bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study of clinico-pathological factors, indications and response to chemotherapy in breast cancer patients in a tertiary care hospital in south India
Authors: Shoeb Mohammad Fazelul Rahman 
Published: July 2017

Background: Breast cancer is considered a systemic disease, surgical interventions on most of the patients can reduce the loco regional burden and chemotherapy can reduce systemic burden by reducing chances of metastasis and recurrence and prolong life expectancy. The objective of this study was to assess the clinic-pathological factors of patient presenting with breast cancer and to study the indications and response to chemotherapy for breast cancer.Methods: A prospective study of fifty patients was carried out at Victoria hospital and Bowring and Lady Curzon Hospital between October 2010 to October 2012 who underwent surgery, chemotherapy, radiotherapy and hormonal therapy.Results: Most patients presented with palpable axillary lymph nodes (64%) and belonged to stage II disease (50%). Invasive ductal carcinoma was seen in 90% of cases while medullary in 04%, colloid in 2% and Infiltrating lobular was seen in 04% of patients. Totally 64% cases were ER or PR+, and 36% were ER/PR- among the study participants. 70% of the patients operated had positive nodes. All 50 cases received chemotherapy. Chemotherapy was indicated in node positive patients and in patients whose tumour was measuring more than 1 cm. After follow-up of 50 patients for about a period of two years, 3 patients died, 4 patients had metastasis and in the remaining 47 surviving patients none of them had recurrence at the end of second year.Conclusions: Most cases and belonged to Stage II disease with Invasive ductal carcinoma being most common histological subtype seen in 90% of cases. FNAC is good diagnostic procedure cost effective and reliable as all cases post-operative HPE confirmed malignancy. Patients should be treated by chemotherapy in indicated cases, as carcinoma breast is a systemic disease and chemotherapy can reduce systemic burden by reducing chances of metastasis and recurrence and prolong life expectancy.
Clinicopathological study on presentation, diagnosis and management of liver abscess in Bhopal region
Authors: Siroliya Anshul , Damor Mahendra , Songra M. C. 
Published: July 2017

Background: This prospective observational study is carried out to study cases of liver abscess and to determine demographic profile, spectrum of clinical presentations, aetiology, laboratory investigations. The objective of the study was to evaluate efficacy of Ultrasonographic (radiological) studies in determining the aetiology and in differentiating from other liver pathologies which may change the treatment outcome, bacteriological and serological characteristics, to study the influence of alcohol, diabetics and immunocompromised diseases (esp. HIV) leading to increased incidence of liver abscess and to evaluate efficacy, recurrence rate, complications, morbidity and mortality, duration of hospital stay associated with different management Strategies.Methods: This prospective observational study was carried out in Department of Surgery, Gandhi Medical College Bhopal and Associated Hamidia Hospital, Bhopal between July 2015 to October 2016.Results: Amoebic abscess (74%) is more common than pyogenic abscess (26%). Amoebic abscess is common in the age group of 31-50 years (73%), pyogenic in the age group of 51-70 years (73.1%). Male preponderance is found in case of amoebic liver abscess (90.5%). Right lobe involvement in common. Right upper quadrant pain, tenderness and fever are the most common clinical features. Alcoholism is most common risk factor (71.6%) and diabetes mellitus has strong association with pyogenic liver abscess (15.4%). E coli (19.2%) and klebsiella (11.5%) are the most common organisms cultured. Medical therapy is more useful in case of amoebic liver abscess (58.1%) while catheter drainage is more useful in case of pyogenic liver abscess (61.5%). Pleuropulmonary complications are much more common and complications rate is more common among pyogenic group.Conclusions: In our study, alcohol was found to be the most common predisposing factor for liver abscesses (68%), this underpin the finding of other studies. Amoebic liver abscess is a medically treated common infection prevailing in unhygienic condition, affecting people mostly between 30-40 years of age whereas pyogenic liver abscess patient commonly falls between 50-70 years age group. Both liver abscesses show a male preponderance. The present study also corroborates the catheter drainage procedure as a superior modality in treating pyogenic liver abscess.
Endoscopic management of pancreatic pseudocyst
Authors: Sharon Wormi 
Published: July 2017

