http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/issue/feedUniversity Journal of Surgery and Surgical Specialities2022-02-06T16:43:57+0530Registrareditorouj@tnmgrmu.ac.inOpen Journal Systems<p>University Journal of Surgery and Surgical Specialities (UJSS) is a peer reviewed, open access jouranal .The journal is published quarterly and covers all areas of Surgery and Surgical specialities<br /><br />This journal is for enterprising scientists who are crossing the frontiers of new scientific research. It offers a platform to share their knowledge.</p><p>After registering as an author in the journal one can submit their work for publication. Registration can be done online. It is a 5 step process. (Caution: During registration ensure that the author box is checked).</p><p>Before registration it is ideal to become member of <a href="http://orcid.org/">ORCID</a>. The author on registration to orcid will be assigned an unique ID. The same may be entered in the journal registration form. This not only ensures credibility to the author, but also will help in showcasing their work to a larger audience.</p><p>All submissions will be peer reviewed before publishing.</p><p>Authors should submit their unpublished original work only.</p><p>Articles can be submitted under the following categories:</p><p>1. Original article</p><p>2. Review article</p><p>3. Interesting case reports</p><p>4. Image of the issue</p><p> </p><p>This Journal is free to access and free to publish.</p>http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/18894Liposarcoma Breast - A Case Report2022-02-06T16:43:37+0530Srilaxmi M, Rajendran A.K, SanthaKumar, .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p><strong>Introduction:</strong> Primary sarcomas of the breast are very rare tumours and account for less than 1% of all breast malignancies. Liposarcomas of breast has less than 0.3% of all mammary sarcomas. <strong>Case report: </strong>We report a case of an 53yr old postmenopausal woman who presented with an asymptomatic right breast mass, of six months duration. There was no family history of breast malignancy in any first-degree relatives and no history of previous radiation exposure. It was clinically diagnosed as carcinoma right breast. Core needle biopsy showed poorly differentiated malignant tumour and immunohistochemistry was positive for vimentin, S-100, Ki 67. Pre-operative diagnosis of high grade sarcoma probably liposarcoma was arrived. <strong>Management: </strong>Simple mastectomy was done and histology showed malignant phylloides with liposarcomatous changes. Post-operative period was uneventful. Adjuvant chemotherapy was given and the patient was discharged. Regular follow up was advised. <strong>Conclusion: </strong>The radiological, clinicopathological features, immunohistochemistry, molecular genetics are described in detail. Data from similar literatures are compared and therapy recommendations discussed.</p><p> </p></td></tr></tbody></table>2022-02-06T16:43:37+0530Copyright (c) 2022 Srilaxmi M, Rajendran A.K, SanthaKumar, .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19016Primary Extra Cranial Meningioma – A Rare Case2022-02-06T16:43:38+0530Balaji D J .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Meningiomas are the most common intracranial tumour, but rarely, they can develop extracranially, usually in the neck. There are very few cases of mandibular meningioma reported in literature and little is known about their biological behaviour and operative management. We present a patient with a primary mandibular meningioma that presented as a submandibular mass. The initial Fine needle aspiration cytology report was reported as submandibular gland adenoma and the patient was taken up for surgery with a plan of complete surgical excision. Complete surgical excision was done and the specimen was sent for histopathological examination. The post operative histo pathological report was reported as extra cranial meningioma. The post operative period was uneventful and the patient was discharged. On regular follow up of the patient, there are no signs of recurrence and the patient was asymptomatic in the followup period.</p><p> </p></td></tr></tbody></table>2022-02-06T16:43:38+0530Copyright (c) 2022 Balaji D J .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19017Tailgut Duplication Cyst- A Case Report2022-02-06T16:43:38+0530Saravana Kumar R AND Pabitha Devi B M .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p> </p><p>The tailgut cyst, being one of the rare congenital malformations which may present in the presacral space, is a remanant of the postnatal part of the hindgut. The rarity of the lesion and its anatomical position usually leads to difficulty in diagnosis and surgical management. 65yr female with complaints of Right leg pain for 6 month was diagnosed with sciatica. On further evaluation, patient was found to have tailgut duplication cyst. Laparotomy and cyst excision was done. Histopathological report came as tailgut duplication cyst.</p><p> </p></td></tr></tbody></table>2022-02-06T16:43:38+0530Copyright (c) 2022 Saravana Kumar R AND Pabitha Devi B M .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19018A Rare Case of Warfarin Induced Haemoperitoneum: A Case Report2022-02-06T16:43:39+0530Sri Radhu V.G, Kalaivani AND Kuppulakshm .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Warfarin is a coumarin derived anticoagulant used commonly to prevent thromboembolic episodes. Spontaneous haemoperitoneum is the presence of intra-abdominal haemorrhage from non-traumatic causes. The risk of warfarin induced bleeding increases if the INR is out of range<a href="file:///D:/uma%20epublications/7.12.21%20SURGERY%207(5)/5271-7939-1-SM/%5b2%5d%20Garcia%20D,%20Crowther%20MA,%20Ageno%20W%20(2010).%20%22Practical%20management%20of%20coagulopathy%20associated%20with%20warfarin%22.%20BMJ.%20340:%20c1813.%20doi:10.1136/bmj.c1813.%20PMID%2020404060.">.</a> This is a case report of spontaneous intraperitoneal haemorrhage secondary to warfarin toxicity mimicking signs and symptoms of ruptured ectopic pregnancy / ruptured corpus leuteal cyst managed conservatively</p><p> </p></td></tr></tbody></table>2022-02-06T16:43:39+0530Copyright (c) 2022 Sri Radhu V.G, Kalaivani AND Kuppulakshm .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19019A Rare Case of Isolated Traumatic Perforation of Meckel’s Diverticulum2022-02-06T16:43:39+0530Mohamed Fayiz P T .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Isolated traumatic perforation of meckle’s diverticulum is a very rare entity which is usually detected incidentally during surgery. The treatment of this condition is Primary resection of meckel’s diverticulum and anastamosis of adjacent small bowel. We are presenting a rare case of isolated traumatic perforation of meckel’s diverticulum in blunt injury abdomen during emergency laparotomy</p></td></tr></tbody></table>2022-02-06T16:43:39+0530Copyright (c) 2022 Mohamed Fayiz P T .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19020A Rare Case of 2nd Trimester Uertine Rupture – A Case Report2022-02-06T16:43:39+0530Lakshmipriya K, Kalaivani and Rani .