Retrospective analysis of oral cancers in Shimla-Himachal Pradesh (2011-2018): a hospital-based study

Background: Oral cancer ranks in the top three of all cancers in India, and oral cancer control is quickly becoming a global health priority. To analyse the epidemiological and clinical profile of oral cancer patients treated in Tertiary Care Center, IGMC, Shimla from 2011-2018.Methods: A retrospective study of patients with oral cancers treated from 2011-2018 at TCC, IGMC, Shimla was conducted. Demographic characteristics, tobacco use and oral cancer characteristics related to site, histology and stage at presentation were recorded from patient file records at TCC, Shimla. Data was analysed by Statistical package for social sciences (SPSS) version 16. Statistical test used was chi square test. A p value of 0.05 was considered to be statistically significant.Results: Oral cancer represents 1.53% of overall cancers. The total number of subjects were 246 out of which 205 were men and 41 were women thus making a male female ratio of 5:1. Peak age of occurrence is the 5th and 6th decade. The most common site involved was tongue (37.5%) followed by buccal mucosa (35.5%). Buccal mucosa was significantly associated with male gender, age group of less than 40 years. Lip was significantly associated with female gender, more than 60 years and with no habits. Floor of the mouth was significantly associated with males, 40-60 year age group and tobacco smoking.Conclusions: Strategies to overcome the present situation must be undertaken at state level by oral health programs for the early diagnosis and prevention and to support a tobacco free environment.

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Clinico-pathological and radiological correlation of sino-nasal masses in a tertiary care center

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202790 ◽

2020 ◽

Vol 6 (7) ◽

pp. 1342

Author(s):

Dimple Sahni ◽

Gagandeep Kaur ◽

Peeyush Verma ◽

Rajwant Kaur ◽

Harpal Singh

Keyword(s):

Histopathological Examination ◽

Care Center ◽

Tertiary Care ◽

Inflammatory Lesion ◽

P Value ◽

Radiological Investigation ◽

Female Ratio ◽

Histopathological Correlation ◽

Neoplastic Lesion ◽

Neoplastic Lesions

Background: The nasal masses are most commonly encountered condition in outpatient department of otorhinolaryngology. The purpose of this study was to show the clinical, radiological and histopathological correlation of sino nasal masses.Methods: This study was conducted on 100 cases with sino nasal masses over a period of 2 years. A provisional diagnosis was made after clinical and radiological investigation which was confirmed with histopathological examination and the findings were correlated. Results: The number of non-neoplastic lesions were more than neoplastic lesions (75% vs 25%). Incidence was highest in the age group of 31-40 year (21%) with male to female ratio of 1.5:1. In our study among non-neoplastic lesion, inflammatory lesion had highest frequency (75%). We found clinical and histopathological correlation in 94.6% cases (p value 0.04). 93.33% cases correlated radiologically and histopathologically (p value 0.04). Conclusions: We concluded that for proper evaluation of sino nasal masses, clinical, radiological, histopathological evaluation should be carried out conjointly. Histopathologic evaluation remains the gold standard.

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A study on clinical characteristics of herpes zoster in a tertiary care center

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20170081 ◽

2017 ◽

Vol 3 (1) ◽

pp. 79

Author(s):

Rachana R. ◽

Shivaswamy K. N. ◽

Anuradha H. V.

Keyword(s):

Herpes Zoster ◽

Clinical Characteristics ◽

Care Center ◽

Tertiary Care ◽

Age Groups ◽

Age Group ◽

Female Ratio ◽

Varicella Zoster ◽

Medical College ◽

Male To Female

Background: Herpes zoster (HZ), also known as shingles, derived from the Latin word Cingulum, for “girdle”. This is because a common presentation of HZ involves a unilateral rash that can wrap around the waist or torso like a girdle. HZ results due to reactivation of an earlier latent infection with the varicella zoster virus (VZV) in dorsal root ganglia. It occurs at all age groups, common over 60 years of age. It is estimated that in non-immune populations, approximately 15 cases per 1000 people occur per year. The objective of the study was to study the clinical characteristics in patients with uncomplicated herpes zoster.Methods: A total of 72 patients attending dermatology OPD at Ramaiah medical college between June 2013 to September 2014 were recruited after obtaining informed consent. A detailed history regarding onset of rash, pain, progression, duration and distribution of the lesions were recorded. Demographic information including age, sex, and any other co morbidities noted. Tzanck smear and serology for HIV was done where-ever necessary.Results: Of the 72 patients, females outnumbered males [M=35(48.61%), F=37 (51.39%)] with male to female ratio of 0.9 to 1. The mean age of presentation was 58±18 years. Majority of the patients (54%) were in the age group of 51 to 70 years followed by 31-50 years (25%). Least number of cases (9%) was in the age group of 21 to 30 years. Of the 72 subjects, thoracic involvement was noted in 30.6%, followed by lumbar (22%), and trigeminal (16%). Cervical (4%) and sacral (2%) involvement was the least. Conclusions: Herpes zoster commonly occurs in old age and the presenting symptom being pain and burning sensation. Thoracic dermatome is the commonest site. Immunocompromised states like diabetes, malignancy and HIV can increase the risk of developing herpes zoster.

