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Background: The study was to compare 25-hydroxy vitamin D levels in women with benign and malignant breast disease patients to the age-matched controls in a tertiary care center in North India.Methods: This was a prospective study carried out in the Department of Surgery, S.R.N. Hospital associated with M.L.N. Medical College, Allahabad. The levels of vitamin D are measured by electrochemiluminescence and the serum levels divided into normal, mild, moderate, and severe vitamin D deficiency.Results: Overall 60 patients were included. 30 was having malignant breast disease and 30 having benign breast disease. On comparing the mean value of serum vitamin D level between malignant breast disease and controls, the serum vitamin D level was found to be lesser in the former group and the difference was highly significant. On comparing the mean value of serum vitamin D level between benign breast disease and controls, the serum vitamin D level was found to be elevated in the former group, the difference was nonsignificant.Conclusions: Our study supports the hypothesis that vitamin D deficiency is an important risk factor in the development of malignant breast disease. The study was also concluded that vitamin D is not associated with the etiogenesis of benign breast diseases. There is also a possibility of using 25-hydroxy vitamin D as an adjuvant therapy during the treatment of breast malignancy.
ABSTRACT
Pancake kidney is one of rare form of congenital developmental anomaly of kidney. Very rarely it is drained by a single ureter. We are reporting a case of pancake kidney with a single draining ureter. The diagnosis was made during the routine workup for abdominal pain and UTI in a 12 year old male child. Usually pancake kidney may be associated with other congenital malformation but in our case we did not find any. Pancake kidney is managed surgically as well as conservatively depending upon the presenting symptoms and problem. This case was managed conservatively for recurrent UTI.
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Background: There is paucity of information regarding the effects of cholecystectomy on serum lipid profile parameters and blood glucose levels in the patients of cholelithiasis. Therefore, this study was undertaken to compare some serum lipid parameters and blood glucose levels in patients of cholelithiasis and effect of cholecystectomy on the same.Methods: The study was conducted on 50 patients of cholelithiasis who were admitted in Surgery department, MLN Medical College over a period of one year and were planned for cholecystectomy. Complete lipid profile (which included total cholesterol, triglycerides, high density lipoproteins (HDL) cholesterol, low density lipoproteins (LDL), very low density lipoproteins (VLDL) and atherogenic index) and fasting blood glucose was evaluated pre-operatively and post-operatively on the 3rd, 7th and further after 1 month of cholecystectomy. Results: Out of 50 patients, maximum of 38% were in their 4th decade with females constituting 82% of total. There was significant elevation in fasting blood glucose and HDL cholesterol on 3rd, 7th and 30th day post-cholecystectomy as compared to pre-operative values (p value<0.0001). Triglyceride and VLDL cholesterol elevated on 3rd and 7th day but it significantly decreased one-month post-cholecystectomy as compared to pre-operative levels (p value<0.0001). However, LDL, total cholesterol and atherogenic index significantly decreased on 3rd ,7th and 30th day post-cholecystectomy.Conclusions: Cholelithiasis is an important cause associated with significant pathological changes in many lipid profile parameters, which will return towards normal after cholecystectomy. This normalization will be a time dependent phenomenon with long term beneficial effects.
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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.
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Background: Breast cancer is the most common female cancer worldwide representing nearly a quarter (25%) of all cancers. Search for a marker which can predict lymph node metastasis in clinically negative axilla has been a matter of research for long. The present study is an attempt to evaluate role of coagulation makers with special reference to D-dimer and factor 7 and 8 in patients of carcinoma breast in predicting lymph node metastasis in carcinoma patients.Methods: The study was a prospective study conducted in 50 diagnosed patients of carcinoma breast in whom D dimer levels and factor 7 and 8 levels were measured at the time of commencement of the treatment and at six weeks after surgery.Results: Most of the patients in the study group were in the age group 41-70 (80%) years. 22% patients were of early Breast cancer. The reduction in D-dimer, factor VII and factor VIII value after 6 weeks of surgery were significant (p value 0.0001 for all three).Conclusions: D-dimer and factor VII were found to be an independent predictive factor for lymph node metastatsis, thus providing as a safe, easy, objective and convenient supplement to sentinel node biopsy in assessing metastatic disease in axilla. Combined- with other biomarkers, it may prove to be an alternative to sentinel node biopsy in assessing metastatic disease in axilla. Significant postoperative decrease in D-dimer, factor VII and factor VIII may provide objective criteria to assess completion of surgery.
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Background: Liver abscess is defined as collection of purulent material in liver parenchyma which can be due to bacterial, parasitic, fungal, or mixed infection. Liver abscess are categorized into various types based on etiology, of which Amoebic Liver Abscess and Pyogenic Liver Abscess are major types. Common presenting complains of liver abscess are abdominal pain, fever, and weight loss. Most of the amoebic liver abscesses are typically right lobe solitary abscess. Majority of patients are young alcoholic male of lower socioeconomic class. Methods: 60 patients of liver abscess were studied for etiology and clinicopathological evaluation. Results: Out of total 60 cases studied, 47 (78.34%) patients had amoebic liver abscess in which 41 (68.33%) patients had primary amoebic liver abscess with positive amoebic serology and rest 6 (10%) cases had amoebic liver abscess with secondary bacterial infection in which amoebic serology and pus culture both were positive. 11 (18.33%) patients had pyogenic liver abscess in which only pus culture was positive and amoebic serology was negative. Rest 2 (3.33%) patients had abscess of indeterminate etiology in which amoebic serology and pus culture both were negative. Conclusion: Majority of patients of liver abscesses studied were amoebic in nature with positive amoebic serology.