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A comparative study between transumbilical laparoscopic assisted appendicectomy vs conventional 3 ports laparoscopic appendicectomy

2026-08-20T15:04:52Z

Title: A comparative study between transumbilical laparoscopic assisted appendicectomy vs conventional 3 ports laparoscopic appendicectomy Authors: Satvik S Phutane Abstract: The abdomen is frequently termed a "Pandora's box" because of the multitude of organ systems and anatomical features it encompasses. Consequently, abdominal disorders frequently generate considerable clinical interest. A comprehensive assessment of the abdomen is an invaluable diagnostic instrument, especially for surgeons, as it facilitates the identification of the optimal treatment strategy. Acute appendicitis is the predominant cause of "acute abdomen" in paediatric patients, and the signs and symptoms thereof have become a central focus in clinical teaching. Acute appendicitis is a highly prevalent acute surgical condition impacting the abdomen . A little over seven percent of individuals are likely to get appendicitis at some stage in their lives. Although it can manifest at any age, it is predominantly noted in persons around their twenties and thirties. Despite innovations in technology, the diagnosis of appendicitis still mostly relies on the patient's history and physical examination. Rapid identification and quick surgical referral can mitigate the risk of perforation and avert repercussions. The rate of death for non-perforated appendicitis remains below 1%, although it may escalate to 5% or more in young and older individuals, when delayed diagnosis elevates the risk of perforation. Recognition of acute appendicitis is especially difficult in young women, children, and the elderly, despite advancements in medical care and the application of ultrasonography. Diagnostic scoring systems are valuable and straight forward instruments that facilitate decision- making.6 Prolonged diagnostic delays might result in problems, elevating morbidity, whilst excessively conservative diagnoses may lead to unwarranted appendectomies.

Study on evaluation of safety and efficacy of leucocyte platelet rich fibrin (l-prf) versus conventional dressing for the treatment of chronic cutaneous ulcers

2026-08-20T14:58:18Z

Title: Study on evaluation of safety and efficacy of leucocyte platelet rich fibrin (l-prf) versus conventional dressing for the treatment of chronic cutaneous ulcers Authors: Rangavajjula D.S. Vyshnavi Harika Abstract: Introduction: Chronic cutaneous ulcers represent a significant healthcare challenge, affecting approximately 1-2% of the global population and contributing substantially to morbidity and healthcare costs. Conventional wound management strategies often yield suboptimal outcomes, necessitating the exploration of advanced therapeutic approaches. Leucocyte-Platelet Rich Fibrin (L-PRF), an autologous blood-derived biomaterial rich in platelets, leukocytes, and growth factors embedded within a fibrin matrix, has emerged as a promising regenerative medicine strategy for tissue repair. This study aimed to evaluate the efficacy and safety of L-PRF compared to conventional dressings in the management of chronic cutaneous ulcers. Methods: This prospective, randomized controlled trial enrolled 112 patients with chronic cutaneous ulcers of various etiologies, who were randomly allocated to receive either L-PRF (n=56) or conventional dressings (n=56). L-PRF was prepared from autologous blood and applied weekly to the ulcer bed in the intervention group, while the control group received standard saline-soaked gauze dressings. Outcome measures included ulcer size reduction, granulation tissue quality, pain scores, healing rates, time to complete healing, and adverse events, assessed over a 4-week follow-up period. Results: Demographic characteristics and baseline ulcer parameters were comparable between groups. The L-PRF group demonstrated significantly greater ulcer size reduction at 2 weeks (p=0.02) and 4 weeks (p<0.001), superior granulation tissue quality (p<0.001), and lower pain scores (p<0.001) compared to the conventional dressing group. Most notably, 100% of ulcers in the L-PRF group achieved complete healing versus 26.8% in the conventional group (p<0.001), with a significantly shorter healing time (4.25±0.83 vs. 5.4±0.5 weeks, p<0.001). The L-PRF group exhibited a lower incidence of minor infections (5.4% vs. 12.5%), although this difference was not statistically significant (p=0.18). No serious adverse events were reported in either group. Conclusion: L-PRF represents a highly effective regenerative medicine strategy for the treatment of cutaneous ulcers, significantly outperforming conventional dressings in terms of healing rates, healing time, tissue quality, and patient comfort. The autologous nature, minimal preparation requirements, and favorable safety profile of L-PRF enhance its clinical utility and potential for widespread implementation in chronic wound management.