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Histopathology of Polyps and Cancer of Colorectum: A ten years study from a tertiary care center

Journal of Gandaki Medical College-Nepal ◽

10.3126/jgmcn.v14i2.38385 ◽

2021 ◽

Vol 14 (2) ◽

pp. 100-106

Author(s):

Binita Goyal

Keyword(s):

Colorectal Cancer ◽

Care Center ◽

Correct Diagnosis ◽

Tertiary Care ◽

Older Age ◽

Histologic Grade ◽

Age Group ◽

Female Ratio ◽

Pathologic Stage ◽

Male Female Ratio

Introduction and objectives: Polyps and colorectal cancer have overlapping clinical presentation and may be difficult to diagnose on clinical grounds alone and close clinicopathological correlation is required for correct diagnosis and management. This study was aimed to see the spectrum of polyps and cancer in colorectum, see the percentage of colorectal cancer in younger individuals, see association between histologic grade and pathologic stage at presentation and compare site of tumor and pathologic stage at presentation in younger and older age group. Methods: This study was carried out on 138 consecutive cases of polyps and malignant lesions of colorectum during a time period of 10 years from January 2011 to December 2020. Results: Age of the patients ranged from 2 – 90 years with mean 45.1 years and a male female ratio 2:1. There were 58 (42.0%) cases of polyps and 80 (58.0%) cases of malignancies. 37 (46.3%) malignancy cases were seen in individuals ≤ 50 years of age. Most common site of involvement was rectum in 80 (58.0%) cases. Most common non-neoplastic polyp was retention polyp comprising 25 (67.6%) and most common neoplastic polyp was adenoma comprising of 18 (85.7%) cases. Most common malignancy was adenocarcinoma comprising 75 (93.8%) cases. Conclusion: Significant number of malignancies is seen in younger individuals stressing the need for suspicion and surveillance in this age group. Histologic grade is an important prognostic parameter and there is no difference in site of tumor and stage at presentation between younger and older age group.

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Cancer Scenario in Kashmir—A Study Conducted in a Tertiary Care Center, Srinagar, Kashmir, India

Asian Journal of Oncology ◽

10.1055/s-0041-1740107 ◽

2021 ◽

Author(s):

Dar Abdul Waheed ◽

Saba Sumaira ◽

Lone Mushtaq Ahmad ◽

Qurat Ul Ain ◽

Sanaullah Kuchay ◽

...

Keyword(s):

Cancer Patients ◽

Stomach Cancer ◽

Clinical Symptoms ◽

Care Center ◽

Tertiary Care ◽

Cancer Control ◽

Incidence Rates ◽

Anatomical Site ◽

Female Ratio ◽

Common Cancer

Abstract Background Cancer can have profound social and economic consequences for the people in India, often leading to family impoverishment and societal inequity. Reported age-adjusted incidence rates for cancer are still quite low in the demographically young country. Slightly more than 1 million new cases of cancer are diagnosed every year in a population of 1.2 billion. It accounts for about 23 and 7% deaths in United States and India, respectively. The world's population is expected to be 7.5 billion by 2020 and approximations predict that about 15.0 million new cancer cases will be diagnosed, with deaths of about 12.0 million cancer patients. Early detection of cancers is a challenging task because clinical symptoms develop slowly. Objective The aim of the present study was to analyze the cancer scenario in the Kashmir valley. Materials and Methods This was a retrospective study. So, all patients were included who had histopathologically confirmed neoplasm registered at Regional Cancer Centre of Government Medical College Srinagar, Kashmir between 2015 and 2018. All the patient characteristics including age, sex, and anatomical site of the disease were studied in detail. Results The number of cancer patients in 2015, 2016, 2017, and 2018 were 230, 239, 391, and 511, respectively, with a combined total of 1,371. Thus, it is clear from these figures that the number of cancer cases has increased gradually with time. Stomach cancer is the most common cancer in the Kashmir territory. In males the most common cancer is stomach cancer with 175 (12.8%) reported cases and in females the most common cancer is breast cancer with 151 (11%) reported cases. The male to female ratio was 1.4:1. Conclusion A careful reading the reported cancer cases indicates an increased number of cancer patients every year in Indian-occupied Kashmir. Kashmir is a growing state in India playing a crucial role in the development of India and, hence, it needs special attention on this issue. A multidisciplinary approach to cancer treatment is essential and this has to be made available at all regional cancer centers. Cancer control is an area in which we need participation from all sectors of the society.

