scholarly journals Breast fibroadenoma and its clinical perspectives: a prospective observational study

2021 ◽  
Vol 8 (7) ◽  
pp. 2129
Author(s):  
Nishant Kumar
Keyword(s):  
Breast Lesion ◽  
Early Marriage ◽  
Breast Lump ◽  
Medical College ◽  
Tertiary Centre ◽  
Number Of Patients ◽  
Triple Assessment ◽  
Clinical Diagnoses ◽  
Breast Fibroadenoma ◽  
Surgery Department

Background: To study the patterns of breast fibroadenoma in females and to co-relate them with the pathological findings.Methods: Sixty six females who attended the Surgery Department in Darbhanga Medical College, Bihar, a tertiary centre in rural area, with benign breast lump during the period Bihar during period of November 2009 to November 2011, were studied. Early diagnoses by doing a triple assessment like a clinical examination, FNAC or a core needle biopsy and imaging methods like ultrasonography or mammography. The clinical diagnoses were compared with the cytological or histological findings wherever possible and their accuracies were evaluated.Results: Out of the 66 confirmed fibroadenoma female patients who were studied, most patients presented as a painless lump which is need to be differentiated from carcinoma. Most of the patient (63%) presented within 6 months of development of breast lesion showing increasing awareness in females of rural India. The maximum number of patient presented (55%) is of 2nd to 3rd decade. It was found that maximum number of patients have upto three children due to early marriage in rural background.Conclusions: Fibroadenoma is a common cause for breast lump even in rural background. Triple assessment provided a quick diagnosis and it alleviated unnecessary anxiety from the patients about breast cancer. The clinical diagnosis of a breast lump, as confirmed by cytology and histology, was accurate in most of the cases.

scholarly journals Clinico-Pathological Profile and Management Outcome of Fournier’s Gangrene in a Tertiary Care Hospital

2018 ◽  
Vol 9 (2) ◽  
pp. 124-130
Author(s):  
Mahmud Ekram Ullah ◽  
Amreen Faruk ◽  
Rajibul Haque Talukder ◽  
Farukuzzaman ◽  
Noor A Alam
Keyword(s):  
Tertiary Care ◽  
External Genitalia ◽  
Fournier’S Gangrene ◽  
Care Hospital ◽  
Fournier's Gangrene ◽  
Predisposing Factor ◽  
Medical College ◽  
Number Of Patients ◽  
Variable Extent ◽  
Surgery Department

Background: Fournier’s gangrene is a vascular disaster of infective origin occurring about male external genitalia. Diabetes Mellitus is an important predisposing factor. A good number of patients of this rare clinical entity are admitted frequently in our centre. Till now the disease has the potential for significant morbidity and also mortality.Objective: The study was designed to be conducted among patients suffering from Fournier’s gangrene to identify the possible source of sepsis, to denote pattern and extent of area involvement and microorganisms isolated and to observe the treatment course and outcome.Methods: This prospective observational study was carried out in BIRDEM General Hospital, Dhaka among 60 patients of Fournier’s gangrene admitted under surgery department during the period of October 2016 to January 2018 using purposive sampling method.Result: The results of this study suggest that majority of the study population were in 51 to 60 years (Mean 52±4.9) age group. All the patients were diabetic with grossly elevated blood glucose level (Mean RBS=17.3 mmol/dl). In addition to scrotum, perineum, penis, buttock and lower abdomen were also affected to variable extent (73.3%). All patients required major debridement which had to be repeated in 68.3% cases. Steptococcus pyogens was the most common organism isolated (43.3%) followed by Eschericia coli (35%) and majority were of polymicrobial type (61.6%). Mortality rate was 8.3%.Conclusion: The diagnosis and treatment of Fournier’s gangrene is enigmatic and challenging to the physician. Urgent surgical debridement along with other appropriate supportive measures can reduce morbidity and mortality.Anwer Khan Modern Medical College Journal Vol. 9, No. 2: Jul 2018, P 124-130

scholarly journals Measurement of Postoperative Pain in Children by Visual Analogue Scale

