The Safety and Efficacy of Clipless versus Conventional Laparoscopic Cholecystectomy - our Experience in an Indian Rural Center.

Background: Laparoscopic cholecystectomy is one of the most common surgeries performed nowadays. There are lot of advances in closure of cystic duct and artery (clip ligation, suture ligation), but it remains an enigma regarding efficacy, safety and postoperative complications for using non-absorbable suture material or Liga clip for the operating surgeon in laparoscopic cholecystectomy.

Objectives: Our study aimed to evaluate the efficacy, safety and complications of non-absorbable sutures ligation versus clips application in laparoscopic cholecystectomy, and to compare the operative time and cost effectiveness of the two surgical approaches in laparoscopic cholecystectomy.

Plasma Prolactin and Total Lipid Levels and Subsequent Risk of Breast Cancer in Pre- and Postmenopausal Women: Experience from an Indian Rural Centre.

Aims And Objectives: 1) To analyze serum lipid and prolactin levels in breast cancer patients and normal subjects; 2) to correlate those levels with risk and prognostic factors.

Material And Methods: The present study was performed in the Department of Surgery, MMIMSR, Mullana, Ambala, from 2013 to 2014, at a rural centre. The study group comprised 40 patients with carcinoma of the breast who underwent surgery and the control group included 10 patients who underwent surgery for reasons other than carcinoma of the breast.

Modified Carba NP Test: Simple and rapid method to differentiate KPC- and MBL-producing Klebsiella species.

Background: The aim of this study was to evaluate the modified Carba NP test to differentiate KPC (Klebsiella pneumoniae carbapenemase)- and MBL (metallo-β-lactamase)-producing Klebsiella species.

Methods: A total of 508 non-duplicate clinical isolates of Klebsiella spp. were processed by modified Carba NP and combined disc tests which were further confirmed by conventional polymerase chain reaction (PCR), a gold standard method for statistical analysis.

Evaluate the effects of antiepileptic drugs on reproductive endocrine system in newly diagnosed female epileptic patients receiving either Valproate or Lamotrigine monotherapy: A prospective study.

Objective: To investigate the development of reproductive endocrine changes in Indian women with epilepsy initiating on either Valproate (VPA) or Lamotrigine (LTG) monotherapy.

Methods: Reproductive hormonal profiles, hirsutism, ovarian morphology by ultrasonography and menstrual cycle data in newly diagnosed women with epilepsy taking VPA (n=34) or LTG (n=32) monotherapy were compared. None of the women were receiving hormonal contraception.

Evaluation of Multidetector Computed Tomography in Haematuria.

Aims And Objectives: (1) To study the role of multidetector computed tomography in patients with haematuria. (2) To correlate multidetector computed tomography findings with clinical outcome/laboratory findings/FNAC and/or operative findings (wherever performed).

Material And Methods: The present study was carried out in the Department of Radiodiagnosis, M.

Computed Tomography in Craniofacial Fibrous Dysplasia: A Case Series with Review of Literature and Classification Update.

Introduction: Fibrous dysplasia (FD) is a fibroosseous lesion of the osseous structures of the body. It is not a commonly reported lesion yet it is considered as an important lesion which can affect the maxillofacial region as well. As a result, it can cause deformity of the jaw bones which can further lead to severe facial asymmetry.

An antenatal diagnosis: Congenital high airway obstruction.

Congenital high airway obstruction (CHAOS) is a rare lethal fetal malformation characterised by obstruction to the fetal upper airway, which can be partial or complete. Antenatal diagnosis of CHAOS is important due to recent management options. Diagnosis is made with secondary changes such as hyperechoic enlarged lungs resulting in mediastinal compression, ascites, hydrops, flattened or everted diaphragms and dilated distal airways.

Regional Cerebral Glucose Metabolism and its Association with Phenotype and Cognitive Functioning in Patients with Autism.

Introduction: In spite of three decades of neuroimaging, we are unable to find consistent and coherent anatomical or pathophysiological basis for autism as changes are subtle and there are no studies from India.