Background: Pancreatic pseudocyst is a well-known complication of acute or chronic pancreatitis, with a higher incidence in the latter. It represents 80-90% of cystic lesions of the pancreas. Benign and malignant cystic neoplasms constitute 10-13%, congenital and retention cysts comprising the remainder. Diagnosis is accomplished most often by computed tomographic scanning, by endoscopic retrograde cholangiopancreatography, or by ultrasound, and a rapid progress in the improvement of diagnostic tools enables detection with high sensitivity and specificity. Endoscopic drainage provides a good alternative or supplement to a surgical treatment of pancreatic pseudocysts.Methods: This is a prospective study of 26 patients diagnosed to have Pancreatic Pseudocyst and treated by endoscopic drainage from 1st June 2008 to 30th September 2010 in St. John’s Medical College and Hospital, Bangalore. Transabdominal and endoscopic ultrasound, CT scan were used to determine the number, size, volume, wall thickness, location of pancreatic pseudocysts, the extent of pancreatic parenchymal disease, the nature of the main pancreatic duct and its relationship to the cyst, the presence of portal hypertension, venous occlusion, arterial anomalies and pseudoaneurysm. The indications for endoscopic drainage were symptomatic and/or bigger than 6 cm in major diameter pancreatic pseudocysts with a close opposition to the gastric or duodenal wall.Results: There were 26 patients with pancreatic pseudocyst and all of them are located in lesser sac. It mainly affects the middle-aged males with alcohol as the main etiology. Out of 26 patients 24 underwent endoscopic drainage and 2 patients were abandoned in view of vessel between the cyst wall and stomach which was picked up by EUS. Out of 26 patients, 5 developed infection which was proven by culture. Endoscopic cystogastrostomy was performed in 21 patients (80.8%), endoscopic cystogastrostomy with nasocystic drainage performed in 3 patients (11.5%), and abandoned in 2 patients. 2 patients developed bleeding, and managed conservatively. No intervention done. 5 patients underwent re-procedure (3 underwent nasocystic drainage, 1 aspiration, and the other cystogastrostomy), in view of recollection.Conclusions: Endoscopic drainage is safe and effective in experienced hand, less morbidity, cost effective, short hospital stay, can be repeated.
Effect of moist dressing, collagen sheet dressing and epidermal growth factor in healing of chronic wounds
Authors: Jain Sheelchandra , Tote Darshana S. , Kolte Gaurav , Jajoo Suhas , Tote Sachin 
Published: July 2017

Background: Surgical literature is full of innumerable solutions to the problems of wound healing and it speaks of itself that the problem is not so simple and straight forward to tackle with. The aim of the present study was to compare three modalities moist saline dressing, collagen sheet dressing and epidermal growth factor in early epithelization and healing of chronic wounds. to study the effect of various dressing modalities on epithelization of chronic wound in terms of time required for healing and the quality of scar it forms, the functional results both early and late, post-healing morbidity and complications and the practicality and the cost involved in using these modalities.Methods: Prospective randomized controlled study. Study including chronic wound cases admit to AVBRH Sawangi over period of 3 years.Results: Reduction in size of wound by 70-100% was found highest in Epigrof group. In Epigrof treated group 88% of wounds healed within 3 weeks while 80% in collagen group and 56% in moist dressing group it. Collagen dressing is the most cost effective of the three whereas Epigrof was most costly due to the initial cost of purchase. The scar quality was satisfactory in 19 of Epigrof group and 17 of the collagen sheet group and 15 of the moist dressing group.Conclusions: Epidermal growth factor is superior in epithelization, collagen is the next best local applicant, but collagen sheet is more cost effective than Epigrof and non-adherent dressings.
Clinical profile and predictors of outcome in congenital duodenal obstruction
Authors: Chandrasekaran Sankkarabarathi , Asokaraju Anirudhan 
Published: July 2017

