bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Amniotic Membrane Dressing Compared to Banana Leaves Dressing in Management of Partial Thickness Burn Wounds
Authors:   Professor and HOD,Department of Surgery, Vilasrao Deshmukh Government Institute of Medical Sciences, Latur, Maharashtra 413512 India., Jamdade Pundlik T , Jawale Rajesh Dnyaneshwar ,   Senior Resident, Department of Surgery, Vilasrao Deshmukh Government Institute of Medical Sciences, Latur, Maharashtra 413512 India., Chawada Meghraj J ,   Associate Professor, Department of Surgery, Vilasrao Deshmukh Government Institute of Medical Sciences, Latur, Maharashtra 413512 India., Deshmukh Sudhir B ,   Dean and Professor, Department of Surgery, Vilasrao Deshmukh Government Institute of Medical Sciences, Latur, Maharashtra 413512 India.
Published: January 2024

Context: Morbidity and mortality are higher for burn injuries in low- and middle-income countries. The treatment should be effective and cost-effective also for patients from these countries. Aims: To compare the outcome of Amniotic Membrane Dressing and Banana Leaves Dressing, in terms of pain during dressing change, comfort, recovery, hospital stay, complications and future need of skin grafting among partial thickness burn patients in Tertiary care centre Settings and design: Hospital based comparative study was carried out at Burn care unit of Tertiary care hospital of VilasraoDeshmukh Govt. Institute of Medical Sciences,Latur, Maharashtra, India. Methods and material: Hospital based comparative study was conducted among 50 cases with partial thickness burns. They were assigned in equal number of 25 each. One group received amniotic membrane dressing (AMD) while the other received banana leaf dressing (BLD). Statistical analysis: Mean scores of two group were compared with the help of independent t test. P value < 0.05 was considered as significant. Results: Most common cause of partial thickness burn was scalds contributing (42%). Total burn surface (TBSA) area was 16%-30% in 60% of cases. Both groups were comparable for age, sex and TBSA. Patients in AMD group had significantly less scores of pain during dressing removal, discomfort and significantly more scores for ease of dressing removal and less number of days for healing (p<0.05). Signs of infection and need for skin grafting was comparable in two groups. Conclusion: This study proved superiority of Amniotic Membrane Dressing (AMD) over Banana Leaves Dressing (BLD). Key messages: Amniotic Membrane Dressing should be used among partial thickness burn patients for good results Keywords: Effectiveness; Dressing; Amniotic membrane; Banana leaves; Burns.
Choledochal Cyst Excision and Preferred Anastamosis for Biliary Reconstruction in our Institution: A Retrospective Study
Authors:   Associate Professors, Department of Paediatric Surgery, Tirunelveli Medical College and Hospital, Tirunelveli 627011, Tamilnadu, India., Ayyanar Ravikumar , Narasimhan Venkatesa Mohan ,   Associate Professors, Department of Paediatric Surgery, Theni Medical College and Hospital, Theni, Madurai 625706, Tamilnadu, India., Mosessundaram HarisVijila Rani ,   Associate Professors, Department of Paediatric Surgery, Vellore Medical College and Hospital, Vellore 632002, Tamilnadu, India., Nallan Karuppasamy ,   Associate professor, department of paediatric surgery, madurai medical college and govt Rajaji Hospital, Madurai-625020, Tamilnadu, India., Chandrasekaran Aravindan ,   Assistant professor, department of paediatric surgery, Madurai Medical College and Govt Rajaji Hospital, Madurai-625020, Tamilnadu, India., Rajagopal Srinivasakumar ,   Assistant professor, department of paediatric surgery, Madurai Medical College and Govt Rajaji Hospital, Madurai-625020, Tamilnadu, India., Ganesan Selvakumar ,   Assistant professor, department of paediatric surgery, Madurai Medical College and Govt Rajaji Hospital, Madurai-625020, Tamilnadu, India., Pandian Praveen ,   Assistant professor, department of paediatric surgery, Madurai Medical College and Govt Rajaji Hospital, Madurai-625020, Tamilnadu, India., Palanisamy Jayakumar ,   Resident, Department of Paediatric Surgery, Madurai Medical College and Govt Rajaji Hospital, Madurai-625020, Tamilnadu, India.
Published: January 2024

Aim and Backround: To find out the common anastomosis done following choledochal cyst(CC) excision in our institution. Material and Methods: A retrospective study in patients operated for choledochal cyst excision done at our institution was done for a period of 10 years. Results: Total 41 patients operated for choledochal cyst excision. Hepatico-duodenostomy (HD) was the common anastomosis done in our patients. Conclusion: HD was the common preferred anastomosis done in our institution.
Various Foreign Bodies Causing Bladder Stones in Females: The Lessons Learnt
Authors:   Urologist and Assistant Professor,  Department of General Surgery, SMBT Institute of Medical Sciences & Research Centre, Dhamangaon, Ghoti, Taluka - Igatpuri, Nashik, Maharashtra 422403, India., Dhangar Sanjay P , Shenage Vinayak J ,   Assistant professor, Department of General Surgery, SMBT Institute of Medical Sciences & Research Centre, Dhamangaon, Ghoti, Taluka - Igatpuri, Nashik, Maharashtra 422403, India., Shengal Manisha ,   Resident Medical Officer, Department of General Surgery, SMBT Institute of Medical Sciences & Research Centre, Dhamangaon, Ghoti, Taluka - Igatpuri, Nashik, Maharashtra 422403, India.
Published: January 2024

