Comparison between the conventional method & molecular line probe assay for identification & drug sensitivity of mycobacteria tuberculosis from clinical specimens.

Rapid susceptibility testing of Mycobacterium tuberculosis strains is imperative for therapy selection but traditional drug susceptibility tests take weeks or are expensive. Classical drug susceptibility (DST) may take up to 2 to 4 months. The line probe assay is a commercially available line-probe assay that rapidly detects Mycobacterium tuberculosis (MTB) complex, as well as the most common mutations associated with rifampicin and isoniazid. In this study we assessed the sensitivity and specificity of the rapid molecular method in comparison with the conventional method.

Idiopathic granulomatous mastitis: a great diagnostic challenge.

Idiopathic granulomatous mastitis is a rare chronic inflammatory lesion of breast which presents as a spectrum of diseases and is diagnosed only histological. It is often a diagnosis of exclusion in most of the cases. Medical and surgical treatments have been tried with varied success rates and till today no standard protocol could be made in its management though excision remains the treatment of choice in refractory cases which is associated with morbidity more due to psychological factors. In the present case, medical treatment was tried in the initial phase followed by wide excision.

Feasibility of Laparoscopic Cholecystectomy Under Spinal Anaesthesia.

Laparoscopic Cholecystectomy (LC) has been conventionally done under general anaesthesia (GA). Regional anaesthesia is usually preferred in patients where GA is contraindicated. In this study, we present experience of using spinal anaesthesia (SA) for LC with the contention that it is a good alternative to GA. Spinal anaesthesia was used in 134 patients in whom LC was planned. There was no modification in the technique, and the intra abdominal pressure was kept at 8mm Hg to 12 mm Hg. Sedation was given if required, and conversion to GA was done in patients not responding to sedation or due to failure of SA. Results were compared with 100 patients who had undergone LC under GA. Out of 134 patients, two patients required conversion to GA. Hypotension requiring support was recorded in 28 (20.89%) patients, and 32 (23.88%) experienced neck or shoulder pain, or both. Postoperatively, 2.9% (4) of patients had vomiting as compared to 33% (33) of patients who were administered GA. Injectable diclofenac was required in 36.56% (49) for abdominal pain within 2 hours postoperatively and oral analgesic was required in 106 (79.10%) patients within the first 24 hours in SA group. However, 96% of patients operated under GA required injectable analgesics in the immediate postoperative period. Postural headache was experienced by 8 (5.9%) patients postoperatively. Average time of discharge was 1.9 days in patients operated under SA.