Background: Congenital duodenal obstruction is a broad term that refers to a variety of disorders like duodenal atresia, duodenal stenosis, annular pancreas, duodenal membrane and preduodenal portal vein. The aim of this study was to analyse in detail the entire clinical profile of duodenal obstruction and to study the short-term outcome.Methods: A prospective descriptive study was conducted in the Department of Paediatric Surgery, Institute of child Health and Hospital for Children, Egmore, Chennai, among all babies with suspected duodenal obstruction based on clinical symptoms and subsequently proven by surgery from September 2013 to January 2015. Fifty babies were selected for this study based on the eligibity criteria.Results: Upper gastrointestinal contrast radiography is the gold standard investigation in diagnosing duodenal membrane with a hole. The type of surgery such as the duodenoplasty, duodenoduodenostomy or duodenojejunal anastomosis did not affect the post-op outcome.Conclusions: Long term follow up is warranted to know the actual incidence of requirement for redo procedure for feed intolerance. The presence of coexisting Down’s syndrome and congenital cardiac lesions increases the mortality rate in these children.
A study about urinary tract infection among patients attending tertiary care hospital
Authors: U. Arunachalam , C. Ponmudi , Solanke Prashant V. , Das Deepam , N. Vignesh , Pawade Preeti 
Published: July 2017

Background: UTI is a second most common type of infection, accounting for nearly 25% of all infections. Lower UTIs are much more common in women than in men, particularly in the under 50’s. UTI are common among patients with type 2 diabetes mellitus. Recurrent UTI is a common phenomenon that is observed among women who have experienced uncomplicated UTIs. Usually 5-10 days of antibiotic therapy is done for treating UTI. Successful antimicrobial therapy will usually ameliorate symptoms promptly, with substantial clinical improvement in 48 to 72 hours. The objective is to find out the knowledge and practice about UTI among UTI sufferers.Methods: The study design is cross sectional study. The study period is from July 2016 to February 2017. The study place is Sree Mookambika Institute of Medical Sciences. The sample size is (4PQ/d²) = 31. Systematic random sampling techniques are used. Institutional ethical committee clearance was obtained.Results: In the study 90.3% are women. In the study 32.3% had a recurrent UTI. In the study population about 51.7% take adequate or plenty of water. In this study 35.5% have poor knowledge, 42% have moderate knowledge and 19.5% have a good knowledge about UTI.Conclusions: From the study, it is learnt that UTI is common among the women and recurrence is the most common thing among the asymptomatic UTI group. The common symptom experienced by the study group is dysuria and frequency and most in the study group used to take less than recommended amount of water daily. They believe drinking plenty of water and cleanliness can prevent the UTI. The knowledge about UTI among the group is fairly good.
A study of open inguinal hernioplasy with horizontal incision at tertiary care hospital
Authors: Patel Piyush R. , Tandel Chetan J. , Dadiala Gurmitsingh , Parekh Janak N. 
Published: July 2017

Background: Transverse incision may be truly horizontal or may curve to varying degrees. Transverse incisions mostly follow LANGER lines and give better cosmetic results. The present study was planned with an objective to study open inguinal hernioplasty with transverse crease (Langer’s line) incisions.Methods: The present cross-sectional study was conducted on patients operated for inguinal hernia in single surgical unit between March 2013 to October 2015. After admission in a surgical ward, thorough history and clinical examination of all patients done. A transverse skin incision was used (follow the Langer’s line) in all cases.Results: The mean age of the cases in the present study was 45.21±14.2 years. It was noted that among Indirect inguinal hernias (IIH), 85% of the cases were below 50 years of age while among direct inguinal hernias (DIH), 66% cases were above 50 years of age. It was seen that 42.6% of the direct hernia was right-sided while 70.0% of the indirect hernias were right sided. All the patient had a very good cosmetic outcome.Conclusions: It was concluded from the present study that right sided indirect inguinal hernia was the most common type of Hernia. The use of transverse incision through Langer lines is aesthetical, no folding of scar is seen, all the layers are not on same level so preventing ridge effect, repair become sounder, bigger lower flap of external oblique aponeurosis and even wound is infected, no scar widening.
Silver colloid dressings score over conventional dressings in diabetic foot ulcer: a randomized clinical trial
Authors: Sharma Rajkumar , Gupta Niraj , Kumar Vipan , Pal Sanjay , Kaundal Vishal , Sharma Vikrant 
Published: July 2017