Background: Bladder stones are common in males but not so common in females. They account for nearly 5% of the urinary system stone disease. We here share our journey of bladder calculi in female patients and will let you know various foreign bodies that can cause bladder calculus, various treatment modalities that exist to treat them and the lessons that we learnt. Methods: We did a retrospective study from August 2016 to July 2020 at SMBT IMS & RC, Nashik. A total nine patients were included out of the total twentythree bladder stone patients. Diagnostic investigations included X-ray of kidney, ureter and bladder region, ultrasonography of abdomen and pelvis, computed tomography and if needed, cystoscopy before every planned surgical procedure. Results: Nine patients of complicated bladder stone with or without foreign body were treated in the study. Two patients required open surgery. Six patients underwent per urethral cystolithotripsy for their stones and one patient underwent suprapubic percutaneous cystolithotripsy. Psychiatric evaluation was done for one patient. Clean intermittent catheterisation was advised for the neurogenic bladder patient. Conclusion: To find and treat a bladder stone in a female patient is much easy as compared to find out the cause of that stone. The reason being the rarity of bladder calculus in females, more so the secondary calculus. Therefore, whenever you find a bladder calculus in female patient you should find out the cause by taking prior proper history, doing proper clinical examination, ordering relevant investigations and treating them as per the current strategies. Keywords: Bladder calculus females; Foreign body; Calculus over foreign body; Giant bladder calculus; Fragmented D J stent.
Perforating Pilomatrixoma of The Male Breast, A Rare Lesion Simulating Breast Cancer: A Case Report
Authors:   Associate professor, Department of General Surgery,S Nijalingappa Medical College & Hanagal Shree Kumareshwar Hospital & Research Centre, Bagalkot 587103, Karnataka, India., Teli Bhavuray , Mallapur Ashok ,   Professor and Dean, Department of General Surgery, S Nijalingappa Medical College & Hanagal Shree Kumareshwar Hospital & Research Centre, Bagalkot 587103, Karnataka, India., M Yashaswini ,   Post graduate student, Department of General Surgery, S Nijalingappa Medical College & Hanagal Shree Kumareshwar Hospital & Research Centre, Bagalkot 587103, Karnataka, India., G Vishwanath ,   Professor, Department of General Surgery, 6Professor, Department of Obstetrics and Gynecology, S Nijalingappa Medical College & Hanagal Shree Kumareshwar Hospital & Research Centre, Bagalkot 587103, Karnataka, India., Chinnapur Sandeep ,   Associate professor, Department of General Surgery,S Nijalingappa Medical College & Hanagal Shree Kumareshwar Hospital & Research Centre, Bagalkot 587103, Karnataka, India., Katageri Geetanjali M ,   rofessor, Department of Obstetrics and Gynecology, S Nijalingappa Medical College & Hanagal Shree Kumareshwar Hospital & Research Centre, Bagalkot 587103, Karnataka, India.
Published: January 2024

Pilomatrixoma is a rare benign skin appendage tumor of hair matrix origin. It is commonly seen in the first two decades of life, most often presenting on the face, neck or upper extremities. Pilomatrixoma of the breast is uncommon, and can mimic breast malignancy. Male breast Pilomatrixomas an extremely rare entity with only 9 cases reported in English literature. We report a rare presentation of perforating Pilomatrixoma of the breast in a male patient aged 35 years.
Novel Approach to Open Onlay Meshplasty for Ventral Hernia Rep
Authors:   Associate professor, General Surgery, MP Shah medical college, Jamnagar, Gujarat 361008, India., Pathak Aasit L , Khamar Suhan ,   Senior Resident, General Surgery, MP Shah medical college, Jamnagar, Gujarat 361008, India., Bagtharia Jay ,   Senior Resident, General Surgery, MP Shah medical college, Jamnagar, Gujarat 361008, India., Vaja Yagnik ,   Third year Resident,General Surgery, MP Shah medical college, Jamnagar, Gujarat 361008, India., Santhosh Abhishek ,   First Year Resident, General Surgery, MP Shah medical college, Jamnagar, Gujarat 361008, India.
Published: January 2024

Background and Objectives: Hernia is defined as abnormal protrusion of viscus through a normal or abnormal weakness in the wall of its containing cavity. Ventral Hernias are second most common type of hernias accounting for 21 to 35% of all verities of hernias. Reported incidence of Incisional hernias is 2 to 11%. It is the most common complication after laparotomy by a 2:1 ratio over bowel obstruction and is most common indication for reoperation by 3:1 ratio over adhesive small bowel obstruction. This study was under taken to study the various clinical presentation and management of ventral hernias. Materials and Methods: 300 cases of ventral hernias admitted to department of surgery Guru Gobind Singh hospital Jamnagar between periods of October 2010 to March 2021 were chosen for study. Data was collected including detailed history, clinical examination and investigation. Data was tabulated, analyzed and results interpreted.
Injection Sclerotherapy with 3% Polidocanol in 1st and 2nd degree Internal Haemorrhoids – A Prospective Study
Authors:   Associate Professor, Department of General Surgery,Basaveshwara Medical College & Hospital, Chitradurga 577501, Karnataka, India., Kadli Suresh U , BV Sharath ,   Professor & Head,Department of General Surgery,Basaveshwara Medical College & Hospital, Chitradurga 577501, Karnataka, India., NS Soumya ,   Assistant Professor, Department of General Medicine, Basaveshwara Medical College & Hospital, Chitradurga 577501, Karnataka, India., SV Manjunath Rao ,   Professor & Head, Department of ENT, Basaveshwara Medical College & Hospital, Chitradurga 577501, Karnataka, India., Jain Rahul ,   Post graduate, Department of General Surgery, Basaveshwara Medical College & Hospital, Chitradurga 577501, Karnataka, India.
Published: January 2024

