RESUMO
Objective: To determine the diagnostic accuracy of methylene blue dye to detect axillary lymph node metastases in patients with breast carcinoma by taking histopathology as gold standard
Methods: This quasi experimental study was done at Department of Surgery of Dow University Hospital Karachi during January 2013 to September 2015 after the approval of Hospital Ethical Committee. A total number of 85 patients with biopsy proven carcinoma were included in the study. 1% methylene blue dye was infiltrated in the peri tumoural area of the diseased breast. The blue stained node called sentinel lymph node [SLN] was recognized and carefully dissected out. SLN and mastectomy with axillary clearance specimen was sent for histopathology in two separate bottles and the report of the histopathology was compared
Results: The axillary lymph nodes were positive for carcinoma in 61 cases out of 85[71.7%].Two of the patients had negative sentinel lymph node but positive non sentinel lymph node [false negative], and in three cases sentinel lymph node were involved only but not the rest of the axilla [False positive]. The sensitivity, specificity and accuracy were 96.8%, 86.36% and 94.1% respectively
Conclusion: Methylene blue dye technique is a reliable and safe diagnostic modality for detection of Sentinel lymph node in breast cancer patient because of its high accuracy
RESUMO
Objective: To compare the efficacy of haemorrhoidectomy done by using LigaSure with conventional Milligan Morgan haemorrhoidectomy
Methods: This randomized controlled trial was done at Department of Surgery Dow University Hospital Karachi during January 2013 to September 2015. A total of 55 patients were included in the study. Patients were randomly allocated to group A [Haemorrhoidectomy by Ligasure] and group B [Milligan Morgan Haemorrhoiectomy]. Efficacies of both procedures were compared by operative time, Blood loss, wound healing, and pain score on immediate, 1st and 7th post operative day
Results: Out of total 55 patients 23 were male and 32 were females. The most common group of age involved was between 40 - 60 years. Third degree Heamorrhoids were present in 37 [67.3%] of patients while remaining 18 [32.7%] had fourth degree Heamorrhoids. Group A included 29 cases while Group B included 26 cases. The mean operating time of Group A was 52.5 with standard deviation of 11.9 while it was 36.6 +/- 9.8 in the other group. The mean blood loss in group A was 51.92 with standard deviation of 15.68 while it was 70.34 +/- 25.59 in group B. Overall pain score was less in those patients who underwent Heamorrhoidectomy by Ligasure method
Conclusion: The efficacy of Heamorrhoidectomy by Ligasure is better than the traditional Milligan Morgan Heamorrhoidectomy but we need more clinical trials with large sample size and long term follow ups