INTRODUCTIONMalignant skin lesions have become increasingly prevalent over the past several years. In United States, approximately 5.4 million cases of non-melanoma skin cancers are treated in 2012.1 Skin cancer account for more than 40% of all malignancies. Majority of skin cancers are basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma which account for more than 95% of total skin malignancies. 1The incidence in males in Delhi for malignant melanoma is 0.29% and 0.90% for other skin cancers. The incidence ABSTRACT Background: Majority of skin cancers are basal cell carcinoma, Squamous cell carcinoma and Malignant melanoma which account for more than 95% of total skin malignancies. There is an increase in incidence in India over some 10 years of period. This study was done for analysing clinicopathological profile of skin malignancies and association of human papilloma virus (HPV) in skin malignancies in Himalayan Institute of Medical Sciences (HIMS, Uttarakhand, India. Methods: It was a retrospective study done on 101 patients having malignant skin lesions attending the Department of Surgery at HIMS from October 2005 to October 2008 and given their consent. Results: Out of 101 patients, 68 had squamous cell carcinoma, 21 had basal cell carcinoma and 10 had malignant melanoma, prevalence is high in men of lower socioeconomic status (M:F) 1.9:1. The mean age was 54.50 years. Most of the patients were laborers, farmers and factory workers. Ulcers and ulceroproliferative growth were common mode of presentation. Most commonly associated risk factor was exposure to sunlight, the commonest location of skin cancer was face and scalp. Wide local excision was the commonest done procedure with closure of primary defect by SSG, fasciocutaneous or cutaneous flaps. No HPV association was seen. Conclusions: Skin cancers are quite common and their incidence has increased in last few decades, in this study we found that skin cancer were more common in males of lower socioeconomic status, probable cause was increased sun exposure and chemical exposure, in respect to females. Cancer could manifest in many forms but ulcers quite common, Squamous cell carcinoma outnumbered basal cell carcinoma, Wide local excision with skin grafts was main stay of treatment.
Background: Anastomotic leak after intestinal surgery is one of the major reasons behind postoperative morbidity and mortality. This prospective study was undertaken to evaluate various risk factors for anastomotic leakage.Methods: This study was conducted in B.R.D. Medical College, Gorakhpur, Department of surgery from May 2015 to October 2016. Patients who underwent intestinal anastomosis in emergency settings or routine operation were included in this study. Total of 156 patients were included.Results: Anastomotic leak was observed in 16.02% cases and was higher in males and in patients from low socioeconomic status. However, age, sex, and socioeconomic status were not found to be significant risk factors for anastomotic leak. Leak rate was higher in patients suffering from chronic diseases such as malignancy; COPD, DM, and patients with chronic corticosteroid use. Leak rate was significantly high in malnourished patients and in cases having sepsis as shown by their blood investigation report. After logistic regression analysis it was observe that various independent predictors for anastomotic leakages are peritonitis (p<0.05; odds ratio 2.166), bowel obstructions (p<0.05; odds ratio 2.844), blood transfusion>2 u (p<0.05; odds ratio 2.354), S. Albumin <3.0 gm/di (p<0.001; odds ratio 8.873), corticosteroid therapy (p<0.001; odds ratio 4.857), serum creatinine >1.2 mg/dl (p<0.001; odds ratio 11.755), duration of surgery (>4 hrs) (p<0.01; odds ratio 3.0251) and ASA Grading (III&IV) (p<0.01; odds ratio 3.607).Conclusions: This study has identified the potential risk factors that affect the incidence of anastomotic leakage and the result of this study will be helpful in reducing the incidence of AL after surgeries.
