Neurilemmomas constitute one of the most common tumors of peripheral nerves. Rarer amongst them is their occurrence in median nerve in the region of arm. A sixteen-year-old female presented with painless mass in right arm which was non-tender on palpation with positive Tinel's sign and no motor or sensory deficit in the affected arm. Ultrasound examination revealed an eccentrically arising mass of size 19 × 11 mm along median nerve. MRI study revealed a mass homogenously isointense on T1 weighted images and hyperintense in T2 weighted images placed eccentrically in relation to median nerve in arm. Excisional biopsy under loupe magnification was carried out which revealed the mass to be neurilemmoma. This slowly growing benign tumor of peripheral nerves with an incidence of 5% with 14% involvement of Median nerve can be enucleated from the nerve with little or no damage. In spite of advanced imaging studies the mass cannot be differentiated preoperatively from another peripheral nerve sheath tumor neurofibroma. Both these tumors although bearing some clinical and imaging resemblance carry different intraoperative findings, histopathological features and post-operative results.
Elderly patients are usually sicker in terms of comorbidities than the younger population. However, age does not seem to represent a risk of surgical complications after bariatric surgery.
Surgical site infection due to biofilm formation is a common clinical complication in post-operative patients. Surgical site infection is the main complication in the case of gastrointestinal (appendectomy, genitourinary), colorectal, vaginal or abdominal hysterectomy, Caesarean section, abortion, traumatic wound and ophthalmic surgeries. Hence, the main aim of this study was to prepare antibacterial suture materials to prevent the biofilm formation. Surface characterization of drug-coated sutures was chemically analysed by Fourier transform infrared spectroscopy. Antibacterial activity of drug-coated sutures was analysed qualitatively (Agar diffusion test) and quantitatively (bacterial adherence test). Persistence of drugs in the sutures after the elution period was analysed by serial plate transfer test. Fourier transform infrared spectroscopy analysis showed two peak values for drugs (1450.52 and 2870.17). Largest inhibition zone for Staphylococcus aureus (39 mm) was reported; quantitative analysis confirmed significant reduction (p < 0.05) of adhered bacteria in drug-carrier-coated sutures than that of carrier-coated sutures (p > 0.05). Serial plate transfer test indicated the persistence of drug after 5 weeks. In conclusion, the antimicrobial activity and persistence property of these drug-eluting silk sutures could be of great interest for the prevention of surgical site infections.
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