scholarly journals The Present Status of the Management of Colon and Rectal Cancer in Nigeria

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
David O. Irabor ◽  
O. Oludolapo Afuwape ◽  
Omobolaji O. Ayandipo
Keyword(s):  
Rectal Cancer ◽  
Colon Cancer ◽  
Demographic Data ◽  
Tertiary Care ◽  
Late Presentation ◽  
Resected Specimen ◽  
Rapid Progression ◽  
Care Hospital ◽  
Female Ratio ◽  
Colon And Rectal Cancer

Aim. To demonstrate the possibility of the uniqueness of colorectal cancer (CRC) in the native Nigerian by looking at the different facets of the challenges that management of this disease presents in a tertiary-care hospital in Ibadan, Nigeria. Method. A cohort study starting in 2009 where patients were seen in the out-patient’s clinic. All patients who presented with features suggestive of colon or rectal cancer were studied. Biopsies were performed to confirm CRC (especially rectal cancer); patients were then booked for admission and subsequent operation. Patients were excluded if the histopathology of a resected or biopsied mass turned out to be noncancerous or inflammatory. Demographic data like age and sex were recorded. The type of operation done, findings at surgery, and the histopathology of the resected specimen were all recorded. The time taken for the pathology department to process the biopsy and resected specimens was also recorded. Results. 120 patients with CRC were seen over the study period of 5 years (2009–2013) giving an average of 24 patients per annum. The male : female ratio was 1 : 1.14. 86 (71.7%) patients had rectal cancer while the remaining 34 (28.3%) had colon cancer. Most of the colon cancer cases were in the 51–60 age group. The rectum : colon ratio was 2.5 : 1.31% of the patients were 40 years and below. 37% of those with rectal cancer were 40 years and below. 50% of resected specimens were Duke’s B and above. 45% of patients had tumors with unfavorable grade or biology (mucinous 21.7%, signet ring 8.3%, and poorly differentiated 15%). Only 24% of patients below 40 years and 41% of those above 40 years with confirmed rectal carcinoma presented for operation. Conclusion. Advanced tumors at presentation may not always be as a result of late presentation. Unusual aggressiveness of the tumors may lead to rapid progression of the disease. Increasing incidence in younger patients makes abdominoperineal excision of the rectum difficult for such patients to accept.

Delay in time from diagnosis to treatment in metastatic melanoma, lung, and colon cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23186-e23186
Author(s):  
Muhammad Salman Faisal ◽  
Ahmed Khattab ◽  
Vida Jahangiri ◽  
Hira Shaikh ◽  
Soorih Shaikh ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Colon Cancer ◽  
Demographic Data ◽  
Tertiary Care ◽  
The United States ◽  
Definitive Treatment ◽  
Metastatic Colon Cancer ◽  
Female Ratio ◽  
Number Of Patients ◽  
Delay In Treatment

e23186 Background: Delay in cancer treatment is anxiety provoking both for the patient and clinician. We conducted the study to evaluate the patterns of delay in treatment of patients with metastatic colon cancer, lung cancer and melanoma from diagnosis to the initiation of the treatment, and to identify the causes of delay. Methods: In this retrospective study, patients with metastatic colon cancer, lung cancer and melanoma diagnosed between 01/01/2016 to 12/31/2016 in a tertiary care network in the United States were studied. Data was collected from electronic health record (EHR) database, ‘Epic’. Variables such as demographic data, including patient age and gender, and type of cancer, and treatment received were analyzed. The causes of the delay were also evaluated when available. Results: Total number of patients in the study was 288. Mean age was 68.3 years (median 69 years) and 36% were alive at the time of data analysis. Male to female ratio was 1.4:1. 66.7% people had lung cancer, 30% had colon cancer and 3% had melanoma. 67 (23.6%) of total analyzed patients had denied definitive treatment and chose to undergo palliative management. Of the rest, most started treatment with chemotherapy (39.5%), followed by surgery (22.6%) and then radiation (14.6%). With the time of pathological diagnosis of the tumor taken as the date of diagnosis, mean delay from the day of diagnosis to the start of treatment in this study population observed was 27.7 days. 67 patients (23.3%) had a delay of more than 30 days, with the most common reason being systemic factors in 39 patients (58.2%), followed by patient factors in 23 patients (34.3%) and physician factors in 5 patients (7.5%). On logistic regression analysis, time from diagnosis to treatment didn’t predict mortality (OR = 0.99, 95% CI P = 0.10(0.97-1.002). Conclusions: Delay in treatment is common and the system factors one of the common reasons as exhibited by our study. Time from diagnosis to treatment didn’t predict mortality.

