Objective: Core needle biopsy often underestimates ductal carcinoma in situ (DCIS), which leads to the detection of invasive cancer only at surgery. The objective of this study is to identify the frequency and factors associated with upstaging, which can improve surgical planning and patient counseling. Methods: In this retrospective cohort study, 131 female patients aged 20-60 years diagnosed with unilateral pure DCIS on core needle biopsy at Jinnah Postgraduate Medical Centre, Karachi (January 2022-December 2023), were included using non- probability consecutive sampling. Patient records were reviewed to extract demographic, reproductive, pathological, and radiological information, including immunohistochemistry for estrogen receptor, progesterone receptor, and HER2. Statistical analysis was performed using SPSS version 20. Upstaging to invasive breast cancer was assessed, and associations were analyzed using chi-square or Fisher’s exact. The threshold of p-value was set to <0.05. Results: Out of 131 females diagnosed with DCIS on core needle biopsy, 40 females (30.5%) were found to have upstaged to invasive cancer based on surgical pathology. The factors that showed significant association with upstaging were shorter symptom duration (p=0.04), lower parity (p=0.01), higher gravidity (p=0.01), PR positivity (p=0.01), tumor size <2 cm on ultrasonography (p=0.01), and absence of mammographic calcifications (p=0.04). Age, ER status, HER-2 status, family history, margin status, and mammographic architectural distortion showed no significant association. Conclusions: Nearly one-third of patients with ductal carcinoma in situ were upstaged to invasive carcinoma, highlighting the potential relevance of integrating clinical, hormonal, and imaging characteristics during preoperative assessment.

Postoperative pain management in hemorrhoidectomy remains a clinical challenge, with pudendal nerve block (PNB) emerging as an effective technique. Adding steroids to local anaesthetics may enhance analgesic efficacy and prolong pain relief. Objective: To compare the effectiveness of pudendal nerve block (PNB) using bupivacaine alone versus bupivacaine with dexamethasone in reducing perianal pain following hemorrhoidectomy. Methods: A prospective study was conducted at the Department of General Surgery, University of Lahore Teaching Hospital, Lahore, from July 31, 2024, to January 30, 2025. A total of 60 patients undergoing hemorrhoidectomy were randomly assigned into two groups: Group A (n=30) received PNB with 20 mL bupivacaine. Group B (n=30) received PNB with 20 mL bupivacaine and 8 mg dexamethasone. The blocks were performed bilaterally under spinal anaesthesia using anatomical landmarks. All patients received standard postoperative analgesia. Pain scores were recorded at 12 and 24 hours postoperatively using the Visual Analog Scale (VAS). Group comparisons were conducted using the t-test, with statistical significance at p ≤ 0.05. Results: The mean pain score at 12 hours postoperatively was significantly lower in Group B (1.90 ± 0.481) compared to Group A (2.47 ± 0.681), with a p-value of 0.001, indicating a statistically significant difference in pain relief. The addition of dexamethasone resulted in enhanced and prolonged analgesia without increasing adverse effects. Conclusion: The use of PNB with bupivacaine plus dexamethasone significantly reduces postoperative perianal pain after hemorrhoidectomy compared to bupivacaine alone. This combination provides superior analgesic efficacy and can be considered a safe and effective technique for pain management in perianal surgeries.

Background: Although anal fistulae are benign, the condition can still negatively influence a patient’s quality of life. Despite its long history and prevalence, anal fistula management remains one of the most challenging and controversial topics in colorectal surgery today. This study aimed to compare the management of anal fistula with LIFT procedure and Fistulectomy. Methodology: A RCT was conducted in a single surgical unit of a tertiary teaching medical college hospital in Karachi from September 2010 through April 2016. A total of 1188 patients with anal fistula were included out of taken sample, Group A (LIFT): 610 patients (70.5% male, 29.5% female); Group B (Fistulectomy): 578 patients (64.9% male, 36.1% female). All patients were followed up for a total duration of twelve weeks during the postoperative period. Patients were followed up at weekly intervals for the initial 6 weeks and at 4-week intervals for another 6 months, and then 6 months for another 5 years. During each follow-up visit, the patient was assessed for postoperative pain, wound complication, and anal incontinence. Results: The mean age of the patients in group A was 41.11 ±7.49 while the mean age of the patients in group B was 45.03 ±7.07 (p-value 0.005). There were 70.5% males and 29.5% Females in group A, whereas 64.9% males and 36.1% female patients were in group B. Comparison of mean pain score showed statistically significant difference in group A and B (p-value <0.05) with higher frequency of anal incontinence was in group B as compared to group A 1 (p-value 0.352). Conclusion: LIFT is an inexpensive and safe procedure that provided primary healing of anal fistula better than fistulectomy.