2009 ◽  
Vol 12 (Number 1) ◽  
pp. 19-22
Author(s):  
S Alam ◽  
A K M Shamsuddin ◽  
Md. W Abusaleh ◽  
A H Khan
Keyword(s):  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Pain Control ◽  
Analogue Scale ◽  
Paediatric Surgery ◽  
Postoperative Pain Control ◽  
College Hospital ◽  
Medical College ◽  
Number Of Patients ◽  
Surgery Department

Inadequate postoperative pain control causes significant morbidity and mortality. ht the presets mum in the paediatric surgery department the effective pain control is am mandardkert For this reason this study was undertaken to find out the degree of effective postoperative pain control in children by using Visual Analogue Scale iVA.St It was a crospsemional study for two years. Sample sine was 90 with a mean age of 8.7 years. Patients were selected from the Department of Paediatric Surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU). Dhaka; Bangladesh Institute of Child Health & Dhaka Shishu Hospital HliCH &DSH). Dhaka; and Dhaka Medical College hospital (DMC111. Dhaka. Children aged five to 12 years receiving postoperative analgesics were included in this study. All of them were mentally healthy. well responsive and cmoperative. Patients were selected in such a way that neither thee hod any malignant disease nor were they stoffernsg front any chronic pain or postoperative pain due to magical wound sepsis. Postoperative pain was measured by VAS from the first postoperative day to the seventh postoperative day and was graded by she Sriwatanakars method. It vans Plod that difference in pain scams were statistically nowsigo0ficant among the three institutes front the first postoperative day to the seventh postoperative day. Patients experienced moderate pain up to the third postoperative day, mild pain up to the fifth postoperative day and. ome pain up to the sowsh postoperative day. Postoperative pain was mu effectively controlled by currently used analgesics in paediatric surgery departments in these hospitals. So so find at the degree of effrctice postoperative pain control in children fierther study should be carried 0111 with large number of patients in different mares of Bangladesh.

scholarly journals An evaluation of open versus laparoscopic cholecystectomy in tertiary centre

2019 ◽  
Vol 6 (8) ◽  
pp. 2797
Author(s):  
Kanwar Singh Goel ◽  
Sapna Goel ◽  
Sham L. Singla ◽  
Pawan Tiwari
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Stone ◽  
Age Groups ◽  
Stone Disease ◽  
Average Hospital ◽  
Medical College ◽  
Tertiary Centre ◽  
Gall Stone Disease ◽  
Open Versus ◽  
Surgery Department

Background: Cholecystectomy is a method of treatment for acute or chronic cholecystitis with cholelithiasis or any other diseases of gall bladder. The diagnosis of gall stone disease depends on an accurate history, physical examination, supporting lab investigations and a proper ultrasound of abdomen. After the advent of lap cholecystectomy there is revolution in minimally invasive surgery. Because of better technological innovations, the lap cholecystectomy has become gold standard presently.Methods: This prospective observational study was performed in Surgery Department in SGT Medical College, Budhera, Gurugram, over a period of 2 years from January 2017 to January 2019. Patients were taken from both sexes and all age groups from different units of surgery. A total of 100 patients were taken for study who underwent cholecystectomy.Results: Mean age of patients in our study was 38.64 years. Most patients were females. Procedure adopted was open in 18% patients and lap cholecystectomy in 74% patients. Conversion from laparoscopic to open was done in 8% patients. In 8% patients there were operative complications. Average hospital stay was much less for lap cholecystectomy.Conclusions: After the advent of laparoscopic cholecystectomy, most of the surgeons are performing more and more of laparoscopic cholecystectomy. Here incision is small, pain is less, and hospitalization is shorter. Even in acute cholecystitis, in experienced hand, lap cholecystectomy can be performed safely. The author’s inclination is totally in favour of lap cholecystectomy, except the cases where lap cholecystectomy is contraindicated. 

