Surgical and Survival Outcomes of Operable Gastric Cancer-Experience from a Tertiary Care Center in South India.

Gastric cancer is one of the leading cancers in Southern India. Data regarding the gastric cancers among the Indian population is sparse. Most patients in our country have locally advanced gastric cancers due to delayed presentation. In this article, we present our data regarding the presentation patterns, epidemiological demographics, surgical outcomes, and survival patterns from a tertiary care center in South India. This is a retrospective analysis of gastric cancer patients who underwent gastrectomy in our institution between January 2015 and November 2021 (n = 102). The data regarding patient characteristics, histopathology, and perioperative outcomes were analysed from medical records. The adjuvant treatment received and survival details were collected from the follow-up records and by telephonic interviews. A total of 128 patients were assessable, 102 patients underwent gastrectomy in a period of 6 years. The median age of presentation was 60 years and males were more commonly affected (70.6%). Most common presentation was pain abdomen followed by gastric outlet obstruction. Adenocarcinoma NOS (93%) was the most common histological type. Most of the Patients had antropyloric growths (79.4%) and subtotal gastrectomy with D2 lymphadenectomy was the most common surgery performed. Majority of the tumors were T4 tumors (55.9%) and nodal metastases were detected in 74% of the specimens. Predominant morbidity was wound infection (6.1%) followed by anastomotic leak (5.9%) with a combined overall morbidity of 16.7% and 30-day mortality of 2.9%. Seventy five (80.5%) patients were able to complete all planned 6 cycles of adjuvant chemotherapy. The median time of survival calculated by Kaplan-Meier method was 23 months with 2-year and 3-year overall survival rates of 31% and 22%, respectively. Lymphovascular invasion (LVSI) and lymph nodal burden were the risk factors associated with recurrences and deaths. The patient characteristics, histological factors, and perioperative outcomes revealed most of our patients presented in locally advanced stages with poor risk histological types and increased nodal burden contributing to the lower survival in our population. Inferior survival outcomes suggest the need to explore perioperative and neoadjuvant chemotherapy options in our population.

Primary lesser sac myxoid liposarcoma: A case report.

INTRODUCTION: Lesser sac pathological entities are uncommon. Most of these are tumors and are generally misdiagnosed as retroperitoneal lesions. CASE REPORT: A 62year old male with past history of treated hypopharyngeal cancer presented with progressive abdominal distension. Physical examination revealed a midline intra abdominal mass in the epigastrium and umbilical region. Radiological investigations were suggestive of a retroperitoneal tumor,an image guided biopsy was reported as atypical lipoma. Surgical exploration confirmed a large multi lobulated tumor arising primarily from the lesser sac, post operative histopathological examination confirmed a myxoid liposarcoma. DISCUSSION: Primary lesser sac tumors are rare, a literature review of primary lesser sac tumors with particular reference to myxoid liposarcoma is presented. CONCLUSION: Primary lesser sac liposarcomas are rare neoplasms. The myxoid variant is unique for its peculiar biological behavior, in its sensitivity to chemotherapy and radiotherapy and for the presence of specific cytogenetic marker.

The association of hypomagnesaemia, high normal uricaemia and dyslipidaemia in the patients with diabetic retinopathy.

CONTEXT: Diabetic retinopathy is fast becoming an important cause of a visual disability. The visual disability which results from diabetes is a significant public health problem; however, this morbidity is largely preventable and treatable. If it is managed with a timely intervention, the quality of life can be preserved. AIMS: The objective of this study was to investigate the association of serum uric acid, magnesium and the lipid profile in diabetic retinopathy with Normal subjects and Diabetes mellitus without retinopathy, among the south Indian population. SETTINGS AND DESIGN: The diabetic retinopathy patients were identified from the diabetic health camps which were held in rural areas, and they were compared with those with diabetes without complications and the normal subjects. MATERIAL AND METHODS: The diabetic retinopathy patients were compared with the healthy subjects and with diabetes without retinopathy. Furthermore, the Diabetic retinopathy patients were grouped as proliferative and non-proliferative, based on the fundoscopic findings. Magnesium, uric acid, FPG, fructosamine and the lipid profile were measured in the above groups and they were analyzed. STATISTICAL ANALYSIS: The statistical analysis was done by using the SPSS software, by applying the Student 't' test. RESULTS: The mean serum magnesium concentration was observed to be low in the diabetic retinopathy group (1.43mg/dl) as compared to those in the controls and the diabetic subjects. The serum Uric acid concentration was high normal (4.84mg/dl), which was associated with the dyslipidaemia in diabetic retinopathy. CONCLUSION: The poor glycaemic control in diabetes is associated with hypomagnesaemia, and increased uric acid concentration with dyslipidaemia, which can be an initial picture of the ongoing biochemical changes in the complication of diabetes, which can help in predicting the onset of diabetic retinopathy in diabetes.