Objective: To compare outcomes of laparoscopic cholecystectomy versus robot assisted cholecystectomy in patients at tertiary care hospital, Karachi. Study Design: Randomized controlled trial. Duration and Place of Study: Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi from March 2025 to May 2025. Methodology: Total 96 patients (n=96) age 18–65 years were included and divided into two groups with 48 in laparoscopic group and 48 in robot assisted group. Data recorded for demographics and outcomes. Operative time, blood loss, bile spillage, wound complication and pain score were noted. Data analysed by independent sample t test and chi square test or Fischer exact test. Results: Mean age in laparoscopic group was 47.06 ± 9.87 years and in robot group 43.81 ± 9.98 years. Female were 26 (54.2%) in laparoscopic group and 30 (62.5%) in robot group. Operative time was more in robot group 81.81 ± 8.93 minutes as compared to laparoscopic group 57.13 ± 7.33 minutes (p<0.001). Blood loss was 40.88 ± 17.33 ml in laparoscopic and 43.10 ± 15.32 ml in robot group (p=0.506). Bile spillage seen in 7 (14.6%) laparoscopic and 11 (22.9%) robot group (p=0.296). Wound complication was 5 (10.4%) in laparoscopic and 2 (4.2%) in robot group (p=0.435). Pain score also not significant between groups (p>0.05). Conclusion: Both methods are safe and effective but robot assisted cholecystectomy take more operative time with similar outcomes.

Diabetic foot ulcers (DFUs) represent a significant complication of diabetes mellitus, often leading to prolonged hospitalisation, amputations, and increased morbidity. Effective wound healing strategies are crucial in reducing the burden of diabetic foot ulcers (DFUs), particularly in resource-constrained settings such as Pakistan.AFG Objective: To compare the effectiveness of vacuum-assisted closure (VAC) dressing and topical antibacterial dressing in promoting granulation tissue formation and reducing healing time in patients with diabetic foot ulcers. Methods: A randomised controlled trial was conducted at the Department of General Surgery, University of Lahore Teaching Hospital, from July 2024 to December 2024. A total of 60 patients with clinically diagnosed diabetic foot ulcers were randomly assigned into two groups: Group A received a VAC dressing, while Group B received a topical antibacterial dressing (fusidic acid followed by saline gauze). Outcomes measured included the formation of granulation tissue within two weeks and the duration of complete wound healing. Data were analysed using SPSS version 25. A p-value of less than 0.05 was considered statistically significant. Results: The mean age of participants was 56.2 ± 9.4 years. Granulation tissue formation within two weeks was significantly higher in the VAC group (86.7%) compared to the topical dressing group (60%) (p = 0.018). The mean healing duration was shorter in the VAC group (12.3 ± 3.4 days) than in the topical group (17.6 ± 4.2 days) (p<0.001). Stratified analysis showed significantly better outcomes in patients with higher BMI, poor glycemic control, and non-smokers in the VAC group. Conclusion: VAC dressing significantly enhances granulation tissue formation and reduces healing time in patients with diabetic foot ulcers compared to topical antibacterial dressing. Its implementation in tertiary care hospitals in Pakistan could improve wound healing outcomes and reduce the burden of diabetic complications.

Meckel's diverticulum should be considered in cases of unexplained small bowel obstruction, especially in pediatric and adolescent patients. Early recognition and timely surgical intervention can prevent complications and lead to favorable outcomes.

Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract. Its incidence is increasing in the general population. Moreover, contemplation about the need to remove an incidentally discovered Meckel's diverticulum continues. To determine the frequency of Meckel’s diverticulum in patients undergoing acute appendectomy. A cross-sectional study was conducted at the Department of Surgery, Jinnah Postgraduate Medical Center, Karachi. All patients aged 18 to 50 years of either gender who presented with acute appendicitis were enrolled in this study. Meckel’s diverticulum was explored during surgery, and the Presence of a blind segment 3–6 cm long in the distal ileum, within 60–100 cm of the ileocecal valve, was considered as Meckel's diverticulum. The mean age of the patients was 31.19±10.17 years. The mean BMI of the patients was 28.60/m2±1.50Kg/m2. There were 385 (27.80%) females and 1001 (72.20%) males. Obesity was found in 18 (14.30%) patients. In our study frequency of Meckel’s diverticulum was found in 11 (0.79%) acute appendectomy patients.

Introduction: Micronized purified flavonoid fractions (MPFF) have been used extensively throughout Europe and Asia to treat hemorrhoidal disease for at least two decades. MPFF decreases venous stasis by improving venous tone and lymphatic outflow and suppressing the local inflammatory response. Objective: To compare mean pain score and recurrence in patients on micronized purified (Daflon) versus placebo in the management of post-hemorrhoidectomy pain. Methods: A randomized controlled trial was conducted in Jinnah Postgraduate Medical Center, Karachi from September 2010 to March 2016. 3536 Patients were randomly allocated into two groups by drawing sealed opaque envelopes by a third person not related to the study, from a box containing equal paper slips bearing group A and group B, just before going to the operating room. Out of 3536 patients, 1768 were allocated to Group A (Daflon), and 1768 to Group B (Placebo). At the end of 5-year follow-up, recurrence was observed in 14.3% of Daflon patients and 26.7% of placebo patients (p = 0.01). Group A took Daflon 500mg, whereas Group B took a placebo. Two tablets of Daflon 500mg were given every 8 hours and 12 hours (6 tablets per day, i.e., 3000 mg/day for the first 4 days and then 2000mg for the next 3 days) from the first postoperative day up to the 7th postoperative day (POD) and then 1 tablet of daflon 500mg was given every 12 hours for the next 4 weeks in daflon group in addition to paracetamol and a similar inert tablet resembling Teflon. Patients were advised to measure pain on a daily basis till the seventh postoperative day. The outcome of pain was measured at the first follow-up on 7th POD and 21st POD and the mean pain score was calculated. The patient is followed up on 6 monthly basis for the next 5 years to check for the recurrence Results The mean age of the patient in the control group was 40 ± 10.28 years and the mean age of the patients in the DAFLON group was 37.5 ± 9.0 years. The mean weight of the patients in the control group was 50 ± 1.91 Kg and the mean weight of the patients in the DAFLON group was 51.9 ± 2.69 Kg. The mean pain score in the control group was 4 ± 2.43 and the mean pain score in the DAFLON group was 2.19 ± 1.84.

Objective: To determine the frequency of NSTEMI (non- st elevation myocardial infarction) in acute coronary syndrome patients presenting with the chest pain in emergency department of tertiary care hospital. Study Design: Cross Sectional study. Setting: Jinnah Post graduate Medical College Hospital Karachi. Period: June 20, 2023. Methods: Enrolling 112 consecutive volunteers was carried out Interview questions focused on the participants' smoking, blood pressure, diabetes, and type of chest pain. Whether or not the participants had ACS, their diagnosis was documented. NSTEMI frequency was computed. Results: We have 112 patients enrolled with mean age was 52.73±14.24 years. Sixty five (58%) were male while forty seven (41.9 %) were females. out of 112 patients 45 (40.1%) were hypertensive, 32(28.5%) were diabetes and 29 (25.8%) were smoker. Among the participants 21 (18.7%) had NSTEMI and showed positive correlation with age, gender, nature of chest pain, hypertension and smoking. Conclusion: Among the individuals, one of the most frequent causes of chest pain was acute coronary syndrome. High suspicion and additional testing are they key tools for early diagnosis and management.

