Delineation of IOZ by ictal-MEG helped convert DRE patients unsuitable for surgery or planned for phase II monitoring into candidates suitable for surgery, even ECoG-guided resections, and resulted in favorable outcomes in those who were operated.
Background and Aims:
We aim to study the significance of intraoperative hyperlactatemia in reconstructive oncoplastic surgery.
Material and Methods:
A retrospective observational study was conducted on a cohort of patients who underwent reconstructive oncoplastic surgery with free flap for oral cancer over a 6-month period. The study population was divided into two groups based on peak lactate levels. Group N with peak lactate level less than 2 mmol/L and Group H peak lactate level more than 2 mmol/L. The various parameter studied were patient's comorbidities; intraoperative events (vasopressor requirement, blood transfusion, and duration of surgery); postoperative parameters including the need for re- exploration and duration of stay in hospital and intensive care unit.
Results:
The study demonstrates that intraoperative rise of lactate was not influenced by comorbidities. None of the intraoperative parameters studied influenced the lactate levels. Baseline lactate level was found to correlate with peak lactate level intraoperatively. But it was observed that there was normalization of lactate level within 24 hours postoperatively in both the groups. There was no difference in outcome parameters in the two groups.
Conclusion:
Intraoperative hyperlactatemia is not a significant prognostic factor for outcome in oncoplastic reconstructive surgery.
The present investigation conducted in the Reasi district of J&K state during the year 2015 has observed that the sample holding under study area comprise maize-wheat cropping system. By using Cobb-Douglas production function it is predicted that resource used in maize and wheat production like human labour, farmyard manure + fertilizer are underutilized indicating that there is further scope to increase their quantity which in turn will boost the returns. On the basis of regression analysis the value of regression coefficient of wheat for human labour, seed, FYM, urea, DAP and plant protection measures was 0.859,-0.321, 0.002, 0.067, 0.009 and 0.004 and for maize it was 0.522,-0.046, 0.095, 0.046, 0.016 and-0.015, respectively, which were found to be statistically significant. The positive sign indicated that one percent increase in the use of these inputs could increase the returns from crop. The negative sign shows that one percent additional expenditure on these inputs would reduce the return of crops. The marginal value productivity of farmyard manure and human labour of dry land wheat was positive and it was 0.312 and 1.231, respectively. This indicates that there still existed a scope to invest more on farmyard manure and human labour. The negative marginal value productivity estimated for seed at `-5.150 showed that use of seed was more than optimum leading to fall in returns with each additional unit of this input. As far as maize is concerned, positive marginal value productivity of FYM, human labour, urea, DAP and pesticide indicates that there still existed a scope to invest more on these inputs. The negative marginal value productivity estimated for seed at `-1.192 showed that use of seed was more than optimum leading to fall in returns with each additional unit of this input. The crop production function for wheat and maize with R 2 value at 0.74 and 0.87, respectively was statistically significant meaning thereby that 74% of wheat and 87% of maize production of this area was being explained by the mentioned variables in the study.
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