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Uterine rupture is a rare life-threatening complication. It mainly occurs in the third trimester of pregnancy and is rarely seen during the first or second trimesters. Here we report a case of 33 years, G3P2L2 / Previous 2 LSCS/ gestational age being 17 weeks 3 days, presented with complaints of loose stools and vomiting, patient vital signs being stable. Ultrasound revealed extra-uterine pregnancy with live fetus, suggestive of abdominal pregnancy. Emergency laparotomy revealed rupture uterus, uterus given away at previous suture site, placenta invading uterine serosa, gestational sac with dead fetus being found lying outside uterus. Hysterectomy proceeded in view of rupture uterus with placenta increta.</p></td></tr></tbody></table>2022-02-06T16:43:39+0530Copyright (c) 2022 Lakshmipriya K, Kalaivani and Rani .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19021An Interesting Case of Gestational Diabetes Insipidus2022-02-06T16:43:40+0530Nandhini M V .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>A 23 years old primigravida, admitted in our Centre at the 34<sup>th </sup>week of pregnancy, presented with fever increased thirst and increased frequency of urine. She was primigravida, with normal past medical history. Blood levels showed Urea – 53 mg/ dl Creatinine – 1.3 mg/dl Na<sup>+</sup> - 170 mmol/L K<sup> </sup>- 3.8 mmol/L RBS – 106 mg/dl Sr.calcium – 8.8 mg/dl specific gravity of the urine: 1006; no glucosuria or proteinuria was present. Urinary and plasma osmolality were 85 and 355 mOsm/l; water intake about 5500 mL/day; diuresis 6000 mL/day. She was diagnosed positive for enteric fever with elevated liver enzymes. On the basis of the value of urine output and osmolality Gestational diabetes insipidus was diagnosed, after serum vasopressin level confirmed the same desmopressin 20 mg/day was started. Fetal monitoring and periodic ultrasound was done. Patient underwent an emergency LSCS in view of severe oligohydramnios and delivered a female baby of birth weight 1700 grams. This case illustrates some challenges in the diagnosis and management of transient gestational DI.</p></td></tr></tbody></table>2022-02-06T16:43:40+0530Copyright (c) 2022 Nandhini M V .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19022A Rare Case of Spindle Cell Sarcoma of Vulva2022-02-06T16:43:40+0530Ramya K , Kalaivani and Kuppulakshmi .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Malignant tumors of the female reproductive system are second most common after breast cancer. A 48 year old female, P3L3, presented with a firm to hard swelling in the vulval region, which was pedunculated with well defined margins and underwent radical vulvectomy with inguinofemoral lymphadenectomy. HPE report showed it to be a Spindle cell sarcoma of vulva.</p></td></tr></tbody></table>2022-02-06T16:43:40+0530Copyright (c) 2022 Ramya K , Kalaivani and Kuppulakshmi .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19023Interesting Case of Iris Depigmentation2022-02-06T16:43:41+0530Vinitha L Rashme AND Rathinam S R .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>36-year-old male presented with complaints of sudden loss of vision in both eyes for 2 days. Five days earlier he was treated with oral antibiotics for fever. His visual acuity in both eyes was perception of light with accurate projection of rays. Slit lamp examination showed diffuse congestion with corneal edema and severe pigment dispersion on the cornea and raised digital tension. B scan showed normal posterior segment. UBM revealed medial and temporal iris cysts. His previous reports revealed history of taking oral moxifloxacin for fever. So this is a case of acute iris depigmentation following systemic moxifloxacin. Patient was started on inj. Dexamethasone, oral Prednisolone, topical steroids and anti glaucoma medications. At follow up his visual acuity were 6/6 in both eyes with clear cornea and iris atrophy. We are reporting this case for its rarity and to increase awareness of this adverse effect of moxifloxacin.</p></td></tr></tbody></table>2022-02-06T16:43:41+0530Copyright (c) 2022 Vinitha L Rashme AND Rathinam S R .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19024A Rare Case Study of Sigmoid Volvulus In A28 Year Old Young Male - Case Report2022-02-06T16:43:41+0530Senthilraj T, Vijayalaksmi V, Arun .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Volvulus is the term applied to twisting of a loop of bowel so that the mesenteric vessel and the lumen of the bowel become occluded. It should be one of the differentials to be considered in patients presenting with abdominal distention and signs of intestinal obstruction. Here is a case report on sigmoid volvulus in a young male of 28 yrs without significant predisposing factors and the need for early diagnosis and intervention</p></td></tr></tbody></table>2022-02-06T16:43:41+0530Copyright (c) 2022 Senthilraj T, Vijayalaksmi V, Arun .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19025A Rare Case of Hypertropia: A Case Report2022-02-06T16:43:41+0530Keerthana Soundararajan And Shashikant S .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>A 33 year old female presented to us with squinting of left eye since birth. On examination patient had large angle hypertropia with exotropia in left eye which was a diagnostic challenge. Imaging showed reduction in volume of inferior rectus muscle in left eye. Intraoperatively inferior rectus muscle was found to be absent. The surgical correction resulted in excellent alignment in primary position. Hence high index of suspicion is required to consider inferior rectus aplasia. This case is presented for its rarity and surgical expertise to achieve the best possible outcome.</p></td></tr></tbody></table>2022-02-06T16:43:41+0530Copyright (c) 2022 Keerthana Soundararajan And Shashikant S .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19026Primary Gastric Tuberculosis Presenting as Gastric Outlet Obstruction- A Rare Entity2022-02-06T16:43:42+0530Coelho Victor Vijay Frederick .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="421"><p>Tuberculosis is a major health problem worldwide accounting for 1.3 million deaths in 2012 alone <sup>(1).</sup> The largest number of incident cases in 2012 was reported to be in India according to the WHO 2013 guidelines. The most common manifestation of tuberculosis in India and across the world is either pulmonary tuberculosis or an immunodeficient state. Gastrointestinal tuberculosis is not uncommon, the most common site being the ileo-caecal region. In India it is mainly seen due to its endemicity. Gastro-duodenal involvement in TB is very rare with a reported incidence of 0.003-0.21% of all routine autopsies <sup>(2)</sup>. Here we report a case of gastro-duodenal tuberculosis presenting as gastric outlet obstruction in an immunocompetent patient without any evidence of pulmonary tuberculosis. The biopsy confirmed the diagnosis and the patient responded well to anti-tubercular treatment. Even though it is rare, a high index of suspicion should be kept in mind when a patient presents with gastric outlet obstruction particularly in an endemic area.</p></td></tr></tbody></table>2022-02-06T16:43:42+0530Copyright (c) 2022 Coelho Victor Vijay Frederick .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19027Case Report of Preputial Calculus2022-02-06T16:43:42+0530Ragupathy M J .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p> Preputial calculus is a rare form of urolithiasis seen usually in an uncircumcised male with phimosis. We report a case in an elderly male who presented with difficulty in voiding and dysuria. Calculus is evident on clinical examination by palpation. Treatment is by dorsal slit or circumcision. Early recognition and treatment will prevent late complications like obstructive uropathy.