scholarly journals Clinico-pathological study of ovarian tumors at tertiary care hospital, Udaipur

2021 ◽  
Vol 10 (2) ◽  
pp. 555
Author(s):  
Runjhun Jain ◽  
Pooja Patel ◽  
Sharda Goyal
Keyword(s):  
Predictive Value ◽  
Tertiary Care ◽  
Malignant Tumour ◽  
Ovarian Tumour ◽  
Care Hospital ◽  
Embryonic Cells ◽  
Malignant Tumours ◽  
Ovarian Tumours ◽  
Epithelial Tumours ◽  
Mixed Tumours

Background: Diagnosis of malignancy in ovarian tumour is always questionable clinically as well as by investigation. Ovarian tumour arise in any age group and any type of body tissue present in tumour like epithelial tissues, germ cells, embryonic cells due to varied histology of ovary and metastatic non ovarian tumours. Aim and objective of the study was to study the correlation ovarian masses regarding their clinical presentation investigation and histo-pathological report.Methods: All the women who presented with lump and/or pain or menstrual problem attending Gynecology, Surgery and oncology OPD of GMCH, Udaipur. Our study design is prospective hospital based study. The statistical analysis was performed using IBM statistical for social sciences (SPSS).Results: In our study, 85.43% were benign tumour and 12.67% were malignant tumour. Among this, 70.87% were cystic, 14.56% were solid and 14.56% were mixed tumours. Mostly they were epithelial tumours (85.43%). Main surgery was total hysterectomy with bilateral salpingoopherectomy. In malignant tumours 61.53% also had Chemotherapy and 0.97 % had debulking.Conclusions: There is strong correlation of ultrasonography finding with histopathology report. Though clinically it was 55 % only. Specificity of the Ultrasonography was 73.33% but sensitivity was 100%. Positive predictive value was 95.65% and negative predictive value was 100%.

HISTOPATHOLOGICAL SPECTRUM OF OVARIAN TUMOURS IN REPRODUCTIVE AGE GROUP WOMEN OBSERVED AT A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 73-76
Author(s):  
Sivakumar Vulava ◽  
P.R.D. Ganesh Basina ◽  
Aluri Anjanapriyanka ◽  
Uram. Arunajyothi
Keyword(s):  
Clinical Presentation ◽  
Reproductive Age ◽  
Metastatic Tumour ◽  
Care Hospital ◽  
Age Group ◽  
Malignant Tumours ◽  
Reproductive Age Women ◽  
Ovarian Tumours ◽  
Epithelial Tumours ◽  
Reproductive Age Group

Aim and objectives: Ovarian tumours present with a wide variation in clinical presentation and morphological features. Ovaries apart from being a common sites of primary tumors, they are frequent sites for metastasis from organs like stomach, colon and breast. The present work has been undertaken to study the common morphologic and histological types of ovarian tumours in reproductive age group women. Materials and methods: A prospective study s study is conducted for a period of 3 years (August 2010 to September 2013). 100 cases of ovarian tumors in reproductive age women were selected for the present study. Age between 15 and 49 was taken as reproductive age. 100 cases of ovarian tumours in reproductive age women were selected for the present study. Age between 15 and 49 was taken as reproductive age. Out of the 100 cases 99 Results: were primary ovarian tumours, 1 was secondary / metastatic tumour. Out if the 99 primary tumours 94 were benign, 1 was borderline tumour and 4 were malignant tumours. Most tumours occurred in age between 30-40 years. Of the 99 primary tumours 85(90.4%) were surface epithelial tumours, 10 (10.6%) were germ cell tumours and 4 (4.2%) were sex-cord stromal tumours. 1 metastatic tumour, were noted. Benign ovarian tumours are more common than malignant tumours. Conclusion: Surface epithelial tumours are the most common type of all ovarian tumours. Surface epithelial tumours are the most common benign and malignant tumours in reproductive age group. The incidence, clinical presentation of the different types of ovarian tumours is extremely variable. Histopathology is still the gold standard in diagnosing most of ovarian tumours. Studying the macroscopic and microscopic features of different ovarian tumours will enable proper categorization into denite morphologic type.

