scholarly journals Study of ovarian cancer at a tertiary care centre

2020 ◽  
Vol 9 (8) ◽  
pp. 3228
Author(s):  
Jayashree Mulik ◽  
Swapnil Khadse
Keyword(s):  
Ovarian Cancer ◽  
Tertiary Care ◽  
Case Fatality ◽  
Final Diagnosis ◽  
World Health ◽  
Ca 125 ◽  
Tertiary Care Centre ◽  
History Of ◽  
Associated Risk Factors

Background: Despite major advances in case management, ovarian cancer continues to have the highest case fatality rate of all gynaecologic malignancies. There is paucity of meaningful screening and diagnostic protocols. Present study was planned with the objective of assessment of the prevalence of ovarian cancer and the associated risk factors at a tertiary care centre.Methods: The present prevalence study was conducted at a tertiary care government hospital and entailed analysis of data of 73 patients of ovarian cancer. All the participants were subjected to comprehensive history taking, followed by general, systemic, per-speculum and per-vaginal examination. Serum tumour markers of the patients were assessed. Imaging studies including ultrasound, CT or MRI abdomen/pelvis were done as per need. Final diagnosis was confirmed on histopathology and the cases were classified according to histological classification of World Health Organization.Results: Majority (41, 56.2%) were aged more than 45 years and above, most of them with one to two previous issues (64.3%). The disease was observed to be more common in postmenopausal women (65, 89%). Three fourth participants had negative family history of ovarian or breast cancer. Out of 73 patients, 31 had value of CA 125 between 150-400 U/mL and 42 had values >400 U/mL. Epithelial ovarian cancer (serous- 33, 45.2%, mucinous- 18, 24.7%) was observed to be the commonest histological type.Conclusions: To diagnose ovarian tumours early using multipronged approach with focussed risk factor identification and screening with CA-125 is very important and is strongly recommended.

A prospective observational study on the effectiveness of risk of malignancy index score (RMI 3) in a tertiary care centre in Eastern India

2020 ◽  
Vol 11 (5) ◽  
pp. 54-60
Author(s):  
Apurba Mandal ◽  
Shibram Chattopadhyay ◽  
Sushanta Mondal ◽  
Arunava Biswas
Keyword(s):  
Ovarian Cancer ◽  
Adnexal Mass ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Ca 125 ◽  
Tertiary Care Centre ◽  
Gynecology And Obstetrics ◽  
Risk Of Malignancy ◽  
Malignant Lesions

Background: Adnexal mass is a common presentation in today’s gynecological practice. The incidence of ovarian cancer is increasing day by day and diagnosis is often difficult to be made pre operatively with inadequate surgical exploration is a regular occurrence. Aims and Objectives: To assess and validate the importance of RMI-3 score as pre-operative diagnostic tool of differentiating benign from malignant adnexal mass for starting first line therapy of ovarian cancer and to find out the incidences of ovarian malignancy among study population. Material and Methods: The study was conducted in the Department of Gynecology and Obstetrics on (n=115) patients attending GOPD and indoor with adnexal mass fulfilling the inclusion and exclusion criteria using purposive sampling technique. All the selected cases underwent ultrasonography and serum CA- 125 level estimation necessary for calculating RMI score. A score of >200 was taken as suggestive of malignancy and confirmatory diagnosis was performed by histopathological examination obtained from staging laparotomy of adnexal mass. The individual scores were then correlated with final outcomes with statistical analyses. Results: The study revealed benign ovarian tumors are more under 50 years (78.46%) and patients with normal BMI are diagnosed with maximum of malignancy (n = 28). History of tubal ligation carried less risk of malignancy (p<0.0001). Histologically malignant tumors found mostly in 71.4% postmenopausal group whereas 94.1% benign pathology were present in perimenopausal group and there is no association found between parity and histopathology (p=0.058). Bilateral (p=0.013), multilocular (p=0.000) tumors with solid areas (p<0.0001) and thick papillary projections (p<0.0001) had statistically significant association with malignant lesions. RMI score (>200) had more efficacy than serum CA-125 level (>46) in differentiating malignant lesions from benign one in terms of specificity (96% vs 83.87%) and positive predictive value (95% vs 79.17%). Conclusions: RMI-3 score is a simple, reliable and effective tool in differentiating benign from malignant adnexal masses thereby help in quick referral and management of cases with increase chances of survival of the patients.

