D. K. Shah

Meckel's diverticulum is the most common congenital malformation of gastrointestinal tract. It can cause complications in the form of ulceration, haemorrhage, intussusception, intestinal obstruction, perforation and, very rarely, vesicodiverticular fistulae and tumours. These complications, especially bleeding, are more common in the paediatric age group than in adults; however it is not uncommon to miss the diagnosis of Meckel's diverticulum in adults. Here, we reviewed the literature regarding the complications of this forgotten clinical entity in adults with potential diagnostic difficulties and management strategies.

Meckel's diverticulum is the most common congenital malformation of gastrointestinal tract. It can cause complications in the form of ulceration, haemorrhage, intussusception, intestinal obstruction, perforation and, very rarely, vesicodiverticular fistulae and tumours. These complications, especially bleeding, are more common in the paediatric age group than in adults; however it is not uncommon to miss the diagnosis of Meckel's diverticulum in adults. Here, we reviewed the literature regarding the complications of this forgotten clinical entity in adults with potential diagnostic difficulties and management strategies.

Background: This randomized controlled trials was conducted for systematic comparison of suture mesh fixation (SMF) versus glue mesh fixation (GMF) in open inguinal hernia repair with regards to chronic groin pain, recurrence, operative time, post operative pain and postoperative complications.Methods: This study was a single-center, prospective randomized, controlled trial of two groups. It compared post-operative outcomes of mesh fixation with suture (Group A) versus glue (Group B). It was done at Baroda Medical College and S.S.G. Hospital, from May 2018 to January 2019 for case study, intervention and followed up for 9 months till October 2019.Results: Intra operative time duration for mesh fixation is less in Group B (glue mesh fixation) as compare with Group A (suture mesh fixation) with the statistically significant p value of 0.003. Post-operative pain score (mean VAS score) is significantly less in group B. Mean VAS in group A was 1.27 at 3 month while in group B was 1.06 with the p value of 0.048 on 3 month, which is statistically significant. It suggests that chronic groin pain (pain at or after 3 month) significantly less in group B as compared with group A.Conclusions: Mesh fixation by glue has advantage of less intra operative time duration and less post-operative pain and chronic groin pain as compare to mesh fixation by suture.

Background: Although there are many scores to evaluate a patient having trauma, BATSS is a newer score specifically designed for blunt abdominal trauma which is not adequately studied. The objective was to study the efficacy of BATSS by comparing it with conventional experience-based management of Blunt abdominal trauma.Methods: 100 patients presenting with blunt abdominal trauma between March 2019 to May 2020 were randomly selected. Patients were treated by conventional experience-based management and it was compared with management guided by BATSS by prospective observation. Analysis was done by assessing need for CT scan of abdomen and laparotomy to check efficacy of BATSS.Results:100 patients were included in study. CT Abdomen is rarely required in low-risk category (BATSS<8, p <0.0001). In Moderate and High-risk category (BATSS>8), CT Abdomen is required to accurately identify Intra-abdominal injury (p=0.0006 and 0.0965 respectively). Laparotomy may be necessary in any risk category patient for hollow viscous perforation. BATSS does not have a variable like X-ray-Chest standing to diagnose hollow viscous perforation. So, some patients in Low-risk category may also need Laparotomy (p 0.06892) which is not indicated by BATSS. Not all patients in high-risk category needs laparotomy (p=0.00009).Conclusions: Variables used to score the severity of trauma are inadequate and some patients would be improperly categorised in blunt abdominal trauma scoring system. So, we conclude that BATSS is not useful in our setup and requires modifications.

There has been a noticeable increase in the use of alternative strategies such as herbal medicines and laser therapies to tackle a range of health issues, including oral diseases. Therefore, it is of interest to examine how synbiotics affect tooth extraction socket healing and problems. Hence, a total of 210 patients, were split into three groups of 70 individuals each. The primary outcome measures were assessed on the 3rd, 5th, and 7th days after the extraction. Group 3 patients had the highest incidence of bleeding, while group 1 had the lowest. Group 3 experienced the highest level of discomfort and swelling, while group 1 reported the lowest. Thus, post-extraction wound healing using synbiotics' benefits.