Thoracodorsal artery perforator flap in immediate breast reconstruction: a series of twenty cases

Background: The management of breast cancer has shown a progressive change, from radical ablative surgery, to breast conserving techniques. Traditionally, the mini latissimus dorsi flap has been used for reconstruction; which is associated with donor site morbidity. Vascular research has now allowed the use of perforator-based flaps for reconstruction, which reduce donor site morbidity.Methods: Twenty thoracodorsal perforator flaps in twenty early breast cancer patients were studied between January 2018 and December 2018. Parameters studied were adequacy of volume, ease and time taken for flap elevation, and final aesthetic outcome.Results: Flap volume was adequate to fill defect. One of twenty cases had flap loss due to venous congestion secondary to pedicle kinking. Average time taken for flap elevation was 70.45 minutes. All patients were satisfied with cosmetic outcome.Conclusions: The TDAP flap is a safe and reliable flap which provides adequate volume for partial breast reconstruction.

Comparative Study of Topical Treatment in Allergic Rhinitis Using Azelastine and Fluticasone in a Combination Verses Fluticasone Propionate Alone.

Background: Amongst the common problems facedglobally, Allergic Rhinitis (AR) is very distressing attimes. This is an inflammatory response to either knownor unknown allergen. The symptomatic relief in ARusing topical steroid Fluticasone propionate andantihistaminic Azelastine Hydrochloride in acombination has been studied. Very few studies showingcomparison between these two drugs in a combinationand steroid alone are available in the literature. Aim andObjectives: To study the effectiveness of topicaltreatment using corticosteroid Fluticasone propionateand antihistaminic in a combination versus Fluticasonepropionate alone in patients of AR. Material andMethods: The cases presented with symptoms ofallergic rhinitis were randomized in two groups at startof treatment. All cases of Group I were treated withFluticasone propionate whereas of Group II withFluticasone propionate and Azelastine hydrochloridecombination. In each group, the individual symptomscores were recorded pre-treatment and post-treatmentat the end of four weeks with the help of symptomevaluation scale. Based on these individual symptomscores, the Total Symptom Score (TSS) was calculated.The effectiveness of group specific drugs was evaluatedby comparing individual and TSS. Results: After fourweeks, both TSS and individual symptom score werereduced in either group (p<0.05). Further, Group IIspecific drug was found more effective than Group-I inrelieving symptoms of AR. Conclusion: TSS decreasedby an average of 84.14% in Group-I (i.e. treated withFluticasone propionate) and by 91.16% in Group–II (i.e.treated with Fluticasone propionate and Azelastinehydrochloride I in a combination).

Liver Enzyme Changes in Lap Appendectomy a Reason for Concern

Introduction: Abdominal pain remains the foe runner of complaints’ presenting to the general surgeon in the present world. Acute appendicitis is the most common of the acute abdominal conditions presenting which requires immediate surgical intervention. Materials and Methods: The study was a prospective experimental study conducted on 100 cases evaluated and diagnosed as acute appendicitis and was admitted to Father Muller Hospital who underwent laparoscopic appendectomy from the time period September 2014 to August 2016. Results: In present study, the enrolled patients above the age of 16 years, in our study most patients who were treated with laparoscopic appendectomy were in the age group 21–30 years with 39%, females accounted for 51% of the study. In our study, we found that the serum glutamic pyruvic transaminase levels serum glutamic oxaloacetic transaminase levels, unconjugated bilirubin levels increased postoperatively statistically significantly with a P < 0.001 and returned to the baseline levels 7th day postoperatively.

Efficacy of silver diamine fluoride as an antibacterial as well as antiplaque agent compared to fluoride varnish and acidulated phosphate fluoride gel: An in vivo study.

Background: Silver diamine fluoride (SDF) is already proven as an antibacterial agent in vitro. Present study was formulated to compare the efficacy of SDF as an antibacterial as well as antiplaque agent in vivo with fluoride varnish and acidulated phosphate fluoride (APF) gel. Study Design: Total 123 children (male = 82, female = 41) were included in the study for a period of 18 months. Children were divided into three different groups-Group 1: SDF; Group 2: fluoride varnish; and Group 3: APF gel. All subjects were evaluated via plaque score at 6 th , 12 th , and 18 th months as well as Streptococcus mutans counts in saliva at 72 h, 6 th , 12 th , and 18 th months of follow-up. Results: Significant reduction was found in plaque score as well as S. mutans counts irrespective of group division. On intergroup comparison, no statistically significant difference was found in plaque score, but significant reduction in S. mutans counts was found in Group 1 as compared with Groups 2 and 3, while no significant difference was found between Groups 2 and 3. Conclusion: In vivo application of SDF on enamel significantly decreases S. mutans counts as compared to fluoride varnish and APF gel.

