Ganglioneuroma of small bowel mesentery presenting as acute abdomen

Ganglioneuroma is a rare benign tumor, usually seen in children and young adults, arising in the central nervous system. Ganglioneuroma of the mesentery is extremely rare; only one case has been recorded. We report the second case of a primary mesentery ganglioneuroma. The patient underwent surgical intervention for diagnostic and therapeutic purposes.     

Risk adjusted auditing of postop complications in gastric cancer patients by POSSUM

POSSUM (Physiological and Operative Severity Score for the enUmeration of Morbidity and mortality) has been proposed as a promising system for risk adjusted audit in surgical practice. However it has not been generalized in gastric cancer surgery. Present study evaluates the POSSUM on malignant gastric cases in Chinese hospital where patient population or healthcare system might be different than United Kingdom (UK) where the formula was devised. Total of 389 patients who underwent surgical intervention for gastric cancer and malignant gastric lymphomas during the year 2006 were included in the study. Median age was 58 years, with male:female ratio of 7:3. POSSUM data were collected according to standard criteria described by the original authors. Exponential analysis method was used for morbidity predictions. POSSUM predicted satisfactorily for morbidity, observed morbidity was not significantly different than estimated morbidity (p=0.962). Overall, 176 cases were observed to have postoperative complications (including death). The observed to expect ratio (O:E) was 0.99. There was no significant increase in complication rate with increasing age (chi(2)=3.75, 4 d.f, p=0.44). Overall 176 cases were observed to have postop complications (including death). Age was not a risk factor for early postoperative complication. POSSUM predicted well in this study, which means it is a valid system for gastric cancer surgery. However, overall complication rate considered being higher if it is recorded according to POSSUM criteria. Modification in POSSUM equation with revised morbidity definition may be more feasible for major operations.     

Meconium peritonitis presenting as abdominal calcification: three cases with different pathology

Intra-abdominal calcification is uncommon in newborns and has several causes of which meconium peritonitis is the most frequent. Three neonates with intra-abdominal calcification as a complication of meconium peritonitis are presented. The types of meconium peritonitis were cystic, meconium pseudocyst and meconium ascites. Two required surgical intervention. Meconium peritonitis should be considered in newborns with intra-abdominal calcification.     

Extracapsular extension in oral cavity cancers—predictive factors and impact on recurrence pattern and survival

Extracapsular extension (ECE) has long been considered a poor prognostic factor in oral cavity cancer, the presence of which warrants intensification of adjuvant therapy. This study was done to analyze the survival of patients with ECE who received adjuvant chemoradiation. Patients with pathologically confirmed squamous cell carcinoma of the oral cavity, with a minimum of 2 years of follow-up, who were treated at a tertiary cancer centre in New Delhi, India during the years 2009–2017, were included. On multivariate analysis, ECE was significantly associated with depth of invasion >10 mm and tumour deposit size >5 mm. Among the node-positive group, patients without ECE had a 5-year disease-free survival (DFS) and 5-year overall survival (OS) advantage over ECE-positive patients of 7.8% (63.8% vs. 56.0%) and 16.5% (87.2% vs. 70.7%), respectively. For patients with ECE, the hazard ratio for DFS and OS was 1.3 (95% confidence interval 0.97–1.75, P = 0.078) and 2.30 (95% confidence interval 1.35–3.92, P = 0.002), respectively. ECE remains one of the strongest predictors of recurrence and survival in oral cancer patients, and despite aggressive adjuvant therapy, distant recurrence is still significantly high.     

Evaluation of Fluoride Release in Chitosan-Modified Glass Ionomer Cements

ObjectiveThis study assessed the influence of chitosan nanoparticles on the fluoride-releasing ability of 4 glass ionomer cement (GIC) through an in vitro analysis.MethodsFour types of GIC (type II light cure universal restorative, type II universal restorative, GC Fuji VII, and type IX) were modified with nanochitosan particles; 10% chitosan was added to the glass ionomer liquid. Six specimens for each of the 4 groups were created, using expendable Teflon moulds. Discs of each type of GIC (n = 6) were immersed in deionised water at various time intervals. Electrodes selective for fluoride ions were employed to analyse the amount of released fluoride at 1, 7, 14, 21, and 28 days.ResultsChitosan-modified GICs showed greater fluoride release than conventional GICs at all time points. All samples showed an initial high release of fluoride that tapered off with time. The total amount of fluoride released increased from the 1st day to the 28th day on adding chitosan to all the 4 types of GIC. Amongst those, type IX high-strength posterior extra with chitosan released a considerably higher quantity of fluoride at all time intervals.ConclusionsIn all the experimental groups, adding chitosan to the glass ionomer liquid had an accelerating effect on its fluoride-releasing property.