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Purpose: Epithelial cells exposed to carcinogens and genetic damage, once surpass reversible cell damage, either undergo apoptosis or transform into malignancy, chiefly oral squamous cell carcinoma (OSCC). Progressive accumulation of genetic errors in TP53 results in tumorigenesis. Inflammation is also a modulator in this process. The present study attempted to correlate the immunohistochemical expression of TP53 with increased aggressiveness of OSCC, to determine how these immune cells regulate the path of carcinogenesis and to define the role of inflammation in TP53 immunoexpression. Materials and Methods: Tissue sections from 24 biopsy-proven cases of OSCC were stained with anti-TP53 antibody. Five hundred neoplastic epithelial cells and inflammatory cells, each, were counted at invasive tumor front. Two hundred peritumoral neutrophils were counted based on nuclear lobes present. Results: The least TP53 expression was seen in well-differentiated OSCC (P < 0.001), whereas neutrophil count and plasma cell count were found to be least in well-differentiated OSCC (P < 0.001), whereas the number of lymphocytes and macrophages decreased with increased grading of OSCC (P < 0.001). Four- and five-lobed neutrophils were found to be highest in poorly differentiated OSCC (P < 0.001), whereas two-lobed neutrophil count was seen to be maximum in well-differentiated OSCC (P < 0.001). Conclusion: TP53 plays a significant role in the initiation and progression of OSCC. Inflammation plays a role of friend and a foe simultaneously, and little modification in the present treatment modalities for OSCC can bring a favorable change in the life of cancer survivors
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AbstractAim :To compare APACHE-II scoring, C-Reactive Protein (CRP), Interleukin-6 (IL-6) estimation and Contrast Enhanced Computed Tomography in assessing the severity of acute pancreatitis and prognosis of the condition. .To determine the role of these investigations and the most accurate investigation for the detection of severity of acute pancreatitis and prognosis at 72 hours. Method:The present study was conducted at the Department of General Surgery, V.S. General Hospital, Ahmedabad. The Study population consisted of first50 cases of acute pancreatitis fulfilling the inclusion criteria. It was a prospective study. Results: Apache II scoring done at admission predicted severe pancreatitis in 8 cases out of 10 cases which turned out to be severe on Atlantic classification. So, there was 2 false negative cases in severe group. Apache II score at admission predicted 38patients as mild pancreatitis thus giving false positive result in 2 cases. Pearson Chi-square test of significance was applied for the analysis of the data. This clinical scoring done at admission had a sensitivity of 80%,specificity of 95%, positive predictive value of 80%, negative predictive value of 95% and accuracy of 92%. Serum CRP level of the patients at admission predicted 7 as severe pancreatitis out of 10 actual cases of severe pancreatitis thus giving false negative result in 3 cases. This biochemical assay labeled 26 cases as mild at admission thus giving false positive rate in 14 cases. Statistical analysis of the data yielded a p value of 0.07 (Pearson Chi-square test) indicating that the data was statistically insignificant. Estimation of serum CRP level at admission had sensitivity of 70%, specificity of 65%, PPV of 33.33%, NPV of 89.65% and accuracy of 66%. Serum IL-6 level of the patients at admission predicted 8 as severe pancreatitis out of 10 actual cases of severe pancreatic thus giving false negativeresult in 2 cases. This biochemical assay labelled 36 cases as mild at admission thus giving false positive rate in 4 cases. Estimation of serum IL-6 level at admission had sensitivity of 80%, specificity of 90%, PPV of 66.67%, NPV of 94.74% and accuracy of 88%. Conclusion: .Evaluation of the different prognostic indications for the detection of severity at admission showed that Apache II score as well as serum IL-6 were the best indicators of severity. However, due to the complex nature of the calculation, the Apache II score might prove to be cumbersome. Whereas serum IL-6 being costly and not being easily available in the setup is its main drawback.
