ISSN 2756-3324
Research Article
African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 7 (5), pp. 001-007, May, 2020. © International Scholars Journals
Full Length Research paper
Prevalence of breast cancer in menopausal blind women
K. Pushkala1* and P. D. Gupta2
1S. D. N. B. Vaishnav College for Women, Chennai, India.
2Manipal University, Karnataka, India.
Accepted 08 April, 2020
Abstract
A correlation between prevalence of breast cancer with blindness has not been attempted in India and only scanty information is available at the world scenario as well. We have done a pilot study by epidemiological survey of blind menopausal (high risk age group) women (n = 204) from Chennai to find the prevalence of the disease. In the present study, menopausal visually challenged women have shown that the ratio at risk of developing breast cancer in this group is very much lower ( 1:100 ) compared to sighted women in the similar age group, The risk of developing breast cancer is 1:78 (Cumulative Risk 35 - 64 age), among sighted women in Chennai. Statistical analysis of the present data also provide enough evidence that blind women who are > 40 years of age had 13% greater risk of breast cancer compared with those in the study group < 40 years (RR = 1.125; 95% CI = 0.07 to 17.74).The susceptibility to develop the disease among partially blind women is almost twice than that of totally blind women (RR = 2.14; 95% CI = 0.14 to 33.68). Similarly menopausal stage of a woman has more risk of developing breast cancer than pre-menopausal stage (RR = 5.18; 95% CI = 0.33 to 80.75). Vision loss after menarche also indicates an increased risk (RR = 8.27; 95% CI = 0.54 to 127.6) .The intervals for these risks give a very wide range of possible values for the corresponding risk ratio due to small sample size and the rarity of breast cancer among blind women. The topographical location of India close to the equator and life style pattern of the people could be the major reasons for the very low prevalence of breast cancer in Chennai. None of the other high or low risk factors were found to be influencing blind women to develop breast cancer. The relationship between visible light and breast cancer can be studied by taking blind menopausal women as a model.
Key words: Blindness, breast cancer, epidemiology.
K. Pushkala*, P. D. Gupta
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Case Report
African Journal of Medicine and Surgery ISSN 3156-8734 Vol. 7 (3), pp. 001-003, March, 2020. © International Scholars Journals
Case Report
Spinal subdural hematoma associated with phenytoin use
Abrar Ahad Wani*, Anil Dhar, Nayil Kkursheed Malik and Altaf Umar Ramzan
Department of Neurosurgery, Sher-i- Kashmir Institute of Medical Sciences, Srinagar, J&K. India.
Accepted 28 April, 2019
Abstract
A rare case of spinal subdural hematoma (SSDH) is reported in a patient who was receiving phentoin. The hematoma occurred because of combined effects of trauma and underlying haematological disturbance induced by phenytoin. A young male who was a known case of seizure disorder and was receiving phenytoin for last 10 years presented with history of seizure followed by fall from one storey of his house. This was followed by paraplegia. MRI revealed presence of spinal subdural hematoma in dorsolumbar spine. His haematological parameters revealed deranged coagulogram and anemia with thrombocytopenia. The patient underwent laminectomy and evacuation of hematoma and intrathecal drain was kept in for three days till drainage was clear. However the patient did not improve clinically. His anemia and thrombocytopenia responded rapidly to administration of vitamin B12 and stoppage of phenytoin. SSDH should be kept a possibility in posttraumatic paraplegia. The patients receiving phenytoin must be monitored for change in hematological parameters after chronic use.
Key words: Spinal, subdural, hematoma.
Anil Dhar, Abrar Ahad Wani*, Nayil Kkursheed Malik and Altaf Umar Ramzan
Page: 1 - 5
Research Article
African Journal of Medicine and Surgery ISSN 3156-8734 Vol. 7 (2), pp. 001-005, February, 2020. © International Scholars Journals
Full Length Research paper
Symptomatic outcome following laparoscopic anterior 180°partial fundoplication: Our initial experience
S. Kumaresan, A. Sudirman and G. Ramesh*
Department of Surgery, Tuanku Jaafar Hospital, Seremban, Negeri Sembilan, Malaysia.
Accepted 16 October, 2019
Abstract
Gastroesophageal reflux disease is increasing in frequency in the Asia Pacific region, which can be attributed to increase in awareness among doctors and patients and/or true increase in the prevalence of this disease. Surgical treatment of GERD is well established in the West and in selected clinical situations, provides well recognized benefits over non-surgical treatment. In contrast, there are only a few published studies in Asia especially on the outcome of the laparoscopic anterior fundoplication within the Asian community. Our aim is to evaluate symptomatic outcome of laparoscopic anterior 180° fundoplication in our community. Prospective analyses of 25 consecutive patients were done using a standardized questionnaire post-operatively. Overall satisfaction and the symptoms of heartburn and dysphagia were assessed together with other adverse effects of the surgery. Follow up was carried at a median of 9 months after surgery. Symptoms of heartburn assessed using the VAS showed significant drop from mean 7.4 pre-operatively to mean 1.75 postoperatively. De Meester symptom score indicated that a majority (56%) of patients reported none/minimal GERD symptoms, the other 44% reported mild GERD symptoms. This showed a vast improvement compared to pre-operative scoring where 80% of the patients reported moderate to severe GERD symptoms. This directly correlates with the estimation of patient satisfaction using Visick grading system with 24 (96%) patients reported none or mild symptoms post operatively. Overall, it is reasonable to conclude that laparoscopic anterior partial fundoplication achieved a satisfactory rate of overall success in our centre at short term follow up.
