Despite advances in management of breast cancer, etiology is still elusive. Diet, obesity and other life style factors have been implicated in its etiology. We assessed the role of obesity and HDL-C levels in patients with rural background in etiology of breast cancer. To know the relation between obesity and incidence of breast cancer in local population. Also to know serum HDL-C level in breast cancer and its correlation with breast cancer. A nested pilot study of 50 breast cancer patients was done and matched with 50 healthy women as controls.
Background: Despite advances in modern technology accurate diagnosis of cause of cervical lymphadenopathy remains a challenge. It leads to substantial morbidity to patients and sometimes even mortality. Uncertainty in diagnosis can lead to wrong diagnosis and increases cost of treatment. The objective of the study was to conduct a detailed evaluation of cervical lymphadenopathy in tertiary care set up and to enumerate the causes so that appropriate and adequate treatment can be initiated to reduce the morbidity.Methods: A prospective study was carried out on 100 patients of cervical lymphadenopathy and were evaluated clinically. Detailed history was taken of every patient followed by physical examination and appropriate investigations. This was followed by disease specific treatment and surgical intervention wherever necessary. Patient data was collected and evaluated to draw conclusions.Results: Most patients were young (between 12-40 years). Most common cause for cervical lymphadenopathy is due to non-neoplastic (82%) and less commonly from neoplastic (18 %). In non-neoplastic causes most, common cause is due to tuberculosis (51 %). In neoplastic causes, most common cause is due to lymphoma (10 %). In tubercular lymphadenitis the posterior triangle group was the most commonly involved group of cervical lymph nodes (31.3%), followed by upper jugular group (21.5%). FNAC by virtue of it being inexpensive, quick in getting the results and easy to perform, is one of the important and essential diagnostic procedure. Surgery should be to diagnostic biopsy, for treatment of abscess/sinuses and for a lymph node that do not resolve with chemotherapy and as an adjuvant to chemotherapy.Conclusions: Cervical lymphadenopathy can have varied manifestation from non-neoplastic to neoplastic condition. Proper history examination and relevant investigations and disease specific treatment can only cure the patient and improve the prognosis.
The advantages of laparoscopic cholecystectomy over open cholecystectomy are earlier return to bowel functions, less postoperative pain, better cosmetic outcome, shorter length of hospital stay, earlier return to full activity, and decreased overall cost. Laparoscopic cholecystectomy is associated with better preservation of ABSTRACT Background: Cholelithiasis is the most common biliary pathology. Gallstones are present in 10 to 15% of the general population and asymptomatic in the majority (>80%). The prevalence of gallstone varies widely in different parts of the world. In India it is estimated to be around 4%. Since laparoscopic cholecystectomy is the most common procedure done now days we undertook a study to evaluate factors determining difficult laparoscopic cholecystectomy. The objective of the study was to evaluate preoperative data that can serve as predictors of difficult laparoscopic cholecystectomy and help in planning of surgery. Methods: Patients presenting with upper abdominal discomfort and sonographically confirmed cholelithisis were studied in terms of several clinical factors and scoring system was devised. Based on scoring system patients were categorised and evaluated post operatively. Results: In present study prior history of hospitalisation (p<0.001), previous abdominal surgeries (p<0.01), palpable gall bladder (p<0.01), BMI >27.5 (p<0.01), thickened GB wall (p<0.001) were found to be significant predictors of difficult laparoscopic cholecystectomy. Remaining parameters like age, sex, impacted stone and pericholecystic collection were not found significant predictors of difficult laparoscopic cholecystectomy. Conclusions: Difficult laparoscopic cholecystectomy can be predicted preoperatively based on parameters used in the study. Knowledge of these factors for difficult laparoscopic cholecystectomy could help surgeons during preoperative assessment and improve the informed consent.
Gastrointestinal stromal tumour (GIST) is a rare tumour of gastrointestinal tract, comprising of 0.1-3.0% of all gastrointestinal malignancies. They are commonly found in stomach (60-70%), very rarely in rectum and anal canal (<5%). The present case report is of a large anorectal leiomyoma (142×80mm) arising from posterior rectal wall, with its unusual presentation of urinary retention. In our case, in view of its massive size, recurrence and malignant transformation, we planned abdominoperineal resection. Although size and histological grade play an important role, complete resection still is considered the most significant favorable prognostic factor.
Background: Chronic non-healing leg ulcers are a major health problem worldwide and have great impact on personal, professional and social levels, with high cost in terms of human and material resources. The present study was conducted with an aim to demonstrate the efficacy of autologous platelet rich plasma (PRP) in chronic non-healing leg ulcers in comparison to conventional dressings.Methods: A total of 50 patients with leg ulcers were randomized into two groups (A and B) with each group comprising of 25 patients each. Group A were treated with autologous platelet rich plasma (PRP) dressings and group B were treated with conventional dressings using normal saline. Ulcer measurements were taken on day 1, day 7, days 15 and after 30 days. The end point of study was complete wound epithelialization or appearance of granulation tissue, which ultimately lead to spilt skin grafting or secondary healing; whichever is earlier.Results: There was statistically significant difference in the average time taken for complete healing of ulcer in PRP dressings, 3.68 weeks against 6.2 weeks in conventional dressing group (p value <0.0001). PRP dressing group showed a 43.96% reduction in ulcer size as compared to 13.81% in conventional dressing group (p <0.0001). It was observed that PRP dressing group has faster wound healing and contraction of wound.Conclusions: PRP dressing of leg ulcers was better than conventional normal saline dressing as it leads to early reduction of ulcer size and enhances rate of wound healing.
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