BackgroundConventional axillary lymph node dissection (ALND) is associated with significant post-operative morbidity in patients undergoing breast surgery due to increased lymphatic leakage. LigaSure, an electrothermal bipolar vessel sealing system, provides better closure of the leakage. This study aims to compare the efficacy and safety of LigaSure against conventional techniques in patients with breast cancer underwent ALND and breast surgery.MethodsWe conducted a comprehensive search across the databases to identify relevant studies. The search results were imported into Covidence for article eligibility screening, and all relevant outcomes data were synthesized using odd ratios (ORs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs) in meta-analysis models using RevMan 5.4.ResultsTwelve studies with the total of 895 patients (LigaSure = 441; Conventional technique = 454) with breast cancer underwent breast surgery with ALND were included. LigaSure was associated with significantly lower post-operative drain volume (SMD: -0.39, 95% CI [-0.53, -0.24], P < 0.00001), shortened duration of drain (SMD: -0.51, 95% CI [-0.67, -0.34], P < 0.00001), and reduced hospital stay length (SMD: -0.57, 95% CI [-0.96, -0.18], P = 0.004) compared to conventional techniques. However, no difference observed in total operation time, intra-operative blood loss, seroma related outcomes and post-operative complications between the two groups.ConclusionLigaSure significantly reduced the lymphorrhea, duration of drain and hospital stay, however, it did not prove be effective in seroma-related outcomes.

Linkage studies have indicated a potential genetic predisposition to cholelithiasis. This study aims to determine the frequency of positive family history of gallstone disease in patients presenting with gallstones in a Pakistani population. A descriptive, cross-sectional study was conducted at the surgical department of the University of Lahore Teaching Hospital from June 30, 2023 to August 30, 2023. A total of 102 radiologically confirmed cholelithiasis patients were enrolled. Out of 102 participants, 75.5% (n = 77) were females, with a mean age at presentation of 42.1 ± 12.1 years. The study found that 32.4% (n = 33) of participants had a single family member with gallstones, 3.9% (n = 4) had 2 family members affected, and 1% (n = 1) had 3 family members affected. The attributable risk of genetics from our study was 37.2%. Additionally, there was no significant association between positive family history and earlier onset of disease. A significant percentage of Pakistani population may have gallstone disease due to genetic factors.

Objective: To identify the accuracy of surgical clinical acumen in diagnosing severity of appendicitis in adults. Study Design: Observational study (Prospective). Settings: This study was conducted at University of Lahore Teaching Hospital, Lahore (UOLTH); a tertiary Care Hospital, Lahore Pakistan. Duration: November 2021 to April 2022. Methods: After ERB approval (ERC 58/21/09), data collection proforma was administered to general surgeons at UOLTH, who were asked to anticipate the severity of appendicitis preoperatively depending on history, clinical examination, ultrasound findings and laboratory tests reports. Area under the curve (AUC) and the optimal cut-point values for clinical variables were identified by drawing Receiver operating characteristic (ROC) curves for identifying non- complicated appendicitis. Preoperative diagnoses were compared to operative findings using chi-square test. Data was analyzed using SPSS version 24 was used for data analysis and p-value of < 0.05 was accepted as statistically significant. Results: Surgeon’s prediction showed an accuracy of 85.9% with 89.3% positive predictive value and 78% negative predictive value and an error rate of 9.67%. Abdominal ultrasound demonstrated high sensitivity (95.8%) but lower specificity (29.1%) for appendicitis. Clinical variables, such as anorexia, nausea, and elevated temperature, exhibited a substantial diagnostic competence to distinguish complicated and non-complicated appendicitis. Conclusion: Surgeon’s prognostication in appendicitis is more accurate than clinical or imaging alone, yet errors persist. Caution in patient selection for conservative management is vital, aided by integrating clinical judgment with imaging.

Background:Inherited cholestatic liver disorders such as progressive familial intrahepatic cholestasis (PFIC) and Alagille syndrome result in significant pruritus and increased serum bile acids, necessitating liver transplantation. This study aims to evaluate the efficacy and safety of Ileal bile acid transport inhibitors (IBATIs) in children with PFIC and Alagille syndrome. Methods:We conducted a comprehensive search across the databases to identify relevant randomized controlled trials (RCTs), and Covidence was used to screen eligible articles. All outcomes data were synthesized using risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals (CIs) in RevMan 5.4. PROSPERO: CRD42024564270. Results:Four multicenter RCTs involving 215 patients were included. IBATIs were associated with a significant reduction in Itch Observer Reported Outcome (Itch (ObsRo)) score (MD: -0.90, 95% CI [-1.17, -0.63], P < 0.01), serum bile acids (MD: -119.06, 95% CI [-152.37, -85.74], P < 0.01), total bilirubin (MD: -0.73, 95% CI [-1.32, -0.15], P = 0.01), and increased proportion of patients achieving ≥1 score reduction in Itch (ObsRo) score (RR: 2.54, 95% CI [3.83, 1.69], P < 0.01) and bile acid responders (RR: 8.76, 95% CI [2.46, 31.23], P < 0.01) compared with placebo. No differences were observed in any treatment-emergent adverse events (TEAs) (RR: 1.02, 95% CI [1.12, 0.93], P = 0.71), TEAs leading to drug discontinuation (1.03, 95% CI [5.56, 0.19], any serious TEAs, or liver-related TEAs. Conclusion:IBATIs showed significant improvement in various cholestatic parameters with tolerable safety profile; however, future research on optimal dosage and long-term outcomes is needed.