Background: Topical silver treatments and silver dressings are increasingly used for the local treatment of contaminated or infected wounds; however, there is a lack of clarity regarding the evidence for their effectiveness. To compare the outcome of silver colloidal based dressing in comparison to conventional dressing in management of diabetic foot ulcers.Methods: This was a single institution prospective randomized controlled trial. Patients with Wagner grade 1and 2 diabetic foot ulcer were enrolled in this study. Patients were assessed on day one and then at two weeks interval for twelve weeks for ulcer size by planimetry.Results: Out of 25 patients, 13 were randomized to silver colloid group and 12 in conventional dressing group. Age and sex distribution was comparable among two groups. Total 29 ulcers were present in silver colloidal and conventional dressing group. Mean wound area in silver colloidal dressing group and conventional dressing group on admission was 36.8 and 20.46 cm2 respectively. After 12 weeks of dressing mean wound area in silver colloidal dressing group and conventional dressing group decreased by 31.52 (85.65%) and 14.04 (68.62%) and after 12-week complete healing was seen in 11 (84.62%) patients in silver colloidal dressing group and 5 (41.67) patients in conventional dressing group.Conclusions: The results suggest that silver colloidal based dressing had significantly better outcome in form of complete healing and decrease in ulcer size in comparison to conventional dressing in diabetic foot ulcers (p value <0.05).
Two mesh technique in lieu of single mesh in giant prosthetic reinforcement of the visceral sac for bilateral inguinal hernias
Authors: Arora Bhavinder K. , Arora Rachit , Arora Akshit 
Published: July 2017

Background: Posterior wall strengthening is the essential aim of Bilateral Inguinal hernia repair. The two methods for it are tissue repair and tension free repair. Tension free repair have become the gold standard. The preperitoneal repair for Bilateral Inguinal hernia is performed by wrapping the lower part of the parietal peritoneum with a large chevron shape polypropylene mesh.Methods: This study presents a modification of stoppas repair using a polypropylene mesh of size 15×9 cm to cover the myopectineal ostium of fruchaud on each side. The direct hernia sac was inverted with a purse string suture. Indirect hernia was opened and margins approximated with a 2-0 polyglycolic acid suture. No drainage was used.Results: Post-operative period was uneventful in all the patients. This new technique uses less post-operative time and the cost of surgery is reduced. There was one post-operative recurrence on one side only on follow up at one week, three weeks and three months.Conclusions: The use of two small size mesh covering both Fruchaud’s myopectineal orifices for bilateral inguinal hernia repair instead of a large size mesh is a promising technique. It saves the operative time and shortens the hospitalization time.
KIMS modification of Alvarado’s score for acute appendicitis
Authors: Premkumar Daivasikamani 
Published: July 2017

Background: Abdominal pain is one of the most frequent presentations to the emergency department (ED). Acute appendicitis is by no means an easy diagnosis to make and can baffle the best. Problems related to the diagnosis of appendicitis are evidenced by the significant negative laparotomy rate. A scoring system described by Alvarado was designed to reduce the negative appendicectomy rate without increasing morbidity and mortality. Alvarado’s score does not include ultrasonogram which is most commonly done investigation before any abdominal surgery.Methods: The study included the ultrasonography and modified the scoring system and retrospectively we analyzed 153 patients who were admitted as acute appendicitis. When interpreted considering the clinical examination, sonography and modified scoring system and it significantly reduced the rate of false-negative appendectomies. The use of diagnostic imaging tests such as CT scan or ultrasonography should be selective in those with atypical presentation or findings. Laparoscopy, barium enema, ultrasonography and computer assistance have all been shown to improve accuracy, but no one method is of proven superiority.Results: By using KIMS modification of Alvarado’s score it was found that unnecessary appendectomy can be avoided in 11 out of 132 patients.Conclusions: Such diagnostic aids or intensive in-hospital observation must be used to reduce the 15-30 per cent negative laparotomy rate when acute appendicitis is suspected, without increasing the incidence of appendiceal perforation.
Incisional hernia: preliminary observations at a new institute
Authors: Huda Farhanul , Kumar Abhijit 
Published: July 2017

