Background: Outcome of traumatic brain injury is multi factorial. It is common to follow up the conservatively managed patients with repeated CT scans at specific intervals. The study was to observe the epidemiology of TBI and ascertain utility of repeating CT scans in conservatively managed TBI.Methods: 318 patients with TBI admitted to a tertiary care center for a period of 1 year was studied. Adult patients, who have undergone multiple CT scans were included and patients underwent surgery or expired after first CT scan excluded. Personal details, clinical details and reason for repeated CT scan was studied. The change in management based on serial CT scans was measured as outcome.Results: Road traffic accidents were the cause of 69.1% of TBI. 72% of the patients were male. Commonest CT finding was occurrence of mixed lesions, seen in 44.3% patients. In patients who underwent repeated CT scans, the mean number of repeat CT scans were 3.7 CT (SD=1.001), while that of elective cases were 2.40 scans (SD=0.629). The use of routine CT scan for follow up did not alter the management of patients with TBI when compared to patients who underwent elective scans as none of them underwent any surgical intervention.Conclusions: RTA are commonest cause for TBI. Use of routine CT scans was not of advantage over elective scans as none of the patients had any change in management with use of repeat CT scans.

Background: Post-operative pain is a disabling complication of inguinal hernia repair. Sutures that are used to anchor the mesh are blamed for tissue tension and nerve entrapment leading to postoperative pain. Self-fixating mesh, a bicomponent mesh with resorbable polylactic acid gripping system can produce a tension-free repair without sutures, reducing the potential of post-operative pain. The objectives of the study were to compare postoperative pain, the operating time and the efficacy in terms of recurrence among patients undergoing Lichtenstein’s inguinal hernia repair with self-fixating mesh and conventional polypropylene mesh.  Methods: A prospective observational study was conducted among 120 patients. Half of them underwent Lichtenstein’s inguinal hernia repair with self-fixating mesh which did not require sutures and the other half with conventional polypropylene mesh which were anchored with polypropylene sutures. Time taken to complete surgery was noted. Postoperative pain was charted using a visual analogue scale at 15 days, 3 months, 6 months and at 1 year during the follow up.Results: Median postoperative pain score and operating time was significantly lower in patients who underwent repair with self-fixating mesh. None of the patients had recurrence at the end of 1 year follow up period.  Conclusions: Self-fixating mesh can reduce the postoperative pain and the operating time in patients undergoing Lichtenstein’s inguinal hernia repair when compared with a conventional polypropylene mesh. The self-fixating mesh is as efficacious as conventional polypropylene mesh in preventing recurrences.

Background: Abdominal surgeries are associated with an appreciably high rate of post-operative nausea, vomiting and pain due to the severity of the proinflammatory cytokine response arising from peritoneal trauma. This study was designed to study the efficacy of single pre-operative dose of dexamethasone in reducing the incidence of post-operative nausea, vomiting and pain after major abdominal surgeries.  Methods: The study was prospective, randomized and double blinded. 60 adult patients of either sex, scheduled for elective laparotomy from March 2012 to October 2013 were included in the study. Results: In this study 86.7% of patients in the saline group experienced nausea, whereas only 13.3% of patients in dexamethasone group experienced nausea. Chi square value is 32.67 and p value is<0.05. Among the patients who received dexamethasone only 10% experienced vomiting, where as in the saline group 33.3% developed vomiting. Chi square value is 4.812 and p value is 0.029. This is statistically significant as p value is<0.05. Among the patients who experienced very severe pain 100% were from the saline group, whereas none of the patients in dexamethasone group experienced very severe pain. Among the patients who experienced severe pain 85.7% belonged to saline group, and only 14.3% were from the dexamethasone group. The p value is<0.05.  Conclusions: It was found that single pre-operative dose of dexamethasone (8 mg) reduces post-operative nausea, vomiting, pain significantly after abdominal surgery.