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Study on demographic factors of discharge against medical advice in pediatric population

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20200109 ◽

2020 ◽

Vol 7 (2) ◽

pp. 359

Author(s):

Vidya B. U. ◽

Anil Shetty K.

Keyword(s):

Lumbar Puncture ◽

Care Center ◽

Demographic Data ◽

Tertiary Care ◽

Medical Advice ◽

P Value ◽

Against Medical Advice ◽

Female Ratio ◽

Significant Difference ◽

Discharge Against Medical Advice

Background: Discharge against medical advice (DAMA) is of serious concern among the pediatrics population. Parent(s)/guardians understanding about the disease and various other factors play role in their decision of DAMA. The aim of this study is to know the prevalence of DAMA in a tertiary care center and to observe the gender stratification in DAMA.Methods: A retrospective survey of medical records of children discharge against medical advice during the period January 2017 to January 2019. Demographic data, length of hospital stay, clinical diagnosis and procedure refused was collected.Results: Total 12977 were discharged during the study period of which, 387 children were DAMA, prevalence of DAMA was 2.9%, male to female ratio among DAMA patients is 1.2:1. The mean length of stay was 4.8 days. Among the DAMA patients’ newborns were predominant (61.6 %), p value = 0.0001, highly significant. No significant difference with respect to age and gender (p value = 0.535). Out of 370 DAMA patients, 211 patients who required further investigations and procedure was refused by parents/guardians (p value = 0.0001) highly significant. Phototherapy refusal was most common among newborn (59.7%), followed by neuroimaging and lumbar puncture in children (10.9%).Conclusions: DAMA was observed more among the newborns compared to infants, toddlers and children. Among newborns, phototherapy refusal was most common. In infants and children neuroimaging and lumbar puncture was the most commonly refused procedure. There was no gender bias.

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A clinical study of anemia in children aged 6 months–5 years in a tertiary care center, Bengaluru, Karnataka, India

Indian Journal of Child Health ◽

10.32677/ijch.v8i10.3067 ◽

2021 ◽

Vol 8 (10) ◽

pp. 367-370

Author(s):

Siva Saranappa ◽

Jennifer Wu

Keyword(s):

Nutritional Status ◽

Care Center ◽

Tertiary Care ◽

Age Groups ◽

World Health ◽

Deficiency Anemia ◽

Age Group ◽

Female Ratio ◽

Male Predominance ◽

Health Organization

Background: Anemia is the most commonly observed hematological diseases in children. The World Health Organization (WHO) has estimated that globally, 1.62 billion people are anemic, with the highest prevalence of anemia (47.4%) among preschool-aged children. Of these 293 million children, 89 million live in India. Aim: This study aims to evaluate the factors causing anemia in children aged between 6 months and 5 years and its prevalence within this age group. Methods: This study is a prospective observational study conducted in KIMS Hospital, Bengaluru, Karnataka. A total of 200 children in the age group of 6 months–5 years with features of anemia or having hemoglobin <11 g/dl were included in the study for a duration of 18 months between January 2019 and June 2020. Detailed history was recorded and examination findings were noted. The data collected were tabulated and statistically analyzed accordingly. Results: About 57.5% of the children with anemia fell between the age group of 6 months and 2 years and 42.5% of children were in the age groups of 2–5 years. A male predominance was seen (61%) with male-to-female ratio of approximately 1.56:1. Most of the children were found to have mild (46%) and moderate anemia (46%) with only a minority (8%) presenting with severe anemia. About 56.5% of the children had a normal nutritional status while 41% were malnourished and 2.5% had both wasting and stunting. Exclusive breastfeeding (for 6 months) history was present in 59% of the children. These children belonged mostly to the upper lower (45%) and lower middle (41%) socioeconomic status. This study also showed anemia in children most commonly presented majorly with concurrent involvement of the respiratory system (31%) followed by infectious diseases (30%) and gastrointestinal disorders (23%). Conclusion: The current study concludes that iron deficiency anemia is a multifactorial hematological disease. Learning about the predisposing risk factors can help to adopt the necessary precautions to prevent anemia in these children. Improving the nutritional status of the children by involving parents and counseling them regarding important feeding practices can help to prevent anemia.

