Background: Lichtenstein mesh repair technique is widely used throughout the world in inguinal hernia repair. Hernioplasty done under local anaesthesia certainly has some benefits but it is yet to be proven as standard procedure. The aims of this study are to provide the data of a comparative study between Lichtenstein hernioplasties done under local versus spinal anaesthesia as well as add more data in this scenario.Methods: In this non randomized clinical study, 84 patients were selected by calculation of sample size. 42 patients were operated under spinal anaesthesia and another 42 were operated under local anaesthesia.Results: Mean duration of operation was slightly was slightly more in local anaesthesia i.e. 62.5 minutes (SD=17.8) versus 51.1 minutes (SD=21.5) in spinal anaesthesia. At 6 hours, 12 hours and 24 hours postoperative pain was significantly less in local anaesthesia group in comparison to spinal anaesthesia group with p=0.04, p=0.042, p=0.041 respectively. Postoperative complications like urinary retention, hypotension, and headache were more in spinal anaesthesia than in local anaesthesia. Duration of hospital stay was significantly less in local anaesthesia group i.e. 24.5 hours (SD=12.8) in comparison to spinal group 57.1 hours (SD=16.7).Conclusions:The study concludes that in local anaesthesia group, postoperative pain was significantly less and postoperative complications like urinary retention, headache, and hypotension were less evident compared to spinal anaesthesia. Hence the study concludes that local anaesthesia can be used as an alternative of spinal anaesthesia as a standard mode of anaesthesia for Lichtenstein hernioplasty operation.

Background: Post-operative complications following appendectomy are relatively not uncommon and pain during this period is sometimes seen. Persistent or reappearance of similar pain causes the loss of patient’s confidence on the procedure itself as well as despair for surgeons.Methods: The study was conducted at our institution to determine the cause of post appendectomy right iliac fossa pain and to evaluate the role of laparosopic adhesiolysis as a therapeutic tool. 35 patients with post appendectomy right iliac fossa pain were included in the study and outcome of post-operative peri-caecal adhesions (if found) treatment with laparoscopic adhesiolysis was assessed.Results: 80% of the 35 patients were in the age group of 18-38 years. 37.14% (13 patients) were symptomatic within 1 year of appendectomy. Pain due to post-operative adhesion was found in 20% (7) of the patients. With laparoscopic adhesiolysis, the diagnostic accuracy rate was 78.57% and therapeutic relief in pain was 85.72% of the patients in our study.Conclusions: Patients presenting recurrent pain in right iliac fossa, after appendectomy should not be overlooked. Patients with recurrent right iliac fossa pain following appendectomy may benefit from laparoscopy, both as a diagnostic tool and with the added advantage of treating the patients simultaneously in the form of laparoscopic adhesiolysis. Adhesiolysis has offered pain free life as long as our follow up is concerned.

Background: The pathogenesis involves disturbance in the breast physiology extending from an extreme normality to well defined disease processes. The clinician must provide a degree of diagnostic accuracy while at same time ensuring that an excessive biopsy rate is prevented. The aim of this study was to evaluate the benign breast lumps in different age groups and to determine the prevalence of benign breast lumps among the breast symptomatic.Methods: This clinico-pathological cross sectional study was conducted with a sample size of 100. The study was conducted during the period from July 2018 to June 2019 which included all patients presenting with benign breast lump during the study period.Results: Out of 100 studied cases of benign breast diseases, the most common benign breast tumor found as fibro adenoma and majority of the fibro adenoma found in the 2nd and 3rd decade of life. Right breast and upper outer quadrant were most commonly affected. Majority of benign breast lesions presented with painless lump in the breast and most of them were from rural background. Majority of benign Breast lumps (45%) cases were found in the age group of 21-30 years. Majority of the patients (60%) attain menarche between ages 13-15 years. Majority of cases (55%) were belonged to lower socio economic status.Conclusions: Our study indicates that FNAC is diagnostically more accurate, safe, cost effective and OPD procedure, however when FNAC was inconclusive, biopsy is the best choice for breast tumors.