Internal Haemorrhoids has been the most common disease since ages and wide variety of treatment modalities available make it an equally enigmatic disease to approach. Polidocanol is the recent sclerosants in the surgeon’s armamentarium for its treatment. This prospective study included 86 patients with first or second degree internal haemorrhoids. Internal haemorrhoids had sexual predilection towards males in our study in the ratio of 2:1 with a age range of 24-68 yrs. Sixty-one of 86 patients had first degree haemorrhoids and the rest 25 had second degree. Bleeding P/R was the most common complaint followed by constipation and perianal discomfort. Response to first dose of 3% polidocanol was seen in 59.3% of patients, 29.07% patient responded to second dose and 11.63% patients responded to the third dose of sclerotherapy. Sclerotherapy is an effective option in the treatment of first and second degree haemorrhoids and 3% polidocanol has been an effective agent in this strategy.
A Comparative Study Using Interrupted Figure of Eight Suture Versus Conventional Continuous Suturing for Closure of Emergency Midline Laparotomy
Authors:   Senior Resident, Department of general surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka 560002, India., NT Akhila , Nair Sandesh ,   Post graduate, Department of general surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka 560002, India., SG Naveen ,   Post graduate, Department of general surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka 560002, India., Iyer Nagashree ,   Post graduate, Department of general surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka 560002, India.
Published: January 2024

Wound infections continue to represent a major medical problem, both in terms of how they affect the outcome of surgical procedures (surgical site infections), and for their impact on the length of hospital stay and medical costs. Many otherwise successful surgical operations fail because of the development of wound infections. A major SSI is defined as a wound that either discharges significant quantities of pus spontaneously or needs a secondary procedure to drain it Wound infection predisposes the patient to wound dehiscence. Acute wound failure is defined as postoperative separation of the abdominal musculoaponeurotic layers, within 30 days after operation. Most surgical wound infections become apparent within 7 to 10 days postoperatively. Objectives of the study 1. To assess local wound complication in emergency midline laparotomy wounds with interrupted figure of eight technique over conventional continuous closure . 2. To Compare the operative time for interrupted figure of eight closure and Conventional layered closure of laparotomy wounds. 3. To determine the factors affecting wound dehiscence. Materials and Methods: A prospective study was performed at Victoria hospital and Bowring and Lady Curzon hospital , Bangalore during November 2017 – May 2019. A sample of 100 cases were considered. Each Group consisted of 50. Group 1 underwent Interupted figure of Eight suture technique and Group 2 underwent continuous conventional suturing technique. Results: The incidence of burst abdomen in current study was 8%. There were two burst abdomen seen in conventional continuous closure technique and none in the interrupted figure of eight technique group. Conclusion: All the patients with generalized peritonitis in emergency setting need special attention regarding the wound closure. This newer technique of midline emergency laparotomy wound closure, especially in our part of the world significantly reduces the incidence of wound infection and wound dehiscence.
Comparison Between Subcutaneous Tissue Closure V/S Nonclosure in Elective Surgery
Authors:   Additional professor, General Surgery, MP Shah Medical College, Jamnagar, Gujarat 361008, India., Mehta Amrish P , Patel Tushar ,   Senior Resident, General Surgery, MP Shah Medical College, Jamnagar, Gujarat 361008, India., Khamar Suhan ,   Senior Resident, General Surgery, MP Shah Medical College, Jamnagar, Gujarat 361008, India.
Published: January 2024

Background and Objectives: Postoperative wound complication are one of the greatest issues in elective surgeries. Obesity, operative time, diabetes, age of the patient, anemia, associated infection and reduced nutrition are recognized risk factors for wound infections. With the seek to avoid wound infection, many research studies were performed and assessed the infuence of subcutaneous tissue closure in the past 20 years suturing of subcutaneous tissue, the anatomy of the fragile subcutaneous tissue layer is imperfect and suturing leads to a decrease in perfusion to the fatty layer thereby compromising the blood supply to the subcutaneous layer leading to fat necrosis. This study was under taken to study the various post-operative complications in elective surgery like ventral hernia, inguinal hernia and modified radical mastectomy closed with or without subcutaneous closure. Materials and Methods: This study was undertaken from December 2018 to December 2020 in the department of General Surgery, Shree M. P. Shah Govt. Medical College and G.G. Govt. Hospital, Jamnagar. After completing major operative steps subcutaneous suturing using 2-0 polyglactin was done in 54 patients and subcutaneous suturing was not done in 46 patients. Total number of patients–100.
Prophylactic Antibiotics and Surgical Site Infections: the Myths and the Realities
Authors:   Assistant Professor, Department of General Surgery, PK Das Institute of Medical Sciences,Vaniamkulum, Palakkad, Kerala 679522, India., D Anil Raj , PS Sreejith ,   Assistant Professor, Department of General Surgery, PK Das Institute of Medical Sciences,Vaniamkulum, Palakkad, Kerala 679522, India.
Published: January 2024