The feasibility and advantages of billroth-I reconstruction in distal gastric cancers following resection.

Background: Gastric carcinomas are common malignancies in southern India and distal stomach remains the commonest site in low socio economic groups. Surgery still remains an important modality of treatment to achieve local control and also relieve obstructive symptoms. In this study we investigated the feasibility of performing a gastrectomy and billroth-1 type of anastomosis in a rural cancer center setting, with parameters like adequacy of margins, ease of anastomosis and its functional results were analysed Materials and Methods: Eight patients presenting to a rurally based cancer center underwent a distal gastrectomy and billroth-1 type of anastomosis for continuity restoration Results: All the patients had adequate proximal and distal marg. The surgical time varied between-hrs. The anastomosis was constructed without any tension on bowel ends in all patients. The average time to start oral feeds varied between- None of the patients showed symptoms of bile reflux nor dumping. The average hospital stay varied between- Conclusions: Billroth-1 anastomosis is a physiologically more natural way of restoring continuity following a gastrectomy and it is a procedure which would be technically more simpler and decrease per and post operative complications and allow speedier post operative recovery following surgery on distal gastric cancers.

Evaluation of the remineralization potential of amorphous calcium phosphate and fluoride containing pit and fissure sealants using scanning electron microscopy.

Aim: To evaluate the remineralization potential of Amorphous Calcium Phosphate (ACP) and Fluoride containing pit and Fissure Sealants using Scanning Electron Microscopy. Materials and Methods: Thirty maxillary first premolars were divided into three groups of ten each and were randomly selected for ACP containing (Aegis- Opaque White, Bosworth Co. Ltd.), Fluoride containing (Teethmate F1 Natural Clear, Kuraray Co. Ltd.), resin based (Concise- Opaque White, 3M ESPE Co. Ltd.) pit and fissure sealant applications. The Concise group served as a control. The teeth weresubjected to the pH-cycling regimen for a period of two weeks. After two weeks, the teeth were sectioned bucco-lingually into 4mm sections and were observed under Scanning Electron Microscope at 50X, 250X, 500X, 1000X and 1500X magnifications. The qualitative changes at the tooth surface and sealant interface were examined and presence of white zone at the interface was considered positive for remineralization. Results: Both ACP containing (Aegis) and Fluoride containing (Teethmate F1) group showed white zone at the tooth surface-sealant interface. The resin based group (Concise) showed regular interface between the sealant and the tooth structure, but no clear cut white zone was observed. Conclusion: Both, Aegis and Teethmate F1 have the potential to remineralize. Release of Amorphous Calcium Phosphate molecules in Aegis group and formation of Fluoroapetite in Teethmate F1 group, were probably responsible for the remineralization.

Prolonged feeding practice and its effects on developing dentition.

Muscular activity of the lips, cheeks, and the tongue are important factors, which not only guide the occlusal development but also affect the growth of the jaws. Bottle feeding has been known to cause a myriad of changes in the oro-facial development. But the adverse effects of feeding practices with respect to developing dentition has been a subject of controversy. Hence a study was designed with the aim and objectives to check the commonly adopted feeding practices in South Kanara, to compare the occlusion of 3-to 5-year-old children with breast feeding, bottle feeding or combination, and to check whether prolonged feeding has any adverse influence on developing dentition. A total of 250 questionnaires were distributed to parents of 3- to 5-year-old children of which 153 were chosen for recording the impression and for studying the occlusion under various parameters. The results of the study indicated definite potential hazards of prolonged breast and bottle feeding especially with a tendency to develop openbite and posterior crossbite. It also suggested that an early preventive and interceptive approach.

Squamous cell carcinoma of ascending colon. A case study.

We report here a case of squamous cell carcinoma of Ascending colon occurring in a 58 year old male. Squamous cell carcinomas are known to occur in the Ano rectum frequently, but are extremely rare in colon especially the right colon.