International Journal of Surgery and Surgical Sciences (IJSSS)

ISSN 2277-2413

Volume 1 (2) July 2013

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Research Papers

1. A Case Control Study to Evaluate the Relationship of Serum Lipid Profile, Apo-Lipoproteins, Body Mass Index, Waist Hip Ratio in Occurrence of Cholelithiasis
Dr. Vimal Bhandari, Dr. Surya Prakash Gora, Dr. H. G. Vyas, Dr. Charanjeet Kaur, Dr. Neelam Roy
Department of Surgery, Vardhman Mahavir Medical College and Associated Safdarjung Hospital, New Delhi, India.
Vol. 1(2) : pp 61-68 (2013)
Abstract: Introduction: The aim of this study was to evaluate the relationship of lipid profile, Apo-lipoprotein-A, Apo-lipoprotein-B, Body Mass Index, Waist Hip ratio with occurrence of gall stone disease.
Materials and Methods: The study was conducted in the Department of Surgery in collaboration with Department of Biochemistry on 100 patients for a period of one year. The patients were divided in two groups: 50 cases (40 women, 10 men: mean age 39.98 years) and 50 controls (40 women, 10 men: mean age 38.50years). The study design was case control study. Blood was collected in fasting state and analyzed for Lipid profile (total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, total triglyceride, Apo-lipoprotein A, Apo-lipoprotein B). Anthropometric measurements were done to calculate body mass index and waist hip ratio.
Results, Analysis and Discussion: Out of 100 patients, 80% were women and 20% were men. On lipid profile analysis in study group mean serum total cholesterol was 186.78±49.13 mg/dl, mean Triglyceride was 142.54±56.52 mg/dl, mean HDL-C was 39.46±27.97 mg/dl, LDL-C was 126.06±45.82 mg/dl, mean APO-A was 102.24±20.38 mg/dl, mean APO-B was 82.56±15.7 mg/dl. All above lipid profile parameter except HDL-C and APO-A were significantly higher in case group than control group p<0.001. While APO-A was significantly lower p<0.001 and HDL-C was lower but not significant p-0.179.The mean BMI was statistically higher in case group than control group (27.5±0.71 vs 24.31±0.32 kg/m2,p<0.001).The mean WHR was statistically higher in case group than control (0.87±0.39 vs 0.79±0.47,p<0.001).
Conclusion: Elevated Triglyceride, Total Cholesterol, Low density lipoprotein cholesterol and it’s associated Apo lipoprotein-B(Apo-B) while decreased High density lipoprotein cholesterol and its associated Apo lipoprotein A (Apo-A) seems to play major contributing role in the pathogenesis of gall stone. Apo lipoproteins were more sensitive parameter than lipid profile in distinguishing patients with gall stone than without gall stones. Obesity and high Waist Hip Ratio (central obesity) were also associated with occurrence of cholelithiasis.
Keywords: Lipid profile, Serum lipid profile, Apo-lipoproteins, Body mass index, Waist hip ratio, Cholelithiasis.

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2. Penile Fracture: An Experience of 14 Cases
Dr. Umesh Jethwani, Dr. Gulshanjit Singh, Dr. R.S Mohil, Dr. Jainendra Arora, Dr. Pankaj, Dr. Rahul Bamal, Dr. Jitendra, Dr. Nikhil Bansal
Department of Surgery, Vardhman Mahavir Medical College and Associated Safdarjung Hospital, New Delhi, India.
Vol. 1(2) : pp 69-72 (2013)
Abstract: Penile fracture is an under reported surgical emergency condition. Most common causes of penile fracture are over enthusiastic vaginal intercourse and penile manipulation. Aim of this study is to report our experience in managing patients of penile fracture. All patients of penile fracture from July 2011 to July 2013 presented in our surgical unit were included. No invasive investigation was used in the study. Most common cause of penile fracture in our series was sexual intercourse (64%). Most fractures were seen in 21-45 year age group (71.42%). Right lateral tear was seen in 11 patients (78.57%). All patients were operated on same day of admission. Postoperative period was uneventful in all patients.
Keywords: Penile Fracture, Surgical emergency, Penile surgery, Tunicia albuginea, Penis, Penis surgery.