SPECTRUM OF MEDICOLEGAL AUTOPSIES IN A TERTIARY CARE CENTER IN ANDAMAN AND NICOBAR ISLANDS : CAUSES AND TRENDS OVER TWO DECADES.

2021 ◽  
pp. 37-39
Author(s):  
Wajid Ali Shah ◽  
Sakshi Batra ◽  
Harsh Batra ◽  
C.P. Paul
Keyword(s):  
Human Life ◽  
Care Center ◽  
Demographic Data ◽  
Tertiary Care ◽  
Care Hospital ◽  
Andaman And Nicobar Islands ◽  
Female Ratio ◽  
Unnatural Death ◽  
Nicobar Islands ◽  
Te Material

Introduction: Deaths can be due to natural and unnatural causes. While the trend in natural deaths in an area reects the prevalent healthcare practices in an area, the pattern of unnatural deaths in an area conforms with the psychosocial, environmental and mental health. This was a retrospective study of autopsies conducted at a te Material And Methods: rtiary care hospital in Andaman and Nicobar islands over a period of 20 years from 1995-2015. The demographic data was collected from the institutional register. Record and analysis were done using MS Excel. Out of total of 3374 deaths, males Results: were 72.8% and females were 27.2%. Majority of deaths were in the productive age group of 20-39 years (46.5%). Cardiovascular deaths comprised maximum cases of natural deaths (59.8%). Hanging was the most common cause of unnatural death (25.1%) followed by RTA (17.4%). Amongst deaths due to RTA, male to female ratio was 2.5:1. However, deaths due to burns showed a higher predominance in females with female to male ratio of 6.4:1. Medicolegal Conclusion: proling of autopsy provides an important statistical measure to gauge the causes and patterns of untimely loss of human life. Analyzing these and taking imperative measures to curb the same helps in preserving human resources and contribute to country' s development.

scholarly journals Epidemiology and Treatment Outcomes of Head Injury in Bangladesh: Perspective from the Largest Tertiary Care Hospital

2021 ◽  
Author(s):  
Sukriti Das ◽  
Bipin Chaurasia ◽  
Dipankar Ghosh ◽  
Asit Chandra Sarker
Keyword(s):  
Head Injury ◽  
Road Traffic ◽  
Head Injuries ◽  
Skull Fracture ◽  
Tertiary Care ◽  
Acute Subdural Hematoma ◽  
Care Hospital ◽  
Female Ratio ◽  
Mortality And Morbidity ◽  
The Government

Abstract Background Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity. Economic impact is much worse in developing countries like Bangladesh, as victims are frequently male, productive, and breadwinners of the families. Objectives The objective of our study was to highlight the etiological pattern and distribution of varieties of head injuries in Bangladesh and give recommendations regarding how this problem can be solved or reduce to some extent at least. Methods From January 2017 to December 2019, a total of 14,552 patients presenting with head injury at emergency got admitted in Neurosurgery department of Dhaka Medical College and Hospital and were included in this study. Results The most common age group was 21 to 30 years (36%: 5,239) with a male-to-female ratio of 2.6:1. Injury was mostly caused by road traffic accident (RTA [58.3%: 8,484]), followed by fall (25%: 3,638) and history of assault (15.3%: 2,226). The common varieties of head injury were: acute extradural hematoma (AEDH [42.30%: 1,987]), skull fracture either linear or depressed (28.86%: 1,347), acute subdural hematoma (ASDH [12.30%: 574]), brain contusion (10.2%: 476), and others (6.04%: 282). Conclusion RTA is the commonest cause of TBI, and among them motor bike accident is the severe most form of TBI. AEDH is the commonest variety of head injuries. Proper steps taken by the Government, vehicle owners, and drivers, and proper referral system and prompt management in the hospital can reduce the mortality and morbidity from TBI in Bangladesh.

