Seroma formation after modified radical mastectomy: analysing risk factors and incidence

Background: Breast cancer is a prevalent form that affects women and is a leading cause of death among women. The development of seroma is a frequent complication that can arise after breast cancer surgery, and its underlying mechanisms are still not fully understood. Consequently, data was collected to analyze the occurrence and factors that contribute to the development of seroma in patients. We aimed to enhance our comprehension and ultimately discover methods to mitigate it. Methods: A prospective group research study was conducted on a sample of 86 female patients who underwent mastectomy from August 2020 to August 2023. This study was carried out as part of the senior residency program at Nalanda Medical College and Hospital in Patna, Bihar, India. Patients who develop seroma within four weeks of surgery are usually recommended to undergo, specifically ultrasonography, and radiological evaluation to determine the size. Results: 27 out of 86 patients (31%) were found to have seroma. Several factors are closely linked to the development of seroma. Factors that may contribute to increased risk The minimum age at which seroma production occurs following MRM ≥56 or older, having a BMI of 26.50 or higher, a tumour measuring 4 cm or larger undergoing the removal of more than 12 lymph nodes, and having a level 3 axillary dissection. Conclusions: After surgery, a certain group of people in the study experienced seroma formation within four weeks. These individuals had undergone MRM. Age, BMI, tumour size, level 3 axillary dissection, the removal of more than 12 lymph nodes during surgery, and the occurrence of seroma after MRM were found to be positively correlated. There was no observed connection between seroma production and a range of factors, such as neoadjuvant chemotherapy, the timing of drain removal, shoulder workouts, and the use of breast bandages

Intestinal obstruction caused by tuberculosis: unmasking a silent risk

Background: Intestinal tuberculosis (TB) remains a global health challenge, especially in regions with a high TB prevalence. This manifestation, distinct from pulmonary TB, involves the gastrointestinal tract, often leading to intestinal obstruction. The study addresses the insidious nature of the disease, emphasizing the urgency for timely diagnosis and intervention. Recognizing the multifaceted impact of TB on various organs, the study explores the pathophysiology, clinical presentation, and diagnostic complexities of intestinal TB. Methods: This study was conducted at Nalanda medical college and hospital in Patna, Bihar, India, the retrospective study spans three years focusing on 127 patients with intestinal obstruction due to TB. Inclusion criteria prioritized histopathological confirmation of TB, ensuring cohort accuracy. The study employed preliminary investigations, including hemogram, chest X-ray, abdominal X-ray, ultrasonogram, sputum examination, and Mantoux test and CECT whole abdomen. Clinical presentations were systematically analyzed, guiding tailored management protocols based on the mode of presentation. Results: Demographically, the study identified TB as the cause in 127 cases, with a balanced gender distribution and a peak incidence in the 21-30 years age group. Presentations varied, predominantly with acute symptoms. Common complaints included abdominal pain, vomiting, constipation, and distension. Surgical intervention within 24 hours was crucial in 61.1% of cases. Intraoperatively, findings comprised mesenteric thickening, lymph nodal enlargement, and adhesions. Adhesionolysis was the primary procedure. Postoperative complications, mainly wound infections, were noted but had a limited impact on mortality. Conclusions: This study reveals TB as a significant contributor to intestinal obstruction, emphasizing challenges in early diagnosis. Adhesionolysis emerges as a key operative procedure, underscoring the need for surgical flexibility. Postoperative complications, while notable, have minimal impact on mortality

Green Extraction Techniques for Phytoconstituents from Natural Products

The use of green extraction techniques for extracting phytoconstituents from natural sources minimizes the amount of solvents needed and the amount of waste generated during the extraction process. Traditional extraction processes generate a lot of solvent waste, which causes a lot of environmental and health issues. Furthermore, by employing automated modern processes, exposure to solvents and vapor is reduced. Green extraction is based on the analytical procedures that employ less energy, allow the use of different solvents and sustainable natural products, and provide a safe and superior extract/product. According to a life cycle analysis of waste created in Active Pharmaceutical Ingredient (API) manufacturing plants, solvent-related waste accounts for 80% of the waste. In case other pharmaceutical companies generate equal amounts of solvent waste, addressing solvent selection, use, recovery, and disposal will go a long way toward tackling the issue. Solvent considerations will feature regularly in the case histories of the drug development process. Natural extracts comprise phytoconstituents such as proteins, lipids and oils, dietary fibres, carbohydrates, antioxidants, essential oils and fragrances, and colours, and can be found in wide variety of plant materials. In this chapter, we will discuss principles, techniques, and solvents used for green extraction techniques of phytoconstituents