</p></td></tr></tbody></table>2022-02-06T16:43:42+0530Copyright (c) 2022 Ragupathy M J .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19028Evans Syndrome Presenting in a Case of RIF Mass: A Case Report2022-02-06T16:43:43+0530Deepak David Chellappa, Maniselvi S, Bab .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>We describe a case of Evans syndrome in a 69-year female who presented to the surgery department with complaints of abdominal pain, mass in the RIF and severe anemia. The patient tested positive for direct coombs test suggesting the diagnosis of Evans syndrome.</p></td></tr></tbody></table>2022-02-06T16:43:43+0530Copyright (c) 2022 Deepak David Chellappa, Maniselvi S, Bab .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19029A Case of Proliferative Leukemic Retinopathy2022-02-06T16:43:43+0530Tharani N M and Mahima Jhingan .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>A 23year old man presented with complaints of defective vision in his left eye (LE) for the past 15 days. He was a known case of Pre-B cell lymphocytic leukemia on treatment. On examination there was mobile streak hypopyon in his left eye, leukemic optic nerve head infiltration in both eyes and proliferative retinopathy in both eyes. Patient was referred back to oncologist for bilateral radiotherapy and subsequent intrathecal chemotherapy. Pan retinal photocoagulation was done after two and a half months in both eyes. By this case report we would like to attract notice that clinicians should suspect leukemia in an otherwise young healthy patient presenting with ischemic retinopathy.</p></td></tr></tbody></table>2022-02-06T16:43:43+0530Copyright (c) 2022 Tharani N M and Mahima Jhingan .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19030Gall Stone Granuloma - A Rare Case Presentation2022-02-06T16:43:43+0530Sathish Kumar J .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Laparoscopic cholecystectomy is a routine general surgical procedure which has been performed commonly in a general surgical practice. The procedure is fairly simple with least incidence of post operative complications with a very good prognosis in the post operative period. One of the rare complications of a laparoscopic cholecystectomy is the occurrence of port site gall stone granuloma that is caused due to retained gall stone in the port site after the completion of the procedure when the retrieval of the gall bladder is performed through the epigastric 10mm port site. The diagnosis is made by radiological investigations such as ultrasonogram and the treatment is complete excision of the granuloma along with the sinus tract that is formed due to the presence of the retained gall stone.</p></td></tr></tbody></table>2022-02-06T16:43:43+0530Copyright (c) 2022 Sathish Kumar J .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19031Giant Pseudocyst of Spleen - A Rare Case Report2022-02-06T16:43:44+0530Ramesh P and A Nirmala .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Pseudocysts of the spleen are very rare, the incidence of which is 0.75 per 1,00,000 population. Pseudocysts of the spleen are usually asymptomatic and associated with history of trauma, infection and infarction. They require exploration only in symptomatic cases and chances of preservation of spleen in these cases are very less. Splenic pseudocysts (secondary) are considered to be more common than true cysts. Here is a case of non traumatic pseudocyst spleen presented with complaints of pain and lump in the abdomen. After thorough examination and investigation, laparotomy with marsupialization of the cyst was done and spleen was preserved. Post operative period was uneventful. On histopathological examination diagnosis of splenic pseudocysts was confirmed by absence of lining epithelium. We would like to present this case of splenic pseudocyst because of its rarity and of diagnostic challenge to the clinician.</p></td></tr></tbody></table>2022-02-06T16:43:44+0530Copyright (c) 2022 Ramesh P and A Nirmala .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19032Recurrent Imatinib Resistant Gastrointestinal Stromal Tumour of The Rectum: A Case Report2022-02-06T16:43:44+0530Kokila S .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Gastrointestinal stromal tumors (GISTs) are rare neoplasms of the GIT with an incidence of about 0.1-3% of all GI malignancies. They are thought to arise from the interstitial cells of Cajal. Expression of the c-kit gene protein product, CD117 is an important defining feature of GISTs. The most common GIST sites are the stomach (50%-70%) followed by the small intestine (25%-35%), whereas only about 5%-10% of all GISTs start in the rectum. Rectal GISTs make up 0.1% of all tumors originating in the rectum. In this report, we describe a case of imatinib resistant rectal GIST in a 65 year old woman which recurred following primary resection and was treated by debulking surgery and followed by Sunitinib chemotherapy.</p><p> </p></td></tr></tbody></table>2022-02-06T16:43:44+0530Copyright (c) 2022 Kokila S .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19033A Rare Case of Multiple Intussusception In An Adult-Puetz-Jeghers Syndrome2022-02-06T16:43:45+0530Sarath R S and Balasubramanian S .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Intussusception in adult is rare with anincidence of 2-3 in 1000000 population. We present a rare case of multiple intussusceptions in a patient with Peutz-Jeghers syndrome. 20 year old female presented with features of abdominal pain and vomiting. She was pale, dehydrated with tachycardia. The abdomen was minimally distended. A firm mass of size 5×4 cm over left iliac fossa with empty RIF. Investigations showed multiple air fluid levels with features of intestinal obstruction with the possibility of intussusception. Exploratory laparotomy done revealed multiple segments of intussusceptions for which multiple resection and anastomosis was done. There were multiple polyps in the resected specimen and HPE revealed hamartomatous polyps of PeutzJeghers type. Peutz–Jeghers syndrome is a rare autosomal dominant genetic disorder characterized by the development of benign hamartomatous polyps in the gastrointestinal tract and hyperpig-mented macules on the lips and oral mucosa.</p></td></tr></tbody></table>2022-02-06T16:43:45+0530Copyright (c) 2022 Sarath R S and Balasubramanian S .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19034Intestinal Obstruction Due to Fibromuscular Dysplasia2022-02-06T16:43:45+0530Aravind M and Balasubramanian S .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p><strong>INTRODUCTION : </strong>We describe a rare case of small bowel infarction caused by fibro muscular dysplasia with a good prognosis <strong>CASE PRESENTATION : </strong>We present a case, where an elderly male presented with cardinal symptoms and signs of intestinal obstruction. Necessary investigations were done which concluded small bowel infarction. Exploratory laparotomy revealed jejunal gangrene. Resection anastamosis done. Histopathology was suggestive of Fibro muscular dysplasia (FMD). Post operative period was uneventful and he was discharged with antiplatelets with regular follow up. Disease specific investigations to rule out cerebral vessel involvement were all negative. Thus the diagnosis of ischemic bowel disease produced probably by Fibro muscular dysplasia was made. <strong>CONCLUSION : </strong>This case illustrated the importance of consideration of mesentric artery FMD and cause specific treatment should be tailored to any case of intestinal obstruction to prevent recurrences. Owing to its rarity, mesenteric vessel FMD still eludes the surgeon in making a diagnosis. Hence a high degree of suspicion is important for appropriate management.