scholarly journals Various treatment options of early carcinoma buccal mucosa involving commissure: a tertiary care centre experience of six years

2020 ◽  
Vol 6 (12) ◽  
pp. 2229
Author(s):  
Subbiah Shanmugam ◽  
Sujay Susikar ◽  
Syed Afroze Hussain ◽  
Kenny Robert
Keyword(s):  
Buccal Mucosa ◽  
Treatment Options ◽  
Tertiary Care ◽  
Patient Characteristics ◽  
Early Carcinoma ◽  
Treatment Modalities ◽  
Depth Of Invasion ◽  
Tertiary Care Centre ◽  
Unique Challenge ◽  
Carcinoma Buccal Mucosa

<p class="abstract"><strong>Background:</strong> Carcinoma of the buccal mucosa is the most common cancer of the oral cavity in India and involvement of commissure poses unique challenge in reconstruction after surgery. Aim was to analyse the demographics, presentations and various treatment options of early carcinoma buccal mucosa involving oral commissure.</p><p class="abstract"><strong>Methods:</strong> A retrospective review from clinical case records at our institution between 2014 and 2019 were analysed. All the cases recruited were analysed based on patient characteristics, clinical presentation, surgical and adjuvant therapy rendered. Statistical analysis was done using SPSS 20 software.  </p><p class="abstract"><strong>Results:</strong> A total of 40 patients of primary carcinoma buccal mucosa with T1 to T3 disease involving commissure were analysed. Median age of presentation was 51 years with male preponderance (24:16). 32 patients were offered surgery as the initial line of management and 8 received definitive radiotherapy. The estimated 5-year survival was around 30%. Two patients with clinically T2 disease were upstaged in the postoperative histopathology to T3 and T4a respectively one due to depth of invasion &gt;10 mm and the other owing to commissural skin involvement detected only in the final HPE.</p><p class="abstract"><strong>Conclusions:</strong> Early carcinoma of the buccal mucosa clinically extending from commissure poses unique challenges in choosing treatment modalities. In view of the location of the tumour it poses a small chance of upstaging of early disease in the final histopathology.</p>

scholarly journals IV Paracetamol for closure of patent ductus arteriosus in preterm neonates admitted to a tertiary care centre

2018 ◽  
Vol 5 (2) ◽  
pp. 294 ◽  
Author(s):  
Sunil B. ◽  
Shruthi Patel ◽  
Girish N.
Keyword(s):  
Side Effects ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Treatment Options ◽  
Tertiary Care ◽  
Current Treatment ◽  
Preterm Neonates ◽  
Tertiary Care Centre ◽  
Vascular Connection ◽  
Intravenous Paracetamol

Background: Ductus arteriosus is a vascular connection between the pulmonary artery and descending aorta. The incidence is inversely related to birth weight and gestational age (GA). In preterm infants it varies between 40% and 60% on the third day of life. At present, the choice of treatment of clinically significant PDA is with either ibuprofen or indomethacin, but they carry many contraindications and potential side effects. Hence it is important to consider that paracetamol may be used as an alternative to other non steroidal anti-inflammatory drugs and is effective in ductal closure with minimal side effects.Methods:Thirty six preterm infants with hemodynamically significant PDA(hs-PDA) were treated with intravenous paracetamol and subsequent closure was evaluated clinically and by follow-up 2D-Echo.Results: PDA closure following intravenous paracetamol was evident in 27 babies (75%). There were no significant side effects noted with paracetamol therapy.Conclusions: This study shows that paracetamol could offer favourable safety profile in comparison to current treatment options. Therefore, paracetamol may be accepted as a first-line drug treatment for PDA in preterm infants. 

scholarly journals CLINICOPATHOLOGICAL STUDY OF CARCINOMA ORAL CAVITY & PATTERN OF METASTASIS- EXPERIENCE IN A TERTIARY CARE CENTRE

2020 ◽  
pp. 1-3
Author(s):  
Bijan Basak ◽  
Soutrik Kumar ◽  
Kaustuv Das Biswas ◽  
Sayan Hazra ◽  
Debarshi Jana
Keyword(s):  
Indian Subcontinent ◽  
Treatment Options ◽  
Tertiary Care ◽  
Neck Surgery ◽  
Tertiary Care Centre ◽  
Major Health Problem ◽  
Node Metastases ◽  
Long Term Prognosis ◽  
Head Neck Surgery ◽  
Head Neck

Oral cancer (code 145.9, ICD 9) encompasses all malignancies originating in oral tissues & it is a major health problem in many parts of the world. Although incidence is relatively low in the western countries, in the Indian subcontinent & other parts of Asia it remains one of the commonest cancers. The study was conducted on the patients attending the ENT & HEAD-NECK SURGERY OPD at the INSTITUTE OF OTORHINOLARYNGOLOGY & HEAD-NECK SURGERY, IPGME&R, Kolkata during a period of 1 year from 1st March 2019 to 29th February 2020. Buccal mucosa was the commonest site & most cases presented in late stage with cervical lymph node metastases entailing poorer prognosis. People should be made aware of the warning symptoms, need for early diagnosis & treatment options available through IEC (information, education & communication programmes) in order to provide better treatment outcomes, improved long term prognosis & thereby reducing the morbidity & mortality of people at large.

