scholarly journals Management of visceral arterial pseudoaneurysms in patients with acute and chronic pancreatitis: a retrospective study from South Indian tertiary care centre

2021 ◽  
Vol 8 (10) ◽  
pp. 2980
Author(s):  
Afroj Ismail Bagwan ◽  
Kalyansundarbharathi Chidambaram ◽  
Sugaprakash Sankareswaran ◽  
Prabhakaran Raju ◽  
Sugumar Chidambaranathan ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Tertiary Care ◽  
Mesenteric Arteries ◽  
Visceral Artery ◽  
Common Symptom ◽  
Angiographic Embolization ◽  
Tertiary Care Centre ◽  
Therapeutic Modalities ◽  
South Indian ◽  
Acute And Chronic Pancreatitis

Background: Visceral artery pseudoaneurysms (VAP) are defined as those affecting celiac, superior or inferior mesenteric arteries and their branches. In this study, role of various therapeutic modalities in the management of VAP caused by acute and chronic pancreatitis were analysed which can influence choice of treatment for a given patient.Methods: The study was conducted in institute of surgical gastroenterology, Madras medical college and Rajiv Gandhi government general hospital Chennai, based on retrospective analysis of 41 patients diagnosed with VAP caused by acute and chronic pancreatitis admitted between the periods of September 2014 and January 2020. The medical records of all patients were retrieved and descriptive statistical analyses was carried out regarding various details including demographics, presentation, management and complications.Results: This study includes 41 patients with mean age of 39.73±10.54 (SD) years and 40 (97.56%) of them were males. Fifteen patients (36.59%) had acute pancreatitis and 26 patients (63.41%) had chronic pancreatitis. Pseudocysts were found in 25 (60.98%) patients. Pseudoaneurysm arose most commonly from splenic artery (n=32; 78.04%). The most common symptom was abdominal pain (n=40) followed by gastrointestinal bleeding (n=28). Sixteen patients (39%) received primary radiological reintervention (n=16). Twenty-five patients (60.98%) underwent primary surgical treatment (n=25). Rebleeding was seen in 3 patients (7.32%). Twenty-three patients (56.1%) developed complications. Mortality rate was 5/41 (12.2%).Conclusions: Pseudoaneurysms are fatal complications of pancreatitis. Angiographic embolization, when available, is the initial treatment of choice in hemodynamically stable patients. Surgery in experienced hands will still remain main modality in treating these patients in centres that lack a full-fledged angiographic facility with acceptable outcomes. 

PAEDIATRIC POSTERIOR FOSSA TUMORS : AN EPIDEMIOLOGICAL AND ANALYTICAL STUDY AT TERTIARY CARE CENTRE IN EASTERN INDIA

2021 ◽  
pp. 54-56
Author(s):  
S. I. Sadique ◽  
Md. Shahid Alam ◽  
S. Chatterjee ◽  
S. Ghosh
Keyword(s):  
Early Diagnosis ◽  
Posterior Fossa ◽  
Tertiary Care ◽  
Male Dominance ◽  
Morbidity And Mortality ◽  
Posterior Fossa Tumors ◽  
Tertiary Care Centre ◽  
Therapeutic Modalities ◽  
Common Location ◽  
Group 5

Introduction: Posterior fossa is the commonest site of primary intracranial tumors in children, accounting for 45-60% of 1 all pediatric tumors . The aims and objectives of the study is to analyse the incidence, clinical features, surgical outcome and complications in paediatric patients with posterior fossa tumor. Material and Methods: The present study is a non-randomized prospective observational study, conducted in the department of neurosurgery, Bangur Institute of Neurosciences (B.I.N), IPGME & R, Kolkata from January 2019 to December 2020. Sample size is 50. Observations & Results: Out of 480 cases of total CNS tumors who presented in the study period, 96 cases(20%) were of paediatric posterior fossa tumors. Male dominance was seen i.e. 32 cases(64%). Most of them were in the age group 5-12 years i.e. 30 cases(60%). Headache and vomiting was the most common presenting complain present in 41 cases(82%). Fourth Ventricle was the most common location, 30 cases(60%) with Medulloblastoma being the most common tumor, 24 cases(48%). Brainstem involvement was seen in 22 cases(44%). Post-op hydrocephalus and cerebellar mutism were seen in 6 cases(12%) each. Overall mortality was 8%(4 cases). Conclusion: Posterior fossa tumors are critical brain lesions with signicant neurological morbidity and mortality. Early diagnosis of posterior fossa tumors is vital to prevent potential risks of Brain stem compression, herniation, hydrocephalus and death. With rapid advancement in radiology and the advent of modern therapeutic modalities, early diagnosis and treatment reduced the morbidity and mortality rate and improved prognosis among the patients.

