Expression of ER, PR, and HER-2 Neu and correlation with tumor markers in gall bladder carcinoma.

Background: Females having a large proportion of gallbladder carcinoma (GBC) and a higher incidence of gallstones pointed toward the role of sex hormones in GBC development. In this study, we evaluated the expression of Estrogen receptor (ER), Progesterone receptor (PR), and Her2/neu and their correlation with tumor markers and clinicopathological parameters in the GBC. Methods: A total of 50 patients of GBC and 42 patients in control group undergoing surgery for other conditions were taken. The patient's biopsy sample's paraffin block was tested for ER, PR, and Her2/neu expression by immunohistochemistry. Results: ER and PR had no significant expression in GBC and control group, but Her2/neu had 16% expression in GBC, significantly associated with the degree of differentiation with 62.5% (n-5) being well-differentiated; 75% of Her2/neu positive were in stages III and IV. Her2/neu did not correlate with tumor markers despite expression. Conclusions: Her2/neu amplification is a small step in validating that option so it could be included in the treatment and prognostication of GBC.

Laparoscopic Retrieval of a 13-Year-Old Retained Iatrogenic Metallic Foreign Body from the Pelvis: An Uncommon Case Report.

Retained surgical foreign bodies are unanticipated events culminating from inadvertent operating room errors and may cause severe medical and legal problems between the patient and the doctor. Here, we report detecting a surgical instrument fragment 13 years after an open abdominal hysterectomy in a quadragenarian during her evaluation of a month-old complaint of lower abdominal and right thigh pain. A computed tomography scan of the abdomen demonstrated a radio-opaque linear foreign body traversing the right obturator foramen with extension into the pelvis cranially and the adductor compartment of the right thigh caudally. The metallic foreign body, identified as a fragmented handle of a uterine tenaculum forceps with a slender sharp-tip hook, could be removed laparoscopically from the pelvis after a diagnostic laparoscopy, preventing significant complications. The minimally invasive approach enabled a smooth recovery, and the patient could go home on the second postoperative day.

Review of Mesenteric Ischemia in COVID-19 Patients.

The new coronavirus (COVID-19) infection, first detected in Wuhan, China in 2019 has become a pandemic that has spread to nearly every country in the world. Through October 11, 2021, more than 23 billion confirmed cases and 4.8 million fatalities were reported globally. The bulk of individuals afflicted in India during the first wave were elderly persons. The second wave, however, resulted in more severe diseases and mortality in even younger age groups due to mutations in the wild virus. Symptoms may range from being asymptomatic to fatal acute respiratory distress syndrome (ARDS). In addition to respiratory symptoms, patients may present with gastrointestinal symptoms such as stomach pain, vomiting, loose stools, or mesenteric vein thrombosis. The frequency of patients presenting with thromboembolic symptoms has recently increased. According to certain studies, the prevalence of venous thromboembolism among hospitalized patients ranges from 9 to 25%. It was also shown that the incidence is significantly greater among critically sick patients, with a prevalence of 21-31%. Although the exact origin of thromboembolism is unknown, it is considered to be produced by several altered pathways that manifest as pulmonary embolism, myocardial infarction, stroke, limb gangrene, and acute mesenteric ischemia. Acute mesenteric ischemia (AMI) is becoming an increasingly prevalent cause of acute surgical abdomen in both intensive care unit (ICU) and emergency room (ER) patients. Mesenteric ischemia should be evaluated in situations with unexplained stomach discomfort. In suspected situations, appropriate imaging techniques and early intervention, either non-surgical or surgical, are necessary to avert mortality. The purpose of this article is to look at the data on acute mesenteric ischemia in people infected with COVID-19.

Effect of Personal Protective Equipment (PPE) on Surgical Site Infection in Emergency Laparotomy: An Observational Study From a Tertiary Care Centre.

Background In the era of the coronavirus disease 2019 (COVID-19) pandemic, the use of full personal protective equipment (PPE) is advocated for patients undergoing emergency surgery in whom the infection status is unknown. This study aims to determine whether PPE has any influence on the rate of surgical site infection (SSI) in patients undergoing emergency exploratory laparotomy. Methodology Medical records of operated emergency cases in the general surgery department from 1st April 2020 to 24th February 2021 were studied. The surgeries done were divided into two groups: those done with full PPE (group A) and those done without full PPE (group B). The various parameters studied were the patient demography, presence of comorbidities, diagnosis, surgery done, class of surgery performed, the use of PPE, the post-operative presence, and type of SSI. Statistical analysis was done using SPSS software version 27.0 (IBM Corp., Armonk, NY). Chi-squared test was used to find the association of SSI with the use of PPE. Fisher's exact test was used to explore the association between SSI with various comorbidities, surgery performed, and the class of surgery performed. Results A total of 126 patients underwent emergency exploratory laparotomy during the study period. A total of 61 patients were in group A and 65 patients in group B. A significant association was noted between the use of full PPE and the development of SSI (p = 0.032). Diabetes mellitus, history of alcohol intake, and the class of surgery performed were found to be significantly associated with the development of SSI. Conclusion A significant association in the occurrence of SSI with the use of full PPE was observed.