Childhood Intussusception: Timely Management Leads to Decreased Surgical Risk

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
Dr. Sunil Kumar Mehra, Dr. Dinesh Kumar Barolia, Dr. Arun Kumar Gupta, Dr. Vinita Chaturv
Keyword(s):  
Operative Procedure ◽  
Delayed Diagnosis ◽  
Diagnostic Methods ◽  
Treatment Modalities ◽  
Surgical Morbidity ◽  
Surgical Risk ◽  
Medical College ◽  
Pneumatic Reduction ◽  
Surgery Department ◽  
Resection And Anastomosis

Intussusception is the most common cause of intestinal obstruction in infants and children in < 1yr of age (1). Intussusception cases usually reported late therefore operative procedure was inevitable and results in significant morbidity and mortality. By this study we emphasized on timely transfer of intussusception case to a pediatric surgical center so as to decrease surgical risk. The surgical morbidity was low in those who were admitted early or directly to our center.  Methods - We retrospectively reviewed cases of intussusception in children <15 years. Children were treated from October 2015 to December 2107 at pediatric surgery department of SMS medical college Jaipur Rajasthan. Age, sex, month of admission, symptom with duration, diagnostic methods, and treatment modalities were recorded and analyzed.  Results - We studied 300 patients with intussusception.272 (90%) were treated surgically. We recently started ultrasonography guided pneumatic reduction and 24(85.7%) out of 28 treated successfully by it. Out of the patients requiring surgery 202 (67.34%) patients were reduced by per-operative manual reduction and in 60(22%) patients resection and anastomosis with 10(3.6%) treated with resection and ileostomy. 25.34% cases have delayed diagnosis and lately  transferred from peripheral hospitals requiring resection and diversion. Conclusion - In conclusion, Intussusception cases usually reported late therefore high likelihood of surgical management. The patients who underwent resection have longer duration of hospital stay.

The Causative Organisms of Bacterial Meningitis and their Antimicrobial Resistance Profiles in Iranian Children in 2011-2016

2020 ◽  
Vol 20 (2) ◽  
pp. 229-236
Author(s):  
Sepideh Keshavarz Valian ◽  
Shima Mahmoudi ◽  
Babak Pourakbari ◽  
Maryam Banar ◽  
Mohammad Taghi Haghi Ashtiani ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Bacterial Meningitis ◽  
Medical Center ◽  
Blood Cultures ◽  
Gram Positive ◽  
Gram Negative ◽  
Number Of Patients ◽  
Resistance Patterns ◽  
Iranian Children ◽  
Surgery Department

Objective: The study aimed to describe the identity and antimicrobial resistance patterns of the causative agents of bacterial meningitis in children referred to Children’s Medical Center (CMC) Hospital, Tehran, Iran. Methods: This retrospective study was performed at CMC Hospital during a six-year period from 2011 to 2016. The microbiological information of the patients with a diagnosis of bacterial meningitis was collected and the following data were obtained: patients’ age, sex, hospital ward, the results of CSF and blood cultures, and antibiotic susceptibility profiles of isolated organisms. Results: A total of 118 patients with bacterial meningitis were admitted to CMC hospital. Sixty-two percent (n=73) of the patients were male. The median age of the patients was ten months (interquartile range [IQR]: 2 months-2 years) and the majority of them (n=92, 80%) were younger than two years of age. The highest number of patients (n=47, 40%) were admitted to the surgery department. Streptococcus epidermidis was the most frequent isolated bacterium (n=27/127, 21%), followed by Klebsiella pneumoniae (n=20/127, 16%), and Staphylococcus aureus (n=16/127, 12.5%). Blood culture was positive in 28% (n=33/118) of patients. Ampicillin-sulbactam and imipenem were the most effective antibiotics against Gram-negative bacteria isolated from CSF cultures. In the case of Gram-positive organisms, ampicillinsulbactam, vancomycin, and linezolid were the best choices. Imipenem was the most active drug against Gram-negative blood pathogens. Also, ampicillin and vancomycin had the best effect on Gram-positive bacteria isolated from blood cultures. Conclusion: Results of this study provide valuable information about the antibiotic resistance profiles of the etiologic agents of childhood meningitis, which can be used for prescription of more effective empirical therapies.