BACKGROUNDIn spite of the advancement in medical technology, trauma remains a major health threat causing significant mortality and morbidity worldwide. The aim of this study was to evaluate the incidence and cause of the various abdominal injuries and compare the incidence, management, and outcome of blunt trauma and penetrating trauma abdominal injuries. METHODSTotal 99 patients who had visited the surgery department BRD Medical College, Gorakhpur, U. P., from April 2016 to March 2017 (one-year period) were included in this prospective study. Both blunt as well as penetrating trauma patients were included in the study. After recording a detailed history, all relevant laboratory and radiological investigations were done. Depending on the initial test reports, patients underwent either operative or conservative treatment. Postoperative complications, if any, were also recorded. RESULTSIn the present study, majority of patients were in 11-20 years age group. Male to female ratio was found to be 5:1. Blunt trauma is more common than penetrating trauma with a ratio of 3.7:1, and in penetrating trauma stab injury is more common than gunshot injury with a ratio of 3:1. In blunt trauma abdomen, road traffic accident was the most common mode of injury (57.7%) followe d by falling from a height (30.8%) and assault (10.2%). In penetrating trauma abdomen, assault is the most common mode of injury (81%) followed by a road traffic accident (9.5%). Pain abdomen was the most common symptom (100%) in both groups. Most of the patients were treated by conservative management in both groups. A low mortality rate was reported in the present study (3.3%). CONCLUSIONSAbdominal trauma is one of the major health hazards among the younger male population. The most common mode of abdominal trauma is road traffic accident in the blunt trauma group, whereas in the penetrating group, gunshot and stabbing were the most common causes of injury. Conservative therapy was the most common mode of treatment in both groups. No major organ injuries were seen during radiological investigations. HOW TO CITE THIS ARTICLE: Singh UC. Jina A. Abdominal injury and its outcome-a prospective study in a tertiary health care center.
BACKGROUND Breast is modified sebaceous gland. It is an organ of female beauty and pride. From puberty to death, the breast is subjected to constant physical and physiological alterations that are related to menses, pregnancy and menopause. The breast problem could be as simple as breast abscess to as ominous as cancer. Both benign and malignant diseases occur in men and women of all ages but benign lesion tend to occur more commonly at younger age than cancer. Benign breast diseases (BBD) are common with estimate of over half of the female population at some times in life seeking medical advice for breast problem. This prospective study was done on patients attending OPD for breast complaints in 1 year period, to do the risk factors assessment & clinical analysis of patients presented with breast complaints. MATERIALS AND METHODS Total 200 patients who have attended OPD with breast related complaints and given consent for study, were studied in a period of 1 year duration from at Nehru Hospital, B.R.D Medical College, Gorakhpur. RESULTS Benign breast diseases are more common in the population than malignant one, Fibroadenoma, Breast abscesses and Fibrocystic disease and ANDI are the most common cause of mass seen in middle ages. Malignant lesion of the breast is major concern and the second most commonly diagnosed cancer in our region as seen in study. Incidence is high in western industrialized countries and relatively low in developing countries in Asia and other parts of the world, predisposing factors for BBD are age, sex, race, inverted nipple, retracted nipple, cracked nipple, improper feeding due to lack of knowledge about breast-feeding and endogenous hormonal factors.
Background: Various factors have been identified as influencing factors of breast cancer. The free radicals can cause increased oxidative stress by negatively affecting the body’s nucleic acids, lipids and proteins leading to various illnesses including cancer. Therefore, this study was aimed at discovering the progress of treatment of breast carcinoma by exploring the connections of the disease with free radical injury.Methods: The present study was conducted among 30 breast carcinoma patients received in the surgery department of BRD Medical College Gorakhpur. Determination of the levels superoxide dismutase (SOD) (the procedure of photoluminescence), catalase (method of Cavarochi) and the lipid peroxidise was done. The results were presented as mean and standard error (SE). P value of <0.05 was considered as statistically significant.Results: Among the total participants, 73% patients had infiltrating ductal carcinoma and 27% patients had intraductal carcinoma. The dismutase levels showed an increase in the post-operative patients for both the groups. The catalase levels and the lipid peroxide levels showed a reduction in the postoperative patients (p<0.05).Conclusions: The present study result showed that the low amounts of SOD and catalase may not be sufficient to detoxify high amounts of free radicals. The administration of catalase could help in reducing the symptoms. Though, low amounts of SOD and catalase may not be sufficient to detoxify high amounts of free radicals. The administration of enzymes could help in the treatment of breast cancer patients.
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