scholarly journals Clinicoepidemiological study of acute invasive fungal rhinosinusitis in a tertiary care centre

2021 ◽  
Vol 7 (11) ◽  
pp. 1772
Author(s):  
Rajeshree Chaurpagar ◽  
Priyanka Garud ◽  
Apurva Pawde ◽  
Parag Doifode ◽  
Bhagyashree Chiplunkar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Tertiary Care ◽  
World Health ◽  
High Morbidity ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
History Of ◽  
Invasive Fungal Rhinosinusitis

<p class="abstract"><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) accounted for severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), which was declared a global pandemic by World health organization (WHO) in March 2020. In second wave of COVID there was notable surge in Acute invasive fungal rhinosinusitis (AIFRS). We observed that use of systemic corticosteroids in treatment of COVID 19 especially among patients with poorly controlled diabetes mellitus increased the incidence of AIFRS.</p><p class="abstract"><strong>Methods:</strong> This is retrospective observational study carried out in a Tertiary care Hospital GMC Akola from period of February 2021 to august 2021 were patients with the suspected diagnosis of AIFRS were admitted and evaluated following a standardized protocol, including clinical examination diagnostic nasal endoscopy, radiological evaluation. Diagnosis of AIFRS was confirmed on histopathology.</p><p class="abstract"><strong>Results:</strong> Study was conducted in GMC, Akola of 136 patients out of which 97 were males and 39 were females. In our study 78.67% patients had history of covid infection, followed by diabetes mellitus in 54.41%, history of steroid treatment found in 64.70% patients. On HPE 69.85% were positive for mucor and mixed infection (mucor and aspergillus) were found in 6.61%. Most common presenting feature was facial pain and swelling in 66.91%, palatal changes with dental pain in 45.58%, diminution of vision 17.64%, headache in 27.94% patients.</p><p><strong>Conclusions:</strong> Early and prompt diagnosis in high level of clinical suspicion in suspicious patient of AIFRS is vital to improve outcomes as it is known to have high morbidity and mortality (18-80%).</p>

Analytical Study of Complications of Third Stage of Labour in a Tertiary Care Centre in Bhopal, Madhya Pradesh - An Observational Prospective Study

2021 ◽  
Vol 8 (32) ◽  
pp. 2923-2927
Author(s):  
Geetika Thakur ◽  
Aruna Kumar ◽  
Deepti Gupta
Keyword(s):  
Postpartum Haemorrhage ◽  
Tertiary Care ◽  
Case Fatality ◽  
Tertiary Care Centre ◽  
The Third ◽  
Uterine Inversion ◽  
Study Results ◽  
Third Stage ◽  
Gandhi Medical College ◽  
Associated Risk Factors

BACKGROUND The third stage of labour starts when the fetus has completely delivered and ends with the complete expulsion of the placenta. The third stage of labour is usually uneventful, although significant complications can occur in this period, the most common is postpartum haemorrhage (PPH). The purpose of this study was to identify the various third stage complications, their incidence, and associated risk factors in patients admitted to the centre. METHODS This is a prospective observational study performed in the Department of Obstetrics and Gynaecology, Gandhi Medical College and Sultania Zanana Hospital (SZH), Bhopal conducted from 1 st October 2010 to 30th September 2011. All patients who delivered in our centre or outside and developed a third stage complication were included in the study. RESULTS There were a total of 10,277 deliveries during the study period and 171 cases of third stage complications. The incidence of third stage complication was 1.66 %. The most common third stage complication was traumatic PPH (52.1 %) and the least common was inversion of uterus (2 %) but the case fatality rate (20 %) was higher in the latter. The incidence of traumatic PPH was highest among the primipara patients (72.9 %) and in the grand multipara, atonic PPH topped the list occurring in 57.8 % of the patients. CONCLUSIONS As third stage complications occur in approximately 1 in 60 deliveries and cause 19.3 % of the total maternal deaths, it is of utmost importance to outline an effective treatment for the management of postpartum haemorrhage. This could further help in reducing maternal mortality significantly. KEYWORDS Third Stage of Labour, Atonic Postpartum Haemorrhage, Traumatic Postpartum Haemorrhage, Retained Placenta, Uterine Inversion, Peripartum Hysterectomy

scholarly journals Peripartum hysterectomy: a five year review at a tertiary care centre

