ABSTRACT
Background: Breast cancer patients with the same stage of disease can have markedly different treatment responses and overall outcome. The strongest predictors for metastases (for example, lymph node status and histological grade) fail to classify accurately breast tumors according to their clinical behavior. The discordance in estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor 2 (HER2) status between primary and recurrent breast cancer are being intensively investigated and a large amount of data have been produced. Aim: To study the epidemiological and clinical profile of carcinoma breast with analysis of receptor status. Materials and methods: A descriptive study of 40 cases of carcinoma breast with receptor analysis, in Vinayaka Missions Medical College, Karaikal, from June 2015- June 2016 was done. Detailed history, clinical examination, and investigations were done, after staging, patients were treated with a suitable type of mastectomy, chemotherapy, radiotherapy and hormonal therapy as indicated. Cases were followed up for one year, data thus obtained was analyzed and results compared. Results: All our cases were unilateral- 26 (65%) right breast and 14(35%) left breast. Majority of the cases had lump measuring >5cm –30 (75%). 23 (57.5%) of cases had a tumor in the upper outer quadrant, followed by other locations. Most of the cases were stage III- 27 (67.5%), 3 (7.5%) had metastasis at the time of presentation. The predominant histological type was infiltrating ductal M Balasundaram, Reny Jayaparakas, Subith P Bhaskar. Clinical study of molecular hormonal receptor level status among carcinoma of breast in Karaikal population. IAIM, 2017; 4(10): 151-156. Page 152 carcinoma 31 (77.5%). There was a predominance of ER+/PR+24 ( 60%), followed by ER-/PR-, ER+/PR- then ER-/PR+. Conclusion: Majority of the cases belonged to stage III, with a predominance of infiltrating ductal carcinoma. Reporting to the hospital in earlier stages of the disease is lacking in the study population and highlights the need for public education and screening methods. It also emphasizes to analyze hormone receptor status in patients, as receptor positive status significantly reduces recurrence if hormone therapy is initiated.
ABSTRACT
Background: The link between varicocele and infertility was first reported by cessius in 1st century AD but it was not widely acknowledged until TULLOCH and colleagues reported the improvement of sperm parameters in 26 of 30 patients undergoing varicocelectomy. Varicocele is defined as excessive dilatation of pampiniform venous plexus of spermatic cord. varicocele is an important cause infertility which can be corrected by surgery. Several methods have been used for its treatment including open surgical ligation of spermatic veins as well as laparoscopic varicocelectomy. Open varicocelectomy has more risk of recurrence and complications whereas laparoscopic varicocelectomy is simple, has less risk of recurrence and complication in expert hands. Objectives: To compare Laparoscopic varicocelectomy with open varicocelectomy, in terms of postoperative pain, recurrence rate, hospital stay, cost, cosmetic and complication. To prove hospital stay was more in open group than laparoscopic group and also patient of laparoscopic group return to normal activities earlier than open group. To standardize the laparoscopic varicocelectomy procedure for varicocele. Materials and methods: It was a randomized clinical trial done in Department of General Surgery, Vinayaka Mission Medical College, Karaikal. Study was carried out from 1 st March, 2015 to 1st R. Bharathidasan, Reny Jayaprakash, Subith P. Bhaskar, G. Ambujam. Laparoscopic varicocelectomy now the gold standard procedure for varicocele - A comparative study with open technique based on our experience. IAIM, 2017; 4(7): 218-221. Page 219 March, 2016. A total 70 patients was taken in our study of its 36 patient undergone open varicocelectomy and 34 patient undergone laparoscopic varicocelectomy. Results: Recurrence rate 0% in Laparoscopic Varicocelectomy and 5.6% in open varicocelectomy. Wound complication was 0% in Laparoscopic varicocelectomy and 2.5% in open varicocelectomy. Post-operative pain was more in open group as compared to laparoscopic varicocelectomy. Laparoscopic varicocelectomy has less post-operative morbidity and early return to normal activity. Also there was improvement in seminal analysis in both groups. Conclusion: We would like to standardize laparoscopic varicocoelectomy and make it as a gold standard for Varicocele by replacing open technique provided there is good experienced surgical team and good instrumentation. Cost of the procedure is comparatively high.