scholarly journals A clinicopathological study of gestational trophoblastic disease in a tertiary care centre of southern Assam

Author(s):  
Sailendra K. Thakuria ◽  
Monoj K. Deka ◽  
Shah A. Sheikh

Background: Gestational trophoblastic disease (GTD) covers a wide spectrum of benign and malignant conditions that arise from pregnancies with abnormal trophoblastic tissue development. It is a source of significant morbidity as well as increased risk of mortality from their complications if not identified and treated early enough. Our study aimed at the various clinicopathological features of GTDs along with their prevalence in a tertiary care centre.Methods: It was a retrospective cross-sectional study conducted over a period of 3 years from January 2017 to December 2019. All GTD cases were retrieved from department registries and analysed.Results: Out of 60 diagnosed cases of GTDs, 57 cases (95%) were Hydatiform mole. Invasive mole and choriocarcinoma were 2 cases (3%) and 1 cases (2%) respectively. Age ranged from 18-37 years. The most commonly affected age group was 20-25 years with 33 cases (55%). Most cases were presented in the first trimester presenting with bleeding per vagina. The majority of GTD cases belonged to blood group A and 50,000-<1,00,000 mlU/mL beta HCG level.Conclusions: Histopathological examination is helpful for confirmation of diagnosis.It is very important to follow up of such patients for early diagnosis of malignant trophoblastic tumors.

2018 ◽  
Vol 13 (1) ◽  
pp. 26-29
Author(s):  
Anjali Subedi ◽  
Junu Shrestha ◽  
Aashika Shrestha ◽  
Sangeeta Gurung

Aims: To evaluate the maternal and perinatal outcome in adolescent pregnancy,Method: This was a cross-sectional study conducted in Department of Obstetrics and Gynecology, Manipal Teaching Hospital, Pokhara from October 2017 to March 2018 for duration of 6 months.Results: There were total 82 cases of teenage pregnancy in the study duration with incidence of  6% among total deliveries. Majority of cases were of age 19 and were primigravida. Fifty five percent of the cases had normal vaginal delivery and cesarean section accounted for 39% of cases. The major indication for cesarean section was meconium stained liquor (52%) followed by oligohydraminos (15%) and cephalopelvic disproportion (11%). The maternal complication accounted for 59% of total cases. Among them, anaemia was highly prevalent comprising 11% of cases followed by PPROM (9.8%) and hypertensive disorders in pregnancy (8.5%). In perinatal outcome, the incidence of preterm birth was 15.9% and low birth weight was 13.4%. The rate of NICU admission was 2.4% and there was one case of still birth.Conclusion: The study showed that teenage pregnancy is at increased risk of adverse maternal and perinatal outcome. So if we lay an effort for reducing the incidence of teenage pregnancy, we can bring in positive changes in the indicators of maternal and perinatal morbidities.


2019 ◽  
Vol 6 (12) ◽  
pp. 4657-4663
Author(s):  
Neha Yadav ◽  
Binay Kumar ◽  
Usha Joshi ◽  
Mukesh Kumar ◽  
Saurabh Agarwal

Background: Leprosy is a leading cause of permanent physical disability. Approx 60% of global burden of leprosy is represented by India. Histopathological examination is still considered gold standard for accurate categorization of leprosy so that timely treatment can be started. Objectives:  To categorize and correlate types of leprosy clinically and histomorphologically in Kumaon region. Methods: The present cross-sectional study of 62 cases was conducted in the Department of Pathology & Skin and V.D in a tertiary care centre of Kumaon region from August 2016 to April 2018. The cases were clinically examined and categorized according to Ridley-Jopling classification. Skin Biopsy and Slit-Skin Smear (SSS) were taken for accurate histomorphogical categorization of leprosy and assessment of bacterial index, followed by clinico-histomorphological correlation. Statistical analysis was done in term of chi-square test. Kappa test was used as agreement test for clinical versus histological classification of different type of leprosy. Results:  A total of 62 clinically diagnosed leprosy cases evaluated histopathologically. Clinically, lepromatous leprosy (LL) was the most common type of leprosy (38.70%), followed by borderline tuberculoid (30.64%). On histopathological examination, indeterminate leprosy (IL) (21 cases; 33.90%) was the most common followed by lepromatous leprosy (16 cases; 25.80%).  Overall clinico-histopathological correlation was seen in 36 cases (58. 06%) with maximum correlation seen in indeterminate leprosy (100%) and tuberculoid leprosy (TT) (100%). Conclusion: This study concludes that correlation of clinical and histopathological features along with bacterial index is more useful for accurate typing of leprosy than considering any of the single parameter alone so that early and appropriate treatment could be started.