2017 ◽  
Vol 6 (8) ◽  
pp. 3590
Author(s):  
Deepak A. V. ◽  
K. J. Jacob ◽  
Sumi P. Maria
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Case Fatality ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
College Hospital ◽  
Peripartum Hysterectomy ◽  
Medical College ◽  
Obstetric Haemorrhage ◽  
Suboptimal Care

Background: Peripartum hysterectomy is a life-saving procedure resorted to when conservative measures fail to control obstetric haemorrhage. Several predisposing factors, suboptimal care and lack of infrastructure may lead to this emergency procedure. We wanted to find out factors associated with peripartum hysterectomy and the adverse maternal outcomes at our centre.Methods: A retrospective case series analysis of 40 cases of peripartum hysterectomy performed over a period of 5 years from January 2010 to December 2014 at Government Medical College Hospital, Thrissur, Kerala was done.Results: The incidence of peripartum hysterectomy was 0.29%. The most common indication for peripartum hysterectomy was hysterectomy was uterine atony (50%). Thirty-five women (88%) were between 20 and 35 years. Most of the subjects were unbooked. There were two maternal deaths (case fatality rate of 5%) following peripartum hysterectomy during this period. All the subjects required blood transfusion.Conclusions: Prompt performance hysterectomy before the patient’s clinical condition deteriorates is the key to success. The incidence of adherent placenta is increasing, so every effort should be taken to reduce the caesarean section rates globally. 

Pattern of Congenital Heart Diseases and Associated Risk Factors among Children at a Tertiary Care Hospital

2021 ◽  
Vol 15 (9) ◽  
pp. 2451-2453
Author(s):  
Shahid Iqbal ◽  
Muhammad Fareed Khan ◽  
Raja Imtiaz Ahmed ◽  
Shahab Saidullah ◽  
Nisar Ahmed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Folic Acid ◽  
Congenital Heart ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Care Hospital ◽  
Younger Age ◽  
History Of ◽  
Associated Risk Factors

Objective: To find out the pattern of CHD and associated risk factors among children presenting at a tertiary care hospital. Study Design: A case-control study. Place and Duration of the Study: The Department of Pediatrics and Department of Cardiology, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawlakot from July 2020 to June 2021. Material and Methods: A total of 207 children of both genders, screened by ECG along with chest x-ray and further confirmed with the diagnosis of CHD through echocardiography were enrolled as cases. Same number of healthy controls (n=207) were recruited from immunization center of the study institution. Among cases, types of CHD were noted. For cases and controls, demographic, antenatal and maternal risk factors including maternal age, gender of the child, history of consanguinity, history of febrile illness in pregnancy, use or multi-vitamin or folic acid in pregnancy, bad obstetrical history and maternal diabetes mellitus were noted. Results: In a total of 414 children (207 cases and 207 controls), there were 219 (53.8%) male. In terms of CHD types among cases, VSD was the most noted in 62 (30.0%), ASD 35 (16.9%), TOF 33 (15.9%) and PDA in 30 (14.5%). Cases were found to have significant association with younger age (78.3% cases below 1 year of age vs. 64.7% in controls, p=0.0085), bad obstetrical history (p=0.0002), history of febrile illness in 1st trimester of pregnancy (p=0.0229) and lack of multivitamins and folic acid in the 1st trimester of pregnancy (p=0.0147). Conclusion: Majority of the children with CHDs were male and aged below 1 year. VSD, ASD, TOF and PDA were the most frequent types of CHD. Younger age, bad obstetrical history, history of febrile illness in 1st trimester of pregnancy and lack of multivitamins and folic acid in the 1st trimester of pregnancy were found to have significant association with CHDs among children. Keywords: Congenital heart disease, echocardiography, ventricular septal defect.

scholarly journals A pilot study comparing pattern of damage sustained among instruments from different surgical units in a tertiary care centre in Nepal – reappraising the role of instrument reprocessing in retaining their value

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 102
Author(s):  
Sunil Munakomi ◽  
Roshan Shah ◽  
Sangam Shrestha
Keyword(s):  
Tertiary Care ◽  
Health Spending ◽  
Pivotal Role ◽  
World Health ◽  
Tertiary Care Centre ◽  
Surgical Equipment ◽  
Surgical Units ◽  
Wear And Tear ◽  
Health Organization

