Seroma Formation after Breast Cancer Surgery: What We Have Learned in the Last Two Decades

Vivek Srivastava,Somprakas Basu,Vijay Kumar Shukla 한국유방암학회 2012 Journal of breast cancer Vol.15 No.4

Formation of a seroma most frequently occurs after mastectomy and axillary surgery. Prolonged drainage is troublesome as it increases the risk for infection and can significantly delay adjuvant therapy. Seroma has been defined as serous fluid collection under the skin flaps or in the axillary dead space following mastectomy and/or axillary dissection. Because the true etiology of a seroma is unknown, a multifactorial-causation hypothesis has been accepted. Surgical factors include technique, extent of dissection and the surgical devices used for dissection. Obliteration of dead space with various flap fixation techniques, use of sclerosants, fibrin glue and sealants, octreotide, and pressure garments have been attempted with conflicting results and none have been consistent. Early movement of the shoulder during the postoperative period may increase the formation of seroma, although delayed physiotherapy decreases the formation of seroma. A detailed analysis of the use of drains showed that use of single or multiple drains, early or late removal, and drains with or without suction are not significantly different for the incidence of seroma. Although there is evidence for reduced seroma formation after early drain removal, very early removal within 24 hours seems to increase formation of seroma. No patient or tumor factors seem to affect seroma formation except body mass index and body weight. Consensus is lacking among studies/trials with different groups producing conflicting evidence. Besides a few established factors such as body mass index, the use of electrocautery for dissection, early drain removal, low vacuum drains, obliteration of dead space, and delayed shoulder physiotherapy, most of the hypothesized causes have not been demonstrated consistently. Thus, seroma remains a threat to both the patient and surgeon. Recurrent transcutaneous aspiration remains the only successful management.

Hydrometallurgical recovery of critical metals from an incinerated fly ash of municipal solid waste from western India

Desai Yuti,Srivastava Rajiv Ranjan,Srivastava Vijay Kumar,Kaushik Geetanjali,Singh Vinay Kumar 한국자원공학회 2023 Geosystem engineering Vol.26 No.5

The global generation of 2.2 billion tons of municipal solid waste (MSW) as a result of population growth, rapid urbanization, and industrial development has highlighted an urgent need for MSW management. Incineration is widely accepted as one alternative to landfilling; however, the recovery of heavy metals from the incinerated fly ash (IFA) before its final disposal is highly desirable to make the process sustainable. In this study, we studied the recovery of zinc and lead from typical MSW-IFA employing hydrometallurgical techniques. Sulfuric acid leaching was performed to selectively leach out zinc over the lead at the optimal condition of H2SO4 concentration = 1.5 M, temperature = 30°C, S/L ratio = 150 g/L, time = 2 h, and stirring speed = 300 rpm. The sulfate leach liquor was treated with a 5% stoichiometric excess of oxalic acid to precipitate>99% of zinc to be recovered as ZnC2O4·2 H2O. Further, the remaining lead in leach residue was subsequently leached in 50 g/L NaCl solution for 2 h yielded>94% efficiency. The dissolved lead was crystallized to recover the crystals of PbCl2. The demonstrated process leads towards the recovery of critical metals from an alternative source of MSW-IFA.

Municipal solid waste management in India - Current status, management practices, models, impacts, limitations, and challenges in future

Jagriti Patel,Sanskriti Mujumdar,Vijay Kumar Srivastava Techno-Press 2023 Advances in environmental research Vol.12 No.2

Pollution, climate change, and waste accumulation are only some of the new problems that have arisen because of the exponential population growth of the past few decades. As the global population expands, managing municipal solid trash becomes increasingly difficult. This is by far the most difficult obstacle for governments to overcome, especially in less developed nations. The improper open dumping of trash, which is causing mayhem across the country, has two immediate effects: it contaminates groundwater and surface water. Air pollution and the accumulation of greenhouse gases are both exacerbated by the release of methane and other harmful waste gases. Leachate from the landfill leaks underground and pollutes groundwater. In most cases, leachate moves into the groundwater zone and pollutes it after forming in association with precipitation that infiltrates via waste. This has far-reaching effects on people's health and disturbs the natural environment. This review article critically examines the current state of Solid Waste Management (SWM), addressing both the highlighted concerns and the government management solutions that have been put in place to address these issues. In addition, the constraints, and difficulties that India will face in the future in terms of solid waste management and the role of models for such a system are discussed.