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Background ,Abdominal wound dehiscence is a common complication of emergency laparotomy in Indian setup.Factors as relates to burst abdomen and they recommended certain surgical measures. These measures included control of nausea and vomiting, decompression of distended abdomen, choice of appropriate sutures, control ofinfection and use abdominal drains.Wound dehiscence is related to the technique of closure of abdomen and the suture used. it is interned to study the closure of abdomen with non-absorbable (Polypropylene, Nylon) versus delayed-absorbable (Polydiaxanone)in cases operated at V.S. Hospital , Ahmedabad with respect to the effectiveness of these different suture materials in our setup.METHODS AND MATERIALS:The present clinical Prospective comparative study was carried out at the surgery department of V.S. hospital from June2014 to Jan 2017. Patients underwent both elective and emergency laparotomy through midline vertical incisions. First 50 cases of midline laparotomy closure were studied with these three suture materials; Polydiaxanone (PDS), Nylon and Polypropylene (PPL) with/without retention suture. The patients were followed regularly after surgery up to 6 months.RESULT:Wound infection is the most important single factor in the development of burst abdomen and incisional hernia.61The incidence of wound infection was in Polypropylene (Prolene)(12.5%), in Polydiaxanone (PDS) (20%) and in Loop Nylon(12.5%) .The incidence of wound infection was related to type of surgery . As in over study infections were higher in emergency surgery then planned surgery, it was 10% in PDS group,12.5% in PPL group and 12.5% in loop nylon group. And in planned surgery only one case had wound infection, which was in nylon group.CONCLUSION:continuous suture technique using no.1 loop Polydiaxanone(PDS) had comparatively higher incidence of wound infection, and also report a case of burst abdomen, but had low incidence of scar pain for closure of midline laparotomy incision, No.1 Polypropylene had high incidence of stitch granuloma and Loop nylon no.1 had a low incidence of infection and stitch granuloma but high incidence of scar pain.. Burst abdomen had high incidence in high risk patient irrespective of suture material used, however this incidence can be reduced by prophylactic retention suturing
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Background and objectives Hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is a dangerous and life threatening complication in severe preeclampsia. It remains as an important cause of maternal and perinatal morbidity and mortality globally. The objective of this study was to find out the incidence of HELLP syndrome in pregnancies complicated by severe pre eclampsia and to assess the maternal and perinatal morbidity and mortality in women with HELLPsyndrome secondary to severe pre eclampsia. Methodology A one year Cross sectional study was conducted in the labour room of KLE Academy of Higher Education and Research (KAHER), Belagavi for the period of one year from January 2016 to December 2016. Ethical clearance was obtained from the JNMC Institutional Ethics committee. The primary objective was to determine the incidence of severe pre eclampsia and HELLPsyndrome in patients of severe pre eclampsia. The secondary objective was to study the associated maternal and perinatal morbidity and mortality. Results During the study period, a total of 6236 number of deliveries were conducted in the hospital. Among them, 312 (5%) pregnant women developed severe preeclampsia and 33 women developed HELLPsyndrome(10.57%). The mean age was 25.18±3.81 years. Labour was induced in 21.21% of the women. Majority (66.67%) of the women had vaginal delivery, while the rest had caesarean section (33%) . The most common indication for LSCS was HELLP 81.82%. Majority (84.85%) of the women had complications of HELLP alone while 9.09% of the women had HELLP syndrome associated with abruption. The mean birth weight was 2.27±0.69 Kgs. All cases had live births. The requirement of NICU admission was noted in 18.18% and the most common cause of NICU admission was Meconium aspiration syndrome with fetal distress (50%). The perinatal mortality rate was 16.67%. Conclusion and interpretation HELLPsyndrome is one of the rare complications of severe pre eclampsia. This study shows 5% incidence of severe preeclampsia and incidence of HELLP syndrome in pregnancy complicated by severe preeclampsia as 10.57%. The incidence in our study is high as our hospital is a tertiary care centre that receives referral cases (high risk with poor prognosis) from North Karnataka for further management.
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Introduction:Posterior urethral valves (PUV) constitute a rather rare congenital disorder with membranous obstruction of the male posterior urethra. This form of infravesical obstruction is potentially seriously detrimental to the more proximal urinary system already prenatally. The aim of study is to study patients with posterior urethral valve and their Biochemical parameters, imaging studies and urodynamic measurements for diagnosis and identifying complications of the disease. Materials and Methods:This study includes a retrospective study of 35 consecutive patients who were admitted in Pediatric Surgery Department of our institute from January 2015 to January 2017.All the patients were admitted and underwent biochemical and radiological investigations. Depending in the results the definitive treatment was planned. All the patients after discharge were kept on regular follow-up. Most of our pateints presented at 1 year or less of age.RESULT: Vesicoureteric reflux was seen in 23 patients(65.71%), comprising of 32 units. (9 patients had bilateral reflux, left sided reflux was present in 8 patients and right sided reflux was present in 6 patients) 12 patients did not have reflux. The urine examination showed infection in 33 patients(94.28%) and presence of albumin in 10(28.57%). S. Creatinine and blood urea were raised in 25(71.42%) case presentation. Out of the 35 patients, 34 patients underwent cystourethroscopy. In all patients cystourethroscopy showed presence of classicalType -I PUV. There was no case of Type III PUVin our study.Conclusion:With availability of renal scan and urodyanamic study, more and more patients of bladder dysfunction and secondary upper tract changes are likely to be diagnosed and evaluated. Increasing awareness and facility for antenatal diagnosis in early gestational age, allows us to terminate pregnancy for the fetus with adverse sonographic findings secondary to posterior urethral valves.Keywords:Posterior urethral valve,PUV,lower urinar