Comparison Of Axillary Drain Output In Conventional And Advanced Compressive Energy Source Like Ultrasonic Scalpel And Ligasure Dissection Of Axilla In Breast Cancer Surgery.

BACKGROUND: Breast cancer is the most common malignancy worldwide. Surgical treatment of axilla is a part of treatment of locally advanced breast cancer. Conventional knot tying plus electrocautery and advanced compressive energy sources are used to reduce the continued axillary serous fluid discharge when drains are in place and seroma formation afterwards. METHODS: This double-blind comparative study was carried out from April 2018 to October 2019. In total 180 patients undergoing axillary dissection for treatment of locally advanced breast cancer were recruited. Patients were divided into two groups (C and H) depending upon method of dissection used for axillary surgery. RESULTS: For most participants, amount of axillary drain volume in Group C was between 400-700 ml (in 48.9% participants) and for Group H more than 700 ml (in 44.4% participants). This difference is not statistically significant (p=0.288). Duration of hospital stay (p=0.003) and duration of drain placement was significantly longer (p=0.019) for most participants in Group H. More hospital visits were required for the said group. There was statistically significant co-relation between immediate complications and haemostasis techniques (p=0.003) with more incidence of Seroma noticed in Group H than in Group C. CONCLUSIONS: Current study shows limited benefits of using ultrasonic scalpels in breast cancer surgeries. Variables such as BMI, Age and chemotherapy need to be controlled in order to derive a true comparison.

Retinoblastoma presenting as total hyphema: Three year follow-up.

Retinoblastoma very rarely presents as total hyphema. Our patient presented at an early age of 7 months. Follow-up of 3 years shows that unilateral group E retinoblastoma was treated successfully with enucleation and adjuvant chemotherapy. The fellow eye remained normal during this period. The factors associated with delay in treatment are also described. Reports like the present case add to the information available about advanced staging of retinoblastoma at the time of presentation, seen in cases with spontaneous hyphema due to the tumor.

On some properties of the generalized Mittag-Leffler function.

This paper deals with the study of a generalized function of Mittag-Leffler type. Various properties including usual differentiation and integration, Euler(Beta) transforms, Laplace transforms, Whittaker transforms, generalized hypergeometric series form with their several special cases are obtained and relationship with Wright hypergeometric function and Laguerre polynomials is also established. 2000 MATHEMATICS SUBJECT CLASSIFICATION: 33C45, 47G20, 26A33.

Low-level quinolone-resistance in multi-drug resistant typhoid.

OBJECTIVE: To find out the frequency of low-level quinolone-resistance in Multi-Drug Resistant (MDR) typhoid using nalidixic acid screening disc. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Armed Forces Institute of Pathology, Rawalpindi, from January 2005 to December 2005. MATERIALS AND METHODS: Blood was obtained from suspected cases of typhoid fever and cultured in to BacT/ALERT. The positive blood cultures bottles were subcultured. The isolates were identified by colony morphology and biochemical tests using API-20E galleries. Susceptibility testing of isolates was done by modified Kirby-Bauer disc diffusion method on Muellar Hinton Agar. For the isolates, which were resistant to nalidixic acid by disc diffusion method, Minimal Inhibitory Concentrations (MICs) of ciprofloxacin and nalidixic acid were determined by using the E-test strips. Disc diffusion susceptibility tests and MICs were interpreted according to the guidelines provided by National Committee for Control Laboratory Standard (NCCLS). RESULTS: A total of 21(65.5%) out of 32 isolates of Salmonellae were nalidixic acid-resistant by disk diffusion method. All the nalidixic acid-resistant isolates by disc diffusion method were confirmed by MICs for both ciprofloxacin and nalidixic acid. All the nalidixic acid-resistant isolates had a ciprofloxacin MIC of 0.25-1microg/ml (reduced susceptibility) and nalidixic acid MICs > or = 32 microg (resistant). Out of all Salmonella isolates, 24 (75%) were found to be MDR, and all were S. typhi. CONCLUSION: Low-level quinolone-resistance in typhoid was high in this small series. Screening for nalidixic acid resistance with a 30 microg nalidixic acid disk is a reliable and cost-effective method to detect low-level fluoroquinolone resistance, especially in the developing countries.

Peripheral blood-based polymerase chain reaction in diagnosis of pulmonary tuberculosis.

BACKGROUND: The rapid diagnosis of infectious diseases, particularly those that represent a public health problem, like tuberculosis, is a challenging problem. By using nucleic acid amplification techniques like PCR, one may be able to diagnose, the disease on the day of arrival of specimen in the laboratory. For diagnosis of tuberculosis by direct methods like PCR, specimens from site of infection are required. In certain cases it is difficult to get the specimens from site of infection and in such situations; some researchers have tried to detect the DNA of Mycobacterium tuberculosis complex from blood of these patients. The purposive of this study is to determine the diagnostic efficacy of peripheral blood-based polymerase chain reaction for diagnosis of pulmonary tuberculosis. METHODS: This was a simple descriptive study, carried out in Department of Microbiology, Armed Forces Institute of Pathology, Rawalpindi from Jan 2004 to Dec 2004. Sputum and blood samples were collected from 96 suspected patients of pulmonary tuberculosis. Sputum samples processed for ZN staining and AFB culture (gold standard) and blood samples processed for PCR. RESULTS: Out of 96 cases, 60 (62.5%) were culture positive. PCR was positive in 14 (14.5%). AFB smear positive were 34 (35.4%). The overall sensitivity and specificity of the PCR assay was 20% and 94.4% respectively and the positive and negative predictive values were 85.71% and 41.46% respectively. The overall efficiency of the test was 47.91%. CONCLUSION: Due to low sensitivity; a negative PCR assay does not rule the disease. However, this test may be helpful in cases where specimens from the site of infection are not available.

Role of Malassezia yeast (Pityrosporum) in seborrhoeic dermatitis (SD).

OBJECTIVE: The objective of this study was to find out the prevalence of Pityrosporum species in the patients with seborrheic dermatitis (SD) and compare the colonization rate with normal healthy individuals. DESIGN: Comparative study. PLACE AND DURATION OF STUDY: Dermatology Department, Military Hospital and Department of Microbiology, Armed Forces Institute of Pathology, Rawalpindi from 01 March 1996 to 28 February 1997. MATERIALS AND METHODS: Fifty patients with clinically diagnosed seborrheic dermatitis were included in this study. Fifty normal healthy individual with matched age and gender were included as control subjects. Three samples from each effected sites were taken from 2 cm2 area. Identical sites in control subjects were also sampled. These samples were examined under the microscope after treating with 10% potassium hydroxide and staining with parker blue black ink for the presence of Pityrosporum yeast cells. The specimen were also inoculated in special lipid enriched media, incubated at 37 degrees C for 4-6 days. RESULTS: Out of 50 patients, Pityrosporum yeast cells were seen microscopically in 37 (74%), and the cultures were positive in 43 (86%). Among the normal individuals yeast cells were seen microscopically in 23 (46%) and the cultures were positive in 22 (44%). CONCLUSION: The colonization rate of Pityrosporum species was higher in the seborrheic dermatitis patients. It might be playing a causative role in the aetiology of this disease.