Microwave-Assisted Synthesis of Boron and Nitrogen co-doped Reduced Graphene Oxide for the Protection of Electromagnetic Radiation in Ku-Band

Umrao, Sima,Gupta, Tejendra K.,Kumar, Shiv,Singh, Vijay K.,Sultania, Manish K.,Jung, Jung Hwan,Oh, Il-Kwon,Srivastava, Anchal American Chemical Society 2015 ACS APPLIED MATERIALS & INTERFACES Vol.7 No.35

<P>The electromagnetic interference (EMI) shielding of reduced graphene oxide (MRG), B-doped MRG (BMRG), N-doped MRG (N-MRG), and B-N co-doped MRG (B-N-MRG) have been studied in the Ku-band frequency range (12.8-18 GHz). We have developed a green, fast, and cost-effective microwave assisted route for synthesis of doped MRG. B-N-MRG shows high electrical conductivity in comparison to MRG, B-MRG and N-MRG, which results better electromagnetic interference (EMI) shielding ability. The co-doping of B and N significantly enhances the electrical conductivity of MRG from 21.4 to 124.4 Sm-1 because N introduces electrons and B provides holes in the system and may form a nanojunction inside the material. Their temperature-dependent electrical conductivity follows 2D-variable range hopping (2D-VRH) and Efros-Shldovskii-VRH (ES-VRH) conduction model in a low temperature range (T < 50 K). The spatial configuration of MRG after doping of B and N enhances the space charge polarization, natural resonance, dielectric polarization, and trapping of EM waves by internal reflection leading to a high EMI shielding of -42 dB (-99.99% attenuation) compared to undoped MR.G (-28 dB) at a critical thickness of 1.2 mm. Results suggest that the B-N-MRG has great potential as a candidate for a new type of EMI shielding material useful in aircraft, defense industries, communication systems, and stealth technology.</P>

Expression Levels of Tetraspanin KAI1/CD82 in Breast Cancers in North Indian Females

Singh, Richa,Bhatt, Madan Lal Brahma,Singh, Saurabh Pratap,Kumar, Vijay,Goel, Madhu Mati,Mishra, Durga Prasad,Srivastava, Kirti,Kumar, Rajendra Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.7

Background: Carcinogenesis is a multifaceted intricate cellular mechanism of transformation of the normal functions of a cell into neoplastic alterations. Metastasis may result in failure of conventional treatment and death Hence, research on metastatic suppressors in cancer is a high priority. The metastatic suppressor gene CD82, also known as KAI1, is a member of the transmembrane 4 superfamily which was first identified in carcinoma of prostate. Little work has been done on this gene in breast cancer. Herein, we aimed to determine the gene and protein level expression of CD82/KAI1 in breast cancer and its role as a prognosticator. Materials and Methods: In this study, 83 histologically proven cases of breast cancer and a similar number of controls were included. Patient age ranged from 18-70 years. Quantitative Real Time Polymerase Chain Reaction (q-RT PCR) and immunohistochemistry (IHC) were used to investigate KAI1 expression at gene and protein levels, respectively. Statistical analysis was done to correlate expression of KAI1 and clinicopathological parameters. Results: It was revealed that: (i) KAI1 was remarkably diminished in metastatic vs non metastatic breast cancer both at the gene and the protein levels (P < .05); (ii) KAI1 expression levels were strongly correlated with TNM staging, histological grade and advanced stage (p<0.001) and no association was found with any other studied parameter; (iii) Lastly, a significant correlation was observed between expression of KAI1 and overall median survival of BC patients (P = 0.04). Conclusions: Our results suggest that lack of expression of the KAI1 might indicate a more aggressive form of breast cancer. Loss of KAI1 may be considered a significant prognostic marker in predicting metastatic manifestation. When evaluated along with the clinical and pathological factors, KAI1 expression may be beneficial to tailor aggressive therapeutic strategies for such patients.