Aim: To study the regional cerebral glucose metabolism in children with autism using positron emission tomography (PET) scan and to study the behavior and cognitive functioning among them.

Materials And Methods: Ten subjects (8-19 years) meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for autism were evaluated on Childhood Autism Rating Scale (CARS), trail making test (TMT) A and B, Wisconsin card sorting test, Raven's progressive matrices, and PET scan.

Tubercular abdominal cocoon in children - a single centre study in remote area of northern India.

Background: Amongst the numerous causes of intestinal obstruction listed in the literature, sclerosing encapsulating peritonitis also called Abdominal Cocoon (AC) is one of the rarest entities. Its characteristic feature is a thick fibrotic membrane encasing varying lengths of the small and large gut in a cocoon. In India, there is an increasing incidence of tuberculosis, especially in the rural areas.

Efficacy of Myofascial Unwinding and Myofascial Release Technique in a Patient with Somatic Symptoms - A Case Report.

Depression is an aversion to activity disorder which could lead to somatic dysfunctions such as insomnia, excessive sleeping, body aches, listlessness, and irritable bowel syndrome. The World Health Organization has projected the depression to be the second leading cause of disability worldwide by 2020. The physical and mental ill effects of somatic depression can be addressed using the osteopathic manipulative treatment.

Unusual location of primary hydatid cyst diagnosed on aspiration cytology.

Hydatid cyst (HC) is a parasitic infection caused by Echinococcus granulosus. It occurs frequently in liver and lungs. Hydatid cyst of neck is extremely rare occurrence, and here, we report it with this unusual location.

Identification of foramen of Huschke with reversible herniation of temporomandibular joint soft tissue into the external auditory canal on multidetector computed tomography.

The foramen of Huschke, or foramen tympanicum, is a developmental defect in the bony part of the external auditory canal (EAC) due to a defect in ossification of normal bone in the first 5 years of life. Seen in the anteroinferior part of the EAC, it can be asymptomatic or present with salivary discharge into the EAC during mastication or as soft tissue swelling in the EAC in the absence of any inflammation, tumor, or trauma. We present a case of a man who presented with herniation of soft tissues of the temporomandibular joint into the EAC through a persistent foramen tympanicum.

A Study of Evaluation and Management of Rare Congenital Breast Diseases.

Introduction: Polymastia and polythelia may be asymptomatic or cause pain, restriction of arm movement, milk discharge, cosmetic problems or anxiety. Cosmesis is the main indication for surgical excision of accessory breasts in axilla. In addition it also confirms the diagnosis and allays the patient's fear of harbouring a malignancy.

Partial annular pancreas.

Annular pancreas is a developmental anomaly that can be associated with other conditions such as Down syndrome, duodenal atresia, and Hirschsprung disease. A band of pancreatic tissue, in continuity with the pancreatic head, completely or incompletely encircles the descending duodenum, sometimes assuming a "crocodile jaw" configuration. We present the case of an adult who presented with epigastric pain and vomiting and was found to have annular pancreas.

Association of Systemic Lupus Erythematosus and Beta Thalassaemia Trait- A Case Report.

Systemic Lupus Erythematosus (SLE) is a multisystem chronic inflammatory disease of autoimmune aetiology. It has a predilection for female gender and presence of photosensitive rash over the sun exposed area gives a clue to the diagnosis. Diagnosis in a male patient with atypical manifestations is unusual and difficult.

An Epidemiological Study of Malnutrition Among Under Five Children of Rural and Urban Haryana.

Introduction: A child is future of nation. Malnutrition is a big public health problem in India as it can be attributed for more than half (54 percent) of all under five mortality in India.

Aim: To assess prevalence of malnutrition among urban and rural population of Haryana using newly developed WHO growth standards.

Correlation Between Clinical Findings of Temporomandibular Disorders and MRI Characteristics of Disc Displacement.

