Modified radical mastectomy was found to be a safe operative procedure. Breast conservative surgery, although considered the gold standard in early breast cancer, was found unsuitable for our patients, due to the social background and lack of intensive radiotherapy and chemotherapy backup. Infiltrating duct carcinoma was more commonly associated with positive lymph nodes compared to other histopathologies. Cases operated by surgical oncologists had better axillary clearance. Neoadjuvant chemotherapy was used mainly by surgical oncologists suggesting a more rational approach toward the management of breast carcinoma.
Background: Abnormal uterine bleeding (AUB) is defined as any variation from the normal menstrual cycle such as changes in regularity, frequency, duration of flow or amount of flow. Objective of this study was to compare the adequacy and diagnostic accuracy of endometrial aspiration using Karman’s cannula versus dilatation and curettage in women with abnormal uterine bleeding.Methods: This prospective study was conducted on 250 women with AUB in age group of more than 40 years. In all patients, endometrial aspiration was done with manual vacuum aspiration (MVA) syringe attached to 4 mm Karman's cannula without anesthesia. The sample was collected in a bottle containing formalin and was labelled as sample A. After that, intracervical local anesthesia (1% Xylocaine) was given and cervix was dilated and scrapping of endometrial lining with sharp curette was done. The sample was also collected in a bottle containing formalin and was labelled as sample B. Both the samples A and B were sent for histopathology. The histopathology report of aspiration was compared with that of dilatation and curettage sample.Results: Endometrial aspiration biopsy had sensitivity of 92.3%, specificity of 100%, positive predictive value of 100% and negative predictive value of 99.56% for diagnosis of endometrial pathology while considering D and C gold standard. The sample adequacy of endometrial aspiration was 98.8% as compared to dilatation and curettage (98%).Conclusions: Present study showed that endometrial aspiration biopsy is an alternate to traditional dilatation and curettage in diagnosing endometrial pathologies in women with abnormal uterine bleeding.
Introduction Flow diversion with the Pipeline Embolization Device (PED) is increasingly used to treat intracranial aneurysms with high obliteration rates and low morbidity. However, long-term (!1 year) angiographic and clinical outcomes still require further investigation. The aim of this study was to compare the occlusion and complication rates for small (<10 mm) versus large (10-25 mm) aneurysms at long-term following treatment with PED. Methods A systematic review and meta-analysis were performed in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We conducted a comprehensive search of English language databases including Ovid MEDLINE(R) and Epub Ahead of Print, In-Process, and Daily, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. Our studies included a minimum of 10 patients treated with PED for small vs. large aneurysms and with at least 12 months of follow-up. The primary safety endpoint was the rate of clinical complications measured by the occurrence of symptomatic stroke (confirmed clinically and radiographically), intracranial hemorrhage, or aneurysmal rupture. The primary efficacy endpoint was the complete aneurysm occlusion rate. Results Our analysis included 19 studies with 1,277 patients and 1,493 aneurysms. Of those, 1,378 aneurysms met our inclusion criteria. The mean age was 53.9 years, and most aneurysms were small (89.75%; N= 1,340) in women (79.1%; N= 1,010). The long-term occlusion rate was 73% (95%, CI 65% to 80%) in small compared to 84% (95%, CI 76% to 90%) in large aneurysms (p<0.01). The symptomatic thromboembolic complication rate was 5% (95%, CI 3% to 9%) in small compared to 7% (95%, CI 4% to 13%) in large aneurysms. (p=0.01). The rupture rate was 2% vs. 4% (p = 0.92), and the rate of intracranial hemorrhage was 2% vs. 4% (p=0.96) for small vs. large aneurysms, respectively; however, these differences were not statistically significant.
ConclusionThe long-term occlusion rate after PED treatment is higher in large vs. small aneurysms. Symptomatic thromboembolic rates with stroke are also higher in large vs. small aneurysms. The difference in the rates of aneurysm rupture and intracranial hemorrhage was insignificant. Although the PED seems a safe and effective treatment for small and large aneurysms, further studies are required to clarify how occlusion rate and morbidity are affected by aneurysm size.
<p class="abstract"><strong>Background:</strong> Open partial laryngectomies for supraglottic and hypopharyngeal cancers have a very high incidence of aspiration in the post-operative period with resultant delay in restoration of swallowing. The present study examines the functional efficacy and oncological safety of transoral laser microsurgery (TLM) for select subset of T<sub>1</sub>/T<sub>2</sub>/T<sub>3</sub> squamous cancers of the supraglottis and hypopharynx with freely mobile vocal cords that are easily accessible on suspension microlaryngoscopy.</p><p class="abstract"><strong>Methods:</strong> This is a retrospective study of squamous cancers of the supraglottis and hypopharynx treated with transoral CO<sub>2</sub> laser resection. </p><p class="abstract"><strong>Results:</strong> Oncologically, resections performed under the magnification of the operating microscope are safe and yield high local control rates ranging from 79% to 85% for supraglottic cancer and from 63% to 89% for hypopharyngeal cancer.</p><p class="abstract"><strong>Conclusions:</strong> Transoral laser microsurgery (TLM) in selected cases of supraglottis and hypopharyngeal squamous cancers is safe procedure with several advantages over the open partial laryngectomy procedures as also over radiotherapy.</p>
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.