Background: Postoperative wound infections have an enormous impact on patient’s quality of life and contribute substantially to the financial cost of patient care. The potential consequences for patients range from increased pain and care of an open wound to sepsis and even death. Wound infections extend the average hospital stay by one week and increasing the cost of hospitalization by minimum of 20%. Appropriate antibiotics for prophylaxis in surgery depend on the most likely pathogens encountered during the surgical procedure and type of operative wound encountered during the surgical procedure. Inadvertent use of antibiotics is associated with Development of multi-agent drug resistance among nosocomial pathogens. The occurrence of new infections such as clostridium difficile colitis, respiratory tract infections Drug toxicity and allergy Enormous financial impact on health care costs. Objective: To know whether prophylactic dose of antibiotics is enough to prevent surgical siteinfections in post-operative period if there is no comorbidities and surgery is donewith complete aseptic precautions. Methodology: The patients who undergoes clean and clean contaminated surgeries in PK Das Institute of Medical Sciences, Vaniamkulam, Palakkad, Kerala over period of 2 years and who fulfill the criteria of study aredivided randomly into two different groups (70 cases and 70 controls). Routineinvestigations done in both groups. And all other parameters are kept similar like preoppreperations and intra-op strategies. Case group received only prophylacticantibiotic and control group received post-operative empirical antibiotics also. 70patients in case group contain 35 clean cases and 35 clean contaminated cases. 70patients in control group also divided like this. Results: Out of the 35 clean cases in study group 3 got SSI. Out of 35 clean contaminated cases in study group 7 got SSI Out of 35 clean cases in control group 4 got SSI Out of 35 clean contaminated cases in control group 8 got SSI Conclusion: The use of prophylactic antibiotics alone is as effective as post-op empirical therapy in preventing SSI. This will also avoid unnecessary antibiotic resistance and will reduce the cost of treatment.
Fistula in Ano-An Entity with Enigmas: what to do and what not to do
Authors:   Assistant Professor, Department of General Surgery, PK Das Institute of Medical Sciences,Vaniamkulum, Palakkad, Kerala 679522, India., Annigeri Veeresh M , D Anil Raj ,   Assistant Professor, Department of General Surgery, PK Das Institute of Medical Sciences,Vaniamkulum, Palakkad, Kerala 679522, India., PS Sreejith ,   Assistant Professor, Department of General Surgery, PK Das Institute of Medical Sciences,Vaniamkulum, Palakkad, Kerala 679522, India.
Published: January 2024

Background: Fistula-in-ano is the leading complication of perineal sepsis. Usually, a fistula has an external opening, a track, and an internal opening. Following infection and/or an abscess,External opening may appear acutely or with delayed appearance in a chronic manner. Management protocol for a fistula includesassessment of the extent of fistulous track &its relation to the anal sphincter muscle, control of infection,and finally, surgical treatment of the fistula & follow up. The principles in management of anal fistula aredrainage of infection or necrotic tissue, closure of internal opening of fistula tract, and removal of fistulous tract with preservation of sphincter function. The objectives of the studyis to compare the per operative and post-operative complications, mean hospital stay in the treatment of fistula in ano with treatment options like fistulotomy, fistulectomy, and setons. Methods: This is a comparative, prospective study of 60 patients who presented with their complaints to the Surgerical Outpatient department and who were admitted under the Department of General Surgery, P K Das Institute of Medical Sciences, Vaniamkulum, Palakkad, Kerala. Patients who met the inclusion criteria were included in this clinical study. Of the 60 patients selected for the sudy, 20 patients were surgically treated by fistulectomy, 20 by seton, 20 by fistulotomy over a period of 2 years. Results: Most common age of presentation is 21-30 years and more common in males then females (M:F= 2.3:1 ). Most common per operative complication was bleeding which was seen more in patients undergoing fistulectomy. 36% of the patients wound healed in less than 1 week, 22% of patients wound healed in 1 to 2 weeks,15% of patients wound healed in 2 to 3 weeks, 9% of the patients wound healed in 3 to 4 weeks. Conclusion: Fistula in ano is cured by various methods of surgery and higher antibiotics, local antibiotics with good post-operative wound management, like sitz bath without closing the wound and frequent/regular follow up.Seton technique is better compare to fistulectomy and which is better than fistulotomy.
Evaluation of Rectal Compliance amongst Individuals with Hemorrhoids with or without Fissure and its Comparison with Healthy Individuals
Authors:   DNB General Surgery, Department of Laparscopic and General Surgery, Sir Ganga Ram Hospital, New Delhi 110060, India., Vashishtha Vasu , Agrawal Sushrut ,   DNB General Surgery, Department of Laparscopic and General Surgery, Sir Ganga Ram Hospital, New Delhi 110060, India., Mascarenhas Rinelle ,   DNB General Surgery, Department of Laparscopic and General Surgery, Sir Ganga Ram Hospital, New Delhi 110060, India., Das Sri Krishna ,   MS, Department of Laparscopic and General Surgery, Sir Ganga Ram Hospital, New Delhi 110060, India., Arora Vijay ,   MS, Department of Laparscopic and General Surgery, Sir Ganga Ram Hospital, New Delhi 110060, India.
Published: January 2024