Immunosuppressants, such as methotrexate (MTX), can suppress the COVID-19 vaccine response in patients with autoimmune diseases. Thus, this study aims to evaluate the effects of MTX hold following COVID-19 vaccination on vaccine efficacy response. A systematic review and meta-analysis of relevant studies retrieved from Web of Science, SCOPUS, PubMed, and CENTRAL from inception until Oct 1, 2023, was conducted. Covidence was used to screen the eligible articles, and all relevant outcomes data were synthesized using risk ratios (RRs) or standardized mean differences (SMDs) with 95

Background: After surgery for breast cancer, there is a risk of increased wound drainage and seroma formation. Various treatments are utilized to overcome this issue with variable effectiveness. Objective: To compare the outcome of a single preoperative dose of intravenous steroid injection versus control group on wound drainage in patients undergoing modified radical mastectomy (MRM) for stage I and II breast cancer. Methodology: It is a randomized control trial conducted over a period of 6 months. Total 60 patients who underwent MRM for carcinoma of breast were included. They were divided into 2 groups with each group having 30 cases. In group-A 120 mg (3 ml) of injection depomedrol was given one hour before surgery while in group B, 3 ml of normal saline was used, and MRM was performed and two drains were placed. At the time of drain removal, drainage volume was assessed in both groups. Results: Mean age of the patients was 47.3±7.89 and the mean drainage volume in group A versus B was 672±117.63 and 1020±159.9 respectively. Among the patients, 51.7% had stage I and 48.3% had stage II breast cancer. The two groups had statistically significant difference in terms of mean drainage volume (p value =0.048). Conclusion: In patients who underwent MRM, prophylactic steroid injection was associated with significant reduction in mean drainage volume compared to normal saline. Keywords: Modified Radical Mastectomy, Steroid, Seroma Formation

Introduction: Hypocalcemia after thyroid surgery is most important and early complication1. The main aim of this study is to diagnose early hypocalcemia after thyroid surgery and its treatment options Method: 100 patients fulfilling inclusion criteria from December 2018 to February 2021 were included in this study who had undergone thyroid surgery (sub-total, near-total and total). Serum calcium less than 8.1 mg/dl, measured after 24 hours to 48 hours of surgery is taken as hypocalcemia. Following variables are assessed in this study, gender, age, pre-operative serum calcium levels and type of surgery. Hypocalcemia diagnosed by post-operative serum calcium levels, presence of numbness, Chvostek’s sign or Trousseau’s sign noted and analyzed by SPSS v20 was used for statistical analysis. p-value less than 0.05 was considered as statistically significant. Results: Early post-hypocalcemia developed in 71 (71%) patients of them 13(18%) were males and 58 (82%) were females and female gender is significantly more associated with hypocalcemia (p=0.001) Type of surgery (sub-total, near-total and total) is not related to development of early hypocalcemia (p=0.169). Patients who developed early hypocalcemia divided into two groups- A and B respectively. Group A is treated with oral calcium alone and B with oral calcium combined with Vitamin D3. The patients followed up for 6 months. The patients who treated with oral calcium and vitamin D3 combined responded well as compares with oral calcium alone (p=.001). Conclusion: This study suggests that female gender is associated with early hypocalcemia however there is no significant different type of surgery and patients who treated with oral calcium combined with vitamin D3 responded well as compared with oral calcium alone. Keywords: Early Hypocalcemia, thyroid surgery, Goiter

