ABSTRACT
Introduction The effects of an anesthetic agent on the hemodynamic stability are of prime importance in patients with compromised hemodynamics. Although comparative studies of sevoflurane and propofol are reported, most of these are aimed to assess maintenance and early postoperative recovery. There are very few studies on hemodynamic changes occurring with these two agents. This study compares the hemodynamic stability, patient acceptance, and cost of intravenous (IV) propofol versus inhalational (IH) sevoflurane for the induction of anesthesia. Methods This prospective, randomized comparative study was conducted among 80 patients with American Society of Anaesthesiologists (ASA) grade-I requiring general anesthesia (GA) for elective surgical procedures. The study was approved by the institutional ethics committee and was conducted as per the principles of the Declaration of Helsinki and Good Clinical Practice (GCP) guidelines. Enrolled patients were randomized to receive either intravenous (IV) propofol 2 mg/kg (n=40) or gradual inhalational (IH) induction with sevoflurane (n=40). All patients were maintained with sevoflurane 2% in 67% nitrous oxide (N2O) and O2. Hemodynamic parameters like pulse rate and mean arterial pressure (MAP) were monitored every minute up to five minutes. Patients' acceptance was assessed on a 10-item questionnaire, and the cost of anesthesia was assessed based on the anesthetic requirement. The hemodynamic parameters were compared between the two groups using two-way repeat-measures ANOVA. The incidence of hypotension was compared using Fischer's test. Results The two groups were similar at baseline with respect to the demography and other baseline characteristics. There was greater (p<0.05) fall in MAP with propofol induction (28.48%) compared to sevoflurane (14.61%). Greater reduction in pulse rate (p<0.05) with sevoflurane (9.18) induction was observed compared to propofol (5.28). Patient acceptance for both drugs was similar (p>0.05). Although sevoflurane was unpleasant, propofol injection was painful. Ninety percent of patients preferred propofol for repeat anesthesia as against 85% of patients with sevoflurane. Considering the quantity of anesthetic consumed and the unit cost, propofol was more costly as compared to sevoflurane. Conclusion Sevoflurane maintains better hemodynamic stability compared to propofol, and patient acceptance of both drugs is similar. Induction with sevoflurane was found to be cheaper as compared to propofol induction.
ABSTRACT
INTRODUCTION: Breast cancer is the foremost cause of death in women worldwide with more than one million cases occurring annually. AIM: This study was conducted to study the stromal CD10 expression in breast carcinomas (BCa) and its correlation with various prognostic factors such as tumor size, histological grade, lymph node status, estrogen receptor (ER), progesterone receptor (PR), HER2neu, and Ki67 status. MATERIALS AND METHODS: Sixty cases of BCa diagnosed between 2013 and 2015 were included in the study. Stromal expression of CD10 was studied on entire section of selected BCa blocks for all cases. A technique of manual tissue microarray was employed for the analysis of expression of immunohistochemical markers ER, PR, and HER2/Neu and Ki67 in all cases. Results were subjected to statistical analysis. RESULTS: Stromal CD10 positivity was seen in 78.3% cases, out of which 53.3% of cases were strongly positive, and 25.0% cases were weakly positive. Positivity for ER, PR, HER2, and Ki67 was 31.7%, 33.3%, 65%, and 75%, respectively. Stromal expression of CD10 was found to be significantly associated with increasing tumor grade, lymph node status, HER2neu positivity, ER negativity, and Ki67 positivity. CD10 stromal expression was seen mainly in PR negative BCa cases; however, it was statistically insignificant. It was noted that CD10 stromal positivity increased with increasing grade. CONCLUSION: CD10 can be used as an independent prognostic marker and should be included in routine histopathology report. CD10 could act as a potential target for newer drug development.
ABSTRACT
Secretory breast carcinomas (SBCs) are considered one of the rarest types of BCs accounting for <0.15% of all breast cancers. The lesions are typically solitary, but rare multicentric cases have been reported. SBC have characteristic histopathological, immunohistochemical, and electron microscopic findings. Children and adolescents with SBC have a favorable prognosis, but disease seems slightly more aggressive in adults. The characteristic ETV6-NTRK3 molecular alteration, leading to a stable chimeric tyrosine kinase fusion product, may be the target of promising new treatment for this unique BC. We present a rare case of multicentric secretory carcinoma of breast with aggressive clinical behavior in a 75-year-old female.
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Perifolliculitis capitis abscedens et suffodiens is the least common of the three conditions included in the follicular occlusion triad. It is one of the causes of scarring alopecia in adult males. Clinically it has to be differentiated from other causes of folliculitis affecting the scalp. The histopathology is diagnostic. The treatment is prolonged and the clinical course is characterized by remissions and relapses.
ABSTRACT
Torsion in the ectopic testis is a rare condition and very difficult to diagnose clinically. We present one such case with review of literature.