COMPARISON OF CLINICO-SOCIAL PROFILE OF PULMONARY AND EXTRA PULMONARY TUBERCULOSIS IN TERTIARY CARE HOSPITAL IN A RURALAREA: A RETROSPECTIVE STUDY

2021 ◽  
pp. 70-72
Author(s):  
Gaurav Santosh Nemade ◽  
Sumit Nitin Dhus ◽  
Arushi Ramesh Shetty ◽  
Neha Dhananjay Firake
Keyword(s):  
Tertiary Care ◽  
Care Hospital ◽  
Female Ratio ◽  
Extra Pulmonary Tuberculosis ◽  
Younger Age ◽  
Tobacco Addiction ◽  
History Of ◽  
Early Case ◽  
Male To Female ◽  
Clinical Characteristic

BACKGROUND AND OBJECTIVES: The burden of tuberculosis (TB) in India is the highest accounting for 26% of the global incidence. A total of 1.4 million people died from TB in 2019 (including 208 000 people with HIV). India accounts for a fourth of the global burden of TB and 29% of global mortality. Therefore, we carried out this study to compare demographic, lifestyle and clinical characteristic between pulmonary TB (PTB) and extrapulmonary TB (EPTB). MATERIALS AND METHODOLOGY:Aretrospective analysis was carried of 348 patients diagnosed in DOTS centre, Pravara Rural Hospital, Loni. Characteristics of demographic and clinical characteristics were obtained from medical case records. RESULTS:Among the 348 cases, 71.3% were PTB and 28.7% were EPTB including, pleural (36%), meningeal (27%) and lymphatic (20%) cases. The male to female ratio in PTB and EPTB are 1.99 and 1.22 respectively. EPTB was more common at younger age (<25 years). Tobacco addiction (10.9%), diabetes mellitus (4.03%), HIV positivity (12.1%) and history of contact with Tb patients (17.7%) were more likely to be associated with PTB. CONCLUSION:Increased awareness of the risk factors may facilitate early case nding and better management outcomes for these patients.

scholarly journals Halitosis: Its Aetiology and Psychosocial Impact- A Hospital Based Study

2021 ◽  
Vol 29 (2) ◽  
pp. 145-150
Author(s):  
Gopika Kalsotra ◽  
Monica Manhas ◽  
Sachin Gupta ◽  
Heemani Bhardwaj ◽  
Parmod Kalsotra ◽  
...  
Keyword(s):  
Social Life ◽  
Laryngopharyngeal Reflux ◽  
Systemic Disease ◽  
Tertiary Care ◽  
Neck Surgery ◽  
Psychosocial Impact ◽  
Care Hospital ◽  
Female Ratio ◽  
Study Results ◽  
A Prospective Study

Introduction Halitosis means bad or unpleasant odour from oral cavity. It causes embarrassment to the patients and affects their social life and communication. This study aims to find the causes of halitosis and to assess its psychosocial impact. Materials and Methods A prospective study was conducted in the department of Otorhinolaryngology and Head Neck Surgery in a tertiary care hospital. It included 165 patients, presenting to the ENT OPD with chief complains of oral malodour for at least 3 months. The patients in the age above 15 years and below 75 years, irrespective of gender, were included in the study. Results The age of the patients ranged from 15 to 75 years with a mean age of 52.24 ± 15.67 with male: female ratio of 7:10. The most common cause of halitosis in the present study included chronic rhinosinusitis (38.7%), gingivitis/periodontitis (19.39%), tonsillitis (4.84%), laryngopharyngeal reflux (2%), deep neck space infections (1.2%). In 23.56%, the halitosis was a symptom of an underlying malignancy. Conclusion Halitosis from an extra oral origin can be the sign of an underlying systemic disease or malignancy. The consultation should be done with the periodontist, ENT specialist and a physician.

scholarly journals Basal cell carcinoma- a prospective clinico epidemiological and pathological study

2017 ◽  
Vol 5 (6) ◽  
pp. 2712 ◽  
Author(s):  
V. Ammasaigoundan ◽  
V. N. S. Ahamed Shariff ◽  
A. Ramesh
Keyword(s):  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Health Workers ◽  
Tertiary Care ◽  
Malignant Tumour ◽  
Care Hospital ◽  
Female Ratio ◽  
Histological Variant ◽  
Public Health Workers