scholarly journals Efficacy of morphological indexing of ovarian tumor: preoperative determination of risk of malignancy

2017 ◽  
Vol 6 (8) ◽  
pp. 3458
Author(s):  
Jagan Aishwarya ◽  
Ramasamy Sasikala ◽  
Syed Dilshath
Keyword(s):  
Predictive Value ◽  
Tamil Nadu ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Female Genital Tract ◽  
Wall Structure ◽  
Care Hospital ◽  
Malignant Tumours ◽  
Morphological Index ◽  
Risk Of Malignancy

Background: Ovarian cancers ranks fifth in cancer death worldwide and in India it ranks third among the female genital tract malignancies. Objective of present study was to assess prospectively the efficacy of morphological indexing (MI) as a method to predict malignancy in sonographically confirmed ovarian tumors.Methods: A prospective study conducted in a tertiary care hospital in Tamil Nadu from September 2011 to August 2012.  The risk of malignancy is preoperatively assessed in 136 patients with ovarian tumour using a morphological index based on tumour volume and wall structure. Each tumour was assigned a score of 0 to 10 based on increasing volume and morphologic complexity. The efficacy of the index was assessed by histopathological examination of the tumour.Results: The benign tumours had a mean MI score of 4.3 and malignant tumours had a mean of 8.3 which was statistically significant. Of the 54 tumours with MI <5, only 2 (3.7%) were malignant where else out of the remaining 82 tumours with MI >5, 54 (51.2%) were malignant. With MI >5 as a predictor of malignancy the present study had a Sensitivity-95.5%, Specificity-56.5%, Positive predictive value-51.2%, Negative predictive value-94%, and Accuracy-68%.Conclusions: Morphological index is a simple, valuable and inexpensive diagnostic tool to rule out malignancy in pre operative evaluations of ovarian tumors.

scholarly journals Association of Helicobacter pyloriin Gastric Lesions with Emphasis on Immunohistochemistry

2021 ◽  
Author(s):  
Srushti Basavaraj Mulimani ◽  
Sainath Karnappa Andola ◽  
Bhimaray Dhareppa Katageri ◽  
Meenakshi Malliginath Masgal ◽  
Anuradha Ganesh Patil
Keyword(s):  
Predictive Value ◽  
Tertiary Care ◽  
Care Hospital ◽  
Peptic Ulcers ◽  
Gastric Lesions ◽  
Malignant Tumours ◽  
Gold Standard Method ◽  
Female Ratio ◽  
Chronic Active Gastritis ◽  
H Pylori

Introduction:Helicobacter pylori (H.pylori) is associated with many gastro-duodenal diseases like peptic ulcers and gastric adenocarcinoma. Hence, it is important to identify H.Pylori in the endoscopic gastric biopsies. Though Immunohistochemistry (IHC) is time-consuming and expensive, it has shown excellent results and is considered as gold standard method for detecting H.Pylori. Aim: To study the morphological patterns of gastric lesions, different histo-pathological gastric lesions with clinical presentation and the association of H.Pylori using Haematoxylin and Eosin (H&E), Giemsa and IHC staining techniques and their efficacy. Materials and Methods: The present study was an observational study conducted at a tertiary care hospital Kalaburagi for a period of 5 years (1 July 2014 to 30 June 2019). All patients were referred to endoscopic section for the biopsy. History was documented and clinical examination was performed. For the retrospective cases, clinical details were obtained from medical records section, blocks were retrieved, stained with H&E, Giemsa and IHC, studied, tabulated and results were analysed. Results: A total of 95 samples (mean age 49.74 years) were studied. Male: female ratio was 2.8:1. Most common histological benign lesions were Chronic Active Gastritis (CAG) 23 (24.21%) and Chronic Superficial Gastritis (CSG) 14 (14.73%). Malignant tumours were seen in 23 cases, among which moderately (39.13%) and poorly differentiated (39.13%) adenocarcinoma was the commonest. H pylori was identified by IHC in benign and malignant lesions in 20 (23.53%) and 01 (4.35%), respectively. Sensitivity and specificity of H&E and Giemsa was 57.14%, 66.67% and 100%, 100%, respectively. Positive Predictive Value (PPV) was 100% for both stains and Negative Predictive Value (NPV) was 89.16% and 91.36% for H&E and Giemsa. Conclusion: The present study highlights the utility of IHC in detecting H.Pylori in gastric lesions as inflammation and other factors are known to affect the detection rate by H&E and Giemsa staining methods. Hence, IHC can be considered as the best method in detecting H.pylori.