Background: The quality of instruments plays a pivotal role in governing safe operating room culture. The reprocessing system followed in the institution determines their durability thereby ensuring patient safety as well as minimizing health spending. Rigorous reprocessing in a centralized instrument reprocessing department by well trained staff following formulated guidelines helps to achieve the target of “safe surgery saves lives” as formulated by the World Health Organization. Methods: We sought to determine the patterns of wear and tear sustained among sets of surgical equipment from two surgical units that had been sent to the repair department within a year of their purchase. Analysis of similar changes in the joints of the instrument, as well as pattern of fractures sustained was performed. Results: All patterns of wear and tear were common in both the general surgical arm and neurosurgical counterpart, with the exception of fractures and mal-alignments. Similar study was performed examining changes in the joints. Stains were the most commonly observed change pattern in both sets of instruments. Fractures were most frequent in the working ends in both sets of instruments. Conclusion: There is an alarming incidence of wear and tear patterns in the instruments used in the surgical units, even within the first year of their use. This supports the strict implementation of reprocessing guidelines by well trained workers and their quality assessments via audit checks. The quality of the purchased instruments also plays a pivotal role.

scholarly journals Cutting the chorda tympani: not just a matter of taste

2010 ◽  
Vol 124 (9) ◽  
pp. 999-1002 ◽  
Author(s):  
N Guinand ◽  
T Just ◽  
N W Stow ◽  
H Cao Van ◽  
B N Landis
Keyword(s):  
Middle Ear ◽  
Tertiary Care ◽  
Case Series ◽  
Salivary Flow ◽  
Middle Ear Surgery ◽  
Chorda Tympani ◽  
Tertiary Care Centre ◽  
Ear Surgery ◽  
Salivary Function ◽  
History Of

AbstractIntroduction:Chorda tympani injury as a complication of middle-ear surgery has been extensively studied with regard to its effects upon taste. However, the chorda tympani also carries parasympathetic fibres to the salivary glands of the oral cavity. To date, little has been reported about the effect of chorda tympani section upon salivary function.Setting:Tertiary care centre.Material and methods:We report a case series of three patients with bilateral chorda tympani lesions. Chorda tympani function was assessed using ‘taste strips’ and unstimulated sialometry. A careful history of oral symptoms was taken.Results:All patients showed transient or permanent bilateral ageusia of the anterior two-thirds of the tongue, and a decreased resting salivary flow rate. In addition, all patients suffered from transient or persistent, distressing xerostomia.Conclusion:Taste disorders may occur after middle-ear surgery but they are mostly transient, even when the chorda tympani nerves are sectioned bilaterally. In contrast, bilateral chorda tympani lesions may lead to severe, persistent and distressing xerostomia. Based on this neglected aspect of chorda tympani function, we emphasise the importance of preserving the chorda tympani whenever possible.

scholarly journals Study of incidence and prevalence of hypokalemic periodic paralysis

2019 ◽  
Vol 7 (3) ◽  
pp. 810
Author(s):  
Ajith Dungdung ◽  
Vishwanath Malkappa Jalawadi ◽  
Upendra Prasad Yadav
Keyword(s):  
Tertiary Care ◽  
Medical Science ◽  
Periodic Paralysis ◽  
High Carbohydrate Diet ◽  
Strenuous Exercise ◽  
Hypokalemic Periodic Paralysis ◽  
Tertiary Care Centre ◽  
Carbohydrate Diet ◽  
High Carbohydrate ◽  
History Of

Background: Hypokalemic periodic paralysis (HPP) is a rare autosomal dominant channelopathy characterised by muscle weakness or paralysis when there is a fall of potassium level in the blood. In individuals with mutation, attack begins during adolescents and most commonly occurs after sleep on awakening, rest after strenuous exercise, high carbohydrate diet and meal with high sodium content. This study was conducted to analyse the age of incidence and prevalence of HPP with various clinical presentations, diagnosis and its effective treatment.Methods: A retrospective analysis of 50 patients of Hypokalemic periodic paralysis was analysed in tertiary care centre “Rajendra institute of medical science” Ranchi, Jharkhand, India, with reference to its clinical presentation, age of incidence and prevalence with laboratory parameters and treatment outcomes.Results: Incidence of attack is more common in men between 26-35 years of age. Sudden onset of flaccid quadriparesis was the most common presentation with history of high carbohydrate diet on the background of strenuous work during summer season. Around 60% had similar history of attacks in the past and most of the patients had serum potassium levels between 2.1-3.0mEq/L. Electrocardiography (ECG) abnormalities associated with hypokalemia had been observed in 90% of patients, and also significant clinical, biochemical changes have been observed as well.Conclusions: Early diagnosis not only helps in definitive management with potassium replacement, but also prevents patient going for life threatening respiratory failure.  Patients recover completely without any clinical sequelae. Therefore, it is imperative for physicians, particularly those working in acute care settings, to be aware of this condition. Further management depends on the cause, frequency of attacks, severity of symptoms and the duration of the illness.