Background: A physiological basis of the ailments like hemorrhoids and fissure is necessary for symptom specific treatment of patients. We aimed to evaluate rectal compliance and resting anal pressure by anal manometry as an objective parameter to the disease in these patients and compare them with controls. Material and Methods: Study conducted in 150 patients, after informed consent and IRB approval,in institutional setup, divided into 3 groups. Group 1- patients with Hemorrhoids and fissure in ano (H+F), group 2-Hemorrhoids without fissure (H-F) and group 3-controls without any anorectal pathology. All patients underwent anorectal manometry, results evaluated, noted, and compared between all the three groups. Rectal compliance and resting anal pressure calculated and compared, and its significance evaluated using statistical analysis. Result: Each group consisting of 50 patients underwent Anorectal manometry and rectal compliance compared between all the three groups. Group 1 (H+F) was found to have mean rectal compliance of -0.100 ± 6.70 mL/mmHg, Group 2 (H-F) had a mean value of 8.92 ± 5.29 mL/mmHg and Group 3 (controls) had 13.08 ± 7.61 mL/mmHg of compliance. Group 1 had resting anal pressure of 115.04 ± 26.94mmHg, Group 2 had 79.92 ± 16.88 mmHg and Group 3 had 75.40 ± 28.39mmHg. The difference in rectal compliance and resting anal pressure was statistically significant between Group 1 & 2 and group 1 & 3. Group 2 had a lower rectal compliance and higher resting anal pressure than group 3 but not statistically significant. Conclusion: Hemorrhoids cause significant decrease in rectal compliance and increase in resting anal pressure, more pronounced in fissure in ano as compared to healthy individuals. Therefore, these values can be used as the objective parameter which should be routinely measured in these patients and treatment aimed at correction of the same.
Diabetes and Hypertension as Risk Factor for Conversion to Open Cholecystectomy
Authors:   Assistant professor, Bangalore Medical College, Bowring and Lady Curzon Hospital and Research Institute, Bangalore, Karnataka 560001, India., Yamakanamardi Soundarya , G Nikhil Naithottu ,   Postgraduate,Bangalore Medical College, Bowring and Lady Curzon Hospital and Research Institute, Bangalore, Karnataka 560001, India., Kempraj T ,   Professor, Bangalore Medical College, Bowring and Lady Curzon Hospital and Research Institute, Bangalore, Karnataka 560001, India.
Published: January 2024

Introduction: Laparoscopic cholecystectomy is the gold standard procedure for gall stone disease. Few cases of acute calculous cholecystitis require conversion to open procedure. Patients with diabetes and hypertension are at increased risk of failure of laparoscopic cholecystectomy. Aims and Objectives: To evaluate the risk of failure of laparoscopic cholecystectomy in type 2 diabetes patients with patients without diabetes. Materials and methods: A prospective study was conducted at a tertiary care hospital. Study was conducted after obtaining ethical committee clearance and informed consent from patients. 90 patients were included in the study. Results: 90 patients of acute calculous cholecystitis were taken for laparoscopic cholecystectomy of which 38 patients had to undergo conversion to open procedure. Among these 17 where having diabetes and hypertension and 14 had type 2 diabetes alone. Conclusion: It is important to evaluate in detail before taking the patients with commodities like diabetes and hypertension for laparoscopic cholecystectomy and prevent morbidity
Ultrasonography as a Diagnostic Tool in Breast Carcinoma
Authors:   Assistant professor, General Surgery, Bowring and Lady Curzon Hospital and Research Institute, Bangalore, Karnataka 560001, India., Yamakanamardi Soundarya , G Nikhil Naithottu ,   Postgraduate, General Surgery, Bowring and Lady Curzon Hospital and Research Institute, Bangalore, Karnataka 560001, India., Kempraj T ,   Professor, General Surgery, Bowring and Lady Curzon Hospital and Research Institute, Bangalore, Karnataka 560001, India.
Published: January 2024

Introduction: Breast cancer is one of the leading causes of death among females. This necessitates a proper screening modality for early diagnosis and treatment of breast cancer. Due to limited resources in few setups it would be difficult to get an access to mammography. Hence in our study we are trying to evaluate the diagnostic accuracy of ultrasonography to use it as an alternative to mammography in breast cancer patients. Materials and Methods: A prospective study was conducted on 80 women presenting with breast condition. All patients underwent sonomammography followed by histopathological assessment of the lump. Results: Irregular shape with irregular margins on sonomammography was found to be significant marker of malignancy with extensive vascularity. Calcification in malignancy was 7.92 times more common than benign. The diagnostic accuracy of sonomammography was 75% with sensitivity and specificity of 72.58% and 83.33% respectively. Conclusion: Our study concluded that sonomammography can be used as a diagnostic modality for breast conditions in resource limited facilities. Keywords: Breast Cancer; Sonomammography; Benign lesion of breast; Diagnostic accuracy of sonomammography; BIRADS.
Failure of Laparoscopic Cholecystectomy Preoperative Factors as Predictors
Authors:   Assistant professor, General Surgery, Bowring and Lady Curzon Hospital and Research Institute, Bangalore, Karnataka 560001, India., Yamakanamardi Soundarya , G Nikhil Naithottu ,   Postgraduate, General Surgery, Bowring and Lady Curzon Hospital and Research Institute, Bangalore, Karnataka 560001, India., Kempraj T ,   Professor, General Surgery, Bowring and Lady Curzon Hospital and Research Institute, Bangalore, Karnataka 560001, India.
Published: January 2024

