BACKGROUND: Incisional hernia is a common complication following visceral organ transplantation. Transplant patients are at increased risk of primary and recurrent hernias due to chronic immune suppression and large incisions. We conducted a retrospective review of patients with a history of liver or kidney transplantation who underwent hernia repair to analyze outcomes and hernia recurrence. METHODS: This is a single center, retrospective review of 19 patients who received kidney and/or liver transplantation prior to presenting with an incisional hernia from 2011 to 2017. All hernias were repaired with open component separation technique (CST) with biologic mesh underlay. RESULTS: The mean age of patients was 61.0±8.3 years old, with a mean body mass index of 28.4±4.8 kg/m², 15 males (78.9%), and four females (21.1%). There were seven kidney, 11 liver, and one combined liver and kidney transplant patients. The most common comorbidities were hypertension (16 patients, 84.2%), diabetes (9 patients, 47.4%), and tobacco use (8 patients, 42.1%). Complications occurred in six patients (31.6%) including hematoma (1/19), abscess (1/19), seroma (2/19), and hernia recurrence (3/19) at mean follow-up of 28.7±22.8 months. With the exception of two patients with incomplete follow-up, all patients healed at a median time of 27 days. CONCLUSIONS: This small, retrospective series of complex open CST in transplant patients shows acceptable rates of long-term hernia recurrence and healing. By using a multidisciplinary approach for abdominal wall reconstruction, we believe that modified open CST with biologic mesh is a safe and effective technique in the transplant population with complex abdominal hernias.
Abdominal Wall ; Abscess ; Body Mass Index ; Comorbidity ; Female ; Follow-Up Studies ; Hematoma ; Hernia ; Hernia, Abdominal ; Herniorrhaphy ; Humans ; Hypertension ; Immunosuppression ; Incisional Hernia ; Kidney Transplantation ; Kidney ; Liver Transplantation ; Liver ; Male ; Organ Transplantation ; Recurrence ; Retrospective Studies ; Seroma ; Surgical Mesh ; Tobacco Use ; Transplants

Introduction: Diabetes mellitus is a wide spread metabolic disorder characterized by hyperglycemia. In Pakistan, many traditional or medicinal plants are being used to treat ailments or disorders, both in children and adults. To date, there has been no research study done to investigate the effect of Morus alba (white mulberry) leaves on blood glucose levels of individuals with type II diabetes mellitus in Pakistan. The present study was conducted to determine the effect of Morus alba (white mulberry) leaf powder on glycated haemoglobin (HbA1c) of patients with type II diabetes mellitus. Methods: The study design of this study was a randomised controlled trial. Eighty patients with type II diabetes mellitus were randomly selected from the Fatima Memorial Hospital and were equally divided into two groups - control group and experimental group. Patients in the control group were asked to follow their regular hypoglycaemic medications, while patients in the experimental group were administered with 500mg of Morus alba leaf tablet twice a day, 15 minutes before breakfast and dinner, along with their regular hypoglycaemic medications. HbA1c of patients in both groups were assessed on day zero before the study and on the ninetieth day at study completion. Results: HbA1c of patients in the control group at baseline was 8.92% and 8.91% at final, whereas HbA1c of patients in the experimental group at baseline was 9.13% and 8.59% at final. Conclusion: The results of this study concluded that Morus alba leaves had a significant effect in lowering high blood sugar levels.