Inguinal hernia repair remains one of the most frequently performed operations worldwide. Although mesh-based techniques currently represent the standard of care in most adult patients, tissue-based repairs continue to play an important role in selected clinical situations, including contaminated surgical fields, resource-limited settings, and patient preference. Among the classical tissue repairs, Bassini repair and darning repair have maintained clinical relevance. Edoardo Bassini revolutionized hernia surgery in the late nineteenth century by introducing anatomical reconstruction of the posterior wall of the inguinal canal, significantly reducing recurrence rates compared with previous techniques. Darning repair, particularly the Moloney darn, was later developed as a tension-reducing tissue repair that employs nonabsorbable sutures to create a mesh-like support between the conjoint tendon and inguinal ligament. This review examines the indications, outcomes, advantages, disadvantages, and contemporary role of Bassini and darning repairs in adults with inguinal hernia. Current evidence suggests that while both techniques are effective in selected patients, darning repair generally demonstrates lower postoperative pain and tension, whereas Bassini repair provides a solid anatomical reconstruction but may be associated with higher recurrence rates when excessive tension is present. Despite the predominance of mesh repairs, both methods remain valuable components of the hernia surgeon's armamentarium.

Background: Asthma is a common chronic respiratory disease characterized by variable respiratory symptoms and airflow limitation. Despite the availability of effective therapies, a substantial proportion of patients continue to have uncontrolled asthma. Identification of clinical and treatment-related factors associated with poor control is important for improving patient outcomes. Objective: To study the clinical profile and factors associated with uncontrolled asthma among adult patients attending the Medicine Clinic of a tertiary care hospital. Methods: A hospital-based observational study was conducted among 30 adult patients with clinically diagnosed asthma attending the Medicine Clinic. Sociodemographic and clinical details, including age, sex, duration of asthma, smoking or passive smoke exposure, previous exacerbations, comorbidities, medication adherence and inhaler technique, were recorded using a structured proforma. Asthma control was assessed using the Asthma Control Test (ACT). Patients were categorized as having controlled or uncontrolled asthma according to their ACT score. The association between selected clinical and treatment-related factors and asthma control was assessed using appropriate statistical tests. Results: Among the 30 participants, 17 (56.7%) were females and 13 (43.3%) were males. The largest proportion belonged to the 31–45-year age group (33.3%). Overall, 18 (60.0%) patients had controlled asthma, while 12 (40.0%) had uncontrolled asthma. Previous exacerbation was significantly associated with uncontrolled asthma (p=0.017). Longer duration of asthma (>10 years) was also significantly associated with poor control (p=0.018). Incorrect inhaler technique was significantly more frequent among patients with uncontrolled asthma (p=0.026). Similarly, poor medication adherence showed a significant association with uncontrolled asthma (p=0.018). Smoking exposure and comorbidities showed higher proportions among patients with uncontrolled asthma but did not demonstrate statistically significant associations. Conclusion: Uncontrolled asthma was common among adults attending the Medicine Clinic. Previous exacerbations, longer disease duration, incorrect inhaler technique and poor medication adherence were important factors associated with poor asthma control. Routine assessment of asthma control, inhaler technique and medication adherence may help improve asthma management.

Introduction: Fatigue is a common problem faced by health care professionals all over the world due to long working hours, but it is more prevalent among anesthesiologists, especially among trainees, adversely affecting the quality of health care and resulting in more complications in patients; it also hurts the mental and social health of trainee anesthesiologists. Materials and Methods: A Cross-sectional study was carried out in hospitals in Sindh that offer FCPS (Fellow of College of Physicians and Surgeons) and MCPS (Member of College of Physicians and Surgeons) training in anesthesia. Results: A total of 98 anesthesiologists were enrolled in this study. Out of which, 59(60.2%) were females. The median (IQR) age was 28(27-30). 56(57.1%) were getting trained in private institutes. The majority of them were in the first year and third year of residency, 29(29.6%) and 24(24.5%), respectively. No association was found between age, gender, institute of training, and year of residency and fatigue status [p=0.456, p=0.116, p=0.506, p=0.505]. While as expected fatigue participants reported more subjective feeling of fatigue, less concentration, less motivation, and less physical activity in comparison to non-fatigue participants (40.1±8 vs 24.6±8; p=0.000, 22.5±4 vs 14.2±5; p=0.000, 17.3±5 vs 9.3±4; p=0.000, 13.7±4 vs 8.2±4; p=0.000respectively). Conclusion: The majority of anesthesia trainees turned out to be fatigued in training institutes of Sindh, resulting in less concentration, less motivation, and less physical activity; hence, we believe that trainees must be provided with better resting facilities during on-call hours to improve the quality of health care in our institutes.

Inguinal hernia repair is one of the most performed surgical procedures worldwide. The introduction of prosthetic mesh has significantly reduced recurrence rates and transformed the management of groin hernias. Among the various tension-free techniques developed, the mesh plug repair, popularized by Rutkow and Robbins in the 1990s, emerged as a simple and effective method that combines a conical polypropylene mesh plug inserted into the hernia defect with supplementary mesh reinforcement when necessary. The procedure gained widespread acceptance because of its technical simplicity, short operative time, low recurrence rates, and suitability for ambulatory surgery. However, concerns regarding mesh-related complications, including migration, chronic pain, erosion into adjacent organs, and foreign body sensation, have led to increasing scrutiny of the technique. Recent international hernia guidelines have increasingly favored flat mesh repairs and laparo-endoscopic approaches over mesh plugs. This review discusses the mesh plug repair, its clinical outcomes, advantages, limitations, complications, and contemporary role of mesh plug repair in inguinal hernia surgery. We also compare the mesh plug repair with the other open mesh inguinal hernia repairs and the laparoscopic inguinal hernia repairs.