Acute mastoiditis and intracranial complications in children

2021 ◽  
Vol 70 (4) ◽  
pp. 207-213
Author(s):  
Andrea Kaliariková ◽  
Klára Perceová ◽  
Jan Machač ◽  
Michal Jurajda ◽  
Milan Urík
Keyword(s):  
Streptococcus Pneumoniae ◽  
Patient Group ◽  
Clinical Manifestations ◽  
Aetiological Agent ◽  
Acute Mastoiditis ◽  
Average Value ◽  
Tertiary Centre ◽  
Number Of Patients ◽  
Intracranial Complications ◽  
Low Incidence

Objectives: Characterisation of clinical manifestations in children who had acute mastoiditis (AM) -related intracranial complications (ICCs) and to determine the incidence of ICCs in the study group. To define children with a higher risk of ICCs and gain new information on aetiological microbial agents of AM. Methods: A retrospective analysis of 137 paediatric patients with AM treated at a tertiary centre using standard dia­gnostic and therapeutic protocol between 2002 and 2019. Results: Altogether 137 patients with AM were hospitalised at our centre between 2002 and 2019. During this time, the occurrence of ICC in children with AM was low (n = 3, incidence 2.19%). Due to the low number of patients with ICC with AM in our patient group, we were unable to define a specific group of patients with a higher risk of ICC development in AM. Despite this fact, the average value and median of CRP were considerably higher in patients with AM-associated ICCs. The most frequent aetiological agent was Streptococcus pneumoniae. Conclusions: The low incidence of ICC in patients with AM in our patient group might be caused by routinely performed paracentesis in developed acute otitis, rational antibio­tic therapy and the good availability of an ENT specialist in the Czech Republic. The most common aetiological agent of AM was Streptococcus pneumoniae. Keywords: Streptococcus pneumoniae – acute mastoiditis – intracranial complications – aetiological agent – antibio­tic therapy – antromastoidectomy

scholarly journals Comparison of free radicals in blood in pre-operative and post-operative phases of breast malignancies: a clinicopathological study

2019 ◽  
Vol 7 (1) ◽  
pp. 210
Author(s):  
Abhishek Jina ◽  
U. C. Singh
Keyword(s):  
Breast Cancer ◽  
Free Radicals ◽  
Breast Carcinoma ◽  
Ductal Carcinoma ◽  
Lipid Peroxide ◽  
P Value ◽  
Breast Cancer Patients ◽  
Medical College ◽  
Surgery Department

Background: Various factors have been identified as influencing factors of breast cancer. The free radicals can cause increased oxidative stress by negatively affecting the body’s nucleic acids, lipids and proteins leading to various illnesses including cancer. Therefore, this study was aimed at discovering the progress of treatment of breast carcinoma by exploring the connections of the disease with free radical injury.Methods: The present study was conducted among 30 breast carcinoma patients received in the surgery department of BRD Medical College Gorakhpur. Determination of the levels superoxide dismutase (SOD) (the procedure of photoluminescence), catalase (method of Cavarochi) and the lipid peroxidise was done. The results were presented as mean and standard error (SE). P value of <0.05 was considered as statistically significant.Results: Among the total participants, 73% patients had infiltrating ductal carcinoma and 27% patients had intraductal carcinoma. The dismutase levels showed an increase in the post-operative patients for both the groups. The catalase levels and the lipid peroxide levels showed a reduction in the postoperative patients (p<0.05).Conclusions: The present study result showed that the low amounts of SOD and catalase may not be sufficient to detoxify high amounts of free radicals. The administration of catalase could help in reducing the symptoms. Though, low amounts of SOD and catalase may not be sufficient to detoxify high amounts of free radicals. The administration of enzymes could help in the treatment of breast cancer patients.

scholarly journals Clinical profile and outcome of pediatric surgical patients in a rural tertiary centre