Key words: Laparoscopic anterior fundoplication, GERD, symptomatic outcome.
S. Kumaresan, A. Sudirman and G. Ramesh*
Page: 1 - 5
Research Article
African Journal of Medicine and Surgery ISSN 3156-8734 Vol. 7 (2), pp. 001-005, February, 2020. © International Scholars Journals
Review
Inflammatory response after laparoscopic versus open colonic resection: Review of the literature
Dimitrios Tsamis1, George Theodoropoulos1, V. Nikolaos Michalopoulos1, Thalassini Delistathi1, Nikolaos Nikiteas2, Christos Tsigris3 and Emmanuel Leandros1
1Propedeutic Surgical Department, Hippokration University Hospital, Athens Medical School, Athens, Greece.
2Propedeutic Surgical Department, Laiko University Hospital, Athens Medical School, Athens, Greece.
3Surgical Department, Laiko University Hospital, Athens Medical School, Athens, Greece.
Accepted 21 November, 2019
Abstract
Surgical trauma may lead to immune dysfunction as a result of the intense inflammatory response which arises in order to restore tissue function. The inflammatory response after surgical trauma is mediated by a number of substances which are produced at the site of wounded and manipulated tissues or at more distant places and they can act locally and systematically. These substances are TNF, Interleukins, Heat shock proteins, etc. Laparoscopic surgery is associated with reduced surgical trauma, much less manipulation of tissues and an environment of CO2 pneumoperitoneum comparatively with open procedures. All of these contribute to the theory that laparoscopic colonic resections are expected to be associated with less inflammatory and acute phase response than open resections. As indices of inflammation in colon surgery cytokines, such as TNF, Interleukins and CRP are the most studied ones. From the studies which are reviewed, comparing these cytokines in serum and peritoneal fluids in patients undergoing open versus laparoscopic colectomy, some showed that inflammatory response after laparoscopic colorectal resections seems to be slightly attenuated, as long as values of IL-6, IL-8 and CRP in peripheral blood are in lower levels in the first postoperative hours than open procedures. This phenomenon was not noticed in all studies and for other inflammatory and anti-inflammatory cytokines in the serum of the patients or in the peritoneal fluids.
Key words: Laparoscopic colectomy, open colectomy, inflammatory response.
George Theodoropoulos, Thalassini Delistathi, Christos Tsigris and Emmanuel Leandros, V. Nikolaos Michalopoulos, Dimitrios Tsamis, Nikolaos Nikiteas
Page: 1 - 5
Case Report
African Journal of Medicine and Surgery ISSN 3156-8734 Vol. 7 (1), pp. 001-002, January, 2020. © International Scholars Journals
Case Report
Sharp foreign body and ischio-rectal abscess
Chi Man Ng*, K. K. David Tsui, H. H. Wong, K. K. Yau and M. K.W. Li
Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
Accepted 23 August, 2019
Abstract
This article presents a case of rare cause of peri-anal abscess caused by ingested fish bone. A 72 year old gentleman presented with left buttock painful swelling for 1 week associated with fever. Physical examination revealed a peri-anal abscess. During incision and drainage a 3cm fish bone was found inside the abscess cavity, impinging from the rectal wall. He recalled history of fish bone ingestion around one month before admission. Ingestion of sharp object can cause perforation of gastro-intestinal tract, not only the upper tract, but even the lower tract and anal canal. High index of suspicion is needed in cases with history of foreign body ingestion presenting with ischio-rectal abscess, to aid diagnosis and prevent injury to the operating surgeon.
Key words: Peri-anal, ischiorectal, abscess, fish bone, sharp, foreign body ingestion.
K. K. David Tsui, Chi Man Ng*, K. K. Yau and M. K.W. Li, H. H. Wong
Page: 1 - 2
Case Report
African Journal of Medicine and Surgery ISSN 3156-8734 Vol. 7 (1), pp. 001-003, January, 2020. © International Scholars Journals
Case Report
Managing a major traumatic bronchopleural fistula in a resource scarce community
Shahla Haleem1*, Maulana Mohd. Ansari2, Mehmood-uz-Zafar2, Farrukh Ansari2, Abu Nadeem2 and Yasir Ahmad Khan2
1Department of Surgery, Faculty of Medicine J. N. Medical College, A. M. U., Aligarh 202002, U.P., India.
2Department of Anaesthesia, Faculty of Medicine J. N. Medical College, A. M. U., Aligarh 202002, U.P., India.
Accepted 07 October, 2019
Abstract
A case of penetrating chest trauma owing to bull horn goring injury was managed surgically. Postoperative respiratory distress and severe hypoxia was managed initially by conventional modes of ventilatory assistance. We were unable to correct non resolving hypoxaemia through usual course of tracheal intubation and positive pressure ventilation. Large amount of persistent air leak at the intercostal chest tube drainage site arose the suspicion of associated severe traumatic bronchopleural fistula and led to try out alternative methods of respiratory support. An early tracheostomy was planned due to lack of facility for high frequency jet ventilation, which provided two-pronged benefits of a lowered airway resistance to breathing and avoided the need for positive pressure breaths.
Key words: Chest trauma, bull horn goring injury, hypoxaemia, traumatic bronchopleural fistula.
Shahla Haleem*, Farrukh Ansari2, Maulana Mohd. Ansari2, Mehmood-uz-Zafar2 , Abu Nadeem and Yasir Ahmad Khan
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