Pub Date : 2022-07-06eCollection Date: 2022-01-01DOI: 10.3389/jaws.2022.10517
Johannes A Wegdam, Dite L C de Jong, Tammo S de Vries Reilingh, Ellis E Schipper, Nicole D Bouvy, Simon W Nienhuijs
Background: The posterior component separation technique with transversus abdominis release (TAR) was introduced in 2012 as an alternative to the classic anterior component separation technique (Ramirez). This study describes outcome and learning curve of TAR, five years after implementation of this new technique in a regional hospital in the Netherlands. Methods: A standardized work up protocol, based on the Plan-Do-Check-Act cycle, was used to implement the TAR. The TAR technique as described by Novitsky was performed. After each 20 procedures, outcome parameters were evaluated and new quality measurements implemented. Primary outcome measure was Textbook Outcome, the rate of patients with an uneventful clinical postoperative course after TAR. Textbook Outcome is defined by a maximum of 7 days hospitalization without any complication (wound or systemic), reoperation or readmittance, within the first 90 postoperative days, and without a recurrence during follow up. The number of patients with a Textbook Outcome compared to the total number of consecutively performed TARs is depicted as the institutional learning curve. Secondary outcome measures were the details and incidences of the surgical site and systemic complications within 90 days, as well as long-term recurrences. Results: From 2016, sixty-nine consecutive patients underwent a TAR. Textbook Outcome was 35% and the institutional learning curve did not flatten after 69 procedures. Systemic complications occurred in 48%, wound complications in 41%, and recurrences in 4%. Separate analyses of three successive cohorts of each 20 TARs demonstrated that both Textbook Outcome (10%, 30% and 55%, respectively) and the rate of surgical site events (45%, 15%, and 10%) significantly (p < 0.05) improved with more experience. Conclusion: Implementation of the open transversus abdominis release demonstrated that outcome was positively correlated to an increasing number of TARs performed. TAR has a long learning curve, only partially determined by the technical aspects of the operation. Implementation of the TAR requires a solid plan. Building, and maintaining, an adequate setting for patients with complex ventral hernias is the real challenge and driving force to improve outcome.
背景：腹横肌松解术（TAR）后部组件分离技术于2012年推出，作为经典的前部组件分离技术（拉米雷斯）的替代方案。本研究描述了在荷兰一家地区医院实施这项新技术五年后，TAR 的效果和学习曲线。方法：根据 "计划-实施-检查-行动 "的周期，采用标准化的工作程序来实施 TAR。采用诺维茨基所描述的 TAR 技术。每完成 20 例手术后，对结果参数进行评估，并实施新的质量测量。主要结果指标是 "教科书结果"，即 TAR 术后临床疗程顺利的患者比例。术后 90 天内无任何并发症（伤口或全身并发症）、再次手术或再次入院，且在随访期间无复发，最长住院时间为 7 天。获得 "教科书式 "结果的患者人数与连续实施 TAR 的总人数的比较被描绘成机构学习曲线。次要结果指标是 90 天内手术部位和全身并发症以及长期复发的详细情况和发生率。结果：自2016年起，共有69名患者连续接受了TAR手术。教科书结果为35%，69例手术后，机构学习曲线并未趋于平缓。全身并发症发生率为 48%，伤口并发症发生率为 41%，复发率为 4%。对连续三批各 20 例 TAR 进行的单独分析表明，随着经验的增加，教科书结果（分别为 10%、30% 和 55%）和手术部位事件发生率（分别为 45%、15% 和 10%）均有显著改善（P < 0.05）。结论开放式腹横肌松解术的实施表明，手术效果与 TAR 手术次数的增加呈正相关。TAR 的学习曲线较长，仅部分取决于手术的技术方面。实施 TAR 需要一个可靠的计划。为复杂腹股沟疝患者建立并维持适当的环境是提高疗效的真正挑战和动力。
{"title":"Assessing Textbook Outcome After Implementation of Transversus Abdominis Release in a Regional Hospital.","authors":"Johannes A Wegdam, Dite L C de Jong, Tammo S de Vries Reilingh, Ellis E Schipper, Nicole D Bouvy, Simon W Nienhuijs","doi":"10.3389/jaws.2022.10517","DOIUrl":"10.3389/jaws.2022.10517","url":null,"abstract":"<p><p><b>Background:</b> The posterior component separation technique with transversus abdominis release (TAR) was introduced in 2012 as an alternative to the classic anterior component separation technique (Ramirez). This study describes outcome and learning curve of TAR, five years after implementation of this new technique in a regional hospital in the Netherlands. <b>Methods:</b> A standardized work up protocol, based on the Plan-Do-Check-Act cycle, was used to implement the TAR. The TAR technique as described by Novitsky was performed. After each 20 procedures, outcome