Breast surgery for Metastatic Breast Cancer : Cochrane Analysis Kundan Singh
Breast surgery plus systemic treatment may improve local PFS when compared to systemic treatment alone (HR 0.22, 95% CI 0.08 to 0.57; 2 studies; 607 women; I2 = 43%; low quality evidence)
The group receiving breast surgery plus systemic treatment probably had a shorter time
to distant PFS compared to the group receiving systemic treatment alone (HR 1.42, 95%CI 1.08 to 1.86; 1 study; 350 women; moderate-quality evidence)
Study of the distribution and determinants of
health-related states or events in specified populations and the application of this study to control health problems.
John M. Last, Dictionary of Epidemiology
Impact of Multidisciplinary Discussion on Treatment Outcome For Gynecologic C...Emad Shash
Tumor conferences are multidisciplinary meetings at which the
management of cancer patients is discussed. They have been
an integral part of oncology services and are regarded
as an essential component of quality control and continuing
medical education. There are data to suggest that the tumor conference enhances patient care. Many studies of effectiveness have been conducted. Reported benefits include improved patient management and treatment. In this presentation, I'll try to assess the role of the multidisciplinary tumor conference in patient management in gynecologic oncology services.
Breast surgery for Metastatic Breast Cancer : Cochrane Analysis Kundan Singh
Breast surgery plus systemic treatment may improve local PFS when compared to systemic treatment alone (HR 0.22, 95% CI 0.08 to 0.57; 2 studies; 607 women; I2 = 43%; low quality evidence)
The group receiving breast surgery plus systemic treatment probably had a shorter time
to distant PFS compared to the group receiving systemic treatment alone (HR 1.42, 95%CI 1.08 to 1.86; 1 study; 350 women; moderate-quality evidence)
Study of the distribution and determinants of
health-related states or events in specified populations and the application of this study to control health problems.
John M. Last, Dictionary of Epidemiology
Impact of Multidisciplinary Discussion on Treatment Outcome For Gynecologic C...Emad Shash
Tumor conferences are multidisciplinary meetings at which the
management of cancer patients is discussed. They have been
an integral part of oncology services and are regarded
as an essential component of quality control and continuing
medical education. There are data to suggest that the tumor conference enhances patient care. Many studies of effectiveness have been conducted. Reported benefits include improved patient management and treatment. In this presentation, I'll try to assess the role of the multidisciplinary tumor conference in patient management in gynecologic oncology services.
Overview about evolution of the term Oligometastases,the paradigm and various states of oligometastases,treat options ,clinical trials and relevance in current clinical practice
Overview about evolution of the term Oligometastases,the paradigm and various states of oligometastases,treat options ,clinical trials and relevance in current clinical practice
This study aimed to compare the overall and disease specific survivals of patients who underwent laparoscopic and open resection of colorectal cancer in a high volume tertiary center.
Tried to summarise all landmark trials in carcinoma breast in radiation oncology,medical oncology as well in surgical oncology.
References taken from Devita Book,Breast Disease book from Springer,journals like NEJM,JAMA,LANCET,ANNL ONCOLOGY etc,internet,Perez book,Practical Clinical Oncology by Hanna etc textbooks.
Thanks.
Advantages of Cervicofial flaps :
Operative time is short.
It causes minimum deviations in relations to important structures around cheek.
reduce surgical risk in high risk patients like old age, diabetic patients, un-controlled hypertension
It can provide excellent skin colour and texture match.
Oncoplastic Breast surgery is simultaneous application of lumpectomy and reconstructive techniques. The word ‘oncoplastic’ is derived from the Greek words ‘onco’ (tumour) and ‘plastic’ (to mould).
Approximately 10% to 30% of patients submitted to BCS alone are not satisfied with the aesthetic outcomes like “swan beak/ parrot beak deformities. The main reasons are related this is the tumour resection which can produce asymmetry, retraction, and volume changes in the breast.
Recently, increasing attention has been focused on oncoplastic procedures since the immediate application of plastic breast surgery techniques provide a wider local excision while still achieving the goals of a better breast shape and symmetry to obtain oncologically sound and aesthetically pleasing results. Thus, by means of customized techniques the surgeon ensures that oncologic principles are not jeopardized while meeting the needs of the patient from an aesthetic point of view.
Randomized comparison of adjuvant aromatase inhibitor exemestane (E) plus ovarian function suppression (OFS) vs tamoxifen (T) plus OFS in premenopausal women with hormone receptor positive (HR+) early breast cancer (BC):
Evaluation of POSSUM scoring system in patients with perforation peritonitis ...Kundan Singh
Background: Continuous audit of clinical practice is an essential part of making improvements in medicine and
enhancing patient care. Recently, physiological and operative severity score for the enumeration of mortality and
morbidity (POSSUM) scores has been developed, which would help to identify those patients who are at increased
risk of developing complications and deaths. This scoring system is based on 12 physiological characteristics of
patient and 6 characteristics of the surgery performed.
Methods: This study was done in Department of surgery at Patna medical college, Patna, Bihar, India from April
2014 to October 2015 on 100 patients. Physiological variables were collected prior to induction of anesthesia and
operative variable collected during operation chi-square test was used for expected and actual mortality differences.
Results: In present study 100 patients of peritonitis due to different cause of intestinal perforation were studied.
Comparison of observed and POSSUM predicted mortality and morbidity rates were done. Observed to expect
mortality and morbidity ratio was 1.005 and 1.001 respectively and there was no statistically significant difference
between the predicted and observed values.
Conclusions: This study confirms and validates the findings of previous work that POSSUM is an accurate and
reliable tool for estimating in-hospital mortality.
multilobed spleen : A case report
The spleen plays multiple supporting roles in the body. It is a vital organ for the functioning
of immune system. It acts as a filter for blood as part of the immune system. Old red blood
cells are recycled in the spleen, and platelets and white blood cells are stored there. It can
have a wide range of congenital anomalies including its shape, location, number, and size.
