Objective: Umbilical hernia and paraumbilical hernia are ventral herniae that occur in infants and adults. According to current evidence, mesh repair is the treatment of choice to avoid recurrence. The aim of this study is to analyze the surgical methods, the types of meshes used, and their benefits. Material and Methods:A retrospective analysis of patients diagnosed with umbilical hernia and paraumbilical hernia was performed. The patients' consent was obtained retrospectively. The various surgical techniques and different meshes used were analyzed. Forty-three patients were selected for the study. Of these, 23 patients underwent open mesh repair, 12 patients underwent laparoscopic intraperitoneal onlay mesh repair repair, and eight patients underwent open intraperitoneal onlay mesh repair repair. The duration of the surgery, mesh used, number of days of hospital stay, type of anesthesia, and postoperative complications were analyzed. Results:Of the 43 patients, the patients who underwent open intraperitoneal onlay mesh repair had shorter postoperative hospital stays compared to other methods (median=1 day; range=1 to 2 days). The duration of surgery was longer for laparoscopic intraperitoneal onlay mesh repair and open mesh repair compared to the open intraperitoneal onlay mesh repair technique (p<0.05). Conclusion:The open intraperitoneal onlay mesh repair technique had advantages over the other methods for small-defect umbilical hernia and paraumbilical hernia. The duration of surgery was long for laparoscopic intraperi- INTRODUCTIONUmbilical hernia (UH) and paraumbilical hernia (PUH) are ventral herniae that occur in the region of the umbilicus or around the umbilicus (1, 2). UH accounts for 10% of abdominal herniae (3). UH occurs in infants and children, while PUH occurs in adults. UH rarely occurs in adult patients with ascites, obesity, and massive abdominal distention from various causes. There are advantages to the management of UH and PUH using meshes MATERIAL AND METHODSA retrospective analysis of patients who underwent operations for UH and PUH at the Institute of General Surgery, Madras Medical College, was performed. Patients who underwent surgery for UH and PUH over a period of four months, from November 2015 to February 2016, were chosen for the study. Institutional ethical committee clearance was obtained to collect the data. Informed consent was obtained from the chosen patients. Fifty-four patients were diagnosed with UH and PUH. Of these, five patients underwent open anatomical suture repair operations as an emergency procedure and another six patients underwent open mesh repair with associated bowel pathology, for which bowel surgery was performed. Excluding these 11 cases, 43 patients with UH and PUH in whom different types of mesh were used were chosen for the study. All the patients were euthyroid before and after surgery. Of the 43 patients who underwent mesh repair, 23 patients underwent open mesh repair using Prolene mesh, 12 patients underwent laparoscopic IPOM using composite dual...

Ever since the advent of Smartphones, Smartphone applications (SAs) are revolutionizing the contemporary medicine. Smartphone application which was created in view of swift communications among the general public has now intruded the medical fraternity. But the ethics for using these applications to transfer patients' medical records through SA is bewildering among the medical professionals (MPs).

Sir,I am glad to share the results of a questionnaire-based survey done using SurveyMonkey™ to assess the communications by medical professionals through WhatsApp. A questionnaire was formulated pertaining to the extent of use of WhatsApp by the medical professionals, and the e-link was circulated in the various social media like Facebook, Twitter, Viber, and emails for a period of 1 month by secured SSL encryption. All participants (N = 84) were medical professionals. The cohort had medical students (21.43 %), post diploma (17.86 %) and medical post graduates or residents (27.38 %), post graduates working in private sector (13.1 %), assistant professors in government medical colleges (10.71 %), and professors in private sector (9.52 %). Around 97.62 % (n = 82) agreed that they knew about WhatsApp. The entire cohort agreed to communicate through WhatsApp to their medical friends of the same cadre but not to their superiors (11.9 %; n = 10). Most of the medical professionals (86.9 %) had WhatsApp group for their batch. Medical professionals (28.57 %; n = 24) did not like to discuss about their patients or case discussion in WhatsApp. When the question was raised about the ethical issue that is it ethically acceptable to share about the patients' details in WhatsApp group, majority replied that they did not know (42.86 %; n = 36), the rest said that it is ethically unacceptable (38.1 %; n = 32), and few (19.05 %; n = 16) thought it is ethically acceptable. There was near equal priority to use WhatsApp in emergencies to call their colleague for help (yes vs no; 45.24 vs 54.76 %, respectively). A WhatsApp group by the medical professionals is preferred to discuss about the academics (66.67 %; n = 56) and journals (23.81 %; n = 20). Studies project the use of WhatsApp during emergencies [1], but among the medical professionals, it is a tool for discussion but not for treating the patient. Compliance with Ethical StandardsSource of Funding None. Conflict of InterestThe authors declare that they have no conflict of interest.

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