2020 ◽  
Vol 42 (2) ◽  
pp. 21-25
Author(s):  
Kamal Sharma Lamsal ◽  
Keshab R Neupane ◽  
Niranjan Acharya ◽  
Dinesh K Lamsal ◽  
Niraj Karmacharya ◽  
...  

Introduction Diabetes mellitus (DM) and lipid disorders (LD) in hypertensive patients are associated with increased risk of cardiovascular complications requiring close follow-up and more aggressive treatment. Hence, the present study was done to study the prevalence of diabetes and dyslipidemia in young hypertensive patients i.e. <40 years in a tertiary care hospital, Nepal. MethodsThis is a hospital based cross-sectional study carried out in Civil Service Hospital, Kathmandu. Study included 165 patients of <40 years who had hypertension, either newly diagnosed or undergoing antihypertensive treatment from September 2018 to September 2019. Blood pressure was measured two times on right upper arm in sitting position at interval of 30 minutes and the aver­age was taken. Fasting Lipid Profile and Fasting Blood Glucose was measured after 12 hours of fasting and the prevalence of dyslipidemia and diabetes were analyzed from the data collected. All calculations and statistical analyses are processed by the SPSS 25.0. ResultsAmong 165 patients included, majority of patients, 107 (64.8%) were among 31-39 years, followed by 53 (32.1%) patients among 21-30 years. In total, 98 (59.4%) were male and 67 (40.6%) female. The prevalence of diabetes was 24 (14.5%) and pre-diabetes was 49 (29.7%). The prevalence of dyslipidemia was 125 (75.6%), high triglyceride being the most common disorder followed by low HDL in 87 (52.1%). Elevated total cholesterol was found in 53 (32.1%) patients and 48 (29%) had high LDL cholesterol level. ConclusionA high prevalence of diabetes, pre-diabetes and dyslipidemia was observed in the hypertensive patients <40 years of age.


2019 ◽  
Vol 21 (3) ◽  
pp. 173-177
Author(s):  
S. Thapa ◽  
M. Basnet

Preoperative cardiac consultations are regularly performed during pre-anaesthetic checkup. However, the efficiency and usefulness of these consultations are unclear. The objective of this study is to assess the indication and usefulness of preoperative cardiac consultation. In this cross sectional study, 100 patients sent for preoperative cardiac consultation were evaluated. Baseline characteristics, Revised Cardiac Risk Index (RCRI), comorbidities were recorded. The motive for referral and outcome of the consultation were evaluated. Evaluated patients consist of male (45%) and female (55%) with age ranging from 18 to 89 years (average 51.28 ± 14.6 years). Most common co morbidities were hypertension (53%) and diabetes (30%). High proportion (49%) of patients we resent for cardiac consultation with suspicion of abnormal ECG. Most of the patient had RCRI of 0 and1 (45% and 28% respectively), while 14% and 13% had RCRI of 2 and 3 respectively. “Clearance for surgery” was the most common reason for consultation (60%) followed by risk stratification (41%) and optimization of cardiac disease (40%). Twenty four percent of patients were sent with suspicion of cardiac co morbidity. Twenty six percent were sent without any specific cause. Only 27% of the patient had increased risk of major adverse cardiac events. Further management was not needed in 58% patients. Only 12% patients had a new diagnosis. Preoperative cardiac consultation can be useful in detecting newer cardiac comorbidities and optimization in some patients. However, most preoperative cardiac consultation does not alter the perioperative management


