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Background: Surgical site infection (SSI) is the most common complication occurring in 19–47% of patients undergoing surgery for head-and-neck cancers. This study aims to assess the predictive factors of SSIs and antibiotic resistance patterns in patients undergoing resection and reconstructive surgery for oral cancers. Materials and Methods: The clinicopathological data of all patients who underwent surgery for oral cancers at our oncological referral center in South India between October 2014 and May 2019 were reviewed. The differences between groups were compared using independent samples t-test or Mann–Whitney U-test and categorical data were analyzed by Pearson’s Chisquare test, Fisher’s exact, or continuity correction where appropriate. Receiver operating characteristic (ROC) curve analysis was performed to find the cutoff levels for the various predictors of SSI, using the Youden’s index method. A linear regression analysis was done to define the cause-effect relationship of the categorical response variable with explanatory variables. Results: Of the 135 patients who were studied in our cohort, 43 patients (31.2%) developed SSI. The most commonly isolated organism was Staphylococcus aureus (11%; n = 15) followed by Enterococcus species (4.4%; n = 6) followed by coagulasenegative S. aureus (3%; n = 4) and Escherichia coli (37%; n = 5). In this study, univariate and multivariate analyses have showed that diabetes mellitus, body mass index (BMI) >25 or <18, neutrophil-to-lymphocyte ratio (NLR) >3.75, platelet-tolymphocyte ratio (PLR) >137.5, neoadjuvant chemotherapy or radiotherapy, prolonged operative duration, and prolonged anesthesia exposure may render patients more vulnerable to SSI. Moreover, among these parameters, a PLR >137.5, NLR >3.75, and BMI >25 or <18 were found to be highly predictive of SSI. The highly resistant organisms isolated were S. aureus and Enterococcus species in our study. Conclusion: The identification of these risk factors in patients undergoing surgery for oral cancers can help in the identification of patients who may be at a higher risk of developing SSI and therefore help in improving the overall outcome, especially in an LMIC setting.
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INTRODUCTION: Cervical cancer is the second most common cancer among Indian women. Radical radiotherapy with external beam radiation therapy (EBRT) and brachytherapy is the standard treatment for FIGO stage IB2 to IVA. An appropriate selection of brachytherapy applicator is needed according to the patient's anatomy. The two most commonly used applicators for intracavitary radiotherapy (ICR), Fletcher's and Henschke, have dosimetric differences which are not well studied with two-dimensional (2D)-based planning which is the most common method used for women with carcinoma cervix in India. The purpose of our study was to compare and evaluate the dosimetric differences between these two applicators, which would help in better selection of the applicator in cervical cancer patients. MATERIALS AND METHODS: This is a single-institute prospective study. Fifty patients randomly included in the study received EBRT and ICR by Ir192 HDR remote afterloading technique with computer-based 2D planning. Fletcher's and Henschke applicators were used alternately for first two fractions. RESULTS: The results of the study showed lower bladder and rectal doses with Fletcher's applicator and similar doses to point A for both applicators. However, point B doses are lower with Fletcher's applicator. CONCLUSION: Our results showed a favorable dosimetry with Fletcher's applicator in ICR of carcinoma cervix. The feasibility of placement is much better for Henschke but dosimetric advantages of Fletcher's encourage use of Fletcher's applicator for patients with favorable anatomy to reduce organs at risk doses but with the disadvantage of lower dose to point B.
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Objective: The present study is to evaluate antiepileptic activity of some fluoro benzothiazolo oxadiazolo quinazoline and sulfonamido quinazoline derivatives. Background of the Study: Epilepsy is a chronic disorder of the brain, characterized by the periodic and unpredictable occurrence of seizures. Epilepsies affect around 1–2% of the world population including the fact that the convulsions of approximately 25% of epileptics are inadequately controlled by medication. Materials and Methods: Albino mice (weighing 20-25g) of either sex were used in this study. MES seizures were induced in mice by delivering electroshock of 60ma for 0.2 seconds by means of an electro- convulsiometer transauricularly through a pair of ear clip electrodes. Both test animals and standard group received diazepam (5mg/kg) p.o strychnine nitrate (1 mg/kg) was administered. Results and Discussion: MES induced convulsion the mentioned dose was administered one hour prior to MES elicitation. It was observed that all SSBDs except ap- 7, bz-10 and s-5 shown significant anticonvulsant effect. The results are compiled in the Table 1 and graphically depicted in Figs 1 and 2 respectively. Conclusion: The present investigation revealed that the SSBDS ap-3, ap-6 and bz-9 were shown significant anticonvulsant activity against both MES and strychnine induced models.
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Immunomodulatory effect of ethanolic extract (50%) of M. oleifera leaves (MOE) has been studied in normal and immunosuppressed mice models. Different doses of MOE i.e. 125, 250 and 500 mg/kg body weight of mice were administered orally for 15 days. Cyclophosphamide at a dose of 30 mg / kg body weight was administered orally for the next 3 days. On day 16 and 19, hematological parameters like white blood cell (WBC) count, red blood cell (RBC) count, haemoglobin level (Hb), percent neutrophils and organ weight were recorded. Effect of MOE on phagocytic activity of mice macrophages was determined by carbon clearance test. MOE showed significant dose dependent increase in WBC, percent neutrophils, weight of thymus and spleen along with phagocytic index in normal and immunosuppressed mice. The results indicate that MOE significantly reduced cyclophosphamide induced immunosuppression by stimulating both cellular and humoral immunity.
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Laparoscopic fundoplication is rapidly becoming the surgical procedure of choice in western countries for the management of gastro-oesophageal reflux disease (GERD). Experience with this technique is limited in India. Most operations continue to be performed through the traditional open technique, thus denying the advantage of a minimal invasive approach to patients. This study was done to evaluate the feasibility and short term results of laparoscopic Nissen fundoplication. Between June 2000 and March 2002, a total of 10 patients with GERD refractory to medical therapy or requiring daily treatment underwent laparoscopic Nissen fundoplication. Preoperative evaluation included scoring of symptoms, oesophagogastroduodenoscopy, barium swallow and nuclear scan. The intraoperative and post-operative course of the patients was recorded. At 3 months post-surgery, patients were re-evaluated using pre-operative symptom scores and investigations to assess the benefit of and complications associated with surgery. Laparoscopic nissen fundoplication was successfully completed in all the patients. Follow up ranged from 3 to 18 months with a mean of 5.9 months. The mean symptom score decreased from 10.1 pre-operatively to 1.7 (p value < 0.001). Eight out of 9 patients (88%) had endoscopic resolution of oesophagitis. Seven patients (70%) were off medication following surgery while the remaining 3 (30%) were taking medication intermittently. Overall, 80% of the patients were satisfied with the surgery. One patient required re-exploration due to bleeding from a short gastric vessel. The most frequent post-operative complication was temporary dysphagia in 60% of patients, which improved with conservative management over 2 to 3 weeks. We concluded that laparoscopic Nissen fundoplication is a safe and effective procedure to treat patients with GERD.