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Immunization status of children aged 1-5 years attending tertiary care center and reasons for partial or non-immunization

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20204038 ◽

2020 ◽

Vol 7 (10) ◽

pp. 1978

Author(s):

Babitha Rexlin G. ◽

Suresh Placode Manikandan

Keyword(s):

Tamil Nadu ◽

Parental Education ◽

Care Center ◽

Tertiary Care ◽

Family Health ◽

Female Gender ◽

Home Delivery ◽

Family Welfare ◽

P Value ◽

Immunization Status

Background: Immunization is a reliable evidence-based approach to eradicate deadly infectious diseases. National family health survey (NHFS4) data reveals that immunization after 1 year of age dropped in Kanyakumari district, Tamil Nadu, India. Methods: Our aim was to determine immunization status and reasons for partial or non-immunization of children aged 1 to 5 years in Kanyakumari district from April 2019 to March 2020. It’s a prospective and descriptive hospital-based study. Here 613 children were split-up in three categories based on ministry of health and family welfare (MOHFW) guidelines as fully, partially or unimmunized. The samples were analysed with IBM. SPSS statistics software 23.0 Version.Results: Of the 613 children 5 were excluded from the study due to contraindications to immunizations. Of the 608 children 529 (87%) were fully immunized, 79(13%) were partially immunized and none were unimmunized. Among partially immunized, 2 parents lacked information (2.5%), 26 parents lacked motivation (32.9%), 45 parents faced obstacles (57%) and 6 parents had other reasons (7.6%). 2 parents who lacked information were migrant laborers, illiterates and the children were home delivered. In the partial immunization, chi-square and regression analysis revealed that for female gender the p-value was 0.001, OR 2.084 with 95% confidence interval (CI) (1.347 to 3.226), for parental education the p-value was 0.0005, OR 1.561 with 95% CI (1.034 to 2.335) and for home delivery the p value was 0.0005, OR 1.564 with 95% CI (1.006 to 2.432). Conclusions: The study determines that factors associated with partial immunization are female children, illiterate/less educated parents and home delivery.

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Oral cancer profile in a tertiary care center

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20171191 ◽

2017 ◽

Vol 3 (2) ◽

pp. 343

Author(s):

Nitin Arora ◽

Jai Lal Davessar ◽

Jyoti Singh

Keyword(s):

Risk Factor ◽

Oral Cancer ◽

Oral Cavity ◽

Head And Neck ◽

Tertiary Care ◽

Head And Neck Cancers ◽

Age Group ◽

Common Site ◽

Oral Cancers ◽

Age And Sex

Background: Head and neck cancers constitute around 5-50% of all cancers worldwide. Head and Neck Cancers constitute about 30% of all cancers that are found in India. It is the 8th most common cancer in the world. Oral cancer forms a major public health issue in India due to its rising incidence, especially in women and in younger age group. The purpose of our study was to evaluate, the epidemiologic profile of patients with oral cancer, its incidence according to age and sex, site distribution, risk factors involved and clinical stage at presentation.Methods: It is a prospective study done from January 2014 to November 2014, in a total of 100 patients in age group 21 to 70 years, irrespective of gender, with a proven malignancy confined to the oral cavity. Patients were observed for the age and sex distribution, tumour staging, location and metastasis, commonly associated risk factor and most common site. Results: Oral cavity cancers were more common in males, than females. It is most prevalent in age group of 51-60 years. Oral tongue is the most common site. Betel nut chewing is the most significant risk factor associated with oral cavity cancer.T1 and T2 is the most the most common primary T stage. Neck metastasis occurs most commonly at N2 stage. Most common neck node level involved is level 2.Conclusions: Oral cancers presents at advanced stage and age. It has also been seen in younger generations, which is due to increasing use of tobacco, its related products and alcohol. We see patient’s reports at advanced age and stage, which is increasing the morbidity and mortality related to oral cancers. Hence, today there is great need to create awareness about oral cancers. Preventive strategies must be designed in order to lessen the burden of Oral cancers.

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Frequency of retinal hemorrhage after thrombolysis with streptokinase in patients presenting with ST-elevation myocardial infarction: A single-center experience at a large tertiary care center in Lahore, Pakistan

Journal of Fatima Jinnah Medical University ◽

10.37018/bxos4371 ◽

2021 ◽

Vol 15 (2) ◽

pp. 87-90

Author(s):

Sarmad Zahoor ◽

Hafiz Mudabbar Mahboob ◽

Hafiz Muhammad Sajid Jehangir ◽

Bilal Mehmood ◽

Aleena Khan ◽

...