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3. Use of Calcium Hydroxy Apatite Blocks with or without Cortico-Cancellous Bone Grafting in Different Treatment Modalities – A Retrospective and Prospective Study
Dr. Surendra Kumar¹, Dr. Yash Mohan Lal¹
Senior Resident¹, Central institute of Orthopaedics, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
Vol. 1(2) : pp 73-81 (2013)
Abstract: This is a retrospective and prospective study of patients having a Gap Non-union of the long bones treated with autogenous bone graft and calcium hydroxy Apatite bone block. The study was oriented to observe and treat the gap non-unions of long bones. In this study of 48 patients, majorities (83%) were males and 16% were females. Maximum number of patients belonged to 3rd decade. Out of 42 patients with trauma, 38 had compound grade III fracture. 62.5% involved tibia, 31.2% femur and 6.2% humerus. In 87.2% Bone-Gap was due to Injury and in 12.5% was due to excision of bone segment. In 22 cases implant was used to stabilize the fracture, while in 26 cases, no implant was used. Average time of osseous union was 22.6 weeks to 30 weeks.
Full weight bearing was allowed only when the fracture showed an evidence of adequate bridging callus formation on x-ray and clinically when fracture site was painless on examination and on weight bearing. In upper limb, light physical activity was allowed at 14.6 weeks and full physical activity was allowed at 24.6 weeks.
Deformity in the form of angulation was seen in 55% of cases. Out of 48 patients in study group, 9 developed shortening. There was no patient that showed delayed union or non-union.
Based on Klemm and Borner’s (1986)(9) Criteria for functional assessment, 20 out of 48 cases (41.6%) showed excellent functional results, good results in 14 cases (29.1%), fair results in 12 cases (24.9%) poor results in 2 cases out of 48 (4.1%).
Radiologically, the radiographic density increased with lapse of time (which is a presumptive evidence of bone regeneration). No refracture was observed till the end of follow up. Thus, the use of implant allows early weight bearing, prevents development of a deformity, prevents shortening, and also prevents joint stiffness by allowing early mobilization of the affected part and is an important conjunct in management of segmental bone defects. Calcium Hydroxy Apatite is a suitable alternative to bone graft. When used in conjunction with autogenous bone graft, it serves as an excellent method of filling the bone gaps as large as 2 inches with excellent results.
Keywords: Cortico-Cancellous Bone Grafting, Calcium Hydroxy Apatite Blocks, Apatite Blocks, Bone Grafting, Grafting, Cortico-Cancellous.

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Case Reports

1. Chronic Intestinal Pseudo-Obstruction Affecting Small Bowel: Report of Two Cases And a Review
Dr. Navneet Kaur¹, Dr. Pankaj Panwar², Dr. Pradeep Sharma³, Dr. Nitin Agarwal⁴, Dr. Arun Gupta¹
Professor¹, Post Graduate Student³, Lecturer⁴,
Department of Surgery, University College of Medical Sciences & GTB Hospital, Delhi, India.
Medical Officer²,
Department of Surgery, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
Vol. 1(2) : pp 82-86 (2013)
Abstract: Chronic intestinal pseudo-obstruction (CIPO) can be a disabling condition and there are no guidelines for its proper management. We report two cases of recurrent intestinal obstruction diagnosed as CIPO affecting small bowel. One case was of secondary variety which responded well to Neostigmine therapy. Second case was of primary variety in which bowel decompression provided relief to the patient. Thus, both Neostigmine and bowel decompression can be used as effective therapies for CIPO.
Keywords: Chronic intestinal pseudoobstruction(CIPO), Laprotomy, Enterostomy, Neostigmine, Intestinal pseudo-obstruction, Intestinal obstruction.

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2. Multicentric Paraganglioma - A Rare Case Presentation
Dr. Surya Prakash Gora, Dr. Vimal Bhandari
Department of Surgery, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
Vol. 1(2) : pp 87-90 (2013)
Abstract: Multicentric paraganglioma are a rarest entity encountered in clinical practice. We report a rare case of carotid body tumor with metachronous tumor of the organ of zuckercandal. Our patient was operated 4 years back for carotid body tumor. Currently, the patient had complaints of headache, palpitations, sweating for past 1 year, blurring of vision for around 6 months and pain in right flank for 3 months. MRI and MIBG scan showed right infrarenal mass which was suggestive of a functional paraganglioma. Patient’s 24 hour urine metanephrine, nor metanephrine, and VMA were raised. It is well known that paragangliomas may be hereditary and may be a part of genetic syndromes. Appropriate genetic screening should be considered in patients and families when hereditary syndromes are suspected. Continued follow-up is necessary, however, as recurrence, metastasis and multicentric tumor may occur years later.
Keywords: Paraganglioma, Multicentric paraganglioma, Carotid body tumor, Tumor, Zuckercandall tumor, Metachronous organ.

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Review Paper

1. Retrosternal Goitres: A Modern-Day Review
Dr. Ebrahim Mansoor
Department of Cardiothoracic Surgery, Inkosi Albert Luthuli Central Hospital, Durban, South Africa.
Vol. 1(2) : pp 91-96 (2013)
Abstract: Retrosternal goitres have the propensity to cause fatal airway compromise. All patients must be judiciously investigated prior to intervention. Computed tomography is an essential investigative tool. Surgery must be offered to all patients found suitable for resection. Good visualisation of the intrathoracic component is the cornerstone of complete and safe thyroidectomy. Whilst most retrosternal goitres are wholly accessible from the neck, thoracic access is selectively required. Experience and meticulous technique ensure negligible complication rates.
Keywords: Retrosternal, Goitre, Retrosternal Goitre, Thyroid, Mediastinum, Sternotomy.

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Case Snippet

1. Supernumerary Nipple : A Pictoral CME
Dr. Umesh Jethwani, Dr. Gulshanjit Singh, Dr. Ravi Saroha, Dr. Nikhil Bansal
Department of Surgery, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
Vol. 1(2) : pp 97-98 (2013)

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International Journal of Surgery and Surgical Sciences (IJSSS)
1/2222, RAM NAGAR, MANDOLI ROAD, SHAHDARA, DELHI-110032 (INDIA)
Email :- research.ijsss@gmail.com, editor@ijsss.com
Tele :- +91 9810426970

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