scholarly journals AUDIT of patients referred for DXA scanning in a south Indian Tertiary care centre

2013 ◽  
pp. 1-1
Author(s):  
Thomas Paul ◽  
Mahesh Mruthyunjaya ◽  
Asha Shyamasunder ◽  
Dukhabandu Naik ◽  
Simon Rajaratnam ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
South Indian

scholarly journals Clinical study of multiple myeloma and treatment responses in a tertiary care centre

2021 ◽  
Vol 9 (11) ◽  
pp. 3356
Author(s):  
Immanni S. M. Giridhar ◽  
C. Deepak Yadlapalli ◽  
Muralidhar Gullipalli ◽  
Venkatesh Mushini ◽  
Yerraguntla S. Sarma ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Treatment Options ◽  
Tertiary Care ◽  
Elevated Serum ◽  
Staging System ◽  
Stage Iiib ◽  
Common Symptom ◽  
Tertiary Care Centre ◽  
Incurable Disease ◽  
Unknown Significance

Background: Multiple myeloma (MM) evolves from Monoclonal gammopathy of unknown significance (MGUS), a premalignant clinical condition. Second to non-Hodgkin’s lymphoma, MM is the most common haematological malignancy. The aim of the study was to review the clinical profile and response of individuals treated for MM from this part of country.Methods: We evaluated data of patients with MM managed between 2013 and 2019 at a tertiary care cancer hospital in Rajamahenderi, India. Data regarding demographic variables, clinical features, disease characteristics and treatment details were collected and analysed.Results: Total of 54 patients with MM were managed. Mean age was 59.4 years. Males accounted for 63%. Bone pain (90%) was the most common symptom. Elevated serum creatinine was noted in 16.7% and M band in 42 (77.8%). X-ray of skull showed lytic lesions in 41 (75.9%). Mean haemoglobin value was 8.8±1.9 g/dl and serum calcium was 9.12 mg/dl. Majority of subjects, 44 (81.48%) belong to stage IIIA, 9 (16.67%) to stage IIIB, and 1.85% to stage IIA of Durie Salmon staging system. No response was noted in 17 (31.5%), 4 (7.4%) subjects had a progressive disease even on treatment, and 8 (14.8%) subjects had a very good partial response. Median survival of subjects belonging to DSS stage II was 17 months, IIIA was 11.037 months and stage IIIB was 17.463 months.Conclusions: MM has an early onset in India. Though MM is an incurable disease, many promising treatment options are there which lead to increase in survival. Early treatment helps in improving mortality rates, better quality of life and decreases disease burden.

Surgical management of non-alcoholic chronic pancreatitis (NACP) at a tertiary care centre in India

Pancreatology ◽  
2014 ◽  
Vol 14 (2) ◽  
pp. S7
Author(s):  
Rajesh Panwar ◽  
Vishnu Prasad Ravella ◽  
Arif Ali Khan ◽  
Sujoy Pal ◽  
Nihar Ranjan Dash ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Management ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Alcoholic Chronic Pancreatitis

A Clinicopathological Review of Adnexal Masses in a Tertiary Care Centre of Rural Haryana - A Retrospective Study

2021 ◽  
Vol 8 (30) ◽  
pp. 2719-2723
Author(s):  
Shivani Khandelwal ◽  
Lakra Pinkey ◽  
Sangwan Vijayata ◽  
Mahendru Rajiv ◽  
Siwach Sunita ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Tertiary Care ◽  
Serous Cystadenoma ◽  
Common Symptom ◽  
Tertiary Care Centre ◽  
Adnexal Masses ◽  
Sexually Transmitted ◽  
Medical College ◽  
Wide Range ◽  
Ectopic Pregnancies

