Introduction: Diseases of the thyroid gland are common and comprise a spectrum of entities causing systemic disease or a localized abnormality in the thyroid gland such as nodular enlargement or a tumor mass. Thyroid cancer is a relatively rare malignancy, but it is the commonest endocrine cancer accounting for 92% of all endocrine malignancies. The aim of this study was to describe the pattern of thyroid malignancies in thyroidectomy specimens. The thyroid diseases were classified on histological grounds into non-neoplastic and neoplastic lesions that were further subclassified as benign and malignant as per the WHO histological classification of thyroid tumors.Results: A total of 282 thyroid specimens were received during this study period. Neoplastic lesions were found in 204 cases (72.34%). 78.92% cases were females and 21.08% cases were males with a female: male ratio of 3.75:1. Out of 204 neoplastic lesions, 55 cases were benign accounting for 26.96% of neoplastic lesions. The age of the studied benign thyroid neoplastic lesions ranged from 9 years to 65 years with a mean age 38.11 years and the relative peak age of incidence was seen in 40-49 years age group (29.09%). Malignant thyroid lesions accounted for 72.55% (n=148) of all neoplastic lesions. The age of the studied malignant thyroid neoplastic lesions ranged from 9 years to 74 years with relative peak age of incidence between 20-29 years of age followed by 30-39 years age group. One case was diagnosed as well differentiated tumor of unknown malignant potential (WDT-UMP). Papillary carcinoma was the commonest malignant tumor seen in 85.14% (n=126) of all malignant lesions. Follicular adenoma was most common benign neoplasm. Conclusion:Papillary carcinoma was the commonest malignant lesion while as follicular adenoma was the commonest benign adenoma.
Background: Testicular and paratesticular neoplasia are rare type of tumors affecting adolescents and young adults in India, as observed by paucity of published data. This study was undertaken to analyze the patterns of testicular tumors at a tertiary level hospital in Kashmir valley, Jammu and Kashmir, India highlighting the patient’s demography, clinical presentation, diagnostic evaluation and pathological finding.Methods: This 5-year (retrospective and prospective) study was performed in the Department of Pathology, Government Medical College Srinagar, Jammu and Kashmir, India from January 2012 to December 2016. For the retrospective study, all cases of testicular tumors, their histopathological reports and required clinical details were searched from records maintained in the Department of Pathology, GMC Srinagar, Jammu and Kashmir, India. For the prospective study, the orchiedectomy specimens received in our department were subjected to routine histopathological processing followed by a detailed gross and microscopic examination. Tumour typing and subtyping was done according to WHO classification (2004).Results: A total of 37 cases of testicular and paratesticular neoplasia were included in present study with a mean age of 35.1 years. Out of these 37 cases, 31 (83.78%) were malignant and 6 cases (16.22%) were benign. Right testis was affected in 70.3% of cases. The most common clinical presentation was scrotal swelling. Germ cell tumor was the most common type accounting for 89.2% of tumors followed by lymphomas (8.1%).Conclusions:It is concluded that despite new techniques in imaging and tumor marker assay, the diagnosis of testicular tumors is dependent upon histopathological examination. The present study fairly provides an insight into the clinical presentations, prevalence and patterns of testicular tumors.
Objective: To study the outcome of laparoscopic cholecystectomy at the time of cesarean section. Materials and methods: Eight patients were subjected to laparoscopic cholecystectomy at the time of cesarean section. All of them were diagnosed with cholelithiasis at the first antenatal scan. Laparoscopic cholecystectomy was performed by a standard technique, after assessing the anatomy via the cesarean wound. Results: Laparoscopic cholecystectomy was combined with lower segment cesarean section (LSCS) under general anesthesia in all patients. Surgeries were completed in a mean operating time of 82 minutes. There were no intraoperative or major postoperative complications. No extra antibiotics or analgesics doses were needed. Patients were discharged on the third and the fourth postoperative day. Conclusion:A combination approach of laparoscopic cholecystectomy at the time of LSCS confers the benefits of minimal access for gallstone disease apart from being safe, effective, and well accepted. With an additional small port site incision, single anesthesia, and single hospital stay, the combined procedure confers valuable advantages in terms of time, hospital stay, cost, and convenience. It also prevents the possibility of developing acute cholecystitis while the patient is waiting for cholecystectomy apart from avoiding the separation of mother from newborn entailed by reoperation.
Introduction:Postoperative pain relief is of paramount importance in any surgery.Objective: To compare the effect of local infiltration of bupivacaine versus placebo for post-operative pain relief following inguinal hernioplasty. Materials and Methods:Ours was a prospective randomized controlled trial conducted on 120 patients undergoing elective Lichtenstein hernioplasty. Patients were divided into two groups of 60 each. One group received local infiltration with 10 mL bupivacaine 0.25% below the external oblique aponeurosis and 15 mL bupivacaine 0.25% subcutaneously after completion of the surgical procedure. The other group received an equal amount of normal saline infiltrated in the similar manner. Visual Analogue Scale measured the pain. Results:The baseline parameters were similar in both the groups. Postoperative pain was significantly decreased in patients receiving bupivacaine (p < 0.05). Mean time to first request for rescue analgesic was increased from 245 + 19.42 minutes to 472 + 19.42 minutes (p < 0.05). The consumption of supplementary analgesics during the 24-hour study period reduced from a mean of 2.8 + 0.12 to 1.7 + 0.09 doses in bupivacaine group (p < 0.05). Conclusion:Local infiltration of bupivacaine is an effective modality for post-operative pain relief in inguinal hernioplasty.
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