scholarly journals Impact of Positive Vancomycin-Resistant Enterococcus (VRE) Screen Result on Appropriateness of Definitive Antibiotic Therapy

2020 ◽  
Vol 41 (S1) ◽  
pp. s263-s263
Author(s):  
Jenna Reynolds ◽  
Lynn Chan ◽  
Raelene Trudeau ◽  
Maria Teresa Seville
Keyword(s):  
Antibiotic Therapy ◽  
Predictive Value ◽  
Hematologic Malignancy ◽  
Tertiary Care ◽  
Alternative Therapy ◽  
Care Hospital ◽  
Positive Screen ◽  
Screen Result ◽  
Definitive Therapy ◽  
Vancomycin Resistant

Background: Vancomycin-resistant Enterococcus (VRE) screening has been utilized to identify colonized patients to prevent transmission. However, little is known about the utility of screening to guide antibiotic therapy. We assessed the appropriateness of definitive therapy in patients with a VRE screen and evaluate the predictive value of screening for the development of a VRE infection. Methods: In this retrospective study, we evaluated VRE screening of patients aged 18 years admitted between June 1, 2015, and May 31, 2018, to a 280-bed, academic, tertiary-care hospital. Rectal swabs were tested using Cepheid Xpert. Screening was performed routinely on admission for hematologic malignancy and liver transplantation patients. Only the first screen result was included for patients who had multiple VRE screens. The patient was classified as having a VRE infection if any Enterococcus isolates were vancomycin resistant. The primary outcome was appropriateness of antibiotic therapy in patients who had a VRE screen. Appropriateness of VRE-directed therapy was defined as therapy with linezolid or daptomycin for patients who had a positive VRE culture and an identifiable source of infection, or who had no clinical improvement on alternative therapy, or who had a documented β-lactam allergy. If appropriateness was unclear, 2 infectious diseases specialists determined appropriateness. Results: In total, 1,374 patients who had a rectal VRE screen met inclusion criteria. Of these, 1,053 (88%) had a negative screen. We detected no difference in the appropriateness of VRE-directed therapy between patients with a positive screen and those with a negative screen (59.3% vs 61.0%; P = .8657). The VRE screen had a sensitivity of 60% (95% CI, 43%–74%), specificity of 90% (95% CI, 88%–92%), positive predictive value of 18% (95% CI, 12%–25%), and negative predictive value of 98% (95% CI, 97%–99%) for VRE infection. Conclusions: Although VRE screening may have utility to detect colonization in high-risk patients, a positive VRE screen is of limited value in determining the need for VRE-directed therapy. Patients with a negative VRE screen have a low likelihood of developing a VRE infection, and a negative screen could be used to identify patients who may not require empiric coverage for VRE. Further research is needed to determine optimal utilization of VRE screening for prediction and treatment of VRE infections.Funding: NoneDisclosures: None

Ultrasound Employed to Detect Breast Lumps among Symptomatic Patients in Tertiary Care Hospital

2020 ◽  
Vol 10 (4) ◽  
pp. 296-300
Author(s):  
Ameet Jesrani ◽  
Pari Gul ◽  
Nida Khan ◽  
Seema Nayab ◽  
Fahmida Naheed
Keyword(s):  
Predictive Value ◽  
Imaging Modality ◽  
Tertiary Care ◽  
Ultra Sound ◽  
Categorical Variables ◽  
Breast Lesions ◽  
Care Hospital ◽  
Continuous Variables ◽  
Cross Sectional ◽  
Breast Lumps