Background: Liver injury is the most commonly encountered trauma among all abdominal traumas. It is associated with high morbidity and mortality. The choice of treatment for such injury depends on the type as well as severity of injury. Objective: To determine the outcome in terms of (success and complications) of managing liver trauma either conservatively or with operative management. Methodology: 62 patients with liver trauma (blunt or penetrating) who presented in the surgical emergency department of Jinnah Hospital, Lahore were enrolled in the study. Detailed history, clinical examination and radiological examination of all patients were carried out using CT scan. Depending on the grade of injury and type of trauma patients were managed either conservatively or by operating them. Success of treatment and its outcomes were noted down. Results: The results revealed that the mean age of the patients was 40.1±11.74, mean diastolic blood pressure was 62.34±14.36, mean systolic blood pressure was 105.2±11.41, mean pulse rate was 92.37±19.06, mean respiratory rate was 19.8±5.353 and mean number of fresh frozen plasma (FFPs) infused were 2.8±0.81. Conservative management was carried out in 42 (67.7%) patients and operative management was carried out in 20 (32.3%). Out of these, conservative management was successful in 35 (56.5%) patients and operative management was successful in 18 (29%) patients. Common complications seen were intra-abdominal sepsis in 24.2%, bile leakage 14.5%, recurrent hemorrhage 6.5%, coagulopathy 3.2% and death 4.8%. Conclusion: Conservative management of liver trauma is highly successful and is associated with less complications and unless needed must be adapted and operative management should only be carried out in patients who have injury to liver of such an extent that cannot be managed conservatively. Keywords: Liver injury, Blunt trauma, Penetrating trauma, Conservative management, Outcome

Aim: To determine the accuracy of the RIPASA (Raja Isteri Pengiran Anak Saleha Appendicitis) grading system for the diagnosis of acute appendicitis. Study design: A cross-sectional study Place and Duration: This study was conducted at Jinnah Postgraduate Medical Centre Karachi Pakistan from March 2020 to November 2021. Methodology: A total of 150 patients with clinical signs of acute appendicitis were studied. To determine the RIPASA score's validity, testing was assessed for acute appendicitis. Patients with gynecological and urological disorders, appendicular lumps, were excluded from the study. The RIPASA Score chart was employed, and the findings of additional clinical studies corroborated the findings. Results: Among the 150 patients, 80 (53.3%) were males, and 70 (46.66%) were females. The participants' average age was 22 ± 5.4 years. At a cut-off score of 7.5, the RIPASA scoring system exhibited good validation testing. The majority of the population (n=135, 90 %) was under the age of 40, with the minority (n=15, 10%) being over 40. The incidence of appendicitis increases dramatically in the second and third decades. There is no case below the age of ten and no case over the age of sixty years. Conclusion: For the diagnosis of AA, the RIPASA score is more sensitive and specific. This Scoring system is a valid and significant selective power in the diagnosis of appendicitis and in reducing unnecessary admissions and abdominal explorations, especially in the Asian race. Keywords: Acute appendicitis, Histopathology, RIPASA, Validation study

Background: Health care burden has increased since the pandemic of Covid-19 has emerged. The healthcare resources are limited currently and majority surgeries have been postponed because of the current pandemic. Therefore, the main concern of carrying out any surgery at current point is mainly in those patients that are landing in emergency. Symptomatic inguinal hernia being a common presentation in emergency can be dealt by applying local anesthesia. Objective: To evaluate the outcome (in terms of efficacy and safety) of local anesthesia for managing symptomatic inguinal hernia in a tertiary care hospital during current Covid-19 pandemic. Methodology: It was a descriptive study.60 males were enrolled with inguinal hernia of age 30-60 years. IV line was secured and local anesthesia was administered under aseptic measures. Lichtenstein repair, a mesh technique was applied in all patients for treating the inguinal hernia. Patients were evaluated postoperatively after 2 hours and 6 hours for any complications. Results: Mean age of the patients was 38.2±10.542, Mean time to eat was 3.85 ±3.138. Mean time to ambulate was 4.37 ±2.51. Mean pain score was 5.78± 2.131 postoperatively and after 6 hours it was 2.24 ±0.84. Indirect hernia was present in 74% patients whereas direct hernia was present in 26%. 6.67% patients had nausea/vomiting, 3.3% developed hematoma and 1.67% had wound infection. Conclusion: Local anesthesia is effective in all patients who have to undergo inguinal hernia surgery, in terms of efficacy and safety. Keywords: Inguinal hernia, Local anesthesia, Covid-19 pandemic.