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Background: Haemorrhoids are common pathology of anal canal. Over the last few years, because of new surgical techniques, increased attention has been laid on Surgical Management of hemorrhoids, still open Haemorrhoidectomy remains the mainstay of treatment. Postoperative pain is one of the most common complications of open Haemorrhoidectomy. In our study we decided to compare the incidence of postoperative pain in open Haemorrhoidectomy with or without lateral sphincterotomy. Methods: To compare the incidence of post-operative pain in patient of open Haemorrhoidectomy with lateral sphincterotomy versus open Haemorrhoidectomy without lateral sphincterotomy. Results: In our study group A in which open Haemorrhoidectomy along with lateral sphincterotomy was done had statistically significant less postoperative pain at 6 hours and 24 hours postoperatively and on postoperative day 7 at the time of follow up with Chi square test (P<0.0001). Conclusion: Addition of lateral sphincterotomy decreased post-operative pain and also reduced the need for post-operative analgesia in a significant number of patients. Hence through this study, we concluded that in conventional open Haemorrhoidectomy, addition of lateral sphincterotomy is an effective, convenient, and simple way to reduce post-operative pain.
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Background: Both General and Regional anaesthesia can be used for lower Lumbar Disc surgery but SPINAL ANAESTHESIA is also a better alternative as it is accompanies by less blood loss and haemodynamics instability. Materials & Methods: 60 patients were randomly assigned to receive either General Anaesthesia( GA group) or Spinal Anaesthesia(SA group). Patients were supplemented with i.v. Propofol sedation in Spinal anaesthesia group. The values were recorded preoperative, intraoperative & postoperative. HR, MAP, amount of blood less, surgeon Satisfaction were noted. The severity of nausea, vomiting, duration of recovery and total analgesic use was also recorded. Results: Total anaesthesia, surgical time and blood loss is less in spinal anaesthesia group as compared to general Anaesthesia group. Intraoperative hypertension and tachycardia is more in GA group. Surgeon satisfaction and cost effectiveness is more in SA group. Postoperative nausea ,vomiting is more in GA group. Conclusion: Spinal anaesthesia is better ,safe and economical alternative to general anaesthesia for lower spinal surgery
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Background: Brain Trauma Foundation recommends EDH volume of greater than 30 cm3 warrants surgical evacuation irrespective of Glasgow Coma Scale. Often it is observed that Not all cases of acute EDH require immediate surgical evacuation, cases with lesser than 5 mm midline shift, no focal neurological deficits and GCS>8 and can be managed conservatively provided the patients are closely observed for any deterioration in GCS. For EDH with a volume more or less than 30ml in the supratentorial space and, a midline shift 6-10 mm, with a GCS score > 10, was attempted non-surgical management, with close observation and serial CT scanning. Aim: The aim of this study was to discover the most important factors influencing the management strategy and outcome of EDH. Methods: 70 adult patients treated for EDH were included in this retrospective study, 26 cases (37%) underwent urgent surgery, 44 cases (62.8%) were managed conservatively out of which one third of patient required delayed surgery. Results: Our study showed that out of 62 % of the patients who were conservatively managed, 72 % had a favorable outcome despite the presence of a midline shift of 6- 10 mm and an EDH volume of >30 ml but having a good GCS score. Conservatively managed patients with GCS >10, 77% had Good Recovery. Those with high EDH volume, 61% had a good outcome. 84 % of the patients having a midline shift between 6-10 mm had a good recovery. Patients with GCS < 8 had a poorer outcome than patients in good neurological status, regardless of the therapy. Conclusions: Hence we conclude, EDH must be promptly diagnosed by CT scan and considered as an emergency lest misdiagnosed and should be admitted into a neurosurgical care unit. Close neurological monitoring, appropriate follow up CT scans in the setting of improved GCS score resulting in good outcome in patient on conservative management.
