SCIENTIFIC STUDY OF VITAP MARMA

Marma is a vital point of the body where trauma or injury may cause a various range of signs and symptoms from Ruja (pain) to even death. Ayurvedic Acharya’s has explained 107 Marma” that are present in the anterior and posterior aspect of the human body. Depending upon the effect of injury on Marma is five types like Sadhyo pranhara, Kalantara pranhara, Vishlyaghna, Vaikalykara & Rujakara Marma. Out of them, Vaikalykar Marma are the points where an injury causes structural or functional deformity. Another type of classification of Marma has also been made as Mamsa (muscle) marma, Sira (artery/vein) marma, Snayu (ligament) marma, Asthi (bone) marma and Sandhi (joint) marma. The Vitap Marma is placed under the Snayu Marma by Acharya Sushrut and Sira Marma by Acharya Vaghbhata. Vitap Marma is situated between Vankshan (Groin) and Vrishna (Testes) and the Viddha lakshan (symptoms of trauma) is Shandata (impotency) and Alpashukrata (oligospermia). The struc- ture present at this point is the inguinal canal. The clinical importance of the inguinal canal is related to the inguinal hernia. Direct or indirect Injury at this particular point affects the physiology of the reproductive system and may cause sterility, which is similar to Viddha lakshan of Vitap marma as described by Sushrut. Keywords: Vitap marma, Vaikalyakar marma, Inguinal canal, Spermatic cord, round ligament

Tufts of microfilarial worms in cytological aspirate of spermatic cord: A rare case presentation

Filariasis is a major health problem in many tropical countries including India. Most commonly affected organs are lymphatics of lower limbs, retroperitoneal tissue, spermatic cord, epididymis and breast. Despite high incidence, it is infrequent to find microfilariae in fine needle aspiration cytology smears and body fluids. Microfilaremia is usually detected in blood or skin specimens. Cytological examination with FNAC is an investigation of choice especially in patients with evident swelling with difficult clinical diagnosis. We present a case of spermatic cord microfilariasis in a 32 years male presented with right scrotal swelling with dancing filarial sign on ultrasonograpghy, while the peripheral blood smear was negative for the organism.

HISTOPATHOLOGICAL DIAGNOSTICS OF TESTICULAR SERTOLI CELL TUMOR IN INGUINAL CRYPTORCHIDISM

The research was carried out in the Interdepartmental Scientific Veterinary Center of Veterinary Medicine based in the Ulyanovsk State Agricultural University. We studied the testis tumor - sertoli cell tumor, according to histological classification, in a male dog with inguinal cryptorchidism. The research goal was to study possible changes in the differentiation, hormonal and metastatic activity of sertoli cell tumor in case of inguinal cryptorchidism in comparison with this type of tumor in physiologically located testes, described in literature. The clinical examination revealed the presence of left-sided inguinal cryptorchidism as well as signs of hyperestrogenism: hyperpigmentation and non-inflammatory alopecia of scrotum, prepuce, located sym-metrically in the right and left iliac regions of the abdomen. The studied neoplasm showed the presence of a dense capsule, the absence of infiltrative growth and metastases in the regional lymph nodes, distinct secretory activity. Fragments of tumor tissue from the testis, epididymis and spermatic cord were obtained for histological examination by the means of excisional biopsy. As a result, the neo-plasm was found to be a sertoli cell tumor of a high degree of differentiation. The tissues of the epididymis showed a significant thickening of the stroma due to the proliferation of connective tissue - a sign of severe sclerosis. The mi-croslides of the spermatic cord and epididymis did not show any signs of infiltrative growth or metastatic spread of tumor cells which meant that the relative benign quality of sertoli cell tumor was found in this clinical study of inguinal cryptorchidism.

Method of internal drainage of seroma after hernioplasty

A method for allohernioplasty of indirect inguinal hernia has been developed, in which an additional layer consisting of the peritoneum of the hernial sac is formed between the spermatic cord and the mesh. The peritoneal flap prevents direct contact between the mesh and the spermatic cord and ensures rapid absorption of inflammatory serous fluid. The manifestations of implant-associate inflammation of the spermatic cord and persistent seromas decrease in the tissues. The method was applied in 25 patients in the period from 2017 to 2021.

Metastasis to spermatic cord from carcinoma prostate: A case series

Despite the high incidence of secondaries to lymph nodes, bones, and lungs in carcinoma (CA) prostate, metastatic involvement of scrotal organs is rare and usually associated with a poor prognosis. Here, we report a case series of three cases of CA prostate with metastatic involvement of scrotal organs. All three patients had metastatic involvement of the spermatic cord, with involvement of epididymis in the first patient and testes in the third patient, revealed incidentally on orchiectomy. Two patients were also found to have coexisting lymphatic filariasis. To date as per the best of our knowledge, only one such case of CA prostate with metastasis to scrotal organs and associated filariasis has been reported. This highlights the need for histopathological evaluation of all orchiectomy specimens. Chronic infection and inflammation leading to lymphatic obstruction due to filariasis probably led to the unusual retrograde spread of the tumor.

P144 SPERMATIC CORD LIPOSARCOMA - A VERY RARE FINDING DURING INGUINAL HERNIA SURGERY

Aim Repair of inguinal hernia is one of the most common operations in general surgery in industrialized countries. Isolated spermatic cord liposarcoma is a very rare soft tissue tumor. Despite standardized diagnostic algorithms for inguinal hernia, it could be difficult to predict such a rare finding. Material and Methods We report a case of inadvertent inguinal liposarcoma excision during hernia surgery in a 72-year-old male patient. Except for polyposis coli there were no further illnesses. Results After a minimal invasive transabdominal preperitoneal (TAPP) repair of a symptomatic inguinal hernia last year a persistent scrotal swelling developed. Computed tomography (CT) showed a protrusion of fatty tissue into the scrotal sac. Diagnosis of scrotal hernia was made. We performed an open Lichtenstein procedure. The final pathologic examination revealed a highly differentiated liposarcoma. Staging was completed and the case was presented to a multidisciplinary sarcoma tumor board at our institution. As recommended, a inguinal reoperation was performed with wide excision. Conclusions Although a very rare condition, spermatic cord liposarcoma should be considered as a possible differential diagnosis for inguinal hernia surgery.