Inguinal lymph node metastasis of colon cancer

We present a case of adenocarcinoma of colon with unusual metastasis to inguinal lymph nodes. Our patient is a young male with bilateral inguinal lymphadenopathy, bone pains, and jaundice who presented as carcinoma of unknown primary. He was diagnosed as widely metastatic adenocarcinoma of colon for which he received chemotherapy and has had a good response to the treatment

Effects of Ketamine Gargle for Post-operative Sore Throat, Hoarseness of Voice and Cough Under General Anaesthesia- A Randomised Control Study

Introduction: Majority of the patient undergo endotracheal intubation for various time duration, when given general anaesthesia. Injury in airway mucosa or vocal cords due to endotracheal intubation can be a contributing factor. Ketamine without affecting local healing process has an antiproinflammatory effect as it limits exacerbation of systemic inflammation. Aim: To study the role of ketamine gargles as a pharmacological measure in order to attenuate POST, HOV and cough followed by endotracheal intubation during surgeries under general anaesthesia. Materials and Methods: A randomised controlled study was carried out for a duration of 22 months from the institutional ethical committee (Study Approval No. SVIEC/ON/MEDI/ BNPG18/D19046), on 50 patients of American Society of Anaesthesiologists (ASA) grade I and II. They were allocated into two groups of 25 patients. Group (K): ketamine 50 mg in 29 mL 0.9% normal saline and Group (C): 30 mL 0.9% normal saline. Patients were advised to gargle for 30 seconds just 5 minutes prior to induction of anaesthesia. Patients were intubated with appropriate size of the endotracheal tube and were extubated when fully awake and conscious. Pateints were shifted to postoperative ward and were kept in propped up position with oxygen. Pateints were assessed at 1,2,4,24 hours for incidence of POST, HOV and cough. Assessment was made as per the 4 point scale grading system. The statistical analysis was performed using unpaired t-test, p<0.05 considered statistically significant. Results: In terms of POST grading in both K and C groups p-value was statistically significant (p<0.05) at 1 and at 2 hours postoperatively. In terms of HOV, in group K voice quality issues were reduced till 24 hours, (p<0.05). In terms of cough, in group K there was a significant reduction in complaints of cough till 4 hours postoperatively, (p<0.05). Conclusion: Ketamine gargles is effective in attenuating POST and cough till 2 hours and HOV till 4 hours postoperatively in patients following endotracheal intubation

Comparison of haemodynamic response to induction with propofol versus etomidate in patients scheduled for elective surgery

Introduction: Laryngoscopy and endotracheal intubation are harmful stimuli that can produce adverse response in the cardiovascular, respiratory and other physiological systems. These changes are reflected in haemodynamic parameters which can be fatal for patients with low cardiac reserve and may alter the balance between myocardial oxygen supply and demand and as a result, myocardial ischemia can be precipitated. This observational comparative study was conducted to compare the haemodynamic effects of Propofol and Etomidate during induction of general anaesthesia in patients scheduled for elective surgery. Materials and Methods: 58 patients of American Society of Anaesthesiologists (ASA) physical status &nbsp;I and II of age group 18-60 years scheduled for elective surgeries under general anaesthesia were randomly assigned in two groups (n=28). Group P received injection Propofol (2.5mg/kg) and group E received injection Etomidate (0.3mg/kg) during induction. Hemodynamic parameters were recorded at various time intervals. Statistical analysis was done using software (MedCalc Version 20.014). P value was considered significant if p £ 0.05. Results: Demographic profile was comparable in both the groups. Hemodynamic parameters at baseline and after premedication were comparable

A Review of an Unfavorable Subset of Breast Cancer: Estrogen Receptor Positive Progesterone Receptor Negative

This review highlights the role of the progesterone receptor in breast cancer and discusses a significant subset of breast cancers that are estrogen receptor positive and progesterone receptor negative, and provides insight into the epidemiology, development, treatment concepts, prognosis, and resistance of these tumors to selective estrogen receptor modulators like tamoxifen