This anatomical study addresses the dual issues of determining the number of dissectable lymph nodes in a particular population as well as assessing the quality of nodal dissection by providing quantitative surgical guidelines.
This study was conducted to find the number, size, and distribution of the lymph nodes in the mesorectum in fresh cadavers without rectal cancer in Indians and to compare fat clearance method versus manual dissection of lymph nodes in terms of efficacy of lymph node yield. Thirty fresh cadavers underwent total mesorectal excision (TME) by midline incision. TME specimen was divided transversely (upper, middle, and lower thirds), and then further divided radially into 4 equal areas and the right lateral, left lateral, and posterior areas were taken for lymph node harvesting. In the first 15 cases (group A), lymph nodes were dissected manually from each of 9 areas. Number and diameters of harvested nodes were noted, and specimens were histopathologically examined. In the next 15 cases (group B), fat clearing technique was used, and the procedure was repeated. Mean number of lymph nodes recovered per cadaver was 6.2 (SD = 1.3; range, 5 to 9, group A = 5.86 ± 1.24, group B = 6.60 ± 1.29, P = .126) and mean size of the lymph node was 2.1 mm (SD = 0.38; range, 2 to 8 mm). Size and numbers of nodes in all the areas were similar between the 2 groups except in lower third, where smaller nodes were identified in greater numbers in group B. Manual dissection is an effective technique for node harvesting after TME, except for very small nodes found in the lower third of mesorectum. Accurate pathological examination of TME specimen is mandatory to avoid understaging of disease.
Pediatric intramedullary schwannoma without neurofibromatosis is extremely rare with only five cases reported so far. We present this rare finding in an 8-year-old boy who presented with a sudden onset of weakness in all limbs. An intraoperative diagnosis of schwannoma enabled us to carry out a total excision of the tumor, which resulted in near complete recovery at 18 months follow-up. Although rare, this diagnosis should be considered when a child presents with a solitary intramedullary tumor, since its total resection can be achieved improving surgical outcome.
Background: Before starting to discuss about Diarrhoea, we have to remember diarrhoea is one of the main causes of morbidity and mortality in children. Aims & Objective: The aim of this study was to determine the prevalence of intestinal parasitic and bacterial infections as cause of childhood diarrhoea. Materials & Methods: During the study period, a total of 116 stool samples were collected and processed. Examined grossly and microscopically for presence of ova/cyst. They were also cultured on MacConkey agar and E. coli isolated were identified by standard biochemical tests. Results: Out of 116 stools samples, Entamoeba histolytica (63.33%) and Giardia lamblia (23.33%) were more common parasitic cause diarrhoea among children by either ova or cyst. E.coli (74.13%) was common bacterial cause of diarrhoea among children. E. coli isolated in pure culture and sent for sero typing to Central Research Institute (CRI), Kasauli. Maximum percent were found to be pathogenic Escherichia coli i.e. EPEC 22.5%. Conclusion: According to the result, the most common cause of bacterial diarrhoea is E.coli. EPEC were more prevalent followed by EHEC. Thus, macroscopic and microscopic stool examinations as well as culture were important for finding out the course of diarrhoea in childhood.
Use of mosquito net, in place of polypropylene mesh, had been reported for tension-free hernia repair, as a better cost-effective option. This experimental histopathological study was performed in rats to find out the tissue response and the foreign body reaction and its comparison between commercial polypropylene mesh and the sterilized mosquito net. This experimental study was conducted in the Department of Surgery, Government NSCB, Medical College, Jabalpur (Madhya Pradesh), India. It was carried out in 40 albino rats. A 1.5 × 0.5-cm hernial defect was created by excising full-thickness abdominal wall muscle. All rats underwent on-lay mesh repair of hernial defect (polypropylene mesh, n = 20; mosquito net, n = 20). Half of rats in each group were sacrificed on day 14, and the other half, on day 90. Sections of containing mesh were examined histopathologically for inflammatory infiltrate, giant cells, and collagen deposition. Mosquito net group showed significantly greater number of giant cells and inflammatory cells at 14 and 90 days (p < 0.0001, p < 0.001, p < 0.05, and p < 0.001, respectively), as compared to polypropylene group. Grades of collagen fiber deposition were almost equal in both groups, both at 14 and 90 days (p > 0.05 and p > 0.05, respectively). Results of mosquito net are comparable to conventional polypropylene mesh. In a setup, where cost-effectiveness is of primary importance, use of mosquito net for tension-free hernia repair can be an acceptable alternative as proven histologically, to commercially available polypropylene mesh.
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