Background: Cancer is an expanding cause of morbidity and mortality worldwide, with a growing share of the burden occurring in low- and middle-income countries. In sub-Saharan Africa, deficiencies in population-based registration, pathology, imaging, screening, and treatment access continue to limit cancer control. Hospital-based data, while not population-representative, remain useful for characterizing local service demand and identifying priority cancer types. Objective: To describe the demographic and site-specific pattern of malignancies and factors associated with female cancer presentation at the Federal University of Health Sciences Teaching Hospital (FUHSTHO), Otukpo, Benue State, Nigeria, from January 2023 to December 2025. Methods: This three-year retrospective hospital-based descriptive study included histologically confirmed malignancies and clinically diagnosed malignancies supported by radiological evidence where histology was unavailable. Cancer records were identified from the Hospital Cancer Registry and Medical Records Department using ICD-10 codes C00–C97. Age, sex, residence, and primary cancer site were extracted. Categorical variables were summarized using frequencies, percentages, and 95% confidence intervals. Binary logistic regression was used to examine demographic factors associated with female cancer presentation. Analyses were performed in IBM SPSS Statistics version 26. Results: Of 160 cancer records identified, 145 were eligible for analysis after exclusion of 5 duplicate and 10 incomplete records. Females accounted for 91 cases (62.8%) and males for 54 (37.2%), giving a female-to-male ratio of 1.7:1. Most cases occurred among adults aged 35–64 years (87/145; 60.0%), followed by those aged ≥65 years (40/145; 27.6%). Among males, prostate cancer was the leading recorded malignancy (16/54; 29.6%), followed by lung cancer (5/54; 9.3%) and acute myeloid leukemia (4/54; 7.4%). Among females, breast cancer (33/91; 36.3%) and cervical cancer (17/91; 18.7%) together accounted for 55.0% of female cases. In adjusted analysis, age 35–64 years (AOR 3.46; 95% CI 1.52–7.88; p=0.003) and residence in Otukpo LGA (AOR 2.14; 95% CI 1.12–4.09; p=0.021) were associated with female cancer presentation; the estimate for age ≥65 years was of borderline statistical significance (AOR 2.41; 95% CI 0.99–5.84; p=0.051). Conclusion: The hospital cancer case mix was dominated by breast and cervical cancers among females and prostate cancer among males, with most cases occurring in middle-aged and older adults. These findings support strengthened cancer registration, evidence-based early detection, diagnostic capacity, and oncology referral pathways. Because the study is hospital-based, the results should not be interpreted as population incidence or prevalence estimates for Benue State.

Introduction: Asthma and tuberculosis (TB) are two major lung diseases whose coexistence could alter the risk of onset, clinical course, and therapeutic management of TB. This review aimed to synthesize the available data on the impact of asthma on these various aspects. Methods: A narrative literature review was conducted in PubMed, Semantic Scholar, Google Scholar, and the Cochrane Library. Publications in English or French published between 2010 and 2025 were considered. Original articles, systematic reviews, meta-analyses, and clinical guidelines addressing the asthma–tuberculosis relationship were included. Results: The data suggested that asthma may increase susceptibility to TB, primarily through the prolonged use of inhaled or systemic corticosteroids, with a dose-dependent effect. A Th1/Th2 immune imbalance, certain genetic factors, and common environmental and socioeconomic determinants may also play a role. The coexistence of the two diseases could lead to atypical clinical presentations and therapeutic challenges, particularly due to interactions between rifampin, corticosteroids, isoniazid, and theophylline. However, some data suggested a possible protective effect of eosinophilic inflammation. Conclusion: Asthma may promote the onset, reactivation, and progression of TB, but the evidence remains mixed and is primarily observational. Longitudinal and interventional studies are needed to clarify this association and optimize the management of patients with this comorbidity.

Acute appendicitis is the most common non-obstetric surgical emergency during pregnancy and remains a significant cause of maternal and fetal morbidity when diagnosis or treatment is delayed. The diagnosis of appendicitis in pregnant patients is particularly challenging because physiological, anatomical, and biochemical changes of pregnancy may obscure classical clinical manifestations. Delayed diagnosis increases the risk of appendiceal perforation, which is associated with preterm labor, fetal loss, maternal sepsis, and adverse neonatal outcomes. Imaging modalities, particularly ultrasonography and magnetic resonance imaging (MRI), have become essential components of the diagnostic pathway. Surgical intervention continues to represent the cornerstone of treatment. Recent evidence and international guidelines support laparoscopic appendectomy as the preferred surgical approach in most pregnant patients because of its favorable maternal outcomes, shorter hospital stay, and lower wound complication rates. Nevertheless, open appendectomy remains appropriate in selected clinical situations. Emerging literature on non-operative management using antibiotics has generated interest; however, current evidence suggests that surgery remains the standard of care due to concerns regarding treatment failure, recurrence, and maternal-fetal complications. Multidisciplinary collaboration among surgeons, obstetricians, anesthesiologists, radiologists, and neonatologists is crucial to optimizing outcomes. This review examines the diagnostic and current recommendations regarding the management of acute appendicitis in pregnancy.