Radiofrequency tissue ablation: an early Indian experience.

INTRODUCTION: Radiofrequency (RF) tissue ablation has been tried safely and effectively in the West as percutaneous local tissue ablation therapy. We present our experience with this technique in malignant lesions. METHODS: RF tumor ablation was done using an RF generator (Berchtold; Germany) generating 35-50 RF watts of power output. The RF needle was placed in the tumor under image guidance (n = 22) or at open surgery (n = 1). Around 1500 watts/cm3 RF energy was delivered to the tumor. Over 21 months, 23 patients underwent the procedure for 73 lesions, including metastatic liver lesions (n = 21) and locally advanced inoperable carcinoma of pancreas (n = 2). RESULTS: All lesions less than 3 cm in size (n = 15) and 39% of lesions 3-4 cm in size (17/44) had complete necrosis. Residual tumor was seen in 27/44 lesions (61%) 3-4 cm in size and in all 14 lesions more than 4 cm in size. There was no mortality or major morbidity. There were two minor complications (ascites 1, pleural effusion 1). Of 21 patients treated for liver metastases, 10 are still alive (6-month survival 19/21 [90%] and 12-month survival 11/17 [64.7%]). Only 2 of 32 (6.2%) lesions with complete necrosis had local recurrence. CONCLUSION: RF tumor ablation is a safe and effective local tissue ablative method in Indian patients.     

Comparative Measurement of Mesiodistal Width of Six Anterior Maxillary and Mandibular Teeth in Rajasthan Population

The purpose of the study was to determine the mesiodistal width of six anterior teeth for better esthetics and good tooth arrangement in a cross section of Rajasthan population. The mesiodistal dimension of central, lateral incisor and canine on right and left sides was measured in 250 males and 250 females, these readings were used to determine the mean, minimum and maximum maxillary/mandibular teeth ‘anterior ratio’, difference in mesiodistal width, combined mean mesiodistal width, the number and percent of similar teeth of maxilla and mandible. It was observed from the present study that there is variation in mesiodistal width in right and left sides signifying that the anterior teeth are not mirror images of one another. Male subjects have greater mesiodistal width than female subjects and right side dominates in most of the readings indicating that mesiodistal width is greater on right side than on left side. Percentage variability and sexual dimorphism are also important findings of this study. This study can prove helpful in replacement of artificial teeth of prosthesis in this cross section of population.     

Sequential changes at puberty in boys

A cross-sectional study of 1602 school boys of Sirohi town aged 8 to 18 yr for development of secondary sex characters using Tanner’s sexual maturity ratings carried out. Mean (±SE) age of onset of puberty is 9.95 (±0.06) yr and that of completion is 16.26 (±0.08) yr. Though boys of Rajasthan begin earlier to have pubertal changes, but total time taken to attain full maturation is longer than British. The Growth of genitalia starts first and completes in last, whereas that of pubic hair starts later but completes earlier. Facial hair and axillary hair follow pubic hair in development. Development of breast and apocrine function take place between stage 3 and 4 of genital growth.     

Deceased donor liver transplant: Experience from a public sector hospital in India

Background

Deceased donor liver transplant (DDLT) is an uncommon procedure in India. We present our experience of DDLT from a public sector teaching hospital.

Methods

A retrospective analysis of all DDLT was performed from April 2012 till September 2016. Demographics, intraoperative, donor factors, morbidity, and outcome were analyzed.

Results

During the study period, 305 liver transplants were performed, of which 36 were DDLT (adult 32, pediatric 4; 35 grafts; 1 split). The median age was 42.5 (1–62) years; 78% were men. The median donor age was 28 (1–77) years; 72.2% were men. About 45% of organs were procured from outside of Delhi and 67% of all grafts used were marginal. Three of 38 liver grafts (7.8%) were rejected due to gross steatosis. Commonest indication was cryptogenic cirrhosis (19.4%). The median model for end-stage liver disease sodium and pediatric end-stage liver disease scores were 23.5 (9–40) and 14.5 (9–22), respectively. Median warm and cold ischemia times were 40 (23–56) and 396 (111–750) min, respectively. Major morbidity of grade III and above occurred in 63.8%. In hospital (90 days), mortality was 16.7% and there were two late deaths because of chronic rejection and biliary sepsis. The overall survival was 77.8% at median follow up of 8.6 (1–54) months.

Conclusions

DDLT can be performed with increasing frequency and safety in a public sector hospital. The perioperative and long-term outcomes are acceptable despite the fact that most organs were extended criteria grafts.