Keyword(s):

Myocardial Infarction ◽

Vision Loss ◽

Care Center ◽

Tertiary Care ◽

Retinal Hemorrhage ◽

St Elevation Myocardial Infarction ◽

P Value ◽

Cross Sectional ◽

Female Ratio ◽

St Elevation

Background: Thrombolytic therapy with streptokinase is the mainstay of pharmacological treatment in acute myocardial infarction in Pakistan. Retinal hemorrhage is a common complication of streptokinase-induced thrombolysis and is often overlooked which can lead to permanent vision loss. Therefore, this study was carried out to determine the frequency of retinal hemorrhage after thrombolysis with streptokinase in patients presenting with ST-elevation myocardial infarction (STEMI). Patients and methods: It was an observational, cross-sectional study conducted at the Emergency Department of Mayo Hospital Lahore from 11-08-2015 to 10-02-2016. The patients underwent injection of streptokinase (1.5 million U) intravenously over 60 min and intravenous heparin 5,000 U bolus followed by 1,000 U/hour. Then patients were followed up for 24 hours followed by the ophthalmoscopy to confirm the presence of retinal hemorrhage. The data were entered and analyzed using SPSS version 20. Results: A total of 130 patients were included in this study. The mean age of patients was 62±9.86 years. The male to female ratio was 1.6:1. The retinal hemorrhage was present in 17 (13.08%) patients. About 80 (61.5%) were diabetics and 96 (73.8%) were hypertensive. Stratified variables like age, gender, hypertension, and diabetes were not found associated with retinal hemorrhage (p-value ≥0.05). Conclusion: Retinal hemorrhage was found in 13.08% after streptokinase injection in patients presenting with STEMI. Although the association was statistically insignificant but still the proportion of retinal hemorrhage was substantially high in these patients. This higher percentage demands vigilant monitoring with the drug for timely diagnosis of this ignored complication which latter can be proved hazardous to the vision.

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Outcomes of metastatic colorectal cancer over fifteen years from an Indian tertiary care center: A retrospective analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e15050 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e15050-e15050

Author(s):

Vinod Sharma ◽

Atul Sharma ◽

Sushmita Pathy ◽

Nootan Kumar Shukla ◽

S V Suryanarayana Deo ◽

...

Keyword(s):

Colorectal Cancer ◽

Metastatic Colorectal Cancer ◽

Cox Regression ◽

Care Center ◽

Tertiary Care ◽

Tumor Location ◽

P Value ◽

Female Ratio ◽

Retrospective Data Analysis ◽

Ecog Ps

e15050 Background: Management of metastatic colorectal cancer (CRC) has revolutionised over the past 2 decades and a number of drugs are part of active disease management including biologicals. Published large database on metastatic CRC outcome has been lacking from India. Methods: A retrospective data analysis of metastatic CRC from prospectively based database was performed from the year, 2001-2015. All patients who have received at least 1 cycle of chemotherapy were enrolled. Kaplan Meier analysis was done for overall survival (OS). Cox-regression model was done to determine prognostic factors of OS. Results: A total of 288 patients including upfront metastatic (n = 197, 68%) and relapsed (n = 91, 32%) with male to female ratio of 1.4:1 and median age of 46 years were studied. CEA was high in 78% with median level of 20 ng/ml. Most common site of primary tumor location was rectum (47%). Proportions of left side, right side and transverse colon was 75%, 20% and 4.2%. Mucinous and signet histologies were seen in 24% and 9.2% of patients. Most common sites of metastases being liver (43%), peritoneum (31%) and lung (18%). Oxaliplatin based therapy was used 71% of patients as 1st line. Median chemotherapy cycles for both 1st and 2nd line regimen was 6. Biologicals were part of 1st line regimen in only 12.5% of patients. Median OS of our cohort was 18.5 months. Predictors of poor OS were ECOG PS > 1 (HR 2, CI: 1.3-3.3, p value = 0.003), high CEA ( > 5ng/ml, HR 2.5, CI: 1.3-4.6, p value = 0.004), low albumin (< 3.5 g/dl, HR 1.7, CI: 1.03-2.9, p value = 0.045), < 2 lines of chemotherapy received (HR 2, CI: 1.3-3.3, p value = 0.001). Conclusions: Outcomes of metastatic CRC in our cohort with use of doublet chemotherapy (small proportion with biologicals) is comparable to published literature worldwide. We have higher proportion of younger population, rectum cancer, signet and mucinous histology and higher incidence of peritoneal involvement.

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