parameters were evaluated and new quality measurements implemented. Primary outcome measure was Textbook Outcome, the rate of patients with an uneventful clinical postoperative course after TAR. Textbook Outcome is defined by a maximum of 7 days hospitalization without any complication (wound or systemic), reoperation or readmittance, within the first 90 postoperative days, and without a recurrence during follow up. The number of patients with a Textbook Outcome compared to the total number of consecutively performed TARs is depicted as the institutional learning curve. Secondary outcome measures were the details and incidences of the surgical site and systemic complications within 90 days, as well as long-term recurrences. <b>Results:</b> From 2016, sixty-nine consecutive patients underwent a TAR. Textbook Outcome was 35% and the institutional learning curve did not flatten after 69 procedures. Systemic complications occurred in 48%, wound complications in 41%, and recurrences in 4%. Separate analyses of three successive cohorts of each 20 TARs demonstrated that both Textbook Outcome (10%, 30% and 55%, respectively) and the rate of surgical site events (45%, 15%, and 10%) significantly (<i>p</i> < 0.05) improved with more experience. <b>Conclusion:</b> Implementation of the open transversus abdominis release demonstrated that outcome was positively correlated to an increasing number of TARs performed. TAR has a long learning curve, only partially determined by the technical aspects of the operation. Implementation of the TAR requires a solid plan. Building, and maintaining, an adequate setting for patients with complex ventral hernias is the real challenge and driving force to improve outcome.</p>","PeriodicalId":36033,"journal":{"name":"Medical Journal of Dr. D.Y. Patil University","volume":"10 1","pages":"10517"},"PeriodicalIF":0.0,"publicationDate":"2022-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10831686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74487727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-01DOI: 10.4103/MJDRDYPU.MJDRDYPU_96_17
M. Bhatia, Murtuza J. Ali
Background: Liver abscess (pyogenic and amebic) is frequently encountered clinical condition; however, it can result in lethal outcome if there is a delay in diagnosis and treatment. Despite modalities to diagnose the condition early, still ruptured liver abscess presents with a common cause of acute abdomen in surgical emergency. In developing countries, ruptured liver abscess is a common cause of mortality. For contained abscess, nonsurgical options are considered; however, for ruptured liver abscess, surgical intervention is considered necessary. Materials and Methods: This was a retrospective study carried in Safdarjung hospital, New Delhi, between 2015 and 2016. All patients with ruptured liver abscess (clear signs of peritonitis) were included in this study, and those patients having other causes of peritonitis were excluded. A preformed protocol for management was followed for all the patients, and various parameters contributing to the illness and its prognosis were evaluated and assessed. Results: Out of the fifty patients assessed, male patients were mainly affected (86%). The most affected age group was 31–40 years (64%) followed by 41–50 years (22%). Right hypochondrium pain was the most common presenting complaint. Nine patients (18%) had presented with signs of toxemia. Only right lobe of the liver was affected the most in 44 patients (88%). Escherichia coli was the most common organism isolated in our study in 19 patients (38%). A total of 19 patients (38%) had diabetes in our study and total of 13 patients had mortality in our study. Conclusion: Ruptured liver abscess most commonly involves the right lobe of the liver. Males are affected far higher than the females; probable cause believed to be higher alcohol consumption. Most common affected age group falls between 30 and 60 years of age. If prompt treatment is started in time, mortality involved with it is evitable.