2021 ◽  
Author(s):  
Sunil Pathak ◽  
R. V. Mhapsekar ◽  
Neeraj Gupta ◽  
Karthik Surabhi ◽  
Shruchi Bhargava ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Clinical Profile ◽  
Surgical Patients ◽  
Curative Therapy ◽  
Tertiary Centre ◽  
Number Of Patients ◽  
Important Means ◽  
Surgical Conditions ◽  
Time Of Admission ◽  
Surgical Condition

Background: Pediatric surgery is a sub-speciality involving the surgery of foetuses, infants, children and adolescents. Congenital malformations, trauma and childhood cancers are their three major concerns requiring the focus of their attention. Rural pediatric population in India still remains devoid of such facilities. Little is factually known about the burden of surgical disease globally. Surgical treatment is an essential component of basic medical care and an important means of providing preventive and curative therapy. Pediatrician has a significant role in caring for surgical patients. There is a need to know the spectrum of diseases that warrant admission into the pediatric surgical units. Current study was conducted to find out the clinical profile and immediate outcome of the various pediatric surgical conditions. Methods: This prospective observational study was conducted at Vadodara. All the patients 0-18 years, with surgical condition were enrolled in the study. Patients were followed from the time of admission to discharge.  All the clinical data from admission to discharge were recorded and analyzed.Results: Total 127 (3%) patients were enrolled in the study. Males were 93 (73.2%). One to 5 years 45 (35.4%) was the largest age group folowed by infants 23 (18.1%). Largest number of patients were from Gastro Intestinal Condition 52 (40.9%) and congenital causes forms 83 (65.35%) of admissions. Commonest congenital anomaly was inguinal hernia 23 (27.7%). Complications were recorded in 46 (36.22%) patients. The average duration of stay was 7.7 days. The 124 patients were discharged successfully.Conclusions: Surgical conditions are important part of pediatric and neonatal care. Management of congenital surgical condition is important to decrease infant and under five mortality and other comorbidities as well.

scholarly journals Awareness about cervical cancer screening among reproductive aged women attending gynaecology outpatient department in ESI PGIMSR & ESIC medical college & Hospital, Joka, Kolkata

2017 ◽  
Vol 4 (4) ◽  
pp. 1319
Author(s):  
Susmita Chaudhuri ◽  
Rekha Dutt ◽  
Shweta Goswami ◽  
Joydeb Roychowdhury
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Rural Areas ◽  
Hpv Infection ◽  
Early Marriage ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Reproductive Aged Women

Background: Cervical cancer is a leading cause of morbidity and mortality in women especially India. The mainstay of prevention rests on early detection of cases through screening. So, this study aims to determine the knowledge of cervical cancer screening, Human papilloma virus & its vaccination status. Methods: This was an observational study of cross-sectional design conducted among the adult reproductive aged women (18-45 years) visiting Gynaecology OPD at ESI-PGIMSR and ESIC Medical College and Hospital, Joka. A pre-designed and pre-tested interview schedule was prepared. Face to face interview was conducted in local language. Data was compiled & computed in SPSS software version 20. Results: Total respondents were 97. Majority of the respondents (62.9%) belong to the age group of 21-30 years. 8 in 10 participants follow Hinduism. Almost equal percentages of participants were from urban & rural areas (51.5% & 48.5% respectively). 6 in 10 participants had heard about cervical cancer. Majority of the respondents (55%) mentioned friends & family as a source of information. 48.3% of the respondents knew poor genital hygiene as a predisposing risk factor for cervical cancer. Very few knew about other factors like multiple sexual partner (20%), early marriage (33.3%), young age (20%), repeated childbirth (35%), OCP usage (26.7%) as risk factors for cervical cancer. Only one participant had undergone screening test for cervical cancer (1.7%). 46.7% of the respondents were aware about association of HPV infection with cervical cancer. But none of the participants had received vaccine against cervical cancer & they cited lack of awareness as a reason for not receiving the vaccine. Conclusions: A well-designed health education program focusing on effective multipronged IEC strategies utilizing pictorials, audio-visual and personal communication on cervical cancer could yield beneficial results. 

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