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.

scholarly journals CLINICAL PROFILE AND MANAGEMENT OF PATIENTS OF AMOEBIC LIVER ABSCESS IN A TERTIARY CARE CENTRE

2020 ◽  
pp. 5-7
Author(s):  
Rakesh Mishra ◽  
Debabrata Banerjee ◽  
Debarshi Jana
Keyword(s):  
Drug Treatment ◽  
Liver Abscess ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Needle Aspiration ◽  
Intestinal Disease ◽  
Amoebic Liver Abscess ◽  
Treatment Modalities ◽  
Tertiary Care Centre ◽  
Early Recovery

Introduction: Amoebiasis is caused by the protozoan Entamoeba histolytica. Most infections are asymptomatic; clinical manifestations include amoebic dysentery and extra intestinal disease. Amoebic liver abscess is the most common extraintestinal manifestation of amoebiasis. Amoebae establish hepatic infection by ascending the portal venous system. Aim: To study various aspects of Amoebic Liver Abscess like demographic profiles, clinical presentations, association with intestinal disease, radiological and laboratory findings, treatment modalities and complications. Materials and Methods: A hospital based prospective observational study was performed in the Department of Internal Medicine, Command Hospital (Eastern Command), Kolkata, from Jan 2018 to Jun 2019. All confirmed cases of amoebic liver abscess above the age of 18 years admitted in Command Hospital (EC) were included in this study. The patient were then subsequently followed up for 01 year with USG abdomen every 03 monthly. Results: Total 40 patients of Amoebic Liver Abscess with age more than 18 year were enrolled in the study. The age ranged from 26 to 70 years (mean age 46.2 year). Male patients were dominated over female. 80.0 % were from rural background. About 55% patients were addicted to alcohol & 25.0 % were known diabetics at presentation. In all, 07 (17.5%) patients with abscess size of 6 cm to 10 cm (Vol> 300 cc) were treated by needle aspiration and drug therapy. Remaining 17(42.5%) patients with abscess size more than 10 cm were treated with pigtail drainage and drug. Conclusion: There is significant advantage of pigtail drainage with drug treatment over needle aspiration with drug and only with drug treatment in terms of decrease in lesion size and early recovery.

scholarly journals Ectopic pregnancy: an observational study in a tertiary care centre of Southern Rajasthan, India

2020 ◽  
Vol 9 (2) ◽  
pp. 516
Author(s):  
Shrusti Parmar ◽  
Nalini Sharma ◽  
Vimla Dhakar
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
First Trimester ◽  
Treatment Modalities ◽  
Public Health Issue ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Early Presentation

Background: One among the three chief obstetric causes of bleeding in first trimester, ectopic pregnancy is the first thing to rule out as a gestation is suspected. The present study observes and analyses sociodemographic distribution, risk factors, presentation, diagnosis and treatment modalities in a tertiary care centre.Methods: An observational cross-sectional study, conducted among patients who were diagnosed and managed in department of obstetrics and gynaecology of a tertiary care centre. Data analyzed and explained as frequency, percentage, mean and standard deviation.Results: Age group between 21 to 30 years (69.9%) and multigravida (68.5%) are high risk for ectopic pregnancy (EP). Menstrual history was regular in 86.3%. Risk factors identified were previous abortion (30%) and history of pelvic inflammatory disease (30%). In 80.9% pain in abdomen was presenting complaints followed by bleeding per vaginum (60%), amenorrhoea (60%) and nausea and vomiting (32.9%). Right salpingectomy was most common in 43.8%, followed by left salpingectomy in 28.8%, methotrexate in 15.1%, left salpingo-ophorectomy in 5.5%, right salpingo-opherectomy in 5.5% and removal of tubal abortion in 1.3% patients. Laparoscopy was chosen route in majority 64.4% patients.Conclusions: Ectopic pregnancy - a gynecological catastrophe as well as a major challenge to the reproductive performance of women worldwide, should be considered a relevant public health issue. By providing adequate materials, manpower, well-equipped health facilities as well as a prompt and efficient referral system, good access roads and efficient transportation, will ensure early presentation in hospitals and prompt management of cases.

scholarly journals Prevalence of various dermatoses in pregnancy at a tertiary care centre in Moradabad, Uttar Pradesh, India: an observational study

2019 ◽  
Vol 8 (2) ◽  
pp. 425
Author(s):  
Shruti Uniyal ◽  
Ritika Agarwal ◽  
Nupur Nandi ◽  
Pulkit Jain
Keyword(s):  
Observational Study ◽  
Low Socioeconomic Status ◽  
Treatment Options ◽  
Tertiary Care ◽  
Liver Function Tests ◽  
Skin Lesions ◽  
Personal Hygiene ◽  
Tertiary Care Centre ◽  
Palmar Erythema ◽  
In Pregnancy

