High risk histopathological factors in retinoblastoma in upfront enucleated eyes: An experience from a tertiary care centre of Pakistan

2021 ◽  
Vol 38 (ICON-2022) ◽  
Author(s):  
Nausheen Yaqoob ◽  
Salima Mansoor ◽  
Kanwal Aftab ◽  
Bushra Kaleem ◽  
Ahmer Hamid ◽  
...  
Keyword(s):  
Risk Factors ◽  
Optic Nerve ◽  
High Risk ◽  
Anterior Chamber ◽  
Tertiary Care ◽  
Histologic Grade ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
High Risk Factors ◽  
Pathologic Staging

Background & Objectives: The assessment of histopathological risk factors (HRFs) in retinoblastoma in upfront enucleated eyes is important in deciding treatment protocols. Limited data is available from the developing countries as very few studies were conducted on retinoblastoma. The study aims to report this data from Pakistan. Methods: This cross-sectional study included treatment naïve retinoblastoma patients who underwent upfront enucleation between 2017 to 2021. Various tumor characteristics i.e. laterality, size, histologic grade, anaplasia grade, growth pattern, extent and length of optic nerve invasion, pathologic staging, tumor involvement of ocular structures were assessed. High-risk factors such as involvement of anterior chamber, choroidal, scleral, extrascleral, and optic nerve were also noted. Results: A total number of 54 patients were enrolled, out of which 53.7% were females while remaining were males. Median age at presentation was 24 months. Unilateral tumor was seen in 92.6% cases. Most frequent histologic grade was G2 (64.7%) and moderate anaplasia was observed in 59.2% cases. Vitreous involvement was seen in (86.5%). Pathologic staging of most of the tumors was pT1 (39.2%). Assessment of high-risk factors revealed that optic nerve involvement (35.1%) was the most common finding with retrolaminar tumor invasion seen in 75% cases. Choroidal invasion (≤3mm) was seen in 55.6% of patients. Limited involvement of anterior chamber (3.8%), sclera (7.4%), and extrascleral (3.8%) tissue was also observed. Conclusion: The presence of high risk histopathological factors in enucleated eyes diagnosed with retinoblastoma are known to have a profound impact on the risk stratification as well as decision of future treatment plan. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5787 How to cite this:Yaqoob N, Mansoor S, Aftab K, Kaleem B, Hamid A, Jamal S. High risk histopathological factors in retinoblastoma in upfront enucleated eyes: An experience from a tertiary care centre of Pakistan. Pak J Med Sci. 2022;38(2):369-374.  doi: https://doi.org/10.12669/pjms.38.ICON-2022.5787 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Screening for Hearing Impairment in High-Risk Neonates in a Tertiary Care Centre in Central Kerala

2020 ◽  
Vol 7 (49) ◽  
pp. 2959-2963
Author(s):  
Maina J ◽  
Rati Santhakumar ◽  
Manoj V.C. ◽  
Mridula Vellore
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Hearing Impairment ◽  
Otoacoustic Emissions ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Auditory Rehabilitation ◽  
History Of ◽  
Evoked Response Audiometry

BACKGROUND Hearing loss is a chronic condition, and many cases can be detected in the neonatal period. Recognizing it early is of crucial importance as early auditory rehabilitation would help in child’s comprehensive development. We wanted to assess the prevalence of hearing impairment among high risk newborns admitted to inborn unit of tertiary care centre in Central Kerala and screen for the associated risk factors in these newborns. METHODS Thousand consecutive inborn neonates from Neonatal ICU, Department of Paediatrics, tertiary care centre in Thrissur, Kerala, detected as high risk by Joint Committee on Infant Hearing (JCIH) criteria were enrolled for the study from December 2011 to November 2012 after the approval by Institute’s Ethics Review Board. Risk factor assessment was done before enrolment. A qualified audiologist conducted the test on babies in soundproof chamber. DPOAEs (Distortion Product Otoacoustic Emissions) were used for initial testing after checking ears for debris. Those who failed in the first test were asked to come for a retest after 2 weeks. Those who failed in the retest were asked to report for Brainstem Evoked Response Audiometry (BERA). Those who were diagnosed as having hearing impairment were advised auditory rehabilitation as well as auditory verbal therapy. RESULTS Of the 1000 eligible neonates born in our hospital during the study period (December 2011 to November 2012) 69 were lost to follow up. Among the remaining 931 babies the frequency of hearing impairment was 0.8 %. Among the 931 neonates, 130 had absent response with the first OAE test contributing to 13.9 %. Twenty-one neonates had absent response to second OAE test out of 130 contributing to 16.1 %. The failure rate for second test is 2.2 % of the total population of 931 newborns. Eight of the 21 neonates who were subjected to BERA had severe hearing loss. The prevalence of hearing impairment was 8 per 1000. CONCLUSIONS The prevalence (percentage) of hearing impairment by two staged screening protocol is 0.8 %. Risk factors which were present in these babies were prematurity, low birth weight, low Apgar score, history of exanthematous fever in mother, neonatal jaundice, ototoxic medication history, craniofacial anomalies, and family history of deafness, meningitis and mechanical ventilation. KEYWORDS Otoacoustic Emissions, Brain Stem Evoked Response Audiometry, Risk Factors, Hearing Impairment, Neonates

scholarly journals Clinical profile and risk factors for mortality among COVID-19 inpatients at a tertiary care centre in Bengaluru, India