Objective: To assess different pathological breast lesions in ultra sound in a subgroup of population. Study design and setting: It was a cross sectional study conducted at Bolan Medical Complex Hospital Quetta, Pakistan from June 2018 to January 2019. Methodology: Total 103 patients with breast swelling, pain and discharge were targeted. Gray scale and Doppler Ultrasound of breast followed by FNAC/biopsy of breast lesion was performed. Data presented as mean ± standard deviation for continuous variables and frequency with percentages for categorical variables. Results: Out of 48 clinically palpable lumps US detected all of 48 lumps and additionally 12 clinically non palpable masses were detected on US examination. Thus, overall sensitivity of ultrasound in detecting breast lumps was 100%. Fibroadenoma of the breast was diagnosed accurately in 80.3% of women. Ultrasound reliably differentiated cystic from solid breast masses (100%). The sensitivity of ultrasound for detecting breast carcinoma was 63.4% with a positive predictive value of 87.5%, a negative predictive value of 99.5% and accuracy of 58.33%. US findings most suggestive of benign lesions were oval or round shape in 88.3%, well defined margin in 84%, absent lobulation in 86.04% and wider than taller ratio in 90.69% of the cases.US findings of most predictive for malignancy were of irregular shape in 81.8%, ill-defined margin in 90.9% and length to height ratio in 63.6% of cases. Conclusion: Ultrasound is simple, cheap, safe and relatively accessible imaging modality for evaluation of breast pathologies. Due to its high sensitivity in diagnosing benign breast lesions particularly cystic lesions and fibroadenoma unnecessary interventions can be avoided

Diagnostic accuracy of Multiparametric MRI in detection of prostate cancer compared with histopathology obtained by MRI directed TRUS guided cognitive fusion biopsy are T2WI, DWI and DCE enough for Indian scenario

2021 ◽  
Vol 20 (1) ◽  
pp. 10-12
Author(s):  
Mallinath Biradar ◽  
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Prostatic Cancer ◽  
Tertiary Care ◽  
Multiparametric Mri ◽  
Care Hospital ◽  
Cognitive Fusion ◽  
Fusion Biopsy ◽  
Indian Scenario

Background: The incidence of prostatic carcinoma is increasing worldwide. With its high resolution, ability to provide excellent tissue characterization and multiplanar imaging capabilities, multi-parametric magnetic resonance imaging (mpMRI) plays a crucial role in detection, local staging and follow-up of carcinoma prostate. It also helps guide targeted biopsies in initial biopsy negative patient. Objectives: Study diagnostic accuracy of mp-MRI and primarily that of the three MR sequences T2, DWI and DCE in detection of prostatic cancer by correlating them with histopathology and thus whether it is feasible for a short MRI of 3 sequences to be used on a large scale in Indian scenario. Materials and Methods: A prospective study was done at a tertiary care hospital between April 2017 to November 2018 in which 50 patients who presented with suspicion of prostate cancer were referred to radiology department for evaluation using MRI. MRIexamination was done using 3T Siemens Magnetom Verio. Followed by this MRI directed TRUS guided cognitive fusion biopsy was done from the prostate. Samples were sent for histopathology. Results: Out of 50 cases studied, 24 cases (48%) were found to be malignant and 26 cases (52 %) were benign on histopathology. In our study, combined T2 + DWI + DCE gave sensitivity of 95.83 %, specificity of 57.69%, positive predictive value of 68.21 % and negative predictive value of 93.75%. Conclusion: Multiparametric MRI using T2, DWI and DCE has a high diagnostic accuracy for evaluation of prostatic cancer.

