RESUMEN
Venous thromboembolism (VTE) is the most common preventable cause of hospital death. Several audits in the west have demonstrated that appropriate thromboprophylaxis is not being offered to a large number of surgical patients. Similar audits are lacking in the Indian population, and a perception exists among Indian surgeons that Indian patients are not susceptible to VTE. Hence we undertook a survey to analyze the existing knowledge and practice of VTE prophylaxis amongst general surgeons in India. A questionnaire-based survey was conducted on 100 active general surgeons. We found that 97% of surgeons had encountered VTE in their practice, and 49% had encountered mortality from pulmonary embolism. 64% of surgeons do not routinely score patients preoperatively for their VTE risk, and only 33% reported the presence of an institute-based protocol for the same. There was a wide disparity in the prophylaxis methods used for each risk group, particularly in the moderate-risk group. These findings suggest the need for adoption of institute-based protocols for prophylaxis and the evolution of Indian guidelines for VTE prophylaxis.
RESUMEN
Sebaceous carcinoma is a highly aggressive, potentially lethal tumour arising from the sebaceous glands in the skin. It accounts for 3.2 % of all malignant skin tumours. An advanced case of sebaceous carcinoma with distant metastasis is very rare as most of them present in the periocular area and are easily visible. We present an elderly woman who presented with two large fungating exophytic masses over the right parotid/orbital region and right side of neck. FNAC showed cytological features suggestive of poorly differentiated carcinoma which on histopathological exam confirmed it to be sebaceous carcinoma. Unfortunately the patient succumbed to cardiac arrest before initiation of treatment. This is the largest case of sebaceous gland carcinoma of eyelid reported in the medical literature, confirming the local aggressive behavior of the tumor and highlighting the importance of early diagnosis.