Contraindications of sentinel lymph node biopsy: Áre there any really?

BACKGROUND: One of the most exciting and talked about new surgical techniques in breast cancer surgery is the sentinel lymph node biopsy. It is an alternative procedure to standard axillary lymph node dissection, which makes possible less invasive surgery and side effects for patients with early breast cancer that wouldn't benefit further from axillary lymph node clearance. Sentinel lymph node biopsy helps to accurately evaluate the status of the axilla and the extent of disease, but also determines appropriate adjuvant treatment and long-term follow-up. However, like all surgical procedures, the sentinel lymph node biopsy is not appropriate for each and every patient. METHODS: In this article we review the absolute and relative contraindications of the procedure in respect to clinically positive axilla, neoadjuvant therapy, tumor size, multicentric and multifocal disease, in situ carcinoma, pregnancy, age, body-mass index, allergies to dye and/or radio colloid and prior breast and/or axillary surgery. RESULTS: Certain conditions involving host factors and tumor biologic characteristics may have a negative impact on the success rate and accuracy of the procedure. The overall fraction of patients unsuitable or with multiple risk factors that may compromise the success of the sentinel lymph node biopsy, is very small. Nevertheless, these patients need to be successfully identified, appropriately advised and cautioned, and so do the surgeons that perform the procedure. CONCLUSION: When performed by an experienced multi-disciplinary team, the SLNB is a highly effective and accurate alternative to standard level I and II axillary clearance in the vast majority of patients with early breast cancer

Is Internal Podalic Version A Lost Art? Optimum Mode Of Delivery In Transverse Lie

AIM: To study the changing trend in the delivery of transverse lie, and its effect on neonatal outcome, in a developing country. SUBJECTS AND METHOD: This is a retrospective study involding records of 12 years of all patients with transverse lie. Neonatal outcome of births by internal podalic version (IPV) and lower segment caesarean section (LSCS) were compared. RESULTS: In the first six years, 37.3% of transverse lie underwent IPV and 62.7%, LSCS. In the next six years, 15.8% underwent IPV and 84.2%, LSCS. 87.7% and 12.3% of live babies were delivered by LSCS and IPV respectively. 52% of the live born IPV were discharged compared to 95% of LSCS babies. Neonatal outcome was best when IPV was performed on second twin. CONCLUSION: IPV has a role in the delivery of second twin, pre-viable and dead babies

Not Available

Not AvailableEstuarine ecosystems are not only physically and chemically dynamic, but also harbor unique and often specialist floral and faunal species. Nonetheless, they are subject to an increasing threat from existing human and projected climatic activities. This study examines the heavy metal contents of the Ulhas rivere stuary in Maharashtra, India – a biodiversity-rich and critically important ecosystem for native and migrant species. The drainages (within the catchment area) which supply water to the estuary were investigated to ascertain heavy metal levels, possibly resulting from anthropogenic activities. Concentrations of selected environmentally important heavy metals such as chromium (Cr), lead (Pb), nickel (Ni), copper (Cu), cadmium (Cd), zinc (Zn) and mercury (Hg) were measured using standard techniques. The findings reveal pre-occupying pollution levels that constitute a significant threat to both terrestrial and aquatic species dependents on the estuary. The abundance of heavy metals in the estuary was in the order of Pb > Ni > Cr > Cu > Zn > Hg > Cd (Pb between 0.018 mg/l to0.039 mg/l; Cd 0.006 mg/l to 0.009 mg/l). The contamination of heavy metals (often toxic over the recommended levels) was found to be high at sampling sites under the direct influence of human habitats and industries. The finding of this study not only adds to the available information regarding the status of the estuary, but also highlights the critical need to implement targeted s trategies towards management and protect this vital ecosystem.Not Availabl

Risks to Big Data Analytics and Blockchain Technology Adoption in Supply Chains

Supply chains (SCs) are susceptible to risks because of their dynamic and complex nature. Big data analytics (BDA) through blockchain technology (BCT) can significantly contribute to managing SC risks. However, to date, the combined effect of BDA-BCT for SC risks has not been investigated extensively in the literature. This paper aims to identify the risk factors of the BDA-BCT initiative for Indian manufacturing organisations. Through the literature and experts’ judgments, sixteen risk factors were identified. Data was collected from machine tool, automobile component, and electrical manufacturing organisations. Further interrelations between risk factors were evaluated using the grey DEMATEL approach. The results show that ‘supply chain visibility risks’, ‘infrastructure and development costs’, ‘demand forecasting and sensing risks’, ‘data privacy and security risks’, ‘policy and legality related risks’, and ‘supply chain resilience’ were identified as common factors in the adoption of BDA-BCT practices by the three organisations. The cause-effect relationship between risk factors can assist managers, suppliers, service providers, and policymakers in the significant adoption of BDA-BCT in the context of manufacturing organisations. The study provides a novel way to utilise BDA-BCT in minimising supply chain risks. Limitations of the study are that it was conducted only for Indian organizations. In the future, the findings of the study can be validated through empirical analysis