{"title":"Ruptured liver abscess: Analysis of 50 cases","authors":"M. Bhatia, Murtuza J. Ali","doi":"10.4103/MJDRDYPU.MJDRDYPU_96_17","DOIUrl":"https://doi.org/10.4103/MJDRDYPU.MJDRDYPU_96_17","url":null,"abstract":"Background: Liver abscess (pyogenic and amebic) is frequently encountered clinical condition; however, it can result in lethal outcome if there is a delay in diagnosis and treatment. Despite modalities to diagnose the condition early, still ruptured liver abscess presents with a common cause of acute abdomen in surgical emergency. In developing countries, ruptured liver abscess is a common cause of mortality. For contained abscess, nonsurgical options are considered; however, for ruptured liver abscess, surgical intervention is considered necessary. Materials and Methods: This was a retrospective study carried in Safdarjung hospital, New Delhi, between 2015 and 2016. All patients with ruptured liver abscess (clear signs of peritonitis) were included in this study, and those patients having other causes of peritonitis were excluded. A preformed protocol for management was followed for all the patients, and various parameters contributing to the illness and its prognosis were evaluated and assessed. Results: Out of the fifty patients assessed, male patients were mainly affected (86%). The most affected age group was 31–40 years (64%) followed by 41–50 years (22%). Right hypochondrium pain was the most common presenting complaint. Nine patients (18%) had presented with signs of toxemia. Only right lobe of the liver was affected the most in 44 patients (88%). Escherichia coli was the most common organism isolated in our study in 19 patients (38%). A total of 19 patients (38%) had diabetes in our study and total of 13 patients had mortality in our study. Conclusion: Ruptured liver abscess most commonly involves the right lobe of the liver. Males are affected far higher than the females; probable cause believed to be higher alcohol consumption. Most common affected age group falls between 30 and 60 years of age. If prompt treatment is started in time, mortality involved with it is evitable.","PeriodicalId":36033,"journal":{"name":"Medical Journal of Dr. D.Y. Patil University","volume":"10 1","pages":"532 - 535"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70833458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-01DOI: 10.4103/MJDRDYPU.MJDRDYPU_88_17
V. Grewal, A. Khera
Introduction: Food poisoning is an acute gastroenteritis caused by ingestion of food or drink contaminated with either living bacteria or their toxins or inorganic chemical substances and poisons derived from plants and animals, commonly occurring as explosive outbreaks. The authors investigated an outbreak of food poisoning reported from a working men's hostel in urban area of Pune, Maharashtra. Materials and Methods: A retrospective cohort study design was adopted to investigate the outbreak. Of the total 170 members, 68 had symptoms of food poisoning. Remaining 102 unexposed members were also interviewed as part of the study. Data for environmental and laboratory parameters were also collected. Results: The point source outbreak indicated cooked chicken as the source with a risk ratio of 3.34 (95% confidence interval: 2.02–5.54) and attributable fraction for chicken was 75.3%. As is the case with 70% of food poisoning outbreaks, laboratory confirmation of causative organism could not be established, due to lack of specimens. However, the clinicoepidemiological profile of the patients displays a median incubation period of 8 h (range 5–17 h), along with the clinical symptomatology of a self-limiting disease of diarrhea, abdominal cramps, and nausea; suggested the implicating organisms to be either Clostridium perfringens or Bacillus cereus. Conclusion: The defaulting environmental parameters of compromised sanitary conditions, inadequate storage in refrigerator, improper storage of raw food, and unsafe cooking practices were enhancing factors, which need to be mandatorily addressed in bulk cooking.
{"title":"Outbreak of food poisoning in a working men's hostel: A retrospective cohort study","authors":"V. Grewal, A. Khera","doi":"10.4103/MJDRDYPU.MJDRDYPU_88_17","DOIUrl":"https://doi.org/10.4103/MJDRDYPU.MJDRDYPU_88_17","url":null,"abstract":"Introduction: Food poisoning is an acute gastroenteritis caused by ingestion of food or drink contaminated with either living bacteria or their toxins or inorganic chemical substances and poisons derived from plants and animals, commonly occurring as explosive outbreaks. The authors investigated an outbreak of food poisoning reported from a working men's hostel in urban area of Pune, Maharashtra. Materials and Methods: A retrospective cohort study design was adopted to investigate the outbreak. Of the total 170 members, 68 had symptoms of food poisoning. Remaining 102 unexposed members were also interviewed as part of the study. Data for environmental and laboratory parameters were also collected. Results: The point source outbreak indicated cooked chicken as the source with a risk ratio of 3.34 (95% confidence interval: 2.02–5.54) and attributable fraction for chicken was 75.3%. As is the case with 70% of food poisoning outbreaks, laboratory confirmation of causative organism could not be established, due to lack of specimens. However, the clinicoepidemiological profile of the patients displays a median incubation period of 8 h (range 5–17 h), along with the clinical symptomatology of a self-limiting disease of diarrhea, abdominal cramps, and nausea; suggested the implicating organisms to be either Clostridium perfringens or Bacillus cereus. Conclusion: The defaulting environmental parameters of compromised sanitary conditions, inadequate storage in refrigerator, improper storage of raw food, and unsafe cooking practices were enhancing factors, which need to be mandatorily addressed in bulk cooking.","PeriodicalId":36033,"journal":{"name":"Medical Journal of Dr. D.Y. Patil University","volume":"10 1","pages":"517 - 521"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46326870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-01DOI: 10.4103/MJDRDYPU.MJDRDYPU_50_17