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Background: Breast cancer is the second most common malignancy in Indian women. Among the members of the steroid receptor superfamily the role of estrogen and progesterone receptors (ER and PR) is well established in breast cancer in predicting the prognosis and management of therapy, however, little is known about the clinical significance of androgen receptor (AR) in breast carcinogenesis. The present study was aimed to evaluate the expression of AR in breast cancer and to elucidate its clinical significance by correlating it with other hormonal receptors and clinical parameters. Methods: It was a prospective study which include 30 patients of histopathologically proven breast cancer admitted to department of surgery at S.N Medical College Agra .Expression of AR, ER, PR, HER2/ neu receptor by immunohistochemistry (IHC) and clinical parameters were studied. Results: AR expression is related to ER(P<0.015), PR(p<0.008) and triple negative breast cancer patients (p <0.008). There is significant correlation between AR and menopausal status(p<0.006) while no significant correlation was found with age and parity. Conclusions: Since there is significant association of AR in triple negative and post-menopausal women so we can say that AR expression possibly help in confirming their predictive role for therapeutic response in breast cancer patients
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Anatomy and dissection have long been considered a cornerstone in medical education, irrespective of nation, racial background or medical school. By learning gross anatomy, medical students get a first “impression” about the structure of human body which is the basis for understanding pathologic and clinical problems. Anatomy teaching methodology has been revolutionized in the 2Ist century, due to time constraints, less availability of cadavers, stress on computer aided learning, scarcity of qualified teachers, changes in the demands of medical profession and neglect of vertical integration of anatomy teaching. Until recently, dissection and didactic lectures were its sole pedagogy, worldwide. But over the last few decades, traditional anatomy teaching based on topographical structural anatomy taught in lectures and gross dissection classes has been replaced by a vivid range of study modules like problem based learning(PBL) and computer assisted learning(CAL),and curricula integration. Though the anatomy curriculum is undergoing international reformation but it lacks uniformity among institutions. The available modern international literature, describing various methodologies for teaching/learning anatomy conclude that Anatomists are constantly debating over the following questions-How much to teach, when to teach and how to teach gross anatomy. We endeavor to answer these questions and contribute to the debate on the ideal methodology for teaching /learning anatomy. Alternative strategies and resources are also discussed so that we can re establish more effective teaching /learning tools while maintaining the beneficial values of orthodox dissection .If we are not concentrating on optimum anatomy education, it will inevitably lead to incompetent anatomists and healthcare professionals, leaving patients to face unwanted consequences of medical error.
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Among the chemical hazards, heavy metal like nickel (Ni) is considered to be a serious one. It induces severe liver and kidney damage by altering several marker enzymes and ascorbate-cholesterol metabolism. The objective of the study was to investigate the possible protective role of α-tocopherol on NiSO4 (Ni II) exposed alteration of hematological parameters, markers of liver and kidney functions, hepatic and renal antioxidant defense system in male albino rats. We have studied the effects of α-tocopherol supplementation on nickel sulfate induced alteration of body weight, hematology, liver and kidney toxicity markers (SGOT, SGPT, total protein, urea, creatinine) and hepatic and renal antioxidant defense system of male albino rats. Nickel toxicity results in decreased body weight gain and relative liver and kidney weight. Nickel treatment also resulted in alteration of hematological parameters along with increased liver and kidney toxicity markers. Nickel sulfate administration significantly increased the level of lipid peroxides and decreased antioxidant enzyme activities in hepatic and renal tissue. Simultaneous treatment with á-tocopherol exhibited a possible protective role on the toxic effect of nickel on body and organ weights, hematological parameters, SGPT activity and improved tissue antioxidant defense system. α-tocopherol, may partially prevent nickel induced alteration of hematological and biochemical parameters as well as have amelioratic effects on nickel induced alteration of antioxidant status of liver and kidney.
ABSTRACT
Heavy metals are stable environmental contaminants, causing various alterations in target tissues. Garlic has some beneficial effect in preventing heavy metal induced various alteration. The objective was to investigate the possible protective role of fresh aqueous homogenate of garlic on hematology, erythrocyte antioxidant defense system in male albino rats treated with NiSO4 and K2Cr2O7. Rats were divided into six groups. Group I was untreated control. Group II was given aqueous homogenate of garlic (orally). Group III was administered with nickel sulfate (i.p). Group IV was given NiSO4 and garlic simultaneously. Group V was administered with K2Cr2O7 (i.p). Group VI were treated simultaneously with K2Cr2O7 and garlic. RBC, WBC, platelet count, PCV%, hemoglobin concentration decreased significantly and clotting time increased significantly after nickel treatment. After chromium treatment all the values decreased except clotting time. Increased malondialdehyde and glutathione level after nickel and chromium treatment was observed. Also erythrocyte superoxide dismutase, glutathione peroxidase and catalase activities significantly increased after nickel and chromium treatment. Simultaneous garlic supplementation exhibited protective role to combat nickel toxicity, whereas no such beneficial effects were observed for chromium (VI). Garlic may partially prevent nickel and chromium induced alteration but such ameliorated effects as an antioxidant is only restricted on nickel induced alteration.