HighlightsSweat gland carcinoma is very rare with a reported incidence of less than 0.005% of all tumour specimens resected surgically. Due to limited availability of literature, the diagnosis as well as management of these tumours is quite difficult.Presented to us with a solitary swelling over the left chest wall since two month. We managed the case with wide excision of the swelling with segmental excision of the involved segments of the ribs with pleura followed by a Delto-Pectoral fasciocutaneous flap with insertion of an intercostal drain.Histopathology report confirmed an eccrine carcinoma with involvement of the ribs. The tumour cells immunohistochemical study showed that tumour cells were positive for pancytokeratin/CK7/Calretinin with focal luminal immunoreactivity for CEA.

Context: Tuberculosis (TB) is a common infectious disorder in developing countries. A significant load of patients with extrapulmonary TB are diagnosed in our institute, mostly involving the spine. Aim: We aimed to present our experience in the surgical management of spinal TB. Setting and Design: This was a retrospective observational study. Materials and Methods: Seventy patients (year 2016–2018) who underwent surgical management with minimum of 1-year follow-up (17 patients lost during follow-up) were graded as per the American Spinal Injury Association (ASIA) grading system for neurological deficits. All were surgically treated with laminectomy and epidural abscess drainage/transpedicular debridement of granulation with/without spinal stabilization. Thoracic and lumbar cases were managed by posterior approach; among them, 12 patients who had no significant cord compression and good ASIA grade with facet involvement (requiring fusion) underwent minimally invasive pedicle screw fixation. Cervical cases were managed mostly by anterior approach. All patients received Anti-tubercular treatment (ATT) post operatively as per protocol postoperatively, following which magnetic resonance imaging (MRI) spine was done. Statistical Analysis: Data were analyzed using SPSS software version 18.0 (SPSS Inc. Released in 2009. PASW Statistics for Windows, version 18.0. Chicago, IL, USA: SPSS Inc.). The continuous variables were analyzed using descriptive statistics using mean and standard deviation. Results: The average age was 42.5 years. The most common location was thoracic (28 patients), followed by lumbar (20 patients), cervical (16 patients), and thoracolumbar (6 patients). Twenty patients had epidural abscess with cord compression. All patients who presented within 4 weeks of onset of symptoms showed a statistically significant improvement postsurgery. Sixteen patients with epidural abscess had good neurological recovery immediately after surgery (ASIA B to ASIA D/E). Four patients with epidural abscess with late presentation remained ASIA A after surgery. All patients had good fusion rates (follow-up X-ray) at 1 year. After ATT course completion, all patients had complete eradication of disease (MRI spine). Conclusion: Surgical treatment for spinal TB, if performed early (within 4 weeks) with good decompression, results in satisfactory clinical outcome with early improvement in the neurological deficits. Posterior approach to the spine with decompression and fixation gives good results, and minimally invasive procedures further help lessen muscle dissection, less pain, and early mobilization.

The aim of this investigation was to determine the bacterial load on used instruments and to evaluate the relationship between the bacterial load and holding time prior to cleaning. Forty six sets were evaluated to establish the average number of bacteria per square centimeter. For the experimental study, three different bacteria were prepared in sheep blood and used to contaminate sterile stainless steel pieces with surface area of 10cm 2 . After incubation at room temperature for 2, 4,6,8, 12, 24, 36 and 48 h, colonies were counted as compared to time zero. Bacterial counts were between 20 and 320 CFU/cm2, depending on the operation site. Bacterial load was found to have increased after 6 hrs. An increase of 3log10 CFU/cm2 was measured after 12 h. It is imperative to clean surgical instruments in the first 6 h to ensure effective disinfection and sterility. KEYWORDSSurgical Instruments, Bacterial Load, Bioburden, Holding Time, Contamination. HOW TO CITE THIS ARTICLE:Mohite ST, Mahesh Reddy S, Kshirsagar AY, et al. Effect of holding time on the bacterial load of surgical instruments.

OBJECTIVEThe purpose of this study was to determine the diagnostic and therapeutic role of hyperosmolar water-soluble contrast medium gastrografin in cases of small bowel obstruction. BACKGROUNDAdhesive small bowel obstruction is a common emergency problem; post-operative abdominal adhesions represent the main aetiological factor for intestinal obstruction. It is commonly used for the diagnosis of small bowel obstruction, but it also has a therapeutic role in Small Bowel Obstruction (SBO).

BACKGROUNDAlthough stone disease is one of the most common afflictions of modern society, it has been described since antiquity. Urinary stone disease has perplexed the physicians for many centuries. Even today in spite of sophisticated research techniques and expand understanding of disease process, urinary calculi are major problems.