</p></td></tr></tbody></table>2022-02-06T16:43:45+0530Copyright (c) 2022 Aravind M and Balasubramanian S .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19035A rare presentation of Ileal of GIST- Mimicking carcinoma rectum2022-02-06T16:43:45+0530Umamaheswaran S, Dhamotharan S R. Arul R .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p><strong>Introduction</strong> : Gastro intestinal stromal tumors are rare</p><p>neoplasms. They represent 0.1-3% of all gastro</p><p>intestinal malignancies. They can arise anywhere along the</p><p>gastrointestinal tract. GIST of the small bowel is less</p><p>common. Clinically, most of the GIST present as GI bleed</p><p>and rarely with intestinal obstruction and perforation. We</p><p>report here a case of Ileal GIST presented with Lower</p><p>Gastro intestinal bleeding which mimicked as a Recto</p><p>sigmoid growth with radiological investigations and been a</p><p>diagnostic dilemma, on intraoperatively we found the</p><p>tumor growth from Ileum.</p><p><strong>Case Report</strong> : This is about a 66 years old male patient</p><p>who presented with lower abdomen pain and frequent</p><p>blood stained stools for 2 months. He was diagnosed as</p><p>Recto sigmoid growth and to surprise intraoperatively</p><p>diagnosed as Ileal gist of moderate malignant potential,</p><p>and resection anastomosis done, followed by imatinib</p><p>therapy.</p><p><strong>Conclusion</strong> : GIST should always be among the</p><p>differential diagnosis of an intra-abdominal non-epithelial</p><p>malignancy. Radiological Imaging even though advanced</p><p>can impede an early diagnosis, as in this case it mimicked</p><p>a recto sigmoid exophytic growth.</p></td></tr></tbody></table>2022-02-06T16:43:45+0530Copyright (c) 2022 Umamaheswaran S, Dhamotharan S R. Arul R .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19036A rare case of malignant melanoma of the Lacrimal Sac2022-02-06T16:43:46+0530Suhan, Usha Kim .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Malignant melanoma is a malignancy of the pigment</p><p>- producing cells known as melanocytes. The organ usually</p><p>affected is the skin. While melanoma accounts for roughly</p><p>4% of all skin cancers, it is responsible for more than 77%</p><p>of skin cancer deaths. Mucosal melanoma is a rare entity</p><p>compared to cutaneous malignant melanoma.</p><p>Mucosal malignant melanoma of the head and neck</p><p>represents approximately 8% of all melanomas that develop</p><p>in the head and neck and generally behaves far more</p><p>aggressively than cutaneous melanoma.</p></td></tr></tbody></table>2022-02-06T16:43:46+0530Copyright (c) 2022 Suhan, Usha Kim .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19037A rare case of Periocular Desmoplastic Trichoepithelioma2022-02-06T16:43:46+0530Aunton Gnana Wilfer, Usha Kim .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Trichoepitheliomas are benign cutaneous neoplasms</p><p>derived from the hair follicle. Three distinctive variants of</p><p>Trichoepithelioma are recognized: Solitary, Multiple and</p><p>Desmoplastic. Desmoplastic are rare benign adnexal</p><p>tumour that is derived from basal cells in the outer root</p><p>sheath of the hair follicle. It is also known as Sclerosing</p><p>Epithelial Hamartoma. Incidence wise is1 in 5,000 of the</p><p>occurrence of the disease noted so far. 85% female</p><p>predominance had been reported. It mimics Basal Cell</p><p>Carcinoma.</p></td></tr></tbody></table>2022-02-06T16:43:46+0530Copyright (c) 2022 Aunton Gnana Wilfer, Usha Kim .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19038Clinical study and management of peritonitis secondary to hollow viscus perforation2022-02-06T16:43:47+0530Vivek Nagappa, T Sivakumar, Jim Jebakuma .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p><strong>Aim:</strong></p><p>To study the frequency of peritonitis secondary to</p><p>Hollow viscus perforation in relation to</p><p>Age.</p><p>Sex.</p><p>Symptoms.</p><p>Anatomical location.</p><p>Reliability of investigations like erect ‘X - Ray’- Abdomen.</p><p>To study the Surgical Management of Peritonitis</p><p>secondary to Hollow viscus perforation in Stanley Medical</p><p>College and Hospital.</p><p>To study complication of operative management.</p><p><strong>Materials and Methods </strong>: The study was carried out from</p><p>January 2017 to December 2017. A thorough history and</p><p>clinical examination of the patients were carried out. Then,</p><p>various investigations such as Complete Blood Count</p><p>(CBC), X-Rays, ultrasound of the abdomen if needed were</p><p>done, in order to arrive at the diagnosis. Once diagnosed</p><p>patients were either treated accordingly.</p><p><strong>Type of study</strong>: A prospective descriptive study.</p><p><strong>Results </strong>: In this study, 50% patients were in the age group</p><p>of 21-40 years. Male to female ratio was found to be 5:1.</p><p>The most common symptom was abdominal pain which</p><p>was present in all the patients. 73.33% of cases had air</p><p>under the diaphragm. Among the 30 cases of gastrointestinal</p><p>perforation, perforation of duodenal ulcer 10 cases</p><p>(33.3%) was the commonest. The most common complication</p><p>recorded was wound infection 6 cases (20%) and</p><p>death in 1 case.</p><p> </p></td></tr></tbody></table>2022-02-06T16:43:47+0530Copyright (c) 2022 Vivek Nagappa, T Sivakumar, Jim Jebakuma .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19039A rare case of external auditory canal cholesteatoma with facial nerve palsy – our experience2022-02-06T16:43:47+0530Murali Mohan Kamalakkannan .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>External Auditory Canal Cholesteatoma is a rare and</p><p>distinct otological entity, with an incidence of 0.1 – 0.5% of</p><p>all patients with ear complaints. This disease is</p><p>characterised by invasion of squamous epithelium of the</p><p>ear canal into an area of localised bony erosion. It may</p><p>either be primary (spontaneous, which is rare) or</p><p>secondary (following trauma, surgery or post irradiation).</p><p>The fact, that by the time patients seek consultation the</p><p>disease would have gone on to erode the bony constraints</p><p>of external auditory canal and spread to adjacent</p><p>structures, poses a great challenge for the otologist. In this</p><p>article, we present our experience in diagnosis and</p><p>management of one such rare case of Giant External</p><p>auditory canal Cholesteatoma complicated by facial nerve</p><p>palsy.</p><p> </p></td></tr></tbody></table>2022-02-06T16:43:47+0530Copyright (c) 2022 Murali Mohan Kamalakkannan .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19040Unilateral congenital facial palsy with Anotia2022-02-06T16:43:47+0530Rajalakshmi A, Rita Hepsi Rani .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Congenital facial palsy (CFP) is considered to be</p><p>either developmental oracquired in origin. Developmental</p><p>facial paralysis is associated with other anomalies most</p><p>commonly those of pinna and external auditory canal,</p><p>rangingfrom mild defects to severe microtia and atresia.