Juniper Publishers-Open Access Journal of Surgery

  Journal of Surgery -  JuniperPublishers Dear Editor, Communication, especially delivery of difficult news (DDN), remains a key part of clinical practice. Despite its importance, many medical providers lack the skill and ability to effectively DDN to their patients. Due to lack of data specific to sub-Saharan Africa and to help us develop an appropriate training tool for this geographical area, we sought to explore what challenges and barriers residents at our institution faced when they deliver difficult news to their patients. Methodology A qualitative approach using thematic analysis was adopted and a self-administered open ended survey was administered amongst residents currently doing their Masters in Medicine at the Aga Khan University Hospital in Nairobi and Dar es Salaam. The survey was emailed to all the residents within the two campuses using the REDCap software. Two independent researchers identified rec...

  Journal of Surgery -  JuniperPublishers  In breast cancer great endeavors are going on to find new markers in determining the prognosis. In addition to well-known prognostic factors such as tumour size, grade, nodal status, molecular subtype, proliferation index, gene-expression based recurrence score, recently there is increasing evidence that tumor-infiltrating lymphocytes (TILs) are of important role as an immune biomarker in breast carcinoma [1-3]. TILs might be a reflection of host immune response which plays an important role in cancer control and patient’s clinical outcome. TILs are mononuclear immune cells that infiltrate tumour tissue and mainly comprised of cytotoxic (CD8+) T cells as well as macrophages, helper (CD4+) T cells, B cells, and NK cells [4,5]. There are two types of TILs: Stromal TILs (sTILs) are defined as the percentage of tumour stromal field in which lymphocytes are located without direct connection to tumour cells. In contrast, i...

  Journal of Surgery -  JuniperPublishers Abstract Introduction:  During laparoscopic total extra-peritoneal pre peritoneal (TEPP) hernioplasty for inguinal hernia, posterior epimysium of rectus abdominis muscle was studied, and the novel observations hitherto unreported in literature are presented herein. Materials and methods:  A prospective study was conducted in adult patients of inguinal hernia who underwent Laparoscopic Total Extra-Peritoneal Pre-Peritoneal hernioplasty under the ethical clearance and informed consent. Standard 3-midline port technique was utilized. Initial access dissection in posterior rectus canal was performed with unhurried to-and-fro movements of the 0º 10-mm telescopic for careful observation of undersurface of rectus abdominis. Results:  A total of 68 hernioplasties (Unilateral 52, and Bilateral 8) was performed in 60 adult male patients with primary inguinal hernia. Mean age and BMI were 50.08±17.15 years (Range 18-80 years) and 2...

  Journal of Surgery -  JuniperPublishers Abstract Nanotechnology is a novel scientific advancement with potentially breath-taking applications across various fields of medical sciences. Brain and spinal surgeries are potential fields where this technology may revolutionize the management and meliorate the outcome. This article reviews the possible applications of the miniscule nano-particles in the field of Spine Surgery. Go to Introduction Spinal pathologies, which do not respond to conservative management, are traditionally managed with spinal surgeries. While surgical procedures are considered to be the best solutions to spinal ailments, operative interventions alone cannot be the answer to a number of subtler pathologies involving the fine neural elements [1]. Interventions causing alterations at the cellular and subcellular levels of the neural tissues are feasible today; and nanotechnology is one such unique scientific venture which holds a potentially huge prospect in ...

  Journal of Surgery -  JuniperPublishers Abstract Follicular variant of papillary carcinoma of thyroid (FVPTC) constitutes approximately 10% of papillary carcinoma of thyroid. Classic papillary carcinoma of thyroid (PTC) and the follicular variant of PTC have similar prognostic implications. The encapsulated follicular variant of PTC is usually quite indolent with an excellent prognosis. We report herein a case of a right follicular variant of papillary carcinoma thyroid with right submandibular lymph node metastasis. The diagnosis of follicular variant of papillary carcinoma of thyroid was made after histopathological examination of specimen after surgery. Go to Introduction Follicular variant of papillary carcinoma of thyroid (FVPTC) whether invasive or not, behaves like usual PTC, with multiple tumor foci in the gland in many cases, lymphatic invasion and nodal metastases, and rare hematogenous spread [1,2]. FVPTC is defined by the presence of tumor cells arranged almost e...