scholarly journals Accidental tramadol ingestion in children admitted in tertiary care centre

2019 ◽  
Vol 8 (12) ◽  
pp. 2661
Author(s):  
Vadlakonda Sruthi ◽  
Annaladasu Narendra
Keyword(s):  
Pediatric Population ◽  
Care Center ◽  
Tertiary Care ◽  
Ventilatory Support ◽  
Case Series ◽  
Pediatric Intensive Care ◽  
Hemodynamic Instability ◽  
Tertiary Care Centre ◽  
Medical College ◽  
History Of

Background: Tramadol use has been increasing in the adult and pediatric population. Practitioners must be alert because Tramadol misuse can lead to severe intoxication in which respiratory failure and seizures are frequent. Overdoses can lead to death. We report 47 pediatric cases with history of accidental tramadol exposure in children.Methods: An observational, retrospective, single center case -series of children with a history of accidental tramadol exposure in children admitted in pediatric intensive care unit of tertiary care center, Niloufer Hospital (Osmania Medical College) Hyderabad, Telangana India.Results: Of 47 children, 22 (47%) are male and 25 (53%) were female. At presentation 11 (23%) had loss of consciousness, 14 (29%) seizures, 17 (36%) hypotonia was noted. Pupils were miotic in 22 (47%) mydriatic in 2 (4.2%) normal in rest of children. Hemodynamic instability noted in 13 (27.6%). Serotonin syndrome (tachycardia, hyperthermia, hypertension, hyper reflex, clonus) was noted on 5 (10.6%) children. Respiratory depression was seen in 4 (8%) children who needed ventilatory support. Antidote Naloxone was given in 7 children. No adverse reaction was noted with Naloxone. All 47 children were successfully discharged.Conclusions: Overdoses can lead to death and practitioners must be alert because of the increasing use of tramadol in the adult and pediatric population. The handling of the tramadol should be explained to parents and general population and naloxone could be efficient when opioid toxicity signs are present.

scholarly journals Incidence and Risk Factors for Severe Dehydration in Hospitalized Children in Ujjain, India

2020 ◽  
Author(s):  
Abhishek Sharma ◽  
Aditya Mathur ◽  
Cecilia Stålsby Lundborg ◽  
Ashish Pathak
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
World Health ◽  
Respiratory Pattern ◽  
Care Hospital ◽  
Severe Dehydration ◽  
Cross Sectional ◽  
Oral Rehydration ◽  
History Of ◽  
Independent Risk Factors

Diarrhoea contributes significantly in the under-five childhood morality and mortality worldwide. This cross-sectional study was carried out in a tertiary care hospital in Ujjain, India from July 2015 to June 2016. Consecutive children aged 1 month to 12 years having &ldquo;some dehydration&rdquo; and &ldquo;dehydration&rdquo; according to World Health Organization classification were eligible to be included in the study. Other signs and symptoms used to assess severe dehydration were capillary refill time, urine output, and abnormal respiratory pattern. A questionnaire was administered to identify risk factors for severe dehydration, which was the primary outcome. Multivariate logistic regression modeling was used to detect independent risk factors for severe dehydration. The study included 332 children, with mean &plusmn; standard deviation age of 25.62 &plusmn; 31.85 months; out of which, 70%(95% confidence interval [CI] 65 to 75) were diagnosed to have severe dehydration. The independent risk factors for severe dehydration were: child not exclusive breast fed in the first six months of life (AOR 5.67, 95%CI 2.51 to 12.78; p&lt;0.001), history of not receiving oral rehydration solution before hospitalization (AOR 1.34, 95%CI 1.01 to 1.78; p=0.038), history of not receiving oral zinc before hospitalization (AOR 2.66, 95%CI 1.68 to 4.21; p&lt;0.001) and living in overcrowded conditions (AOR 5.52, 95%CI 2.19 to 13.93; p&lt;0.001). The study identified many risk factors associated with severe childhood dehydration; many of them are modifiable though known and effective public health interventions.

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