Background: Basal cell carcinoma is the most common malignant tumour of the skin worldwide. The objective was to find out the age and sex incidence of basal cell carcinoma in patients attending the outpatient department of dermatology and to find out the various clinical and histopathological features of basal cell carcinoma.Methods: It was a prospective observational study carried out in a tertiary care hospital, Chennai, Tamilnadu, India. Patients with clinical diagnosis of basal cell carcinoma were included in the study after thorough history, clinical examination, routine and special investigations like skin biopsy.Results: Out of 20 patients with basal cell carcinoma 6 were males and 14 were females with a male to female ratio of 1:2.33. Most commonly affected age group was 50-70 years (70%). Distribution of BCC in our study was confined to head and neck area. Most common morphological subtype encountered in this study was nodular/nodulo-ulcerative BCC (70%), followed by pigmented type (25%) and superficial BCC (5%). The most common histological variant observed in present study was nodular type (55%), followed by pigmented variant (25%), adenoid (5%), basisquamous (5%), superficial BCC (5%) and BCC with sebaceous differentiation (5%).Conclusions: This study highlights a paradoxically increasing trend of BCC with female predilection. Early detection and treatment of lesions are crucial to decrease the functional and cosmetic disfigurement and also this study highlights the importance of improving awareness among general practitioners, public health workers and general population.

scholarly journals An assessment of pattern of adverse drug reactions of cardiovascular drugs in a tertiary care institute

2018 ◽  
Vol 7 (2) ◽  
pp. 273 ◽  
Author(s):  
Smita Y. Wankhede ◽  
Milind L. Pardeshi ◽  
Vishal V. Ghorpade ◽  
Balasaheb B. Ghongane
Keyword(s):  
Adverse Drug Reactions ◽  
Demographic Data ◽  
Tertiary Care ◽  
Cardiovascular Drugs ◽  
Care Hospital ◽  
Drug Reactions ◽  
Microsoft Excel ◽  
Entire Study ◽  
Cardiovascular Medications ◽  
One Year

Background: Cardiovascular disease is very prevalent in India. So, use of cardiovascular drugs is also more. So, it is very important to keep watch on adverse drug reactions. Aim of this study was to assess the pattern of adverse drug reactions (ADRs) reported with cardiovascular drugs in a tertiary care institute.Methods: The study was carried out in medicine department of a tertiary care hospital over a period of one year. Each ADR was analysed for demographic data, causality, relationship between frequency of ADRs and the number of drugs used etc. In statistical analysis Microsoft excel 2013, SPSS software was used.Results: A total of 136 patients, 58 (43%) men and 78 (57%) women, using cardiovascular medications reported ADRs during the entire study period. Total 168 ADRs were reported out of which, Amlodipine (causing headache and edema feet) was the most common drug with 51 (30.3%) ADR’s followed by Enalapril, Aspirin and Isosorbide Dinitrate with 37 (22%), 24 (14.2%), 23 (13.6%) ADRs respectively. Most common ADR was headache (due to amlodipine and Isosorbide di nitrate) affecting 38 (22.62%) cases followed by dry cough 37 (22.02%) cases, edema feet 36 (21.43%), gastritis 24 (14.29%) and 10 (5.95%) of nausea.Conclusions: Monitoring ADRs in patients using cardiovascular drugs is a matter of importance since this class of medicines are mostly used as multidrug therapy and always prone for ADRs.

scholarly journals Palonosetron for the prevention of chemotherapy induced nausea and vomiting: a comparative study in a tertiary care hospital from India

2019 ◽  
Vol 8 (10) ◽  
pp. 2197
Author(s):  
Shubhatara Swamy ◽  
Vijaya Rajendran ◽  
Durga Prasan ◽  
Pratibha Nadig
Keyword(s):  
Tertiary Care ◽  
Nausea And Vomiting ◽  
Research Centre ◽  
Care Hospital ◽  
Serious Adverse Events ◽  
Female Ratio ◽  
First Line Therapy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Despite advances in symptom management, chemotherapy-induced nausea and vomiting (CINV) remains one of the most dreadful consequences of cancer therapy.Methods: The study was carried out at Medical Oncology Department, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Hundred and forty-four cancer patients of either sex, aged 18-65 years with adequate blood counts requiring moderately emetogenic chemotherapy (MEC) as per Hesketh classification were included. The patients were prospectively divided into two groups before the initial cycle of chemotherapy. Patients in Group A (n=71) received ondansetron, and dexamethasone along with aprepitant capsules, Whereas, Group B (n=73) received palonosetron, and dexamethasone along with placebo capsules, 30 minutes before chemotherapy. Thereafter the patients were administered with the drugs and observed for nausea and vomiting. The efficiency of both regimens was assessed by adopting validated functional living index emesis (FLIE) questionnaire. Analysis of the data was done using the SPSS 21.0 software.Results: The mean age of the patients was 40.5 years and the male to female ratio was 1:2.4. In all the patients, no changes were detected in the ECG readings after MEC. The nausea and vomiting score were comparable in both groups. No significant difference (p>0.05) was noticed between group A and group B in both mm and in FLIE points. No serious adverse events were found relating to antiemetic treatment.Conclusions: Palonosetron in combination with corticosteroids was non inferior to ondansetron in combination with aprepitant and corticosteroids in controlling acute and delayed stages of CINV in patients requiring MEC. Thus, it can be recommended as first-line therapy for patients treated with MEC.

