60 research outputs found
Laparoscopic transabdominal extraperitoneal repair of lumbar hernia
Lumbar hernias need to be repaired due to the risk of incarceration and strangulation. A laparoscopic intraperitoneal approach in the modified flank position causes the intraperitoneal viscera to be displaced medially away from the hernia. The creation of a wide peritoneal flap around the hernial defect helps in mobilization of the colon, increased length of margin is available for coverage of mesh and more importantly for secure fixation of the mesh under vision to the underlying fascia. Laparoscopic lumbar hernia repair by this technique is a tensionless repair that diffuses total intra-abdominal pressure on each square inch of implanted mesh. The technique follows current principles of hernia repair and appears to confer all benefits of a minimal access approach
Amyloid goitre: a rare case report
Amyloid goitre is a rare disease which occurs in association with both
primary and secondary amyloidosis. This condition has to be
distinguished from other types of goitre and malignancy. Medical
intervention has not been effective for amylodosis. Inspite of
extensive involvement, patients are usually euthyroid and diagnosis is
established on histopathological evaluation. Medical intervention has
not been an effective tretament for amylodosis. Surgical intervention
is necessary to relieve the symptoms of neck mass and establish a
diagnosis. We report a case of a 44-year-old lady with amyloid goitre
Association of GST null genotypes with anti-tuberculosis drug induced hepatotoxicity in Western Indian population
Background. The first line anti-tubercular (anti-TB) treatment normally involves isoniazid, rifampicin, pyrazinamide, and ethambutol. Clearance of these drugs depends on the activity of several enzymes such as N-acetyl transferase 2, cytochrome P450 oxidase and glutathione S-transferase (GST). Some of these enzymes are highly polymorphic leading to significant inter-individual variation in their activity thereby increasing the risk of drug induced hepatotoxicity (DIH). Aim. To investigate the possible association of anti-TB D1H with genetic polymorphism of GST genes in Western Indian population. Material and methods. A prospective case-control study was undertaken on patients who received anti-TB treatment. Cases (n = 50) were distinguished from controls (n = 246) based on occurrence of DIH during anti-tubercular treatment. A multiplex polymerase chain reaction was employed to identify homozygous null mutation at GSTM1 and GSTT1 loci. Results. Homozygous null mutation in GSTM1 gene alone or in both GSTM1 and T1 genes was found to be significantly associated with anti-TB DIH at p < 0.02 and p < 0.007, respectively, in our study population. Conclusions. This is the first study to report GSTM1 null and combined GSTM1 and T1 null genotypes to be risk factors of anti-TB DIH in Western Indian population. Screening of patients for these genotypes prior to anti-TB regimen would provide better control of hepatotoxicity
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