2021 ◽  
Author(s):  
Yamini Marimuthu ◽  
Radhika Kunnavil ◽  
NS Anil ◽  
Sharath Burugina Nagaraja ◽  
N Satyanarayana ◽  
...  
Keyword(s):  
Risk Factors ◽  
South India ◽  
Linear Models ◽  
Tertiary Care ◽  
Male Gender ◽  
Clinical Profile ◽  
Rank Test ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre

COVID-19 is an emerging viral disease affecting more than 200 countries worldwide and it present with varied clinical profile throughout the world. Without effective drugs to cure COVID-19, early identification and control of risk factors are important measures to combat COVID-19.  This study was conducted to determine the clinical profile and risk factors associated with mortality among COVID-19 patients in a tertiary care hospital in South India. This record-based longitudinal study was conducted by reviewing the case records of COVID-19 patients admitted for treatment from June 2020 to September 2020 in a tertiary care centre in South India. The clinical details, discharge/death details, were collected and entered in MS Excel. Potential risk factors for COVID-19 mortality were analysed using univariate binomial logistic regression, generalized linear models (GLM) with Poisson distribution. Survival curves were made using the Kaplan-Meier method. Log-rank test was used to test the equality of survivor functions between the groups. Out of 854 COVID-19 patients, 56.6% were men and the mean (standard deviation) age was 45.3(17.2) years. The median survival time was significantly lesser in male COVID-19 patients (16 days) as compared to female patients (20 days). Increasing age, male gender, patients presenting with symptoms of fever, cough, breathlessness, smoking, alcohol consumption, comorbidities were significantly associated with mortality among COVID-19 patients. Patients with older age, male gender, breathlessness, fever, cough, smoking and alcohol and comorbidities need careful observation and early intervention.  Public health campaigns aimed at reducing the prevalence of risk factors like diabetes, hypertension, smoking and alcohol use are also needed.

scholarly journals Evaluation of Risk Factors for Retinopathy of Prematurity in Premature Born Infants in Tertiary Care Centre in Punjab

2020 ◽  
Vol 9 (1) ◽  
pp. 1-5
Author(s):  
Jatinder Singh ◽  
Vaneeta Bhardwar ◽  
Harshdhawann Singh ◽  
Isha Bhardwaj ◽  
Sushmita Choudhary ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retinopathy Of Prematurity ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Premature Born

scholarly journals Ectopic pregnancy: an observational study in a tertiary care centre of Southern Rajasthan, India

2020 ◽  
Vol 9 (2) ◽  
pp. 516
Author(s):  
Shrusti Parmar ◽  
Nalini Sharma ◽  
Vimla Dhakar
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
First Trimester ◽  
Treatment Modalities ◽  
Public Health Issue ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Early Presentation

Background: One among the three chief obstetric causes of bleeding in first trimester, ectopic pregnancy is the first thing to rule out as a gestation is suspected. The present study observes and analyses sociodemographic distribution, risk factors, presentation, diagnosis and treatment modalities in a tertiary care centre.Methods: An observational cross-sectional study, conducted among patients who were diagnosed and managed in department of obstetrics and gynaecology of a tertiary care centre. Data analyzed and explained as frequency, percentage, mean and standard deviation.Results: Age group between 21 to 30 years (69.9%) and multigravida (68.5%) are high risk for ectopic pregnancy (EP). Menstrual history was regular in 86.3%. Risk factors identified were previous abortion (30%) and history of pelvic inflammatory disease (30%). In 80.9% pain in abdomen was presenting complaints followed by bleeding per vaginum (60%), amenorrhoea (60%) and nausea and vomiting (32.9%). Right salpingectomy was most common in 43.8%, followed by left salpingectomy in 28.8%, methotrexate in 15.1%, left salpingo-ophorectomy in 5.5%, right salpingo-opherectomy in 5.5% and removal of tubal abortion in 1.3% patients. Laparoscopy was chosen route in majority 64.4% patients.Conclusions: Ectopic pregnancy - a gynecological catastrophe as well as a major challenge to the reproductive performance of women worldwide, should be considered a relevant public health issue. By providing adequate materials, manpower, well-equipped health facilities as well as a prompt and efficient referral system, good access roads and efficient transportation, will ensure early presentation in hospitals and prompt management of cases.

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