Association of serum beta hCG levels in women with palpable malignant breast lesions.

This study aims to determine whether serum Beta hCG can be used as a tumour marker in Breast malignancies. The objective of this study is to evaluate the serum Beta hCG in various stages of breast carcinoma and to correlate its level with disease severity and prognosis. Cross sectional analytical study of assessing serum Beta hCG in 200 patients with palpable breast malignancies at hospitals in urban Mangalore, India. In our study there was No increase in serum Beta hCG, in women with breast malignancies, but there was a pattern amongst the negative results. A Beta hCG of < 5mIU/mL is taken as negative, but in our study of 200 individuals, a mean value of 2mIU/mL was used as differentiation between low and high risk individuals. With our study we tried to correlate the value of Beta hCG with malignant breast lesions, and even though women with such lesions did not have a value of > 5mIU/mL, we found substantial evidence that women who had a value of > 2mIU/mL had a more advanced disease, be it in terms of staging, and comparing it with markers like ki67. A direct correlation between Beta hCG and severity of the disease in terms of staging was proved, hereby directly affecting the outcome of patients. Higher the level of Beta hCG, graver the prognosis. Even though Beta hCG cannot be used as tumour marker, it can be used to prognosticate the severity in women with palpable breast malignancies.

Left sided Amyand hernia - A case report.

INTRODUCTION: Amyand hernia is a clinical condition wherein content of the inguinal hernial sac is formed by the vermiform appendix. CASE PRESENTATION: 1 year 3-month-old male child presented to our OPD with an irreducible left inguinal hernia for which he was taken up for an emergency herniotomy. The terminal ileum, caecum and appendix were found to be the contents of the hernial sac. DISCUSSION: As the appendix is anatomically located on the right, Amyand hernia more commonly occurs on the right, however its occurrence on the left, is a rare event and is usually associated with congenital anomalies like Intestinal malrotation, Situs inversus and mobile caecum. CONCLUSION: Amyand hernia presenting on the left is extremely rare and high index of clinical suspicion is required to manage such patients. We report one such rare case of a Left sided Amyand hernia in a young child.

Applications of indocyanine green in surgery: A single center case series.

Background: Fluorescence imaging using indocyanine green (ICG) has revolutionized commonly performed general surgical procedures by providing superior anatomic imaging and enhancing safety for patients. ICG, when injected, shows a bright green fluorescence when subjected to the near infra-red (NIR) spectrum. Materials and methods: We employed the use of ICG in Laparoscopic cholecystectomy, Intestinal Colorectal Anastomosis and Hernia to assess vascularity of resected ends and bowel viability, Sentinel Lymph node mapping, Vascular surgery to assess amputation stump success and in assessing Flap Vascularity and healing. Results: ICG when administered had successfully shown bright green fluorescence in different cases thereby aiding in surgical procedures. Conclusion: Routine intraoperative use of ICG could pave the way for a more objective assessment of different surgical circumstances and thereby reduce personalized barriers to aciurgy. ICG fluorescence therefore seems to be a promising apparatus in standard general surgical procedures minimizing untoward errors and improving patient conformance.

Rare cause of thyroid enlargement: Localized AA amyloid goiter - A case report.

INTRODUCTION: Amyloidosis is extracellular deposition of fibrillary amyloid proteins in various organs. Amyloid infiltration in thyroid is common; however, the occurrence of clinically enlarged thyroid, subsequently leading to goiter, is a rare phenomenon. CASE PRESENTATION: 36 years old female presented to our OPD with multinodular goiter. She subsequently underwent total thyroidectomy. Thyroidectomy specimen revealed amyloid deposition with characteristic congophilia and birefringence. Further evaluation revealed it to be AA amyloidosis. There were no features of systemic amyloidosis. DISCUSSION: Amyloidosis is classified on the type of amyloid protein. Treatment of individual types of amyloidosis is diverse, and hence identification of the protein subtype is paramount. CONCLUSION: AA amyloidosis localized primarily to thyroid is infrequent, as it usually occurs with chronic inflammatory conditions or infections. Currently, there are no guidelines for the treatment of localized AA amyloid goiter. We have evidence demonstrating the successful treatment of such a condition with no recurrence noted.