A study on accuracy of “point of care ultrasound” in diagnosing and management of necrotizing fasciitis

2026-08-20T14:51:50Z

Title: A study on accuracy of “point of care ultrasound” in diagnosing and management of necrotizing fasciitis Authors: Medikonda Eswar Abstract: Background: Necrotizing fasciitis (NF) is a rapidly progressive, life- threatening soft tissue infection with high mortality rates. Early diagnosis and prompt surgical intervention are crucial for survival, yet the initial diagnosis remains challenging due to nonspecific early presentations. This study evaluated the diagnostic accuracy of point-of- care ultrasound (POCUS) in identifying NF and its utility in guiding clinical management decisions. Methods: This prospective observational study included 85 patients with suspected NF at a tertiary care center in India from April 2023 to April 2025. Trained emergency physicians performed POCUS examinations using high-frequency linear transducers and low-frequency curvilinear transducers when necessary. Sonographic findings were documented and correlated with surgical observations, clinical outcomes, and laboratory parameters. Primary outcomes included POCUS diagnostic accuracy, need for surgical intervention, and mortality rates. Results: The study population had a mean age of 50.2 years, with male predominance (62.4%) and primarily lower limb involvement (77.6%). POCUS demonstrated high positivity (97.6%) with predominantly fluid collection (77.6%), loss of vascularity (65.9%), and fascial thickening (52.9%). Sensitivity was highest for fascial thickening (97.1%) and fluid collection (92.5%). The majority required multiple debridements (83.5%), with 43.5% undergoing three procedures. At three-week follow-up, 25.9% achieved partial recovery and 18.8% complete recovery, with 15.3% mortality. Complications included amputation (11.8%), sepsis (9.4%), and wound infection (8.2%). POCUS assessment at three weeks showed persistent changes in 36.5% of patients despite clinical improvement in many cases. Conclusion: POCUS is a highly sensitive diagnostic tool for NF with excellent correlation to surgical findings. Its immediate availability, non- Invasive nature and repeatability position it as a valuable adjunct in the initial assessment and monitoring of this life-threatening condition. Integration of POCUS into standard assessment protocols for suspected NF can potentially expedite diagnosis, guide surgical interventions, and improve clinical outcomes.

Role of preoperative hematological markers in carcinoma breast and its efficacy in correlation with clinicopathological staging – a novel technique

2026-08-20T14:44:43Z

Title: Role of preoperative hematological markers in carcinoma breast and its efficacy in correlation with clinicopathological staging – a novel technique Authors: M. Hemanth Reddy Abstract: Carcinoma breast ranks second globally in terms of cancer-related deaths among women and is the most common disease diagnosed in women. The breasts are superficially situated glandular structures that fluctuate in size and density over the pectoralis major muscle. They consist of milk-producing cells arranged into lobules, which are grouped into lobes interspersed with fatty tissue. Milk is produced in the acini and transferred by lactiferous ducts that connect to the nipple. The breasts are supported by Cooper's ligaments, which anchor them to the underlying muscle fascia . The ductal epithelium(ductal carcinoma) is where the majority of carcinoma breast begin, though some arise from the lobules (lobular carcinoma). Carcinoma breast risk factors are many and well-established. In Western countries, widespread screening programs have led to early detection, often before symptoms appear. Conversely, in many developing countries, symptoms such as a palpable breast lump or abnormal nipple discharge are common presenting complaints3. Diagnosis typically involves a physical exam, tissue biopsy. Treatment may include surgery, chemotherapy, radiation, hormone more recently, immunotherapy. Decisions regarding treatment are tailored to the individual, basedon factors such as tumour histology, stage, molecular markers, and genetic mutations. Even with breakthroughs in early detection and dozens of novel therapeutic choices, carcinoma breast remains the most common tumour in females. It is a multifaceted illness with a range of biomolecular subgroups and clinical presentations. It has taken significant work to categorize this carcinoma according to its molecular makeup, and treatment regimens are currently defined by subtype. These are typically chosen after surgery, though. Chronic inflammation and cancer have a complicated and reciprocal interaction. In this investigation, we concentrate on how inflammation contributes to the growth of breast cancer. It is now commonly known that the characteristics of the tumour do not determine the fate for cancer patients alone, but that inflammation linked to cancer plays a crucial role in the development and prognosis of most cancers Systemic changes associated with the inflammatory response include an elevated neutrophil count and a modest increase in platelet count. Systemic inflammatory markers have just recently been made available as trustworthy and simple prognostic indicators. Tumour characteristics such as size, histological grade, lymph node involvement, ER, PR status and HER2NEU status are important prognostic indicators. Recently, gene expression profiling has emerged as a valuable tool to further stratify risk, inform therapy choices, especially for breast cancer that has hormone receptors, where it can help determine the need for chemotherapy. Liquid biopsy assays that detect circulating tumour cells have also entered the field of prognosis for early-stage and locally advanced breast cancer10. But these tests are frequently expensive, experimental, and not commonly accessible in standard healthcare settings.