HighlightsSurgical diagnosis of conditions causing acute abdominal pain in situs inversus is complicated by the mirror image anatomy.Chest X-ray and Ultrasonography abdomen can be helpful in diagnosing this condition.Laparoscopic cholecystectomy in situs inversus is problematic for right handed surgeons.We describe a modified 4 port configuration where right handed surgeons can use the left mid-clavicular port for dissection.
Background A sudden emergence of global pandemic due to SARS- Cov -2 has changed the scenario of
management of non COVID diseases. With very high infectivity rate and stormy course, this disease has
made the lives of people miserable so with the health care facilities and treatment. All the medical fraternities are in the state of
confusion that how to treat or not to treat the patients of illness other than the corona virus infection. We are sharing our
experience of cardiac surgery at our tertiary center in lockdown and unlockdown period. Material And Method This is a
retrospective study from April 2020 to November 2020. We have operated upon 232 cases in this duration. Results Out of 232
cases – Overall mortality –26, Post covid operated – 4, Number of covid positive after surgery – 3, Post covid mortality – 1
Conclusion Use of N95 mask, PPE kit or HIV KIT, with regular sanitization of hands have made possible to perform cardiac
surgery in this difcult situation on the patients of cardiac illness which usually cannot wait longer.
Metaplastic breast carcinoma is very rare neoplasm. Authors report a case of metaplastic breast carcinoma containing characteristic features of infiltrating ductal carcinoma and chondrosarcoma. A 62-year-old female presented with complaint of a lump in the right breast for the last 2 years. FNAC was suggestive of mucinous tumour. Tru-cut biopsy had been performed outside the institution, which was suggestive of a Ductal carcinoma with mucinous component. Modified radical mastectomy of the right breast was performed and histopathology was suggestive of infiltrating ductal carcinoma and chondrosarcoma of the right breast. All resected lymph nodes were free of metastasis. Immunohistochemistry was suggestive of a metaplastic carcinoma with components of ductal carcinoma and chondrosarcoma with moderately positive ER, negative PR, positive Pancytokeratin in ductal carcinoma component, positive S-100 and KI-67.
Background: Thymectomy for widespread Myasthenia gravis may be associated with a turbulent
postoperative course especially if preoperative circulating acetylcholine receptor autoantibody levels
are towering. Plasmapheresis remove these antibodies. The aim of this study was to explore the results of preoperative
Plamapheresis on postoperative course after thymectomy. Material And Method This is a retrospective study at tertiary care
center where 13 patients of myasthenia gravis were operated in 3 year duration (2017-2020). All patients had undergone 2
cycles of plasmapheresis before surgery. Result was evaluated postoperatively in ICU, at the time of discharge, and at follow up
after 7 days, 1 month and 6 month in terms of weaning from ventilator, ICU stay, level of autoantibodies and length of hospital
stay, improvement in symptoms, and mortality. Results Out of 13 patients 5 (38.46%) were male and 8 (61.54%) were female in
the age range of 20 to 60 years. 6 (46.15%) were in stage IIA and 7 (53.85%) in stage IIB. Preoperative autoantibody levels were in
the range of 30-50 nmol/ml. Almost total thymectomy was done in all patients. Patients were extubated with in 4-6 hrs after
surgery and there was no mortality. Patients were discharged at postoperative day 4-7. Conclusion The study shows that
preoperative use of plasmapheresis to reduce the autoantibody level is associated with an early extubation, early discharge
and less complication after thymectomy.
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