Introduction: Laparoscopic cholecystectomy is the gold standard procedure for gall stone disease. Few cases of acute calculous cholecystitis require conversion to open procedure which can increase the morbidity and financial burden to patient. Hence, through this study we are trying decide regarding the parameters which would help to assess the patient preoperatively and predict the outcome of laparoscopic cholecystectomy. Aims and Objectives: To assess the preoperative parameters to predict conversion of laparoscopic cholecystectomy to open cholecystectomy in patients with acute calculous cholecystitis. Materials and Methods: A prospective study was conducted at a tertiary care hospital. Study was conducted after obtaining ethical committee clearance and informed consent from patients. 100 patients were included in the study. Results: 100 patients of acute calculous cholecystitis were taken for laparoscopic cholecystectomy of which 80 patients successfully completed the procedure and remaining 20 patients had to undergo conversion to open procedure. Conclusion: Male gender, older age, patients with higher pain (VAS) score, raised TLC, raised total bilirubin, raised serum ALP are associated with failure of laparoscopic cholecystectomy. Keywords: Acute calculous cholecystitis; Cholecystectomy; Laparoscopic cholecystectomy; Failure of laparoscopy; Conversion to open cholecystectomy.
Silveron Gel (Nano Silver Formulation): A Powerful Antimicrobial for the Future
Authors:   Nirmal Hospital, Near MLB Medical College, Jhansi, Uttar Pradesh 284001, India., Gupta Ajay
Published: January 2024

Introduction: Nano silver itself is not new. It has been used for various applications in consumer and commercial products over the past century without showing adverse effects on patients. Nano-silver dispersions were used as medical products already in the 19th century. Additionally, the concept of Nano-silver being used as a topical antibacterial dates back to the days of Sushrut in the 6th century where finely powdered Silver was used as a topical antibacterial/antiseptic after surgery. Material and Method: Silver ions and the compounds made like nanosilver exhibit a broad antimicrobial profile against bacteria, fungi and virus and also have low toxicity towards animal cells. Various studies have also demonstrated definitive antibacterial property of nanosilver against Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, C. albicans, V. Parahaemolyticus, S. enterica, B. anthracis, B. Cereus, Bacillus subtilis, Salmonella entrica and Pseudomonas aeruginosa. Result: Nano silver particles have ability to alter the expression of matrix metallo-proteinases (proteolytic enzymes that are important in various inflammatory and repair processes), suppress the expression of tumor necrosis factor (TNF-α), interleukin (IL)-12, and IL-1b, and induce apoptosis of inflammatory cells. Therefore, nano silver gel also displays an anti-inflammatory action. Conclusion: In conclusion, Silveron gel due to its nano silver particles and unique formulation has the power to protect, penetrate, and heal in cuts, wounds, burns, diabetic foot ulcer, and surgical dressings. Keywords: Silveron Gel; Antimicrobial; Nano Silver.
A Clinical Study of Scrotal Swelling and its Various Treatment Modalities
Authors:   Assistant professor, Department of General surgery, Adichuchanagiri Institute of Medical Science, Karnataka 571432, India., HS Akshatha , Basavaraju Sachin Murukanahalli ,   Assistant professor, Department of General surgery, Adichuchanagiri Institute of Medical Science, Karnataka 571432, India., AP Manjunath ,   Junior Resident, Department of General surgery, Adichuchanagiri Institute of Medical Science, Karnataka 571432, India.
Published: January 2024

Aim: To study the etiology, clinical presentation, investigations, treatment modalities & their outcomes, post operative complications for scrotal swellings and follow up. Materials and Methods: The cases admitted to the surgical wards over a period of one and a half years i.e., November 2018 to May 2020, formed the material for this study. During this period 100 cases with h/o scrotal swelling admitted in various surgical units, selected at random were studied in detail as per proforma. Sampling Method: A Simple Random Sampling Results: 100 cases of scrotal swellings were studied and compared based on age, occupational distribution, mode of presentation, duration of symptoms, predisposing factors, treatment modalities and post operative complications. Conclusions: Scrotal swelling was commonest symptom. The other symptoms included pain/ heaviness of scrotum, fever, etc. • Definitive surgery was done in 90 cases. • Various forms of hydrocele constituted a major portion of the study (50 cases). • Varicocele was the second commonest cause comprising of 13 cases. • A total of 9 cases of Fournier”s gangrene, 6 cases of torsion of testis including one with scrotal abscess. • There were 09 cases of epididymo-orchitis, 4 cases of testicular tumor, 3 cases each of sebaceous cyst and encysted hydrocele of cord and 2 cases of hydrocele with hernia. Keywords: Treatment modalities; Scrotal swellings; Hydrocoele; Varicocele; Outcome.
Study on Incidence of Benign Breast Diseases and Carcinomabreast in Breast Lump Cases of 200 Patients in a Tertiary Care Center in Southern Kerala
Authors:   Associate Professor, Travancore Medical College, Kollam, Kerala 691020, Asokan Meena , Francis Joseph ,   Associate Professor, Travancore Medical College, Kollam, Kerala 691020, Babu Bibilash ,   Consultant Plastic Surgeon, Cosmetiq Clinic, Trivandrum, Kerala 695024, India.
Published: January 2024

