Giant Cell Tumor of Tendon Sheath (GCTTS) is the second most common benign tumour affecting hand after ganglion. The tumor generally affects individuals between the age of 30 and 50 years, and is found more often in women than men. The etiological factors responsible for GCTTS are unclear. Some authors consider it as an inflammatory process arising as a consequence of chronic antigenic stimulation. Local excision with or without radiotherapy is the treatment of choice. We recently encountered two cases of Giant cell tumor involving tendon sheath of ring finger in one case and thumb in another case. Both were managed surgically with good results. There has been no evidence of recurrence till date in the follow up varying from 3-6 months.
INTRODUCTIONGallstones (GS) are a common occurrence in India. As many as 16% and 29% of women above the age of 40-49 years and 50-59 years, respectively, had gall stones.1 For every patient with symptomatic gallstone disease (GSD) there are many more with asymptomatic gallstones. Various studies performed on mortals suggest that most of the gallstones are asymptomatic. In a study of 9,332 post-mortem reports performed over 10 years, only 14% of those with GS had undergone cholecystectomy, indicating that up to 86% were asymptomatic. Karl langenbuch in 1882 quoted. "The gallbladder should be ABSTRACT Background: Gallstones are common in Indian population and its treatment has shown a decisive shift from open to minimally invasive route. There is no doubt that laparoscopy require longer and steeper learning curve and higher cost, especially in the absence of health insurance to majority of suburban and rural Indian population. However, preferences of patients are changing rapidly due to better level of awareness and availability of healthcare facility. Aims was to study safety and efficacy of laparoscopic cholecystectomy in patients of cholelithiasis by comparing with results of mini laparotomy cholecystectomy by comparing use of post-operative analgesia, operative Time, postoperative hospital stay, morbidity and mortality. Methods: It is a prospective randomized study of 100 Patients of cholelithiasis aged between 25 years to 65 years operated during 2016-2017 at Dr. D Y Patil medical college Pune. They were divided into mini laparotomy and laparoscopic cholecystectomy group by draw a lot method. Patient's written valid informed consent for the particular procedure was taken and the pros and cons of both the procedure were explained in detail to the patient. This study was done after due clearance of ethical committee. Results: The median (range) operation time for laparoscopic cholecystectomy was 50-175 min (mean=103.98 min) and 35-95 min (mean=70 min) for mini laparotomy cholecystectomy (p<0.001). During the study period operation time for laparoscopic cholecystectomy showed a tendency to become shorter. The use of Injectable analgesics in case of laparoscopic cholecystectomy (Mean no. of days=1.5) is considerably less than mini laparotomy cholecystectomy (Mean no. of days=3.36). Conversion rate in literature in laparoscopic cholecystectomy ranges from 3% to 15% in well trained hands. In our series it is 6% in spite of being a teaching and training institution. Conclusions: Minimally invasive surgery is better than mini laparotomy cholecystectomy in terms of post-operative pain, analgesic requirement and early return to work. However, mini laparotomy cholecystectomy is preferred method for Surgeons in the beginning of their career and in case of difficult cholecystectomy.
Bilateral Breast Carcinoma (BBC) is a rare entity with incidence of synchronous carcinoma being 2-5% of all breast malignancies, which is much less than metachronous carcinoma. Synchronicity/metachronicity are usually associated with local and lymphatic spread and with blood-borne spread to lungs, bones and liver. Moreover, BBC are mostly lobular carcinomas but we report a rare case of Infiltrating Ductal Carcinoma (IDC), medullary type as the primary carcinoma. 56-year-old female who presented with a lump in her right breast for 6 months and lump in her left axilla. There was no e/o palpable lump in her left breast. Trucut biopsy was taken from both the lumps and was s/o infiltrating ductal carcinoma. Different histological subtypes with different grades of tumour in both breasts suggested synchronous primary tumours. Early detection of the contralateral tumour is of utmost importance emphasizing the significance of breast self-examination. Screening tools like MRI have a greater sensitivity compared to Mammography. There are no clear treatment guidelines for bilateral breast cancer. Patients are often treated with bilateral mastectomy, with breast conservative surgery having unclear importance. Meticulous diagnosis and appropriate management help to improve the longevity with an improved quality of life.
We report four cases who were referred to Dr. D. Y. Patil Medical Hospital, Pune suffering from abdominal pain and gastrointestinal manifestations. The patients' history was unremarkable, except that they had contact with dogs and live in rural communities. Laboratory findings showed peripheral blood eosinophilia, leukocytosis, and elevated liver enzymes. Ultrasonography showed well-circumscribed cystic masses in the liver. Diagnosis of hydatid cysts was confirmed by computed tomography (CT). Surgical treatment was performed and all patients recovered well. The results of these cases support the nation that CT scan can led to increased clarity, regarding surgical management, because of discordance between radiographic and laboratory findings.
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