Background: The most common benign pathological lesion in women of reproductive age is uterine leiomyoma. Gestational trophoblastic disease includes tumors and tumor like lesions originating from trophoblastic tissue. The aim of this study was to find the spectrum of molar pregnancy and uterine pathologies focusing on gestational trophoblastic disease as no study has been done in the past few years. Methods: Endometrial and uterine specimens of patients (n=436) between the ages of 15-65 years were collected from a private hospital in Karachi from December 2018 to December 2019. This cross-sectional study was carried out by pathological diagnosis of patients’ samples under light microscopy using hematoxylin and eosin staining. Stratification was done about age and nature of specimen to control the effect modifiers. The post stratification Chi square test was applied and p value <0.05 was considered significant. Results: Mean age of the patients was 36.1 years ±7.8. Total 436 uterine biopsies included 260(59.6%) hysterectomies, 56(12.8%) endometrial curetting’s, 117(26.8%) evacuation specimens and 3(0.7%) polypectomies. Common pathologies included 124(28.4%) leiomyomas, 61(14%) proliferative endometrium, 52(11.9%) adenomyosis and 32(7.3%) endometrial polyps. Gestational trophoblastic disease was seen in 9(2.06%). Seven (87.5%) were partial hydatidiform moles, one (12.5%) exaggerated placental site reaction and one choriocarcinoma. Mole was common between 26-30 years with mean age of 27.2 years and prevalence was 6/100 abortions. Conclusion: Leiomyoma was the commonest (28.4%) uterine pathology followed by proliferative endometrium (14.5%). However, endometrial stromal sarcoma and endometriosis were found 0.2% each. High prevalence of mole was seen in this study. Partial mole was most common and choriocarcinoma was least common. Keywords: Hydatidiform Mole; Pathology; Prevalence.


2021 ◽  
pp. 1-10
Author(s):  
Ryan J. Huang ◽  
Sherri L. Smith ◽  
Libor Brezina ◽  
Kristal M. Riska

Purpose There is a paucity of data that directly compares the falls rate and dizziness handicap of different vestibular diagnoses. The purpose of this study is to compare the falls rate and dizziness handicap of common vestibular diagnoses encountered among a cohort of vestibular patients at a single institution. Method We conducted a retrospective cross-sectional study of patients evaluated for dizziness at a tertiary care center vestibular clinic between August 1, 2017, and March 19, 2019. Vestibular diagnosis, demographic variables, comorbidities, falls status, and Dizziness Handicap Inventory (DHI) were extracted from the medical record for analysis. Associations between vestibular diagnosis and falls history or DHI were evaluated using multivariate logistic and linear regression, respectively. Results A total of 283 patients met our inclusion criteria with the following diagnoses: benign paroxysmal positional vertigo (BPPV; n = 55), acoustic neuroma ( n = 30), Ménière's disease ( n = 28), multiple vestibular diagnoses ( n = 15), vestibular migraine ( n = 135), or vestibular neuritis ( n = 20). After adjusting for age, sex, race, medications, and comorbidities, the odds of falling was 2.47 times greater (95% CI [1.08, 6.06], p = .039) and the DHI score was 11.66 points higher (95% CI [4.99, 18.33], p < .001) in those with vestibular migraine compared to those with BPPV. Other diagnoses were comparable to BPPV with respect to odds of falling and dizziness handicap. Conclusions Patients with vestibular migraine may suffer an increased risk of falls and dizziness handicap compared to patients with BPPV. Our findings highlight the need for timely evaluation and treatment of all patients with vestibular disease.


