The role of hormone receptors as a prognostic and therapeutic tool in breast cancer is widely accepted. The frequency of nonreactivity of estrogen and progesterone receptors in breast cancer patients of India is much more common than in the West. This study was conducted with the aim of analysis of steroid receptor status in breast cancer with clinico-pathological characteristics from the northern hilly state of Himachal Pradesh, India located in the region of the Western Himalayas. Fifty five consecutive patients with the diagnosis of breast cancer were included in this study. Detailed clinical and histopathologic data was recorded in all cases. Estrogen receptor and progesterone receptor status was evaluated by immunohistochemistry. Chi-square test was used for statistical analysis. On immunohistochemical staining, 34.5% cases proved to be estrogen receptor positive and 36.4% cases progesterone receptor positive. The results in the present study documented low estrogen receptor and progesterone receptor positivity in breast cancer from this region of India.

Background: Blunt abdominal trauma (BAT), a common form of trauma, is one of the major causes of morbidity and mortality. The study was aimed at the study of spectrum of injuries to various intra-abdominal organs after blunt trauma and to ascertain cause/mode of BAT in a hospital of hilly locality of Shimla.Methods: A prospective study was designed to conduct in the department of Surgery, IGMC, Shimla, India during the period of one year from 1st June 2005 to 31st May 2006. A total of 30 patients who had sustained BAT with or without other associated injuries were selected. In all patient’s history was taken and detailed physical examination done while concomitant resuscitation was performed. Chest and abdominal radiographs were done in all patients.Results: BAT is a major cause of morbidity and mortality especially in young people in the 11-40 years’ age group. Males are affected more than females. Road traffic accidents are the predominant mode of injury however, a relatively high incidence of blunt abdominal trauma due to falls is observed in a hilly state like ours. Spleen and liver are the two commonly injured organs after blunt abdominal trauma.Conclusions: Proper early diagnosis with initial and adequate resuscitation is beneficial in having a good outcome in patients of BAT.

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Despite a long medical history of identification and treatment, hemorrhoids still pose a challenge to the medical fraternity in terms of finding satisfactory cure of the disease. In this study, Kshar Sutra Ligation (KSL), a modality of treatment described in Ayurveda, was compared with Barron's Rubber Band Ligation (RBL) for grade II and grade III hemorrhoids. This study was conducted in 20 adult patients of either sex with grade II and grade III hemorrhoids at two different hospitals. Patients were randomly allotted to two groups of 10 patients each. Group I patients underwent RBL, whereas patients of group II underwent KSL. Guggul-based Apamarga Kshar Sutra was prepared according to the principles laid down in ancient Ayurvedic texts and methodology standardized by IIIM, Jammu and CDRI, Lucknow. Comparative assessment of RBL and KSL was done according to 16 criteria. Although the two procedures were compared on 15 criteria, treatment outcome of grade II and grade III hemorrhoids was decided chiefly on the basis of patient satisfaction index (subjective criterion) and ability of each procedure to deal with prolapse of internal hemorrhoidal masses (objective criterion): Findings in each case were recorded over a follow-up of four weeks (postoperative days 1, 3, 7, 15 and 30). Statistical analysis was done using Student's t test for parametric data and Chi square test & Mann-Whitney test for non-parametric data. P < 0.05 was considered significant. RBL had the advantages of being an OPD procedure requiring no anesthesia and was attended by significantly lesser postoperative recumbency (P < 0.001 ) and significantly lesser pain (P < 0.005 on day 1) as compared to KSL. However, Group II (KSL) scored better in terms of treatment outcome. In Group II, there was significantly high (P < 0.05) patient satisfaction index as compared to Group I. Group II reported 100% 'cure' (absence of hemorrhoidal masses even on proctoscopy) of internal hemorrhoidal prolapse as against 80% in Group I (RBL); however, this difference was statistically insignificant (P > 0.05). Both the groups were comparable statistically on all other grounds. Kshar Sutra Ligation is a useful form of treatment for Grades II and III internal hemorrhoids.

Giant vesical calculus is a rare clinical entity in modern urological practice. Vesical calculi are usually secondary to bladder outlet obstruction. The usual clinical presentation is with recurrent urinary tract infection, haematuria or with retention of urine. We report an elderly male patient who presented with azotaemia and anuria as a result of bilateral obstructive uropathy due to a giant vesical calculus.