Introduction: Breast cancer accounts for about one third of female cancer. Of all lesions, benign breast diseases have been found to be commonest. The aim of study was to analyze the incidence of breast diseases over the period of 3 years and to study the spectrum of diseases and age distribution. Methods: Retrospective cross-sectional study of breast lump cases at general surgery department of Travancore medical college over a period of 3 years. Result: Of the total 200 cases up looked into, 27 out of 200 cases were found to be malignant. Fibrocystic disease was the commonest (43%), followed by fibroadenoma (34.5%), 67 had lumps in right breast, 87 in the left breast and 46 patients had lump in both breasts. Conclusion: From the study we found that, most of the breast lesions are benign and there is increase in the number of cases each year. Some of the benign lesions may remain undetected and lead to malignant change. So early detection of breast carcinoma and public awareness is crucial to save the patient from morbidity and mortality. Keyword: Breast Diseases; Carcinomabreast; Fibrocystic disease.
Diagnostic Accuracy of FNAC in Solitary Thyroid Nodule A Single Institutional Experience
Authors:   Assistant professor, Department of General Surgery, Kasturba Medical College, Manipal, Udupi 576104, Karnataka., Biradar Nagesh , Lakshminarayana Badareesh ,   Associate professor, Department of General Surgery, Kasturba Medical College, Manipal, Udupi 576104, Karnataka., Bhagat Saumya ,   MBBS Intern, Department of General Surgery, Kasturba Medical College, Manipal, Udupi 576104, Karnataka., Biradar Raghavendra ,   Intern, BGS Global Institute of Medical Science and Research, Bengaluru 560060, Karnataka, India.
Published: January 2024

Background: In this study, we aimed to evaluate the value of FNAC in the diagnosis of solitary thyroid nodule, and asses the correlation with the histopathology. Materials and Methods: Prospectively FNACs of 90 cases of solitary thyroid nodule was compared with histopathology from July 1 2013 till June 31 2015. Results: The sensitivity and specificity of FNAC in our study is 77.7% and 98.7 respectively, the positive predictive value and negative predictive value is 87.5% and 97.5%respectively. Discussion: In our study, FNAC is proved to be an invaluable tool for pre-operative diagnosis of thyroid lesions, and its Bethesda system concords with histopathology results. Keywords: Solitary thyroid nodule; Fine needle aspiration cytology; Thyroid malignancy; Sensitivity; specificity.
Current Trends in the Management of Lower Limb Amputations
Authors:   Assistant professor, Department of General Surgery, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore Karnataka 560001, India., PT Sushanth , Bhattacharya Anchita ,   Postgraduate, Department of General Surgery, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore Karnataka 560001, India., Bhat Padmanabh ,   Professor, Department of General Surgery, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore Karnataka 560001, India.
Published: January 2024

Background: Lower limb amputation is a major but preventable public health problem in a developing nation such as India. It is a burden for the patients as well as their families not only economically but also socially and psychologically. The duration of treatment lasts from a few days to several months and depends on the extent of disease, level of amputation and patient’s comorbid status. The purpose of this study is to outline the demographics, various indications and the complications of lower limb amputations, the newer interventions in the management of lower limb amputations and to evaluate our experience in managing such patients presenting at a tertiary care hospital in South India. Methodology: This is a prospective study done between the period of December 2019 and December 2020 at Sapthagiri Medical College and Research Centre, Bengaluru, Karnataka, India. All patients undergoing lower limb amputation during this time period were included in the study. Results: A total of 50 patients were included into the study. Majority of the patients were males (72%). The most common indication for major limb amputation is peripheral arterial occlusive disease (PAOD) 50% and Diabetic foot in 36.96%. Below knee amputation was the most common procedure performed in 52.17%. The most common additional procedures performed were wound debridement in 23.91%, secondary suturing in 19.57%. Revision amputation rate was 8.7%. Post-operative complication rate was 39.13% and surgical site infection was the most common complication accounting for 17.39%. 8% of the patients underwent vascular interventions which prevented major limb loss. Conclusion: Diabetic foot and PAOD of lower limbs that progressed to gangrene are the most common indications for lower limb amputations, majority of which can be prevented by health education and early presentation. Appropriate management by applying newer trends such as vascular intervention can help in reducing morbidity.
Correlation between Gallstones and Hypothyroidism: Our Experiance
Authors:   Professor, Department of General Surgery, Kempegowda Institute of Medical Sciences, Bangaluru, Karnataka 560004, T Narayanaswamy , RK Prajwal ,   Assistant Professor, Chamundeshwari Medical College, Channapatna, Karnataka 562160, India
Published: January 2024