</p><p>Association of abnormal pinna,multiple defects and facial</p><p>palsy has been reportedin 9-15% of patients. Aural atresia</p><p>occurs in approximately one in 20,000 live births. We</p><p>report a rare case of congenital left facial paralysis</p><p>associated with left anotia. Patient hadsymptoms due to</p><p>associated entropion. Surgical correction of entropion was</p><p>done.</p><p> </p></td></tr></tbody></table>2022-02-06T16:43:47+0530Copyright (c) 2022 Rajalakshmi A, Rita Hepsi Rani .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19041An interesting 3 in 1 surgery2022-02-06T16:43:48+0530Ganesh Babu, Alex Arthur Edwards .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>A 54 year old female patient presented with upper</p><p>abdomen pain for 2 months and loose stools since</p><p>10 days. On evaluating ultrasound revealed normal study.</p><p>CT abdomen revealed metastatic lesion right lobe of liver,</p><p>small bowel exophytic GIST, retroperitoneal cystic</p><p>lymphangioma. Exploratory laparotomy done segmental</p><p>resection of jejunum with end to end anastamosis done,</p><p>wedge resectionof duodenal diverticulum with primary</p><p>repair, metastatectomy of liver and excision of neurolipoma</p><p>of right arm.</p><p> </p></td></tr></tbody></table>2022-02-06T16:43:48+0530Copyright (c) 2022 Ganesh Babu, Alex Arthur Edwards .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19042A rare case report of Interstitial pregnancy with Dermoid Cyst2022-02-06T16:43:48+0530Ramipriya R, Sumathi C, Manickadevi M S .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Interstitial pregnancy constitutes 2 to 3% of total</p><p>ectopic pregnancy. These pregnancies implant with in</p><p>proximal tubal segment that lies within the muscular uterine</p><p>wall. Interstitial pregnancies can be carried up to 16 weeks</p><p>of gestation. This longer period of pregnancy is due to</p><p>greater distension of myometrium covering the interstitial</p><p>fallopian tube segment. 40 year old G4P2L2A1,</p><p>Previous2LSCS, last menstrual period on 28.07.2017 was</p><p>admitted with complaints of spotting per vaginum for 5</p><p>days. She was diagnosed as a case of interstitial pregnancy</p><p>and underwent right partial salpingectomy and left</p><p>salphingo oophorectomy. Hence high index of suspicion is</p><p>needed to diagnose interstitial pregnancy so that disastrous</p><p>effect can be avoided.</p><p> </p></td></tr></tbody></table>2022-02-06T16:43:48+0530Copyright (c) 2022 Ramipriya R, Sumathi C, Manickadevi M S .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19043An unusual presentation of a Thyroglossal Cyst2022-02-06T16:43:49+0530Antony Thomas, Suresh Kumar S, Ravikumar .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Thyroglossal cyst is a congenital neck swelling</p><p>usually affecting young children but can occur at any age.</p><p>It can occur anywhere in the course of development of</p><p>thyroid gland. In rare situations, it may contain the only</p><p>functioning thyroid. Rarely carcinoma develops in the cyst.</p><p>We are presenting here a case of thyroglossal cyst</p><p>presenting late in an adult as internal and external</p><p>swelling, which came as a secondary deposits of</p><p>squamous cell carcinoma in FNAC outside and being</p><p>referred here for evaluation of primary site, and on follow</p><p>up after surgery, proven to be simple cyst. We have done</p><p>Sistrunk operation combined with excision of the</p><p>extension of cyst in vallecula and arytenoid.</p><p> </p></td></tr></tbody></table>2022-02-06T16:43:49+0530Copyright (c) 2022 Antony Thomas, Suresh Kumar S, Ravikumar .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19044A rare case of MoyaMoya disease in pregnancy2022-02-06T16:43:49+0530Janani T, Kalaivani.K , Suganthi S .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>MoyaMoya disease is a rare neurological disorder</p><p>causing cerebrovascular events. It is more common in</p><p>Japan and korea than in India. Incidence of the disease is</p><p>0.28 per 1,00,000 population in Asia. Asymptomatic</p><p>disease is a common mode of occurrence in moyamoya</p><p>disease and it has a predilection to affect females more</p><p>than male population. MoyaMoya disease in pregnant</p><p>women is one of the rarest case causing maternal</p><p>morbidity.</p><p> </p></td></tr></tbody></table>2022-02-06T16:43:49+0530Copyright (c) 2022 Janani T, Kalaivani.K , Suganthi S .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19045A Case of Fundus Falvimaculatus (A Phenotypic Variant of Stargardt Disease)2022-02-06T16:43:49+0530Jeyakumari J, Thasneem Suraiya .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>A 13 years old male attended OPD with chief complaints of progressive painless diminution of vision - 2 years. There was h/o perception of wavy lines and defective dark adaptation. There was no h/o defective field of vision or any history suggestive of cranial nerve dysfunction.</p><p> </p><p>General and systemic examinations were normal. The vision was 6/24 OU. Anterior segment examination was normal OU. Colour vision was defective in both the eyes. Dilated fundus examination showed OU - Beaten bronze appearance of Macula with pisciform flecks distributed throughout the fundus with absent foveal reflex.</p><p> </p><p>Further investigations like FFA, EOG and OCT were done. OU fundus fluorescein angiography showed fundus autofluorescence and silent choroid. Electroretinogram was normal. OCT showed reduced foveal thickness in both eyes.</p><p> </p><p>Owing to the presence of progressive painless loss of vision, beaten bronze appearance of macula with diffuse pisciform flecks, fundus auto fluorescence, with FFA showing dark and silent choroid, the patient was diagnosed to have Fundus flavimaculatus, a phenotypic form of Stargardts disease and was prescribed low vision aids. Reassurance was given.</p><p> </p><p>This case is presented for its visual manifestations and characteristic fundus findings.</p></td></tr></tbody></table>2022-02-06T16:43:49+0530Copyright (c) 2022 Jeyakumari J, Thasneem Suraiya .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19046A Rare Case Report of Perforated Gastrointestinal Stromal Tumour of the Meckel’s Diverticulum2022-02-06T16:43:50+0530Saravanakumar A .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract, 1/3 being asymptomatic and some presenting with a diverse clinical features; like vague gastric discomfort or ulcer like features and very rarely as an acute abdomen due to bleeding, obstruction, perforation; or due to hemoperitoneum. We present a rare case of a perforated GIST of the meckel’s diverticulum (MD). 34year old female presented as an acute abdomen in the casualty with features of peritonitis localized to right iliac fossa, diagnosed as acute appendicitis and a diagnostic laparoscopy was done. Intraoperatively, a perforated meckel’s diverticulum was found. Histopathological examination showed a low grade GIST. Small bowel is the most common site for a perforated GIST; mostly from the meckel’s diverticulum. The commonest tumour to cause perforation of meckel’s diverticulum is a GIST. </p></td></tr></tbody></table>2022-02-06T16:43:50+0530Copyright (c) 2022 Saravanakumar A .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19047A Case of Traumatic Degloving Penile Injury with Primary Skin Graft Cover2022-02-06T16:43:50+0530Manivannan P .