BACKGROUND There is a wide range of adnexal masses ranging from functional cyst to infection and even malignancy. Epithelial ovarian tumours are the most common benign ovarian lesion. The purpose of this study was to study the pattern of adnexal masses in rural area and plan the preventive steps according to the pattern. METHODS It was a retrospective study of patients who presented with adnexal masses in Bhagat Phool Singh Medical College (Women), Khanpur, Sonepat, Haryana, India over a period of 5.5 years from September 2012 to August 2018. The file records of the patients who underwent surgery for adnexal masse were evaluated to identify the risk factors, presenting complaints, examination findings, serological markers and radiological findings. The histopathological reports were reviewed. The cases excluded were ectopic pregnancies. Frequency distribution tables were used and data was analyzed using percentages. RESULTS Out of total 180 adnexal masses, 167 (92.77 %) cases were of ovarian origin. Out of these, 150 (83.33 %) cases were benign and 17 (9.44 %) were malignant. Among the benign lesions, serous cystadenoma was the most common lesion counting for 54 cases i.e., 30 %. In our study, most common symptom was vague abdominal pain- 63.88 %. Maximum adnexal masses were in the age group of 41 - 50 years i.e., 53 (29.44 %). Different types of surgeries were done. Maximum were bilateral oophorectomies with transabdominal hysterctomy 88 (48.88 %). CONCLUSIONS By proper education about personal and perineal hygiene, use of contraceptives, we can at least prevent some sexually transmitted diseases causing pelvic inflammatory disease (PID) and adnexal masses. KEYWORDS Adnexal Mass, Benign, Malignant, Serous Cystadenoma

Determination of Plasma Glycoprotein 2 Levels in Patients With Pancreatic Disease

2004 ◽  
Vol 128 (6) ◽  
pp. 668-674 ◽  
Author(s):  
Ying Hao ◽  
Jing Wang ◽  
Ningguo Feng ◽  
Anson W. Lowe
Keyword(s):  
Pancreatic Cancer ◽  
Acute Pancreatitis ◽  
Chronic Pancreatitis ◽  
Tertiary Care ◽  
Pancreatic Disease ◽  
Pancreatic Acinar Cell ◽  
Enzyme Linked Immunosorbent Assay ◽  
Assay Sensitivity ◽  
Acute And Chronic Pancreatitis

Abstract Context.—Blood tests possessing higher diagnostic accuracy are needed for all the major pancreatic diseases. Glycoprotein 2 (GP2) is a protein that is specifically expressed by the pancreatic acinar cell and that has previously shown promise as a diagnostic marker in animal models of acute pancreatitis. Objective.—This study describes the development of an assay for GP2, followed by the determination of plasma GP2 levels in patients with acute pancreatitis, chronic pancreatitis, and pancreatic cancer. Design.—Rabbit polyclonal antisera and mouse monoclonal antibodies were generated against human GP2 and used to develop an enzyme-linked immunosorbent assay. The assay was tested in patients with an admitting diagnosis of pancreatic disease at 2 tertiary care facilities. The diagnosis of acute or chronic pancreatitis and pancreatic cancer was determined using previously established criteria that incorporated symptoms, radiology, pathology, and serology. Plasma GP2 levels were determined in 31 patients with acute pancreatitis, 16 patients with chronic pancreatitis, 36 patients with pancreatic cancer, and 143 control subjects without pancreatic disease. Amylase and lipase levels were also determined in patients with acute pancreatitis. Results.—The GP2 assay's sensitivity values were 0.94 for acute pancreatitis, 0.81 for chronic pancreatitis, and 0.58 for pancreatic cancer, which were greater than the 0.71 for acute pancreatitis and 0.43 for chronic pancreatitis (P = .02) observed for amylase. The lipase assay sensitivity for acute pancreatitis was 0.66. The accuracy of the GP2 assay was greater than that of the amylase or lipase assays for acute pancreatitis (GP2 vs lipase, P = .004; GP2 vs amylase, P = .003) when analyzed using receiver operator characteristic curves. When daily serial blood samples were obtained for 13 patients with acute pancreatitis, GP2 levels remained abnormally elevated for at least 1 day longer than the amylase or lipase levels. Conclusion.—The GP2 assay is a useful new marker for acute and chronic pancreatitis.