Temporomandibular joint (TMJ) dysfunction is a common condition that is best evaluated with magnetic resonance (MR) imaging. The first step in MR imaging of the TMJ is to evaluate the articular disk, or meniscus, in terms of its morphologic features and its location relative to the condyle in both closed- and open-mouth positions. Disk location is of prime importance because the presence of a displaced disk is a critical sign of TMJ dysfunction.

Cytological features of malignant eccrine acrospiroma presenting as a soft tissue mass axilla: A rare sweat gland tumor with histologic correlation.

Malignant eccrine acrospiroma is an infrequent, highly malignant primary skin tumor derived from eccrine sweat glands. Though fine-needle aspiration cytology (FNAC) is a well-established diagnostic tool, but if a skin adnexal tumor or primary skin lesion is suspected clinically, the usual approach is biopsy due to easy accessibility. Being itself rare, cytologic features of this lesion is hardly encountered in case reports.

Adult necrotising enterocolitis: a rare entity.

A case of Adult Necrotising Enterocolitis in an adult female whom diagnosed with intestinal obstruction was reported. On exploratory laparotomy, the mechanical caused was not found although major part of small bowel, caecum and proximal ascending colon were gangrenous along with intervening normal parts. Resection of affected bowel was performed followed by jejunostomy and transverse colostomy.

Infiltrating ductal carcinoma breast, metastatic to ipsilateral axillary lymph nodes harbouring primary tuberculous lymphadenitis: a case report.

The coexistence of breast cancer and tuberculosis has been described in over 100 cases; however its coexistence in the axillary lymph node is rare with only a handful cases have been reported in the literature. We report a case of infiltrating ductal carcinoma of the left breast, metastatic to ipsilateral axillary lymph nodes harbouring tuberculous lymphadenitis without primary mammary or pulmonary tuberculosis. The case is presented for its rarity and illustrates that the simultaneous occurrence of tuberculosis and carcinoma can create a dilemma in the diagnosis and treatment, so surgeons and pathologists should keep such a combination on the back of their mind, especially in endemic areas.

A comparative study to evaluate liquid dish washing soap as an alternative to xylene and alcohol in deparaffinization and hematoxylin and eosin staining.

Introduction: Our study presents a new deparaffinizing and hematoxylin and eosin (H and E) staining method that involves the use of easily available, nontoxic and eco-friendly liquid diluted dish washing soap (DWS) by completely eliminating expensive and hazardous xylene and alcohol from deparaffinizing and rehydration prior to staining, staining and from dehydration prior to mounting. The aim was to evaluate and compare the quality of liquid DWS treated xylene and alcohol free (XAF) sections with that of the conventional H and E sections.

Materials And Methods: A total of 100 paraffin embedded tissue blocks from different tissues were included.

The 2014 Academic College of Emergency Experts in India's INDO-US Joint Working Group (JWG) White Paper on "Developing Trauma Sciences and Injury Care in India".

It is encouraging to see the much needed shift in the understanding and recognition of the concept of "burden of disease" in the context of traumatic injury. Equally important is understanding that the impact of trauma burden rivals that of nontraumatic morbidities. Subsequently, this paradigm shift reinstates the appeal for timely interventions as the standard for management of traumatic emergencies.

Clinical study of headache in relation to sinusitis and its management.

Aim: To study relation of headache with sinusitis and its management.

Methodology: Patients clinically presenting with headache were selected. Only patients with headache due to rhinogenic causes were subjected to X-ray paranasal sinuses and diagnostic nasal endoscopy and followed-up to evaluate management.

Primary germ cell tumor of the mediastinum - presenting as a huge mass.

Germ cell tumors compromise 15-20% of all anterior mediastinal masses; 50-60% of these are benign mediastinal teratoma. There may be mature, immature, and rarely with malignant component within the tumor mass. There are more chances of malignancy with immature type.

Cadaveric temporal bone dissection: is it obsolete today?

Introduction Traditionally, surgical training in otology, is imparted by dissecting harvested human cadaveric temporal bones. However, maintenance of a cadaveric temporal bone laboratory is expensive and carries risk of exposure to infection. In recent times, other modalities of training are gaining ground and are likely to eventually replace cadaveric temporal bone dissection altogether.