Background: Ventral hernia develops when an area of the abdominal wall weakens and develops a tear or hole. It may develop as a defect at birth, resulting from incomplete closure of a part of the abdominal wall, or develop where an incision was made during an abdominal surgery, occurring when the incision doesn’t heal properly. Incisional hernia is typically observed within the first 5 years after the surgical incision is made, but may develop long afterwards.1 This study was undertaken to review the history and clinical presentations in patients with incisional hernia, and subsequent treatment.Methods: In the present study, the first 20 cases of incisional hernia admitted to this institute for elective herniorrhaphy were studied. History of the previous surgery was obtained and the findings noted. Treatment carried out was included in the study.Results: Out of 20 cases, 12 were female (60%). Mean age of the patient was 41.9±11.9 years. Lower segment Caesarian section was the commonest preceding surgery (7 out of 12 females; 58.33%). Exploratory laparotomy accounted for 5 out of 8 cases amongst males (62.5%). Commonest site of the hernia was infraumbilical (n=9; 45%). Average size of the defect was 6.2 cm x 5.6 cm. 13 patients underwent surgery. Laparoscopic ventral hernia repair was the most common modality used (10 out of 13; 76.9%).Conclusions: Incisional hernia is more common in females, and gynaecological operations are most common cause and most common site is infraumbilical.
Comparison of conventional balloon method and Dulucq method for extraperitoneal access for laparoscopic total extraperitoneal repair of inguinal hernia
Authors: Kakadiya Chirag B. , Choksi Dilip B. , Bhedi Amul , Damor Sushil 
Published: July 2017

Background: Laparoscopic inguinal hernia repair has been shown to be slightly superior to open approaches. The aim of study is to compare advantages and disadvantages between two methods of extra peritoneal access for TEP repair of inguinal hernia using conventional balloon device method and using Dulucq method.Methods: This is a prospective study. It was conducted from June 2014 to November 2016 at SSG Hospital Vadodara. Total 50 patients of inguinal hernia taken for laparoscopic TEP repair among them patients were divided in two groups by envelop method of randomization, in 25 patients extra peritoneal space was created by balloon method and in 25 patients extra peritoneal space was created by veress needle or Dulucq method.Results: The mean time taken for extra peritoneal space creation by balloon method was 13.12 minutes and the mean time taken for extra peritoneal space creation by veress needle method was 9.32 minutes. The mean total operative time required for TEP by balloon method was 66.7 minutes and that for, TEP with veress needle method was 53 minutes.Conclusions: Total time for extraperitoneal space creation by Dulucq method is less as compared to balloon method of extraperitoneal space creation in laparoscopic TEP repair of inguinal hernia.
Desenvolvimento de base de dados ambiental para a cadeia de transformação de plástico no Brasil: primeiros avanços
Authors: Becker Junior Adilson Moacir , Dias Ricardo de Oliveira , Chiumento Giovanna , Motta Felipe Lion Uchôa Lacerda , Almeida Luiz Gustavo Ortega de , Kabe Yuki Hamilton Onda , Rocha Tiago Barreto 
Published: July 2017

A busca por informações dos impactos ambientais gerados pelas atividades e setores econômicos tem aumentado. Adicionalmente, a pressão por parte de consumidores e de diretivas ambientais mais rígidas tem levado empresas públicas e privadas a buscarem meios para a gestão e comunicação do desempenho ambiental dos seus produtos e serviços. Neste contexto a Avaliação do Ciclo de Vida (ACV) tem se consolidado como a técnica mais indicada para comunicações do desempenho ambiental de produtos e no auxílio à gestão ambiental estratégica. Por outro lado, a dificuldade na obtenção de dados nacionais representativos ainda é um obstáculo ao amplo uso da ACV no Brasil. A fim de reduzir a dependência da utilização de bases de dados internacionais em estudos de ACV no país, iniciativas estão sendo tomadas por diferentes instituições acadêmicas, governamentais e empresariais. Tendo em vista a importância do setor de plásticos no país, a ACV Brasil está coordenando projeto para a construção de uma base de dados de transformação de plástico no Brasil. O objetivo deste artigo é relatar os avanços na construção da base dados, apresentando os fluxos de materiais e de energia em diversos processos de transformação de plástico. Os dados dos processos de transformação por injeção, extrusão de perfis planos, moldagem por sopro, extrusão de filmes e extrusão do tipo granulação úmida e granulação seca, empregando as resinas mais utilizadas no Brasil: PP, PEAD, PEBD, PE, ABS, PET e PVC foram coletados em máquinas de escala industrial. Com exceção do consumo de água que foi estimado conforme especificações técnicas, os demais dados são de natureza primária (medidos ou calculados). Os dados coletados permitem uma primeira aproximação para consumo energético e indicadores ambientais dos processos de transformação de plásticos no Brasil.