APPENDICITIS IN PREGNANCY : OUR CLINICAL EXPERIENCE AT A TERTIARY CARE CENTRE

2021 ◽  
pp. 22-23
Author(s):  
Anil Kumar ◽  
Rekha Rani ◽  
Hamid Wani
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Correct Diagnosis ◽  
Tertiary Care ◽  
Fetal Loss ◽  
Common Symptom ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Lower Quadrant ◽  
Number Of Patients

Objective: Acute appendicitis is a common surgical condition presented to emergency. In this study we evaluated the clinical presentation, management and outcome of acute appendicitis complicating pregnancy at a tertiary care centre. Material And Methods: A total of 20 cases of pregnant women who were diagnosed as a case of acute appendicitis were studied from January 2018 to December 2020. Results: Total number of patients diagnosed with acute appendicitis were 20. There were 10 (50%) patients in rst trimester , 6 (30%) in second and 4 (20%) in the third trimester. Abdominal pain was the most common symptom seen in all patients. 12 (60%) patients were multigravida whereas 8 (40%) patients were primigravida. Duration of abdominal pain was 6 hours to 5 days with median of 30 hours. Right lower quadrant was the most common site of pain. Rebound tenderness was seen in 14 (70%) patients. Total leucocyte was raised in 14 (70%)cases. Ultrasound was done in all patients showing viable fetus and features of acute appendicitis in 12 (60%) cases. Surgery was done in 16 (80%) cases. Midline laparatomy was done in 3 patients whereas 4 (20%) patients were managed conservatively with antibiotics. Postoperative tocolytics were given in 6 patients. Postoperative complications such as wound infections seen in 5 cases and pelvic abscess in 1 case. Fetal loss was seen in 2 (10%)cases. Conclusion: Diagnosis of acute appendicitis during pregnancy can be difcult due to anatomical and biochemical changes during pregnancy. Correct diagnosis can be achieved by taking proper history, clinical examination and relevant investigations. Surgery remains the treatment of choice.

Su1508 Treatment Outcomes Following Glue Injection Without Lipiodol for Gastric Varices in South Indian Population Admitted to a Tertiary Care Centre

2016 ◽  
Vol 150 (4) ◽  
pp. S1115
Author(s):  
Chandasekar S. Thoguluva ◽  
Viveksandeep C. Thogulva ◽  
Gokul J. Bollu ◽  
Sathiamoorthy Suriyanarayanan ◽  
Raja Yogesh Kalamegam ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Indian Population ◽  
Tertiary Care ◽  
Gastric Varices ◽  
South Indian Population ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
South Indian ◽  
Glue Injection

scholarly journals Maternal and perinatal morbidity and mortality in COVID-19 positive obstetrics patients in tertiary care centre

2021 ◽  
Vol 10 (7) ◽  
pp. 2676
Author(s):  
Medha . ◽  
Neeta Chaudhary ◽  
Smita Tyagi ◽  
Kirtigiri G. Goswami
Keyword(s):  
Intensive Care ◽  
Neonatal Outcome ◽  
Tertiary Care ◽  
Common Symptom ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Health Crisis ◽  
Medical College ◽  
Satisfactory Condition ◽  
Fluctuating Course

Background: COVID-19 disease had been declared as a public health crisis by WHO by the end of 2019. The effect of SARS-CoV-2 infection on pregnancy including symptoms, disease severity, risk of vertical transmission and perinatal and neonatal outcome have been the subject of research. Preliminary studies showed a fluctuating course of the disease ranging from asymptomatic or mild symptoms to even maternal death. However, recent evidences suggest that effect of COVID-19 infection during pregnancy may not lead to adverse maternal and neonatal outcome.Methods: In this cross sectional prospective observational study, we analysed 60 pregnant women infected with SARS- CoV-2 and their neonatal outcome, who tested positive for COVID-19 at district hospital, and were referred to Muzaffarnagar Medical College, were enrolled in this study.Results: The majority 96.7% (58) of these women were asymptomatic with cough being the most common symptom which was present in 3.3% (2) of the women. 24(75%) women developed pneumonitis radiologically, but they were asymptomatic, so intensive care was not required. Along with 76.08% (35) perinatal/neonatal outcomes were observed normal.Conclusions: In this study we observed that most of the women with COVID-19 were asymptomatic or with mild symptoms. Even though they were asymptomatic, most of the patients showed pneumonitis changes radiologically but still they didn’t require any intensive care, had good recovery postpartum and were discharged under satisfactory condition. The neonatal outcome was highly favourable.

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