Assessing the Severity of Acute Pancreatitis with CT Severity Index and Other Conventional Methods in a Tertiary Care Hospital in Tamil Nadu, India – A Comparative Cross-Sectional Study

2021 ◽  
Vol 8 (41) ◽  
pp. 3541-3546
Author(s):  
Jayaprakash Subramani ◽  
Rajesh Prabhu ◽  
Jagadeesapandian Palpandi
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Predictive Value ◽  
Tamil Nadu ◽  
Objective Assessment ◽  
Tertiary Care ◽  
Severity Index ◽  
Apache Ii ◽  
Care Hospital ◽  
Male Predominance

BACKGROUND Acute pancreatitis is not uncommon in surgical practice with variable clinical presentation. Because of its potential notable catastrophic complications, it is mandatory to assess the severity at the earliest. In recent times, the decision making in the management is quite difficult due to its complications and outcome. So, an objective assessment of severity based on clinical and laboratory scoring verses computed tomography (CT) severity is still debate, hence the need for study. The purpose of this study was to compare the efficiency of CT severity index verses APACHE II and Ranson criteria in predicting the severity of acute pancreatitis. METHODS A total number of 36 consecutive cases of acute pancreatitis who were admitted between January 2013 and December 2014 in Apollo Specialty Hospitals – Madurai were included in the study. Written informed consent was obtained from all study participants. RESULTS In our study, out of 36 patients, 30 (83.33 %) were males and 6 (16.66 %) were females. The sex distribution shows a clear male predominance. Most of the patients in the present study belonged to the middle age group. Alcohol was the most common cause accounting for 41.7 % of the cases followed by the billiary pathology. CT severity index was the superior tool for prediction of the prognosis and early complications. CONCLUSIONS When using contrast enhanced computed tomography, it was found that there was a significant correlation between the development of organ failure and severity of pancreatitis. The specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of Ranson and acute physiology and chronic health evaluation – II (APACHE II) at 48 hours of admission with acute pancreatitis does not correlate in determining the severity of acute pancreatitis. KEYWORDS Acute Pancreatitis, Severity Markers, CT Severity Index

scholarly journals Diagnostic Accuracy of Sonographic Septations in Tuberculous and Malignant Pleural Effusions

2020 ◽  
Vol 9 (2) ◽  
pp. 95-102
Author(s):  
Abdul Rasheed Qureshi ◽  
Muhammad Irfan ◽  
Zeeshan Ashraf
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Tertiary Care ◽  
Positive Likelihood Ratio ◽  
Fisher Exact Test ◽  
Care Hospital ◽  
Pleural Effusions ◽  
Malignant Pleural Effusions ◽  
Malignant Group

Background: Discrimination between tuberculous (TB) and malignant pleural effusions is a real practical challenge because both exist as exudative lymphocytic type. Transthoracic ultrasonography not only identifies and quantifies pleural effusion but also displays sonographic septations, which are frequently seen in TB pleural effusions and can help in differentiation between tuberculosis and malignancy successfully, without any invasive procedure. We designed this study to determine the diagnostic usefulness of these septations for tuberculous and malignant pleural effusions. Material and Methods: This prospective study was conducted in the OPD of Gulab Devi Chest Hospital Lahore, Pakistan, a 1500 bedded tertiary care hospital, from November 2016 to February 2018. Total of 339 consecutive cases, aged 14-83 years with radiological evidence of pleural effusion were included in the study. After detailed history, thorough physical examination, radiological, haematological and biochemical findings were recorded. Pleural fluid macroscopic, cytological, microbiologic and biochemical analysis results were also recorded. Ultrasonography was done, septated and non-septated pleural effusions identified and findings were noted. SPSS-16 was used for statistical evaluation. Fisher Exact test was utilized for comparison between TB and malignant cases with P-value < 0.05 taken as significant. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy and positive likelihood ratio were calculated. Results: Out of total 339 cases, 49 (14.45%) were malignant and 290 (85.55%) were non-malignant. In the malignant group, only 03 cases (6.12%) showed sonographic septations. In the non-malignant group, 259/290 (89.31%) cases showed tuberculous etiology and 187/259 (72.20%) of these cases displayed sonographic septations. By considering septations as predictor of TB, statistical analysis revealed a sensitivity of 79.23%, specificity of 92.85%, PPV of 98.42%, NPV of 44.31% and diagnostic accuracy of 81.29%, respectively. Conclusions: Sonographic septations can be a valuable predictor of tuberculosis, in a population with high prevalence of the disease. We found it to be a useful feature in differentiating between a malignant and tuberculous etiology, in exudative lymphocytic pleural effusions. It can be used with confidence in patients who are unfit for interventional procedures.

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.

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