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Degloving describes a potentially serious injury in which an extensive area of skin is torn from its underlying attachments consequently depriving it of its blood supply. Degloving injury of the male genitals is an uncommon urological presentation. They occur mainly following accidents with industrial or agricultural equipment. A case of isolated penile degloving injury in a 40-year-old farmer arising from avulsion effect of clothing entrapped in a harvesting machine is presented. Reconstruction was achieved with a skin graft, after initial wound optimization.</p></td></tr></tbody></table>2022-02-06T16:43:50+0530Copyright (c) 2022 Manivannan P .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19048Traumatic Abdominal Wall Hernia – A Rare Case Report2022-02-06T16:43:51+0530Mohamed Yasar M Y .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Traumatic abdominal wall hernia is an uncommon injury despite the high prevalence of blunt abdominal trauma. Traumatic abdominal hernia was first described by Selby in 1906. In worldwide literature, less than 50 cases of Traumatic abdominal wall hernia have been reported with only three to five cases from India. We are reporting a case of TAWH resulting from a blunt injury sustained by a bull gore injury and discussion on the management of such injuries.</p></td></tr></tbody></table>2022-02-06T16:43:51+0530Copyright (c) 2022 Mohamed Yasar M Y .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19049Ileosigmoid Knotting - Double Volvulus (Alver Type 4): A Rare Case Report2022-02-06T16:43:51+0530Sanjeev P J .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Ileosigmoid knot is a rare cause of intestinal obstruction. It is also called as compound volvulus or double volvulus. In this condition ileum forms a loop around sigmoid colon and passes beneath itself creating a knot. The incidence of ileosigmoid knot is not well known. It is important to diagnose a case of ileosigmoid knot early because it will rapidly progress to a double loop gangrene. Pre operative CT scanning is useful for the diagnosis of the condition and shows signs of intestinal obstruction. The mean mortality for the condition is 6.8-8% in non gangrenous and 20-100% in gangrenous cases. The following is a case report of a 42 year old male patient describing the presentation, diagnosis and management of ileosigmoid knotting alver type 4 (compound volvulus).</p></td></tr></tbody></table>2022-02-06T16:43:51+0530Copyright (c) 2022 Sanjeev P J .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19050Hernia Uterine Inguinalis – A Rare Case Presentation2022-02-06T16:43:51+0530Esakki S .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Inguinal hernia is a condition which has a common presentation in the general surgical out patient department. Indirect inguinal hernia is the most common type of inguinal hernia. The contents of an indirect inguinal hernia can be omentum, bowel or rarely other structures. In this rare case of hernia uterine inguinalis, the content of the direct hernial sac was found to be an uterus along with two fallopian tubes along with one ovary and one fallopian tube attached to an atrophied testis. The contents were clamped, transfixed and ligated and excised en bloc. The defect was rectified and completion of the surgical procedure was done with a hernioplasty on the side of the inguinal hernia. The patient was discharged without any post operative complications.</p></td></tr></tbody></table>2022-02-06T16:43:51+0530Copyright (c) 2022 Esakki S .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19051A Rare Case of Ohvira / Herlyn Werner Wunderlich Syndrome2022-02-06T16:43:52+0530Sudharsini T S AND Poovathi .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Mullerian duct anomalies have an incidence of 2–3%. Uterus didelphys belongs to Class III, according to American Fertility Society classification of Mullerian duct anomalies. Here we present a rare case of Mullerian duct anomaly-OHVIRA syndrome or HERLYN WERNER WUNDERLICH SYNDROME which is probably a new variant. An unmarried female with primary amenorrhoea presented to our department with complains of pain abdomen, referred from private hospital for hysterectomy. On investigating her, she was diagnosed to have HERLYN WERNER WUNDERLICH SYNDROME. Further management depends on understanding the imaging findings, in conjunction with the clinical presentation and opinion of experts which is critical for prevention of complications such as endometriosis or adhesions. Management depends on the presence or absence of an outflow tract obstruction.</p></td></tr></tbody></table>2022-02-06T16:43:52+0530Copyright (c) 2022 Sudharsini T S AND Poovathi .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19052An Unusual Cause of Recurrent Pancreatitis In an Adult – Duodenal Duplication Cyst2022-02-06T16:43:52+0530Mythili R, Sundareswari P, Saravanakumar .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>A duodenal duplication cyst is a rare congenital anomaly that is usually occurs during infancy or in early childhood. Duodenal duplication cysts generally appear on the first or second portion of the duodenum and may cause duodenal obstruction, hemorrhage or pancreatitis. Here, we report a case of a duodenal duplication cyst on the second and third portion of the duodenum in a man with acute recurrent pancreatitis, which was treated successfully by a surgical excision. The patient is healthy and asymptomatic one year after surgery. The present case illustrates the necessity of considering a duodenal duplication cyst in the differential diagnosis of recurrent acute pancreatitis in previously healthy adults.</p></td></tr></tbody></table>2022-02-06T16:43:52+0530Copyright (c) 2022 Mythili R, Sundareswari P, Saravanakumar .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19054A Rare Case of Recurrent Granulomatous Epulis2022-02-06T16:43:52+0530Prem Kumar S, Dhamotharan S R, Arul Rajk .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Epulis means upon gums- a tumour like proliferative swelling arising from mucoperiosteum of gums. Granulomatous epulis is a mass of granulation tissue in the gum around a caries tooth. It can also arise from a poorly healing extraction socket due to complication of a bone fragment or tooth spicules within the socket. Recurrence of such lesion is rare as excision of the lesion along with the removal of inciting agents cures the disease. Here is a rare case of recurrent epulis granulomatosa in a 70 year old female detailing the clinical features, diagnosis and management.</p></td></tr></tbody></table>2022-02-06T16:43:52+0530Copyright (c) 2022 Prem Kumar S, Dhamotharan S R, Arul Rajk .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19055Paediatric Sarcoid - an Isolated Ocular Involvement, A Rare Case Report2022-02-06T16:43:53+0530Abinaya C AND Rathinam S R .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Childhood ocular sarcoidosis is an uncommon disease and recognition of this disease in children is often delayed because of lack of awareness and familiarity with its clinical features. 