2013 ◽  
Vol 5 (1) ◽  
pp. 11-13
Author(s):  
Mst Syeeda Showkat ◽  
Lubna Khondker ◽  
Shahryar Nabi ◽  
Bishwajit Bhowmik

Background: Transvaginal sonography is superior to transabdominal sonography in most cases of pelvic pathology. Objective: This study was undertaken to see the clinicalpathological characteristics of endometrial hyperplasia. Methodology: This cross sectional study was carried out from January 2007 to December 2008 for a period of two years. All suspected cases of endometrial hyperplasia were included for this study. Transvaginal sonography (TVS) performed and confirmation was done by histopathological examination. Result: A total number of 40 cases were enrolled for this study. The most common diagnosed endometrial pathology was endometrial hyperplasia which was 42.5% cases. Endometrial polyp was diagnosed in 32.5% cases. Endometrial carcinoma was in 7.5% patients and submucosal fibroid was in 10.0%. Conclusion: Endometrial hyperplasia is the most common disease among the women presented with endometrial pathology. DOI: http://dx.doi.org/10.3329/jssmc.v5i1.16198 J Shaheed Suhrawardy Med Coll, 2013;5(1):11-13


2020 ◽  
pp. 1-3
Author(s):  
Anup Latne ◽  
Prabhakar Jirvankar

Hypertension is a major public health problem all over the world. The incidence of hypertension is increasing year after year and the prevalence of hypertension is increasing day by day due to increased life expectancy and aging population and their sedentary lifestyle. Hypertension is known to cause microvascular changes and increased cardiovascular risk from it. Microalbuminuria possibly reflects a state of increased renal endothelial permeability and is an easily measured marker of rather diffuse endothelial dysfunction, low grade inflammation and vascular disease burden2. Microalbuminuria has been determined as an important prognostic indicator and has been reported to be associated with increased cardiovascular risk and progressive renal damage. Reliable data on the prevalence of microalbuminuria in the general population and its association with cardiovascular risk factors is limited. Till now, there is little data available regarding screening and early treatment of hypertensive patients with microalbuminuria, as in the case of microalbuminuric non diabetic subjects. With these perspective this cross sectional study of microalbuminuria in non-diabetic hypertensive patients was undertaken to study prevalence of microalbuminuria in Non Diabetic hypertensive patients. Objectives: To determine the prevalence of microalbuminuria in non-diabetic hypertensive patients and to correlate the presence of microalbuminuria with the patients of different clinical profiles. Materials and Methods: This was observational, cross sectional study of Patients diagnosed with hypertension either admitted in ward or attending OPD of Medical College and Tertiary Care Centre. Urine microalbumin creatinine ratio was used for estimation of microalbuminuria. Conclusion: It was proved that microalbuminuria prevalence was directly proportional to the duration of hypertension, the stage of hypertension. Prevalence of microalbuminria was low in ACE inhibitor and ARB treated hypertensive patients.


2020 ◽  
Vol 58 (232) ◽  
Author(s):  
Badri Rijal ◽  
Krishna Rana ◽  
Srijana KC ◽  
Jamuna Lamsal

Introduction: Orthopedic conditions include a range of condition varying from traumatic injuries, congenital anomalies, chronic back-pain, arthritis, rheumatologic conditions, and other. In Nepal, approximately 2.35 million people are living with musculoskeletal conditions in which 175,000 people are suffering with MSD from non-traumatic causes. The aim of the study is to observe the clinical and demographic pattern of orthopedic problems presenting in the hospital. Methods: A descriptive cross-sectional study was done in All Nepal Hospital Private Limited in the month of November. The data from the medical record section was retrospectively collected. Sample size of 384 was included and convenience sampling technique was used. The descriptive statistical analysis was done. Results: Eight hundred forty four cases were included in the study. Implant removal was the main condition for admission in the hospital 105 (12.44%) followed by Forearm Bone Fracture 84 (9.95%) and Cut Injury 64 (7.58%). Most cases presented during the time 6 PM to 12 AM 312 (36.96%). Conclusions: Most of the orthopedic cases presented in the evening and night time. Implant removal, forearm bone fracture and cut injury form the major bulk of the cases.


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