Background: Among biliary pathology, Gallbladder Stones are the most common. There are well established risk factors associated with formation of Gallstone. Since Biliary motility is affected by thyroid hormone, Patients with hypothyroidism will have Gallbladder Hypokinesia and deranged lipid metabolism leading to formation of Gallstones. Aims & Objectives: The aim of this study is to find out the hypothyroidism is a risk factor in formation of specific type of Gall stone. Methods: A total of 50 patients with gallstone disease were included in the study. Thyroid function tests were performed in all of them. And divided in to two group, Group-A 25 Euthyroid patients and Group-B 25 Hypothyroid patients and morphological type of gallstones assessed post operatively (Pigment or Cholesterol stones). Results: Of the 50 patients included in the study, Group A patient had 18 Pigment stones and 7 Cholesterol stones in Gallbladder and Group B patient had 15 Pigment stones and 10 Cholesterol stones in Gallbladder. On Statistical analysis, the p-value is 22067. The result is not significant at p<.05. Conclusion: Gallstones are more common in patient with hypothyroidism compared to general population but hypothyroidism does not promote any specific type of stone formation. Which suggest that Hypothyroidism is not the individual risk factor for gallstone formation.
A Case Series on Rare Types of Carcinoma Breast
Authors:   MS, Institute of General Surgery, Rajiv Gandhi Government General Hospital & Madras Medical College, Chennai 600003, India., Kumar B Sampath , Kumar MS Kalyan ,   MS, Institute of General Surgery, Rajiv Gandhi Government General Hospital & Madras Medical College, Chennai 600003, India., Vijayalakshmi V ,   Professor, Institute of General Surgery, Rajiv Gandhi Government General Hospital & Madras Medical College, Chennai 600003, India., Kannan R ,   Professor, Institute of General Surgery, Rajiv Gandhi Government General Hospital & Madras Medical College, Chennai 600003, India., Hanif M Mohamed ,   Junior Resident, Institute of General Surgery, Rajiv Gandhi Government General Hospital & Madras Medical College, Chennai 600003, India.
Published: January 2024

Carcinoma Breast is a common occurrence in women. Most common pathological type being invasive ductal carcinoma: No Special Type. Carcinoma breast is a systemic disease and its management requires a multimodal treatment including surgery, chemotherapy, radiotherapy, hormonal therapy and immune therapy based on the type and stage of the disease. Here we are presenting a case series of rarer pathological types of carcinoma breast namely. 1: Solid papillary carcinoma with neuroendocrine differentiation, 2: Metaplastic carcinoma of breast, 3: Invasive carcinoma breast mimicking as sclerosing adenosis.
Triple Test Approach for Diagnosis of Palpable Breast Lesions
Authors:   Professor & Head, Department of General Surgery, Shaheed Hasan Khan Mewati Government Medical College, Nalhar, Haryana 122107, India., Gole Gautam N. , Gole Sheetal G. ,   Professor & Head, Department of Pathology, Employee’s State Insurance Corporation Medical College, Faridabad, Haryana 121001, India.
Published: January 2024

Introduction: Management of breast diseases is a multidisciplinary endeavor dependent on skill and expertise of an array of clinical specialists. Study evaluates efficacy of the individual components of triple test in diagnosis of palpable breast lesions. Materials and Methods: Present study was a hospital based prospective study done over a period of 2 years and included 100 female patients with palpable breast lesions in a tertiary care hospital at Telangana. Detailed clinical history and physical examination was done, followed by mammography, fine needle aspiration cytology. The histopathological report was considered the reference standard. Results: Triple test is the combination of clinical examination, mammography and fine needle aspiration cytology. If all the 3 tests were benign then triple test was concluded as benign, and if all 3 tests were malignant then it was concluded as malignant. Triple test revealed 97.29% sensitivity and 98.41% specificity, with 1 false positive and false negative each. Triple test was scored as concordant if all the 3 tests, had either all malignant or all benign results. Triple test was scored as nonconcordant if all the 3 tests had neither all malignant nor all benign results. Triple test was concordant in 82 (82%) cases. Conclusion: Triple Test is a powerful clinical tool that is, easy to perform, minimally invasive, and provides rapid, cost­effective, reliable, and accurate diagnosis of breast malignancies. Triple Test Score is safe and efficacious for establishing diagnosis and managing the ever­increasing number of patients presenting with breast masses.
Validation of Bisap Scoring System in Predicting the Severity of Acute Pancreatitis according to the Latest Atlanta Classification
Authors:   Assistant Professor, Department of Surgery, MVJ Medical College & Research Hospital, Hoskote, Karnataka 562114, India., .. Gulamnabi , Sudarshan P. ,   Professor, Department of Surgery, MVJ Medical College & Research Hospital, Hoskote, Karnataka 562114, India.
Published: January 2024

Acute pancreatitis (AP) is an inflammatory condition of the pancreas with a clinical course hat varies from mild to severe, leading to activation of pancreatic enzyme and causing selfdigestion of the pancreas. The overall mortality rate of AP is 2–5%, but the mortality of severe acute pancreatitis (SAP) may range upto 20–30%. So it is important to assess the disease severity in a timely and accurate manner There are variety of score systems such as Ransom’s criteria[1], Acute Physiology and Chronic Health Evaluation (APACHE) II [2] and Computed Tomography Severity Index (CTSI). But these systems have their own distinct pros and cons. A new mortality based prognostic scoring system for use in acute pancreatitis has been derived and validated which was named the Bedside Index of Severity in Acute Pancreatitis (BISAP). The 5­point BISAP score system incorporates the variables: Blood urea nitrogen level >25 mg/dl, Impaired mental status, Systemic inflammatory response syndrome (SIRS), and age > 60years, and presence of pleural effusion. Thus the BISAP score represents a simple way to identify patients at risk of increased mortality and the development of intermediate markers of severity within 24h of presentation.