13 year old female child presented with redness, pain, photophobia. On clinical evaluation granulomatous uveitis was diagnosed, followed which tuberculosis was ruled out by mantoux and chest radiography. As Serum angiotensin converting enzyme level was grossly elevated, sarcoid was suspected for which she was started on oral steroids. Four months later she turned up with recurrent symptoms with pain on extraocular movements for which she was evaluated with MRI which showed bilateral lacrimal gland homogenous enchancement which was also suggestive of sarcoid with extraocular involvement. Hence she was started on steroids with methotrexate for which she showed remission of symptoms. We describe this case study because usually children with sarcoid presents with clinical triad of skin, joint and ocular involvement which is early onset type and late onset type children will have clinical picture similar to adults with predominant lung involvement, but our case presents with isolated ocular involvement.</p></td></tr></tbody></table>2022-02-06T16:43:53+0530Copyright (c) 2022 Abinaya C AND Rathinam S R .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19056A Case Report of Turners Syndrome2022-02-06T16:43:53+0530Sarina Vincent Arokia A, Kalaivani AND .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Turners syndrome is a type of gonadal dysgenesis described first by H.h.Turner, which is due to abnormality or absence of one of the X chromosomes. A patient of 15 years presented to our hospital with complaints of delayed onset of menstruation and diagnostic workup {usg abdomen, mri, genetic study} revealed Turners syndrome. The gonadal dysgenesis can either be a monosomy {45X0} or mosaic{45X 46XX,45X 46XY}.</p></td></tr></tbody></table>2022-02-06T16:43:53+0530Copyright (c) 2022 Sarina Vincent Arokia A, Kalaivani AND .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19057A Rare Case of Primary Cervical Signet-Ring Cell Carcinoma (PCSRCC), Presenting at A Tertiary Gynaecology Care Centre in Tamilnadu - A Case Report2022-02-06T16:43:54+0530Annie Rajiah AND Hemalatha N .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Primary cervical signet-ring cell carcinoma has been rarely reported in medical literature, to date, only 18 cases with primary signet cell carcinoma of the cervix has been reported. Any occurrence of signet cell differentiation has to be thoroughly checked by way of ruling out primary from other commonly occurring sites like such as colon, stomach, appendix, urinary bladder, and breast . in our case 41 year old female who had a HPE report of PCSRCC, we ruled out primary from other sites by subjecting her to gastroscopy, colonoscopy mammography and CT of abdomen and chest, further IHC studies on the biopsy specimen confirmed the diagnosis of primary cervical signet-ring cell carcinoma (PCSRCC). This case is been reported for the rarity of presentation.</p><p> </p></td></tr></tbody></table>2022-02-06T16:43:54+0530Copyright (c) 2022 Annie Rajiah AND Hemalatha N .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19058A Rare Case of Benign Angiomyxofibroma of the Spermatic Cord2022-02-06T16:43:54+0530Vijayakumar A .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Benign angiomyxofibroma is rare neoplasm that arises in the paratesticular region that is confused with inguinal or scrotal hernia. We present a case of benign angiomyxofibroma of the spermatic cord and discuss the clinical, imaging, and histological findings as well as the differential diagnosis, with a brief review of the current literature on this topic.</p></td></tr></tbody></table>2022-02-06T16:43:54+0530Copyright (c) 2022 Vijayakumar A .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19059Traumatic Ulcerative Granuloma With Stromal Eosinophilia A Case Report2022-02-06T16:43:54+0530Sivakumar Gopalakrishnan, Deepak Pandyan .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Traumatic ulcerative granuloma with stromal eosinophilia is a benign solitary ulcer, most frequently involves tongue than other parts of the oral mucosa. It is more of a reactive, self- limiting lesion commonly present with raised indurated margins. Thus, TUGSE should not be forgotten as a differential diagnosis for a clinically appearing malignant lesion in absence of risk factor.</p></td></tr></tbody></table>2022-02-06T16:43:54+0530Copyright (c) 2022 Sivakumar Gopalakrishnan, Deepak Pandyan .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19060Evaluation of Pharyngeal Airway Space in Skeletal Class I & Class II patterns in Kundrathur Population2022-02-06T16:43:55+0530Vasanthavalli Devanathan1, Akila Thiruma .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p><strong>Aim:</strong> To evaluate the pharyngeal airway space present in ethnic population in Kundrathur. <strong>Materials and method:</strong> A screening camp was conducted in Kundrathur, 760 people were screened and out of which 120 cephalograms were taken in the Department of Orthodontics, Madha Dental College and Hospital from people who were willing for fixed appliance treatment based on inclusion criteria. The subjects ranging from 11-30 age group were investigated. In this study, upper and lower pharyngeal airway space were measured based on Mc. Namara analysis. <strong>Results:</strong> Parametric test was applied. Descriptive statistics were done to assess the mean among the study variables and an independent t-test was used to find out the measurement values in dental and skeletal malocclusion status. <strong>Conclusion: </strong>Dental malocclusion was shown to be highly significant than skeletal malocclusion.</p></td></tr></tbody></table>2022-02-06T16:43:55+0530Copyright (c) 2022 Vasanthavalli Devanathan1, Akila Thiruma .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19061A Retrospective Study on variations In Chin-Throat Angle in Different Skeletal Malocclusions2022-02-06T16:43:55+0530Ilanchezhian Ja, Udayanandini R @ Nazri .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p><strong>OBJECTIVE:</strong> To assess the variations in Chin Throat Angle in different skeletal malocclusions in local population reported to Madha dental college and hospital.<strong>MATERIALS & METHODS: </strong>Profile photographs and lateral cephalograms of 102 adults aged between 18-28 years were taken, out of which 75 were class I, 23 were class II and 4 were class III malocclusions. All the samples were digitalized and standardized and ANB and Chin Throat Angles were measured. The pre-treatment measurements were compared in between these three groups. The Statistics included normality test, Kolmogorov-Smirnov and Shapiro-Walks tests, parametric test, one way ANOVA and independent t-test for group differences.<strong>RESULTS: </strong>Chin Throat Angle was increased in class II group than that of class I and III groups. Significant differences (P< 0.05) were observed for ANB and Chin Throat Angle between Classes I/II/III as (<0.01) & (<0.036) respectively on lateral cephalograms. On profile photographs Chin Throat Angle between the three classes were significant (<0.027).<strong>CONCLUSION: </strong> The Chin Throat Angle analysis is essential for the orthodontist’s awareness of treatment planning and can also be used for explaining to the patient. Thus not only frontal photographs but also lateral cephalograms along with profile photographs plays an important role in diagnostic purposes.</p></td></tr></tbody></table>2022-02-06T16:43:55+0530Copyright (c) 2022 Ilanchezhian Ja, Udayanandini R @ Nazri .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19065Awareness of Covid-19 Among Middle School Children- Lessons Learnt Over A Year Pandemic-Borne Period2022-02-06T16:43:56+0530Packiaraj Selvajothi1, Santiago Gnanadee .