Approximately 20 million hernia surgeries are performed worldwide each year. The majority of groin hernia repairs are conducted electively and are regarded as low-risk procedures [1, 2]. In our Center, a developing country with government hospitals, laparoscopic available resources are sometimes insufficient to meet the demand for patients with inguinal hernias. As a result, open repair remains widely performed procedure. Based on this, we made a modification to the Rutkow-Robbins technique by applying its two fundamental physical principles—a plug and a mesh patch— reducing the prosthetic mesh used, and for the first time, shifting the paradigm regarding the effect of polypropylene mesh when in contact with the spermatic cord. This modification has shown favourable outcomes in a two-year follow-up. The aim of this paper is to describe our technique and present the outcomes achieved.

Renal cell carcinoma (RCC) is the most common malignant tumor of the kidney, with a rising global incidence. The epidemiology, clinical presentation, and management outcomes of RCC vary across different regions, especially in low-resource settings. This study aims to analyze the demographic patterns, clinical characteristics, treatment modalities, and outcomes of RCC patients at East Oncology Center (EOC) in Sudan. A retrospective study was conducted at East Oncology Center, Sudan, including all patients diagnosed with RCC between 2013 and 2024. Data were collected from hospital records, covering demographic characteristics, clinical presentation, risk factors, diagnostic workup, treatment modalities, and outcomes. A total of 71 patients were included, with a mean age of 57 years (range: 18–100 years). Males constituted 54.9%. The most common presenting symptoms were flank pain (93%), hematuria (33%). Clear cell carcinoma was the predominant histological subtype (52.1%), with more than 70% of patients diagnosed at a locally advanced or metastatic stage. Surgical treatment was performed in 70.4% of cases. The median follow-up period was 23.3 months, with an overall survival rate of 33.8%. This study provides insights into the epidemiology and management of RCC in a low-resource setting. A high proportion of patients presented with advanced-stage disease, highlighting the need for early detection strategies. Further research and resource optimization are required to improve RCC outcomes in Sudan.

Abstract: Clinical scoring systems have been developed to risk-stratify patients who are presented to the emergency department with symptoms of acute appendicitis. They are used to rule out patients with acute appendicitis and those who may require imaging in the form of ultrasound or computerized tomography. The common scoring systems are the Alvarado score, RIPASA score, AIR, and AAS. In this chapter, we will look at the common clinical scoring systems that are used for adults and children. We will also look at the role of these scoring systems in diagnosing acute appendicitis and reducing the negative appendectomy rate.

Liver abscess is a rare condition that can be divided into amoebic liver abscess and pyogenic liver abscess. The diagnosis is confirmed by performing an ultrasound or computerized tomography. The management of liver abscesses has seen a trend toward minimally invasive procedures like percutaneous drainage and intravenous antibiotics. Percutaneous drainage can be divided into percutaneous catheter drainage and percutaneous aspiration. Surgical drainage can be divided into open and laparoscopic drainage. In this chapter, we will look at the management of liver abscesses, especially the role of percutaneous drainage, which includes percutaneous catheter drainage, percutaneous aspiration, and surgical drainage.

The definition of complicated appendicitis has been an area of concern due to the absence of any universal consensus. Complicated appendicitis often means perforation of the appendix with either peritonitis, abscess, or mass formation. The diagnosis of complicated appendicitis is another area where there is no consensus and there is no one investigation that can diagnose this condition. Diagnosis often involves the use of clinical examinations, blood investigations, and imaging modalities. In this chapter, we will look at the definition and diagnosis of complicated appendicitis.

This study was investigated to evaluate the level of malondialdehyde, ascorbic acid and membrane potential among diabetic patients in Owerri.100 diabetics patients and 100 apparently healthy subjects between the ages of 45- 60 years admitted to General Hospital Owerri were selected in this study. Fasting venous blood was collected and was used for the determination of malondialdehyde, ascorbic acid and membrane potential. The results obtained revealed that the levels of malondialdehyde was increased in diabetics when compared with the control. While membrane potentials and ascorbic acid were significantly decreased in diabetics patients when compared with the control at P<0.05. This could probably imply increase of malondialdehyde and decreased membrane potential as well as decreased ascorbic acid could lead to oxidative stress.

The management of emergency groin hernias is difficult due to the absence of any consensus and the surgical management is tailored by the treating surgeon. Emergency groin hernias include incarcerated and strangulated inguinal and femoral hernias and they carry a high morbidity and mortality. The treatment of emergency groin hernias is usually performed with sutured repairs like Shouldice, Bassini, Darning and the Desarda technique. Hernia repairs with mesh can also be safely performed if there is no or minimal contamination of the wound. The laparoscopic repairs like the Transabdominal preperitoneal (TAPP) and Total Extraperitoneal (TEP) can be performed but require training and equipment and is not recommended for the management of emergency groin hernia. In this review we will look at the management of emergency groin hernias.