I. Aliyu, T. Lawal
Multiple exostoses are a rare disorder. It is estimated to occur in 1; 50,000 pregnancies. It presents within the first decade of life and it has an autosomal mode of inheritance; though it has been associated with a spontaneous mutation in 10% of cases. It is known as hereditary multiple exostoses, hereditary multiple osteochondromas, and to fit this diagnosis, there should be at two or more exostoses; usually, long bones of cartilaginous origin such as those of the extremities are mostly affected often sparing the face, these exostoses are osteochondromas arising close to the growth plate (metaphysis and epiphysis). This communication highlights the case of a 42-day-old female delivered at the 7th month gestational age to a nonconsanguineous family setting; she was admitted with the complaint of convulsions and poor suck; she was the second of a set of twin; the first twin was essentially healthy. There was no history of fever or difficulty of breathing. The delivery was at home and she was said to be small at birth, the birth weight was not measured, and cried poorly. On examination, she was wasted with a weight of 1.4 kg, and the length was 34 cm with an occipitofrontal circumference of 29 cm. The lower limbs were malformed with exostosis arising from both shins; she also had a ventricular septal defect.
{"title":"Congenital multiple exostoses with congenital heart disease","authors":"I. Aliyu, T. Lawal","doi":"10.4103/MJDRDYPU.MJDRDYPU_50_17","DOIUrl":"https://doi.org/10.4103/MJDRDYPU.MJDRDYPU_50_17","url":null,"abstract":"Multiple exostoses are a rare disorder. It is estimated to occur in 1; 50,000 pregnancies. It presents within the first decade of life and it has an autosomal mode of inheritance; though it has been associated with a spontaneous mutation in 10% of cases. It is known as hereditary multiple exostoses, hereditary multiple osteochondromas, and to fit this diagnosis, there should be at two or more exostoses; usually, long bones of cartilaginous origin such as those of the extremities are mostly affected often sparing the face, these exostoses are osteochondromas arising close to the growth plate (metaphysis and epiphysis). This communication highlights the case of a 42-day-old female delivered at the 7th month gestational age to a nonconsanguineous family setting; she was admitted with the complaint of convulsions and poor suck; she was the second of a set of twin; the first twin was essentially healthy. There was no history of fever or difficulty of breathing. The delivery was at home and she was said to be small at birth, the birth weight was not measured, and cried poorly. On examination, she was wasted with a weight of 1.4 kg, and the length was 34 cm with an occipitofrontal circumference of 29 cm. The lower limbs were malformed with exostosis arising from both shins; she also had a ventricular septal defect.","PeriodicalId":36033,"journal":{"name":"Medical Journal of Dr. D.Y. Patil University","volume":"10 1","pages":"592 - 594"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48812853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-01DOI: 10.4103/MJDRDYPU.MJDRDYPU_81_17
B. Paul, D. Sinha, R. Misra, M. Basu, S. Ray
Introduction: Injuries are not random events – they have identifiable precipitating factors, and are therefore among public health's winnable battles. Substantial data-based study can help identify measures to prevent the occurrence of physical injury. Our objective was to find out the injury profile of patients attending a tertiary care hospital and assess their perception toward preventability of the event in light of their causation. Materials and Methods: This cross-sectional study was conducted on patients attending selected Outpatient and Inpatient Departments of Institute of Postgraduate Medical Education and Research, Kolkata, from February to March 2014. 216 patients who had suffered any form of physical injury and admitted/attending the selected departments were included in the study by complete enumeration method, after exclusion of unwilling and severely moribund patients. Pearson's Chi-square test was performed using Epi Info software version 3.2. Results: Highest proportion of physical injuries (24.07%) occurred among 30–40 years age group. Road traffic accidents (RTAs) were the most common type of injury (38.8%) followed by falls (34.7%). 38.6% of the falls occurred inside victim's homes and 25.3% occurred on road. Electricity caused 55.1% burn injuries. Faulty driving attributed to 47% of the RTAs as perceived by its victims. Majority of the victims (60.2%) opined that their injuries were not preventable. Conclusion: Raising public awareness that injury is preventable to a great extent, would help in averting such incidents, and thereby reduce unnecessary injury-related morbidity and mortality.