scholarly journals Dengue Fever : Study of 100 Cases in a Tertiary Care Hospital in Dhaka City

2015 ◽  
Vol 24 (Number 1) ◽  
pp. 3-7
Author(s):  
A H M Karnal ◽  
K H Mollah ◽  
A Begum ◽  
K Khoda ◽  
S Tanzeem ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Tertiary Care ◽  
Hemorrhagic Fever ◽  
Viral Disease ◽  
Care Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Male To Female ◽  
Body Ache

Dengue is a rapidly spreading mosquito-borne viral disease worldwide. The endemicity in Bangladesh is also increasing gradually. The study was a prospective observational one, documented the presenting features and outcome of management. It was carried out in Department of Medicine in Holy Family Red Crescent Medical College Hospital, Dhaka from June 2013 to December 2013. Total 100 admitted cases of both sera positive and sera-negative were included in this study. Detailed history was taken, clinical examination and relevant investigations were done. Out of 100 patients 54 (54%) were male and 46 (46%) were female. So male to female ratio was 1.7:1. The age of the patients ranged from 12-75 years. Among them 20-40 years age group was highest 63%. Patients of higher socio-economic group were (69%) more affected. Out of 100 cases 54 had classical dengue fever (DF), 46 had dengue hemorrhagic fever (DHF). Antibody was positive in 81% cases. All patients presented with high fever, headache in 90%, retro-orbital pain in 45%, body ache in 56%, and backache in 48%. Leucopenia found in 60, platelet count <100x1091L was in 57, HCT- normal 17, <20% rise in 48%, ?20% rise in 28%. With proper management all patients were recovered.

scholarly journals Solitary thyroid nodule: an overview of one year study at a tertiary care hospital

2019 ◽  
Vol 6 (9) ◽  
pp. 3117
Author(s):  
Shyam Sundar Tandri ◽  
Ayathu V. S. Sai Mahesh
Keyword(s):  
Thyroid Nodule ◽  
Tertiary Care Hospital ◽  
Demographic Data ◽  
Tertiary Care ◽  
Common Finding ◽  
Clinical Approach ◽  
Care Hospital ◽  
Cross Sectional ◽  
Solitary Thyroid Nodule ◽  
One Year

Background: Thyroid nodules are a common finding in general practice. These nodules are either solitary or multinodular. In the present study thorough evaluation of all the cases presenting with a solitary thyroid nodule (STN) is done. The clear overview of prevalence of STN, associated risk factors, its distribution and its percentage of malignancy, clinic-pathological correlation and findings on ultra-sonogram.Methods: A one year cross sectional study at a tertiary care hospital was done after ethical committee approval. All cases of thyroid with solitary thyroid nodule were included and socio demographic data, clinical examination and USG data was noted. Thyroid hormone profile, FNAC and HPE was performed for every case enrolled and data was noted. The data was analyzed using SPSS version 22.Results: 350 cases were enrolled with 44.42% prevalence and 61.43% were females. Maximum age group was 31-40 years with swelling as the most common sign. 81.14% were euthyroid, 6.3% of cases had lymph node involvement. Micro calcification in 69.7% of nodules and 78.65 were solid. 40.3% of the STN were of colloid on FNAC and 6% were malignant. Malignancy on HPE was 14.6% and papillary carcinoma was the most commonest and follicular least.Conclusions: All cases of STN require a thorough clinical approach supported by ultra-sonogram, FNAC and detailed HPE after surgery for evaluation of benign and malignant lesions. Fine needle aspiration cytology has become an invaluable, minimally invasive and reliable tool in the preoperative assessment of patients with suspicion of malignancy.

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