North Colombo Medical College (NCMC) was the first privately funded medical school in Sri Lanka. It started in 1980 with the admission of 100 local and 20 foreign students. The first batch of students began graduating in 1990. Founded by the College of General Practitioners of Sri Lanka, Dr. G. M. Heenilame was its first chairman and Dr. W.D. Ratnavelle, its first director. It was nationalized in 1989 and became the Faculty of Medicine, University of Kelaniya. The first batch of students of the Faculty of Medicine, University of Kelaniya completed their five-year course and graduated with the MBBS degree in September 1996. G. M.
Variant anatomy in the axillary region is of great clinical significance. It is one of the most frequently accessed regions for radical dissection surgery. During routine dissection of embalmed cadavers, we found a rare case of two accessory muscular slips emerging from the lateral border of latissimus dorsi (LD) and the inferolateral border of pectoralis major (PM), crossing the neurovascular structures in the axilla and merging distally together to the brachial fascia at the upper end of humerus below the bicipital groove. The accessory slip from LD is commonly referred to as the “axillary arch” in literature. We identified the accessory slip from the PM crossing over the axilla as pectoralis quartus. These aberrant slips can cause neurovascular compression in the axilla and can have clinical implications. Prior knowledge of the variant anatomy is the key to successful surgery in the axilla, thereby avoiding inadvertent injuries and post-operative complications.
Cervical cancer is still a public health scourge in the developing countries due to the lack of organized screening programs. Though liquid-based cytology methods improved the performance of cervical cytology, the interpretation still suffers from subjectivity. Artificial intelligence (AI) algorithms have offered objectivity leading to better sensitivity and specificity of cervical cancer screening. Whole slide imaging (WSI) that converts a glass slide to a virtual slide provides a new perspective to the application of AI, especially for cervical cytology. In the recent years, there have been a few studies employing various AI algorithms on WSI images of conventional or LBC smears and demonstrating differing sensitivity/specificity or accuracy at detection of abnormalities in cervical smears. Considering the interest in AI-based screening modalities, this well-timed review intends to summarize the progress in this field while highlighting the research gaps and providing future research directions.
Background Postoperative pain after laparoscopic cholecystectomy still remains a fairly common challenge for the anesthesiologist. Commonly used drugs such as NSAIDs and opioids have their own side effects requiring a need to substantially evaluate the use of non-pharmacological methods like TENS as adjuvants to conventional methods of pain control. We studied the effect of transcutaneous electrical nerve stimulation (TENS) on postoperative pain in laparoscopic cholecystectomy. The primary objective was to compare postoperative analgesia between TENS and placebo groups using visual analog scale (VAS). The secondary objectives were to compare the requirement and dosage of rescue analgesia, hemodynamic parameters (blood pressure and heart rate), and incidence of nausea and emesis between placebo and TENS groups. A total of 64 patients of age group 18 years to 60 years of either gender posted for elective laparoscopic cholecystectomy were randomly allocated into two groups using a computer-generated sequence of random numbers: Group P ( n = 32): placebo TENS and Group A ( n = 32): active TENS. Statistical analysis was performed by the SPSS program for Windows, version 17.0 (SPSS, Chicago, Illinois). Unpaired t test, Mann-Whitney U test, chi-square test, and Fisher’s exact test were used for statistical analysis. Results The two groups were statistically similar in terms of age, gender, and weight. The VAS scores were significantly lower in patients in the active TENS group for up to 2 h after surgery, and the total weighted dose of diclofenac consumed over 8 h in the active TENS group was significantly lower as compared to the placebo TENS group. Patients who received TENS showed significantly less rise in blood pressure and heart rate and remained hemodynamically stable. Total episodes of nausea and emesis though less in the active TENS group were statistically insignificant. Conclusion We conclude that TENS is an effective adjuvant non-pharmacologic modality for postoperative pain relief after laparoscopic cholecystectomy.
INTRODUCTION:Sarcopenic obesity (SO) represents the confluence of two epidemics-an aging population and an increasing rate of obesity. The two diseases may act synergistically, and SO may significantly affect morbidity and mortality. However, the burden is not defined to drive the policy changes. Hence the present study was done to estimate the prevalence and predictors of SO in India.METHODS:We did a secondary data analysis of the 72,250 older adults who participated in the first wave of the Longitudinal Aging Study in India (2017-18). Possible sarcopenia was defined as per the guidelines by the Asian Working Group for Sarcopenia (AWGS) criteria. The modified criterion of overweight and obesity for Asian adults was used to categorize obesity. Presence of both sarcopenia and obesity depicted SO. Weighted analysis was done to estimate the prevalence of SO, and multinomial bivariate logistics regression was used to identify the predictors of SO.RESULTS:The overall prevalence of obesity, sarcopenia, and SO was 27.1%, 41.9%, and 8.7%, respectively. The mean age, weight, body mass index (BMI), and blood pressure of adults with SO were significantly higher compared to others. Higher age, urban residence, west and south regions of India, consumption of tobacco or alcohol, no physical activity, and presence of diabetes contribute to SO.CONCLUSION:The burden of SO seems to be less but amounts to a massive number in an aging country. We stress increased screening of the geriatric age group and advocate increased physical activity and dietary modifications to realize the concept of healthy aging.
Background: Breast carcinoma is the most common malignant tumor and leading cause of cancer related death in women worldwide. Apart from traditional markers, estrogen receptor, progesterone receptor and Her-2neu, which are important for prognostication and staging purposes, a novel marker cyclooxygenase-2 (COX-2) is being studied extensively. We intend to study the spectrum of COX-2 expression in normal breast tissue, ductal carcinoma in situ (DCIS) adjacent to invasive cancer, and in invasive cancer and compare COX-2 expression with histological prognostic parameters and hormone receptor status. Methods: The present study is a prospective study that was conducted in the department of Pathology, SGT Medical College and Hospital, Gurugram (2019-2020). Fifty patients, aged between 21 and 70, suffering from primary breast cancer constituted the study group. Various histological prognostic parameters were assessed. Immunohistochemical profile of the tumor was assessed. COX-2 score was correlated with various clinicopathologic parameters. Results: Among the total of 50 patients suffering from invasive breast carcinoma, 94 percent (47/50) of cases showed the same COX-2 expression level in normal breast epithelium and corresponding tumor areas and this correlation was statistically significant. The correlation between the level of COX-2 expression in tumor and DCIS was highly significant. Conclusion: Inhibition of COX-2 may represent a potential target for preventing breast cancer oncogenesis and as an adjuvant treatment following surgery to reduce local recurrence.
