ABSTRACT
Background: Gastric neuroendocrine tumors (G-NETs) are classified into well-differentiated NETs with three grades and poorly differentiated neuroendocrine carcinomas based on morphology and the Ki-67 index. Besides, G-NETs are broadly classified into four types based on clinical and pathophysiological features. Aim: To study clinical and pathological features of different types and grades of G-NET. Materials and Method: All G-NETs, diagnosed from January 2011 to December 2020, were included. Clinical presentation, peritumoral findings, lymph node status, and liver involvement were obtained and correlated with different grades and types of G-NETs. Results: NET was diagnosed in 88 cases. Tumors were graded as I, II, III, and carcinoma in 58, 14, 12, and 4 cases, respectively. Type I NET (49.2%) in the background of chronic atrophic gastritis was the most common type followed by type III (33.3%). Type I tumors were predominantly graded I (91.1%) and limited to the mucosa and submucosa. MEN-1-associated G-NET (type II) was seen in eight cases. All except one type II tumor was associated with ZES syndrome. Remarkably, peritumoral mucosa showed atrophy and intestinal metaplasia in 52.1% and 24.6% cases, respectively. Two cases were associated with adenocarcinoma. Lymph node metastasis was seen in all carcinoma and grade III cases. All carcinoma cases and 58.3% of grade III tumors showed liver metastasis. Conclusion: Biological behavior of G-NET varies with different types and grades of tumor. Typing and grading of G-NET should be done whenever possible to predict the aggressiveness of the tumor.
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Background: Cholecystitis is one of the most common indications for abdominal surgery. Routine examination of gallbladder grossly and microscopically shows lot of interesting findings. This study aims to quantify the various outcomes of routine gallbladder examination following cholecystectomy procedure.Methods: All clinical details and data from case sheet and patient history are collected and analysed for all the patients who underwent cholecystectomy surgery in the Department of General Surgery, Govt. Omandurar Medical College, Chennai, from August 2017 to August 2018. The Study period of this study was from August 2017 to August 2018. Three sections each from neck, body and fundus taken. Tissues were processed in automated tissue processor and paraffin blocks made. Statistical analysis of the data was done.Results: Total number of specimens received were 36. And among the cases the number of females were 33 and the number of males were 3. The number of cases of calculous cholecystitis were 31 and the number of cases with pigment stones were 26, number of cases with cholesterol stone were 2 and the number of cases with mixed stones were 3. The number of cases of acalculous cholecystitis were 5. The number of cases of cholecystectomy by laproscopy were 30 whereas the number of cases of cholecystectomy by open procedure were 6. Chronic cholecystitis was seen in 34 cases and chronic cholecystitis with stones was seen in 29 cases and chronic cholecystitis without stones was seen in 5 cases and Acute on chronic cholecystitis with pigment stone was seen in 1 case and xanthogranulomatous cholecystitis with pigment stone was seen in 1 case.Conclusions: The risk factors for developing chronic cholecystitis was seen in female gender. The predominant histomorphological pattern seen in this study group is chronic calculous cholecystitis. And the predominant type of stone found in this study is pigment stone compared to mixed and cholesterol stone.
ABSTRACT
Background: Appendicitis is sufficiently common that appendicectomy is the most frequently performed urgent abdominal surgery. Despite extraordinary advances in modern radiographic imaging and diagnostic laboratory investigations, the diagnosis of appendicitis remains essentially a clinical diagnosis. Aim of the study: To determine the outcome of laparoscopic appendicectomy compared to open appendectomy and to rule out the clinical outcome between two major procedures. Materials and methods: This comparative study was done in Government Medical College, Omandurar Government Estate in 2016 to 2018. A total of 75 patients' files that underwent surgery within the study period were perused. Thirty-two patients (42.7%) underwent laparoscopic surgery (LA) and 43 patients (57.3%) underwent open appendicectomy (OA). The relevant data was then extracted from the case notes using a pre-designed proforma questionnaire. Results: There were a total of 44 male patients and 31 female patients in the study. All patients undergoing either LA or OA presented with right iliac fossa pain. Patients who presented with nausea undergoing LA were 53.13% while 31.11% undergoing OA presented with nausea. Vomiting was present in 18.75% of patients undergoing LA while 44.44% of the patients undergoing OA had vomiting. Fever was noted in patients undergoing OA (15.55%). Majority of patients had symptoms duration of between one day and one week. Those with symptoms durations of less than one day were 9.4% for LA group and 23.3% for the OA group. Urea and electrolytes were done in 93.8% of A. Sagaya Inba Sekar, Anandi Andappan. Comparative study on laparoscopic appendicectomy versus open appendicectomy in a tertiary hospital at Chennai. IAIM, 2019; 6(3): 182-187. Page 183 patients undergoing LA and 69.8% of those undergoing OA. Abdominal ultrasound was performed in 40.6% of patients undergoing LA and 18.6% of a patient undergoing OA. Urinalysis and microscopy were performed in 6.3% of patients undergoing LA and 9.5% of patients undergoing OA. Wound sepsis occurred in 6.7% of patients undergoing OA. Miscarriage occurred in 1 patient undergoing OA. Only one patient in LA developed complication due to ileus. Conclusion: Laparoscopic appendicectomy takes longer to perform our institution than open appendicectomy. Postoperative complications are lower with laparoscopic appendicectomy when compared with open appendicectomy.
ABSTRACT
Purpose: Staphylococcus epidermidis is a major commensal bacteria. Various strains of S. epidermidis are capable of forming biofilms by attaching to several surfaces. Biofilm-forming ability of this organism is found to be associated with many hospital-acquired infections and can even impair wound healing. S. epidermidis strains producing polysaccharide-biofilms possess the intercellular adhesion (ica) operon while strains forming the protein adhesion-mediated biofilms possess the accumulation associated protein (aap) gene. We screened for biofilm-forming S. epidermidis in the skin of healthy individuals in Tamil Nadu in order to determine the risk of acquiring S. epidermidis infections in hospital settings. Materials and Methods: Skin swabs were taken from seventy two subjects residing in Chennai with healthy skin who showed no visible signs of skin lesions or allergies. S. epidermidis was isolated from 58 samples out of the 72 collected. The presence of ica operon in S. epidermidis isolates was determined by PCR and biofilm production was examined using quantitative tissue culture plate assay. Results: Majority of the samples (47/72; 65.3%) showed pure S. epidermidis growth, (14/72; 19.4%) showed pure Staphylococcus aureus growth and the remainder (11/72; 15.3%) showed mixed growth. Biofilm-forming S. epidermidis were found in the majority of samples (53/58; 91.4%) and ica operon was detected in 19 samples out of 58 (32.8%) which is a significantly higher percentage when compared to other studies conducted at different parts of the globe ( P = 0.0003). Conclusion: We inferred that ica operon and biofilm-forming S. epidermidis are common in the healthy skin of individuals in Tamil Nadu. Measures have to be taken to reduce the risk of hospital-acquired S. epidermidis infections.