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="421"><p>Background</p><p> </p><p>The year 2020 will be reminisced in the young minds as they have come across the greatest global crisis. Though the school children have been well educated about the preventive measures against COVID 19 but the progression of this pandemic disease remains uncertain. Hence, we wanted to assess the awareness of middle school students towards COVID 19 at its peak, 6 months and after a year period in Tamil Nadu, India through an online survey.</p><p> </p><p>Material and methods</p><p> </p><p>A cross-sectional web-based descriptive survey was done to evaluate COVID-19-related knowledge and awareness among middle school students in June 2020, December 2020 and June 2021, in the state of Tamil Nadu. All data were statistically analyzed using SPSS 20.0. The significance level of tests was accepted as p<0.05.</p><p> </p><p>Results</p><p> </p><p>A total of 125 middle school children in the age group between 9-13 years participated in the study. The questionnaire was categorized into 2 platforms (General, scientific knowledge and preventive measures). Males comprised of 57% and females 43% in our study. The males had 73%, 95 % and females 74%,87 % awareness on platform I and II respectively. The students from urban, semi-urban, rural had 73%,76%,71% knowledge and awareness on platform I and 91%,93%,89% on platform II respectively.</p><p> </p><p>Conclusion</p><p> </p><p>This study evaluated the knowledge and awareness of covid-19 among middle school children. Information on children's knowledge may help health professionals develop age-appropriate explanations of Covid 19 and bring out easily understandable simple preventive strategies.</p><p> </p><p>Running title</p><p>Awareness of covid-19 among middle school children</p><p> </p><p> </p><p> </p></td></tr></tbody></table>2022-02-06T16:43:56+0530Copyright (c) 2022 Packiaraj Selvajothi1, Santiago Gnanadee .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19066Comparison of Anaesthetic Efficiency of Warm and Conventional 2% Lignocaine Solution Using Insulin Syringe in Maxillary Primary Molars: A Randomised Controlled Clinical Trial2022-02-06T16:43:56+0530Girija Selvaraju, Divya Subramanyam, Pri .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p><strong>Introduction: </strong>Pain on injection and incomplete anaesthesia causes failure of the procedure and result in fear and anxiety in children. There are various methods of reducing the pain during anaesthesia, one such method is warming or buffering the local anaesthetic agent prior to administration of injection.</p><p><strong>Aim of the study: </strong>To assess whether administration of warm lignocaine solution using insulin syringe in maxillary primary molars would reduce pain during dental procedures.</p><p><strong>Materials and Methods: </strong>Forty children between the age of 6-12 years who were undergoing dental treatment participated in the study. A random crossover design was used. Each patient was randomly assigned to receive either warm or conventional 2% lignocaine on the first visit and the alternate local anaesthesia on the second visit. For subjective evaluation the Wong-Baker FACES pain rating scale were used.</p><p><strong>Statistical Analysis: </strong>Wilcoxon signed-rank test and Mann-Whitney U tests</p><p><strong>Results: </strong>Pre-warmed lignocaine solution using insulin syringe resulted in less pain on injection (P=0.0004, P<0.001)</p><p><strong>Conclusion</strong>: Prewarming the anaesthetic solution showed a significant reduction in pain than normal solution associated with administration of injection during dental procedures in children.</p></td></tr></tbody></table>2022-02-06T16:43:56+0530Copyright (c) 2022 Girija Selvaraju, Divya Subramanyam, Pri .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19064Evaluation of Arch Widths among Adults with Class I spacing and Class I Crowding Malocclusion2022-02-06T16:43:56+0530Evan. A. Clement 1, Shahul Hameed Faize .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p><strong>Objective: </strong>To test the hypothesis that there is no difference between adults with Class I spacing (CIS), Class I Crowding malocclusion (CIC). <strong>Materials and Methods: </strong>Samples of 40 class I spacing (CIS) patient models (20 male and 20 female), 40 Class I crowding (CIC) patient models (20 male and 20 female) were selected for the study. Alveolar width, Intercanine width and Intermolar width of maxillary and mandibular arches were evaluated. <strong>Results: </strong>The mean intercanine, Intermolar and the alveolar width of both the maxilla and mandibular dental arch of patients with spacing were increased when compared to patients with crowding. The mean comparision based on gender revealed that among the male patients with crowding showed an increased intercanin, Intermolar and an increase alveolar width when compared to female with crowding in both maxillary and madibular arch. Among the individual with spacing female patients had an increased maxillary intermolar width and increased alveolar width of both maxillary and mandibular dentition when compared to Male patients with spacing. <strong>Conclusion</strong>: The results of this study suggest that patient models with Class I skeletal and dental Spacing showed an increase in the arch width when compared to Class I skeletal and dental Crowding patient models.</p></td></tr></tbody></table>2022-02-06T16:43:56+0530Copyright (c) 2022 Evan. A. Clement 1, Shahul Hameed Faize .http://www.ejournal-tnmgrmu.ac.in/index.php/surgery/article/view/19068Evaluation of the Effect of Acidic Beverages on the Surface Roughness of Glass Ionomer Cement- An In-Vitro Study2022-02-06T16:43:57+0530Arjun Thomas1, Joyson Moses2, Arul Pari2 .library@tnmgrmu.ac.in<table border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="402"><p>Context: Glass Ionomer Cement (GIC) plays a very major role in paediatric dentistry due to its fluoride releasing properties and cost effectiveness. Factors that cause surface changes on enamel can similarly influence certain properties of the restoration. This clinically jeopardizes the life of the restoration, as the ultimate success of the restorative material is indicated by its longevity in the oral cavity. One such vulnerability is the surface erosion of restorative cement by acidic beverages.</p><p> </p><p>Aims: To evaluate the effect of 4 commonly consumed beverages on the surface integrity of Glass ionomer cement.</p><p> </p><p>Settings and Design: GIC pellets of three brands were made and exposed to acidic beverages for two intervals of 5 mins and 25 mins.</p><p> </p><p>Material and Methods: Control samples were evaluated using surface profilometry to get base values and Scanning Electron Microscope (SEM) imaging as an adjuvant. Test samples were also subject to profilometry and SEM imaging after exposure to acidic beverages.</p><p> </p><p>Statistical analysis used: One-way ANOVA was applied and SPSS version 22.0 was used to analyse the data. Significance level was fixed as 5% (α = 0.05).</p><p> </p><p>Results: Test samples showed increased surface roughness when compared to base samples with erosion directly proportional to exposure time. Non-coloured </p><p> </p><p>carbonated beverage showed more erosive potential at short duration whereas natural fruit juice showed increased erosion at longer duration.</p><p> </p><p>Conclusions: Post restorative protection along with diet control needs to be practised as an essential step to maintain the longevity of GIC.</p><p> </p></td></tr></tbody></table>2022-02-06T16:43:57+0530Copyright (c) 2022 Arjun Thomas1, Joyson Moses2, Arul Pari2 .