken up for the study. Patients were distributed into four groups and administered Centchroman, danazol, tamoxifen and placebo, respectively.Results: In present study of 78 patients, the median visual analogue score (VAS) in Centchroman group were 3, 1 and 3 after treatment of 4, 12 and 24 weeks, respectively with a pre-treatment VAS of 8. Similarly, in the danazol group, VAS at 4, 12 and 24 weeks were 4, 1.5 and 5, respectively. In the Tamoxifen group it was 4, 1 and 3 after treatment for 4, 12 and 24 weeks. On comparison, Centchroman and Tamoxifen both had better pain relief than danazol at 24 weeks (p <0.001) while Centchroman and Tamoxifen had comparable results (p >0.05) despite Centchroman having a lower mean VAS score.Conclusions: Mild cyclical mastalgia can be treated with reassurance and lifestyle measures. Moderate to severe mastalgia usually require drug treatment. Centchroman, Danazol and Tamoxifen are effective. Centchroman appears to have better pain relief relative to the rest.

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