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Background: In clinical practice all cases of locally advanced breast carcinoma (LABC) warrant chemotherapy followed by multimodality care. Neoadjuvant chemotherapy (NACT) has been the mainstay in the management of LABC. The main aim of NACT is to downstage and prevent systemic micrometastasis early.Methods: This was a prospective study conducted on 36 diagnosed cases of stage III locally advanced breast cancer coming to the Dept. of Surgery, Dr. D. Y. Patil Medical College and hospital, Pune for a period of 2 years from 2017-2019. The effectiveness of neoadjuvant chemotherapy was assessed based on clinical, pathological and radiological response.Results: Among 36 LABC cases, maximum number of patients fell in the 41-50 years (41.6%) and presented in the Infiltrating ductal carcinoma group with a clinical stage IIIA disease. The response to NACT showed that a total of 12 patients (33.3%) showed complete clinical response and 30 patients were downstaged after neoadjuvant chemotherapy which was statistically significant. Only 4 out of the total 12 complete clinical responders went for Breast conservative surgery. Seroma formation was found to be the most common post-operative complication.Conclusions: LABC subjected to neoadjuvant chemotherapy based on taxanes/Anthracyclines show good clinical and radiological response. Patients preferred modified radical mastectomy due to the lack of awareness and low socioeconomic strata.The type of surgery did not increase  the chance of recurrence in the follow up period.

Background: Ventral hernias are defined as a protrusion of abdominal contents through the abdominal wall muscle. It can be categorised as spontaneous or acquired or by their location on the abdominal wall like epigastric hernia, umbilical hernia, para umbilical hernia etc. This original article reveals that laparoscopic trans abdominal pre peritoneal (TAPP) mesh placement for ventral hernia usually follows the current principle of hernia surgery and give better results from open pre peritoneal ventral hernia repair.Methods: A prospective study conducted in Dr. D. Y. Patil Medical College and Hospital, Pune for the period of 2017-2019 comparing laparoscopic TAPP vs. open preperitoneal ventral hernia repair. Total of 25 patients for laparoscopic TAPP repair and 25 patients for open preperitoneal repair were compared.Results: Total 50 cases were studies in which 25 for laparoscopic and 25 for open repair. Majority of patients were female than males. Incidence of para umbilical (56%) was found to be more. Intra operative, post-operative complications were found to be more in open repair than laparoscopic TAPP repair.Conclusions: Laparoscopic TAPP ventral hernia repair is safe with fewer complications. Therefore, offers successful treatment for ventral hernia repair with added benefits of laparoscopy such as better visualization and magnification of the hernia defects which are not clinically apparent and less chances of injury which is not possible by open technique. Laparoscopic TAPP ventral hernia repair gives equal results in terms of recurrence and less complications than open ventral hernia repair.

This paper traces the history of the Moroccan, Romanian, Ecuadorian and Chinese immigrants in Spain. It focuses on two dimensions of integration: access to the labour market and the level of discrimination faced by immigrants. By analysing the socio-economic and political changes taking place in these sending countries it seeks to understand the diverse factors that propelled migration. Migration to Spain is predominantly economic. In order to understand the integration of immigrants in Spain it is essential to analyse the labour market mobility in conjunction with the protection against discrimination as this reflects equality of opportunity coupled with a positive attitude towards inclusion in society. The 20th century led to economic growth and an increased demand for low skilled labourers prompting migration towards Spain. Lack of employment opportunities and political instability in the home countries, larger changes in the world such as the Oil Crisis, creation of Israel, discontinuation of labor recruitment by North-western European Countries were major push factors. Immigrants face discrimination in their access to the labour market. Unequal treatment is experienced by most immigrants except the Chinese who are respected for their hard work but mocked for their appearance.

Background: An association between hiatus hernia and cholelithiasis has been suspected for a long time but has never been adequately documented. Cholelithiasis is an asymptomatic disease. The precise incidence of hiatus hernia is not known. In current era as the practise is getting result oriented not diagnosing Hiatus hernia and persistence of symptoms is considered as failure in case of surgery. Coexistence if diagnosed preoperatively is of great help in management of the patient. The purpose of the study is to study association of Hiatus hernia with cholelithiasis in patients with dyspepsia.Methods: This is a prospective study conducted in DR. D. Y. Patil Medical College, Pune, Maharashtra for a period of two years. 100 patients of dyspepsia were enrolled in the study. All patients of dyspepsia were subjected to USG- abdomen. Patients were divided into diagnosed cholelithiasis (A) and non-cholelithiasis (B) as per USG findings. Both groups were subjected to upper gastro intestinal scopy. Appropriate statistical method was applied to know the incidence of hiatus hernia in cholelithiasis and non -cholelithiasis patients. Comparison was done to know the association between hiatus hernia and cholelithiasis in the patients with dyspepsia.Results: Total 24% patients had both hiatus hernia and cholelithiasis. Whereas 23% patients had neither hiatus hernia nor cholelithiasis on applying chi-square, p-value is 0.58. This is statistically insignificant.Conclusions: There is no obvious association between hiatus hernia and cholelithiasis in patients with complains of dyspepsia.