导言:伤害不是随机事件——它们具有可识别的诱发因素，因此是公共卫生领域可打赢的战役之一。大量基于数据的研究可以帮助确定预防身体伤害发生的措施。我们的目的是找出在三级护理医院就诊的患者的损伤概况，并根据其原因评估他们对事件可预防性的看法。材料与方法:本横断面研究于2014年2月至3月在加尔各答研究生医学教育与研究所选定的门诊和住院部进行。通过完全枚举法，排除不愿意和严重垂死患者后，将216例在选定科室住院或就诊的任何形式的身体损伤患者纳入研究。使用Epi Info 3.2版软件进行Pearson卡方检验。结果:30 ~ 40岁年龄组肢体损伤发生率最高，为24.07%。道路交通事故(rta)是最常见的伤害类型(38.8%)，其次是跌倒(34.7%)。38.6%的摔倒发生在受害者家中，25.3%发生在道路上。55.1%的烧伤由电引起。受害者认为47%的rta是由于驾驶失误造成的。大多数受害者(60.2%)认为他们的伤害是无法预防的。结论:在很大程度上提高公众对伤害可预防的认识，将有助于避免此类事件的发生，从而减少不必要的伤害相关发病率和死亡率。
{"title":"Physical injury: Is it inevitable or preventable? an experience from a Tertiary Care Hospital of Kolkata, West Bengal","authors":"B. Paul, D. Sinha, R. Misra, M. Basu, S. Ray","doi":"10.4103/MJDRDYPU.MJDRDYPU_81_17","DOIUrl":"https://doi.org/10.4103/MJDRDYPU.MJDRDYPU_81_17","url":null,"abstract":"Introduction: Injuries are not random events – they have identifiable precipitating factors, and are therefore among public health's winnable battles. Substantial data-based study can help identify measures to prevent the occurrence of physical injury. Our objective was to find out the injury profile of patients attending a tertiary care hospital and assess their perception toward preventability of the event in light of their causation. Materials and Methods: This cross-sectional study was conducted on patients attending selected Outpatient and Inpatient Departments of Institute of Postgraduate Medical Education and Research, Kolkata, from February to March 2014. 216 patients who had suffered any form of physical injury and admitted/attending the selected departments were included in the study by complete enumeration method, after exclusion of unwilling and severely moribund patients. Pearson's Chi-square test was performed using Epi Info software version 3.2. Results: Highest proportion of physical injuries (24.07%) occurred among 30–40 years age group. Road traffic accidents (RTAs) were the most common type of injury (38.8%) followed by falls (34.7%). 38.6% of the falls occurred inside victim's homes and 25.3% occurred on road. Electricity caused 55.1% burn injuries. Faulty driving attributed to 47% of the RTAs as perceived by its victims. Majority of the victims (60.2%) opined that their injuries were not preventable. Conclusion: Raising public awareness that injury is preventable to a great extent, would help in averting such incidents, and thereby reduce unnecessary injury-related morbidity and mortality.","PeriodicalId":36033,"journal":{"name":"Medical Journal of Dr. D.Y. Patil University","volume":"10 1","pages":"568 - 572"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45630250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-01DOI: 10.4103/MJDRDYPU.MJDRDYPU_143_17
A. Banerjee
{"title":"Can the family physician make a comeback?","authors":"A. Banerjee","doi":"10.4103/MJDRDYPU.MJDRDYPU_143_17","DOIUrl":"https://doi.org/10.4103/MJDRDYPU.MJDRDYPU_143_17","url":null,"abstract":"","PeriodicalId":36033,"journal":{"name":"Medical Journal of Dr. D.Y. Patil University","volume":"10 1","pages":"505 - 506"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45292540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-01DOI: 10.4103/0975-2870.223361
D. Mehta, M. Bohra, A. Anand, S. Parikh, Sandip Shah
Gastric cancer can have protean manifestations, usual symptoms mimicking those of peptic ulcer disease. Gastric adenocarcinomas have rarely been reported with leptomeningeal carcinomatosis (LMC) and dermatoses as initial presenting features. It is also difficult to diagnose breast metastasis of gastric carcinoma due to its rarity. We report two such cases with rare initial presentation. Our first case was a 46-year-old male who presented with LMC. Our second case was a 24-year-old male whose initial complaints were shortness of breath, bilateral breast lumps, and skin discoloration. Both cases on further investigations were found to have primary tumors in the stomach.
