Surgical Review: International Journal of Surgery, Trauma and Orthopedics

Correlation of clinical radiological features with histopathology and IHC to predict aggressive be-haviour of soft tissue sarcomas

2022-03-31T11:22:59+0530

Introduction: A study was taken to assess the pathological predictors of aggressive behaviour ofsoft tissue sarcomas (STSs) and also to the correlation of STSs with clinical, radiological ofhistopathological techniques.

Materials and methods: This was a prospective conducted fromJanuary 2016 to June 2017. All those coming to this institute with oral and oropharyngeal squamouscell cancers (SCCs) included. Smokers, tobacco chewers were not considered. Punch biopsy andsurgical biopsy were taken, respectively from inoperable and operable cases, paraffin blocks wereprepared. Tissue microarray (TMA) were constructed using these blocks. Tissue inhibitor ofmetalloproteinases 1 (TIMP 1) stain-ing was assessed on the cell membrane and cytoplasm of thetumour cells (TCs). Two areas that showed high-density stained cells were selected, several stainedTCs was counted. The intensity of staining was classified as negative, weak, moderate and strong.AXL kinase staining was scored as 0, 1+, 2+, and 3+. Eps8 staining was ranged from negative (0),to strong and diffuse (3+). P less than 0.05 was considered statistically significant.

Results: A totalof 30 (100%) partic-ipants were included. With TIMP 1 expression, in normal mucosa, 63.3% (19)specimens did not stain; statistically, there was a significant difference. Around 53.3% (16) ofnormal mucosa did not stain with EPS8; statistically, there was a significant difference. In thesamples of SCC, 60% (18) showed 3+ sting and 40% (12) showed 2+. Statistically, there was asignificant difference.

Conclusion: The expression of TIMP1, EPS8 and AXL establish their role inthe pathogenesis of oral and oropharyngeal SCCs

A study to correlation serum C reactive protein and bilirubin in appendicitis individuals in a tertiary health care setup

2022-03-31T11:19:52+0530

Introduction: Acute appendicitis (AA) is one of the commonest surgical conditions. CT scan iswidely used for the diagnosis of AA. Different studies reported the utility of CRP and serum bilirubin(SB) in the diagnosis of AA. With this background, a study was conducted to find the diagnosticaccuracy of SB and CRP in the diagnosis of AA.

Materials and methods: The study was conductedin the Department of General Surgery, Konaseema Insititute of Medical Sciences and ResearchFoundation, Amalapuram for 18 months. Individuals AA were included. Those with a history ofjaundice, liver diseases, chronic alcoholism were not considered in this research. Initially, all weresubjected to thorough clinical examination and mantrel score (MS) was defined. USG abdomen, liverfunction tests, CRP were evaluated. Serum bilirubin (SB) and liver enzymes were estimated. A latexagglutination test was used to estimate CRP in the blood. Based on the clinical condition of the studyparticipant appendicectomy was carried out. Chi-Square test. P less than or equal to 0.05 wasconsidered statistically significant.

Results: A total of 60 participants were included. Gender wise,the male-female ratio was 1.85. The mean MS was 8.142, 8.714 and 9.444, respectively for AA,gangrenous appendicitis (GA) and perforated appendicitis (PA); statistically, there was no significantdifference. SB was evaluated, the mean values were 0.91+0.28mg/dl, 1.31+0.22 mg/dl and2.03+1.06 mg/dl, respectively in AA, GA and PA; statistically, there was a significant difference(P<0.05).

Conclusion: Appendicitis is common among males. The MS was an important indicatorfor the diagnosis of appendicitis with elevated SB and CRP

Pneumothorax in Patients with Moderate to Severe Covid-19 Infection:A Retrospective Observational Study

2022-03-31T11:53:00+0530

Background: Spontaneous pneumothorax as a complication of COVID-19 pneumonia is eitheruncommon or under-reported. The exact incidence and risk factors are still unknown. The objectiveof this study is to highlight an important complication, its incidence and explore the predisposing riskfactors.

Methods: We performed a retrospective review of COVID-19 pneumonia cases admitted toour hospital between February 2021 and June 2021. Data on their demographics, pre-existing riskfactors, laboratory workup, imaging, treatment and clinical outcomes were gathered.

Results: Onethousand eight hundred and twenty-five patients have admitted to our institution between February2021 and June 2021 with COVID-19 infection. 11 patients developed a pneumothorax (0.6%). 6 outof the 11 cases were patients who required mechanical ventilation (54.5%). All of these patientsunderwent chest tube insertion. Baseline imaging of these patients showed ground-glass opacities(GGO) and consolidation. 8 of the 11 patients succumbed to the disease (72.7%).

Conclusion: Inpatients admitted with COVID-19 pneumonia and developing sudden respiratory compromise,pneumothorax is an important complication to be considered. Prompt identification of thiscomplication and timely intervention is necessary to reduce morbidity and mortality. Low tidalvolume lung-protective ventilation and the use of non-invasive ventilation for oxygenation remainthe cornerstone in the management of COVID pneumonia. It significantly decreases iatrogeniccomplications like VILI (ventilator-induced lung injury) and P-SILI (patient self-inflicted lung injury.

A case report on large bowel lymphoma

2022-05-26T20:23:25+0530

Large bowel (colorectal) lymphoma is a very rare tumor, accounting for <0.5% of primary colorectal malignancies, ~1.5% of all lymphomas, and ~15% of gastrointestinal lymphoma. The major site of extranodal non-Hodgkin lymphoma is the gastrointestinal tract.(stomach>small intestine >large intestine . The disease appears later in life, predominantly in the male population. Complaints are nonspecific, requiring a high index of suspicion in order to establish the diagnosis.treatment includes surgery/chemotherapy/radiotherapy or combination of all these three modalities.the aim of this paper is to report a rare case of primary colon lymphoma in a female patient.