Polymorphism in MnSOD Gene and Breast Cancer Risk in Kashmiri Patients: a Case Control Study

Reactive oxygen species (ROS) have been implicated in the etiology of many human diseases. Antioxidant enzymes such as MnSOD protects cells from oxidative stress and generation of ROS. A case control study, with aim to evaluate the relationship between MnSOD Ala-9Val polymorphism and breast cancer was carried out. The study included 522 subjects, including 255 cases and 267 controls, 12 samples were missing or yielded no results. Genotyping of samples were carried out using PCR-RFLP method. We observed that neither of two conditions heterozygous (MnSOD Val/Ala) or Variant/(MnSOD Ala/Ala) was significantly associated with overall breast cancer risk. The frequencies of Val and Ala allele was almost similar in cases, however, a significant association was seen in case of older women (above 45 years of age) (OR =1.98, CI=1.07-3.66, P=0.04). Also ORs were elevated in case of women using oral contraceptives carrying Val/Ala genotype. (OR=2.20; CI=0.54-8.96). In conclusion MnSOD Ala-9Val polymorphism may modify the risk for breast cancer development particularly in presence of age above 45years, oral contraceptives, and urban life style

To compare the efficacy of granisetron over droperidol in the prevention of postoperative Nausea and Vomiting following open cholecystectomy

Objectives: To evaluate and compare the efficacy of Granisetron over Droperidol in the prevention of post operative nausea and vomiting following open cholecystectomy. Study Design: Double-blind randomized study. Material & Methods: All patients with ASA status 1 and II, undergoing open Cholecystectomy were thoroughly evaluated and assessed as per the study protocol. The patients were randomly allocated into two groups, X or Y, to receive either injection Granisetron hydrochloride (3mg i/v) or Droperidol (2.5mg i/v) in a double –blind fashion, 5 min prior to induction of general anesthesia. Post-operatively, the incidence of nausea and vomiting was recorded every six hourly for a period of 24 hour on a 3 point scale, i. e.0 = none, 1 = nausea & 2 = vomiting. At the end, all the data collected was subjected to statistical analysis. Results: During the first 6 hrs after anesthesia, 6 (12%) patients in the granisetron group and 20 (40%) patients in the Droperidol group reported an emetic episode. At 6-12 hrs after anesthesia, 11 (22%) of patients in the Granisetron group suffered an emetic episode, whereas this number was 19 (38%) in case of Droperidol group. In the 12-18 hr time frame, Granisetron group reported emetic episode in 12 (24%) patients where as it was seen in 23 (46%) patients in the Droperidol group. At 18-24 hrs, emetic episode was seen in 9 (18%) patients in the granisetron group compared to 22 (44%) patients in Droperidol group. Conclusion: It was concluded that granisetron is superior to Droperidol in the prevention of postoperative nausea and vomiting

Does tramadol wound infiltration offer an advantage over bupivacaine for post operative analgesia in children undergoing inguinal herniotomy and orchidopexy.

Objective: To evaluate and assess post operative pain in children undergoing inguinal herniotomy / orchidopexy under general ansaesthesia and to see whether tramadol wound infiltration offers an advantage over bupivacaine infiltration for providing post operative analgesia following such operations. Study design: Prospective, randomized, hospital based study. Material & Methods: 75 children of ASA I and I I, age 1-7 years, scheduled for elective unilateral inguinal herniotomy / orchidopexy were randomly allocated to 3 groups- A, B & C, who received wound infiltration with either tramadol 2mg/kg in 0.2ml/kg of saline (Group A); 0.2ml/kg of 0.25% bupivacaine (Group B) or 2 mg/kg tramadol intramuscularly 20 minutes before end of procedure (Group C). Pre-operative all children were assessed as per the study protocol and an informed consent to participate in the study was taken from parents. During the study period all patients were monitored for respiratory rate, pulse rate, pain score, requirement of rescue analgesia and post operative complications for the first 24 hours post operatively. Results: Patients in group A had lower pain scores, respiratory rate and pulse rate than group B and group C (p0.05). Conclusions: Post operative analgesia was significantly prolonged and fewer analgesics were required after wound infiltration with tramadol. Thus, our study demonstrates that wound infiltration with tramadol is a good choice for post operative analgesia in children under going inguinal herniotomy / orchidopexy

Evaluation of acute normovolemic hemodilution and autotransfusion in neurosurgical patients undergoing excision of intracranial meningioma

Background : Several blood conservation strategies have been tried with the purpose of reducing homologons blood transfusion. Patients & Methods : In a prospective randomized study, the potential benefits of acute normovolemic hemodilution (ANH) with autologous transfusion were investigated as a blood conservation technique in surgical excision of intracranial meningioma. Over a period of 2 years, 40 patients undergoing excision of intracranial meningioma were randomly assigned to two groups of 20 patients each. Group I (Control Group) received conventional homologous blood intraoperatively and were not subjected to ANH. In Group II (ANH Group), Acute Normovolemic Hemodilution was initiated to a target hematocrit of 30% after induction of anesthesia. Parameters studied included changes in hemoglobin, hematocrit and hemodynamic parameters. Results : The mean value of blood withdrawn in ANH group was 802.5 ± 208 ml. This was replaced simultaneously with an equal volume of 6% Hydroxyethyl starch to maintain normovolemia. There was no statistically significant variation in mean hemoglobin levels between the two groups at various stages of study. Hematocrit decreased significantly in both the groups at various stages as compared to preoperative values , the decrease being more but insignificant in group II. Changes in heart rate and mean blood pressure were similar and without statistically significant differences in either group at various stages of study. The amount of surgical blood loss in group I was 835.29 ± 684.37 ml, as compared to 865 + 409.78 ml in group II. The difference was statistically insignificant (p>0.05). The mean volume of homologous blood transfused in group I was 864.71 ± 349.89 ml, as compared to 165 ± 299.6 ml in group II which was statistically significant (p<0.05). In group II (ANH Group) only 5 patients (25%) required homologous blood whereas in group I I all patients (100%) needed homologous blood. Conclusion : We conclude that acute normovolemic hemodilution up to a target hematocrit of 30% is safe and effective in reducing the need for homologous blood in neurosurgical patients undergoing excision of intracranial meningioma

Hysterectomy in a male? A rare case report

INTRODUCTION: Persistent Mullerian duct syndrome is a rare form of male pseudo-hermaphroditism characterized by the presence of Mullerian duct structures in an otherwise phenotypically, as well as genotypically, normal man; only a few cases have been reported in the worldwide literature. A great variety of organs have been found in indirect inguinal hernial sacs. PRESENTATION OF CASE: We report a case of 70 year old man, father of 4 children with unilateral cryptorchidism on the right side and left-sided obstructed inguinal hernia containing uterus and fallopian tube (that is, hernia uteri inguinalis; type I male form of persistent Mullerian duct syndrome) coincidentally detected during an operation for an obstructed left inguinal hernia. DISCUSSION: PMDS is usually coincidently detected during surgical operation, as was in our case. However pre-operative ultrasonography, computerized tomography and MRI allow possible pre-operative diagnosis.3 CONCLUSION: In cases of unilateral or bilateral cryptorchidism associated with hernia, as in our patient's case, the possibility of PMDS should be kept in mind