{"title":"Rare presenting features of carcinoma of stomach – Leptomeningeal carcinomatosis, breast metastasis, malignant pleural effusion, and dermatoses: A report of two cases and review of literature","authors":"D. Mehta, M. Bohra, A. Anand, S. Parikh, Sandip Shah","doi":"10.4103/0975-2870.223361","DOIUrl":"https://doi.org/10.4103/0975-2870.223361","url":null,"abstract":"Gastric cancer can have protean manifestations, usual symptoms mimicking those of peptic ulcer disease. Gastric adenocarcinomas have rarely been reported with leptomeningeal carcinomatosis (LMC) and dermatoses as initial presenting features. It is also difficult to diagnose breast metastasis of gastric carcinoma due to its rarity. We report two such cases with rare initial presentation. Our first case was a 46-year-old male who presented with LMC. Our second case was a 24-year-old male whose initial complaints were shortness of breath, bilateral breast lumps, and skin discoloration. Both cases on further investigations were found to have primary tumors in the stomach.","PeriodicalId":36033,"journal":{"name":"Medical Journal of Dr. D.Y. Patil University","volume":"10 1","pages":"576 - 581"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45316057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-01DOI: 10.4103/MJDRDYPU.MJDRDYPU_109_17
A. Mandal, P. Sahi
{"title":"Acute respiratory distress syndrome and erosive gastritis with hepatitis A in children","authors":"A. Mandal, P. Sahi","doi":"10.4103/MJDRDYPU.MJDRDYPU_109_17","DOIUrl":"https://doi.org/10.4103/MJDRDYPU.MJDRDYPU_109_17","url":null,"abstract":"","PeriodicalId":36033,"journal":{"name":"Medical Journal of Dr. D.Y. Patil University","volume":"10 1","pages":"608 - 609"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49627018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-01DOI: 10.4103/MJDRDYPU.MJDRDYPU_51_17
Shreeprasad P. Patankar
Congenital buried penis (CBP) is a rare condition characterized by penis with normal length obscured under penopubic and penoscrotal skin and subcutaneous tissue. Though rare, this condition causes great parental anxiety because of abnormal shape and appearance of penis, dribbling of urine and poor hygiene. Abnormal distal attachment of fundiform ligament on penile shaft, large, redundant preputial sac, and severe paucity of nonpigmented penile skin are important anatomical factors responsible for CBP. We here describe a different approach for degloving of penis and achieving penile skin cover using skin and fascial sheath of preputial sac. This method is simple and easy to learn, teach and reproduce.
{"title":"Using skin and fascial sheath of preputial sac; A new technique for surgery for congenital buried penis","authors":"Shreeprasad P. Patankar","doi":"10.4103/MJDRDYPU.MJDRDYPU_51_17","DOIUrl":"https://doi.org/10.4103/MJDRDYPU.MJDRDYPU_51_17","url":null,"abstract":"Congenital buried penis (CBP) is a rare condition characterized by penis with normal length obscured under penopubic and penoscrotal skin and subcutaneous tissue. Though rare, this condition causes great parental anxiety because of abnormal shape and appearance of penis, dribbling of urine and poor hygiene. Abnormal distal attachment of fundiform ligament on penile shaft, large, redundant preputial sac, and severe paucity of nonpigmented penile skin are important anatomical factors responsible for CBP. We here describe a different approach for degloving of penis and achieving penile skin cover using skin and fascial sheath of preputial sac. This method is simple and easy to learn, teach and reproduce.","PeriodicalId":36033,"journal":{"name":"Medical Journal of Dr. D.Y. Patil University","volume":"10 1","pages":"573 - 575"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46783563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-01DOI: 10.4103/MJDRDYPU.MJDRDYPU_99_17
D. Kanade
{"title":"Short training in family medicine during internship: insights gained over a decade","authors":"D. Kanade","doi":"10.4103/MJDRDYPU.MJDRDYPU_99_17","DOIUrl":"https://doi.org/10.4103/MJDRDYPU.MJDRDYPU_99_17","url":null,"abstract":"","PeriodicalId":36033,"journal":{"name":"Medical Journal of Dr. D.Y. Patil University","volume":"10 1","pages":"507 - 509"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44406421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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