Although most of these anomalies are congenital, there are also acquired types. Multilobed
spleen is one of such condition. It is most commonly detected during abdominal surgeries.
Since they are bigger in size than the normal spleen, they are more pre disposed to trauma. In
this case report we have presented such a case of multi lobed spleen, which was detected
incidentally during exploratory laprotomy for blunt trauma abdomen with hemoperitoneum
A retrospective study of outcome of intraoperative gallbladder perforation du...Kundan Singh
Abstract:
Background: During laparoscopic cholecystectomy, gallbladder perforation with leakage of bile and/or gallstones into the abdominal cavity occurs frequently while gallbladder is being dissected from liver bed or while extracting it through the port site. In this retrospective study we have studied the case files of the patients who underwent laproscopic cholecystectomy and had intraoperative gallbladder perforation and had studied its effect on outcome of the surgery.
Material & method: This is a retrospective done at patna medical college and hospital in January 2016 in which the patients records of 310 patients of laproscopic cholecystectomy from January 2015 to December 2015 were studied. The incidence of perforation, duration of operation and the post-operative complications were noted and the data obtained was analysed
A Prospective Study on Role of Water Soluble Contrast in Management of Small ...Kundan Singh
There is no definite protocol in management of small bowel obstruction in relation to duration and need of surgery. The aim is to study the role of gastrografin in management of small bowel obstruction.In this study patients who were diagnosed with intestinal obstruction were administered gastrografin. The patients were followed serially using x-ray at 4hrs interval for 24hrs; decision to operate was taken on non-progression of dye in two consecutive x-ray. Among 20 patients of this study 9 patients were operated on basis of gastrografin study. 11 were treated conservatively. 8 patients were of adhesive bowel obstruction. Out of which 1 was operated, 7 were treated conservatively. The sensitivity, specificity, positive and negative predictive value of gastrografin administration in this study was 100%, 89%, 92%, 100% respectively.Gas¬trografin helps in strengthening the clinical decision about the management of intestinal obstruction; it helps in early decision making regarding continuing the conservative or operative management and allows the introduction of oral intake earlier and earlier discharge from the hospital as well as reduction in operative rate.
A brief presentation regarding etiology , clinical features , and management of chronic limb ischemia. It was presented by our unit at Department of surgery , Patna medical college
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ocular injury ppt Upendra pal optometrist upums saifai etawah
limb salvage therapy
1. A meta-analysis of randomized control
trials of surgical methods with
osteosarcoma outcomes
Presenter
Dr Kundan
Department of Surgical oncology
Mahavir Cancer Sansthan , Patna
2.
3. • Prior to neoadjuvant chemotherapy, amputations and
disarticulations were the dominant treatments for
osteosarcoma with a 5-year overall survival (OS) rate of only
about 20% .
• LSS has functional and physiological advantages over
traditional amputative procedures when combined with
neoadjuvant or adjuvant chemotherapy.
• Previous studies have shown that LSS is applicative for
localized osteosarcoma, while amputation is suitable for
aggressive malignant osteosarcoma
• It has been reported that the risk of local recurrence and the
5-year OS rate did not differ significantly between LSS and
amputation in osteosarcoma patients with pathological
fractures.
4. Literature search
• MEDLINE, Cochrane, EMBASE, and Google
Scholar databases were searched for relevant
data till April 30, 2016.
• Exclusion standard
LSS or amputation groups without a
comparison,
case series with less than 20 total patients,
letters, case reports, editorials, or reviews
9. There was no difference in the local recurrence rate between LSS and
amputation (OR = 0.87, 95% CI 0.62–1.37, P = 0.42).
10.
11.
12. Results
• LSS is better than amputation in functional
outcomes.
• 5- year overall survival rate of patients treated
with LSS was higher than those treated with
amputation.
• There was no difference in the local
recurrence rate between LSS and amputation
13.
14.
15.
16. Results
• No statistical different of risk for developing relapse
between limb-salvage and amputation was found
relative risk (RR) =1.40, 95% confidence interval (CI):
0.71–2.79, (P = 0.33).
• The 5-year survival rate of patients underwent
limb-salvage surgery was smaller than patients
received amputation RR = 1.86, 95%CI: 1.19–2.89, (P =
0.01)
• The metastasis rate of patients underwent limb-salvage
surgery was significant decreased compared with
patients received amputation RR = 0.56, 95% CI: 0.34–
0.94, (P = 0.03).
17.
18.
19.
20.
21. • The overall incidence of local recurrence in LSS and
amputation group was 11.88% (57of480) and 7.73%(50 of
647), respectively. The results showed that there was no
significant differences between LSS and amputation group
(OR:1.03with95% CI 0.65-3.30; Z¼0.14, P¼0.89)
• The 5-year overall survival rate in LSS and amputation group
was 58.60% (252 of 430) and 49.84% (321 of 644),
respectively. In patients treated with LSS, the 5-year overall
survival rate was significantly higher than those treated with
amputation (OR:1.47 with 95% CI 1.10-1.97; Z¼2.61, Po0.05)
• The overall incidence of metastasis occurrence in LSS and
amputation group was 22.67% (17 of 75 ) and 44% (22 of 50),
respectively. Patients treated with LSS had a significantly
lower metastasis compared those with amputation (OR:0.24
with 95%CI 0.10- 0.60; Z¼3.05, Po0.05).
Results
22. Conclusion
• LSS can be safely used in localized
osteosarcoma patients with lower meta- static
occurrence and better survival, which won’t
increase the risk for local recurrence.