ABSTRACT
Background: Breast cancer is the most common cancer in women worldwide. The commonest mode of presentation of diseases of the breast is lump. It is the most common site-specific cancer in women. Triple test score which includes clinical breast examination, mammogram, FNAC score. A simple non-invasive but reliable test can make a huge difference in management between benign and malignant lumps. Aims and objectives of the study were to differentiate between benign and malignant lesions based on TTS and correlated the accuracy of triple test score with histopathology report, and plan the management accordingly.Methods: A prospective study was carried out in which TTS was calculated by summation of individuals’ scores of all three components and compare with histopathology report.Results: In present study of 74 patients (age group of 30 to 65 years), based on TT score 52 benign, 12 malignant, and 10 suspicious (neither benign nor malignant). But the final histopathological result showed 59 as benign and 15 as malignant, which is in concordant with TTS, which shows the accuracy of up to 100%. Out of 10 (suspicious) which were dis-concordant, 7 are benign and 3 are malignant on histopathology.Conclusions: By use of the triple test score and its interpretation, definitive treatment can be initiated, which would reduce the need for unnecessary biopsy and its ability to predict benign lump, can avoid major surgery.
ABSTRACT
Background: Some of the most common wound complications following laparotomy include hematoma formation, seroma formation, wound infection, burst abdomen and wound dehiscence. Closed-suction drains (CSDs) help to drain any wound collection and also reduce any dead space in the wound thereby promoting healing and preventing complication.Methods: We conducted a prospective study and included patients presenting with acute abdomen in emergency department. Patients were selected as per inclusion and exclusion criteria. Two groups (group A and B) with equal number of patients were created based on closed envelope technique. CSD was placed in the wound of patients in group A. Wound healing and complications were compared between the two groups.Results: 50 patients were included in the study with 25 in each group. Hematoma formation was found to be significantly more among group B (24.0%) compared to group A (4.0%). Seroma formation (p value =0.03917), SSI rate (p value =0.039) and wound dehiscence/burst abdomen (p value =0.0415) was more in group B than group A. The mean wound healing time (days) and mean hospital stay (days) was significantly more in group B.Conclusions: Placing a subcutaneous vacuum suction drain at the time of abdominal wall closure during emergency laparotomy results in better wound healing and reduces postoperative wound complication, hospital stay time, morbidity and also decreases overall healthcare cost.
ABSTRACT
Background: Pancreatic injuries are usually subtle to identify by different diagnostic imaging modalities and these injuries are often overlooked in cases with extensive multi-organ trauma. Our study was conducted to evaluate the outcome of a step-up approach in the management of pancreatic trauma patients with late presentation.Methods: The study included 15 patients who presented with grade III AAST delayed presentation of pancreatic trauma from September 2017 to 2019. In our step-up approach 2 staged procedure was done, firstly laparotomy with necrosectomy along with closure of proximal pancreatic duct with external drainage of pancreatic duct, in second stage Roux-en-Y pancreaticojejunostomy was done to drain the remnant pancreas as a definitive procedure 3 to 6 months after initial procedure.Results: In our study, blunt trauma abdomen (83.30%) (n=10) was the most common mode of injury. The main reason for delay in diagnosis of pancreatic trauma was delayed presentation of patient (83.3%) (n=10). Total of 4 patients were admitted to intensive care unit (ICU) at the time of admission. 10 patients underwent both the stages of step up approach management among which one patient had pancreatic fistula as a complication (n=1) (10%) and one patient had post-operative abscess as a complication (n=1) (10%). No mortality was noted in our study.Conclusions: The step-up approach discussed above proves to be beneficial towards management of patients with delayed presentation of pancreatic trauma in our setting.