Background: This was a prospective study which was done to observe various skin lesions in pregnancy and to determine the most likely causes and their incidence in antenatal patients, it was noticed that many women in our institute were having pregnancy related cutaneous complaints thus this observational study was carried out so that better preventive measures and treatment options could be provided to these patients.Methods: Study was conducted in out-patient department of Obstetrics and Gynaecology, TMU, Moradabad. All ANC cases between October 2017 to September 2018 having any type of dermatoses were included in the study irrespective of gestational age. 6348 patients appeared in OPD in the given time period out of which 1256 were included. In case of pruritus, liver function tests were done with USG whole abdomen and patients were reviewed by physician if required. Screening with VDRL, HCV, HbSAg and ELISA for HIV was done in all. Results were tabulated and analyzed.Results: 50.8% primi gravidas ,49.2% multi gravidas. age range 18-38 years. 29.3% presented in third trimester ,25.6% presented in second trimester. Physiological changes seen in all cases, 8.68% specific dermatoses of pregnancy. 40.4 % no complaints, 5.65% melasma, 90.8% hyperpigmentation, 94.6% linea nigra. Secondary areola 89.3%,striae 80.3% out of which 38.9%- primi gravidas and 41.40% -multi gravidas. 92.9% no change in hair density. Montgomery’s tubercles 30-50% of cases. spiders nevi 67%. No cases of palmar erythema. Pruritus gravidarum 38.53%. PUPPP 28.4%. Pemphigoid Gestationis 9.17%. Prurigo of pregnancy 18.34%. Pruritic folliculitis 1.8%. Eczema in pregnancy : pre-existing in 3.7% , out of which exacerbation 1, 3 unaffected. 3 chicken pox.1 filariasis.24 herpetic lesions (herpes simplex).1 scleroderma.17.27% pre-existing taenia infection . Scabies 20.46%.11 0.87% dual infection (scabies-taenia).Conclusions: This study highlights high prevalence of community acquired infections in our region like taenia, scabies giving rise to skin lesions in Antenatal women. Moreover, it highlights a probable association between the prevalence of skin lesions with factors like poor personal hygiene, overcrowding, low socioeconomic status, anaemia and poor nutritional status.

scholarly journals Pediatric Interstitial Lung Disease Masquerading as Difficult Asthma: Management Dilemmas for Rare Lung Disease in Children

2005 ◽  
Vol 12 (6) ◽  
pp. 317-320 ◽  
Author(s):  
EY Chan ◽  
Sharon D Dell
Keyword(s):  
Lung Disease ◽  
Bronchiolitis Obliterans ◽  
Treatment Options ◽  
Tertiary Care ◽  
Asthma Management ◽  
Open Lung Biopsy ◽  
Tertiary Care Centre ◽  
Exertional Dyspnea ◽  
Syncytial Virus ◽  
Difficult Asthma

Idiopathic nontransplant-related childhood bronchiolitis obliterans is an uncommon disease. Most patients present with chronic recurrent dyspnea, cough and wheezing, which are also features of asthma, by far a much more common condition. The present case study reports on a six-year-old girl who presented to a tertiary care centre with recurrent episodes of respiratory distress on a background of baseline tachypnea, chronic hypoxemia and exertional dyspnea. Her past medical history revealed significant lung disease in infancy, including respiratory syncytial virus bronchiolitis and repaired gastroesophageal reflux. She was treated for 'asthma exacerbations' throughout her early childhood years. Bronchiolitis obliterans was subsequently diagnosed with an open lung biopsy. She did not have sustained improvement with systemic corticosteroids, hydroxychloroquine or clarithromycin. Cardiac catheterization confirmed the presence of secondary pulmonary hypertension. Treatment options remain a dilemma for this patient because there is no known effective treatment for this condition, and the natural history is not well understood. The present case demonstrates the need for careful workup in 'atypical asthma', and the urgent need for further research into the rare lung diseases of childhood.

scholarly journals The impact of the COVID-19 pandemic on microbial keratitis presentation patterns

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256240
Author(s):  
Gibran F. Butt ◽  
Alberto Recchioni ◽  
George Moussa ◽  
James Hodson ◽  
Graham R. Wallace ◽  
...  
Keyword(s):  
Time Windows ◽  
Tertiary Care ◽  
Patient Characteristics ◽  
Microbial Keratitis ◽  
Tertiary Care Centre ◽  
Culture Positivity ◽  
Equivalent Time ◽  
Sight Loss ◽  
The Difference ◽  
The Impact

Background Microbial keratitis (MK) is the most common non-surgical ophthalmic emergency, and can rapidly progress, causing irreversible sight-loss. This study explored whether the COVID-19 (C19) national lockdown impacted upon the clinical presentation and outcomes of MK at a UK tertiary-care centre. Methods Medical records were retrospectively reviewed for all patients with presumed MK requiring corneal scrapes, presenting between 23rd March and 30th June in 2020 (Y2020), and the equivalent time windows in 2017, 2018 and 2019 (pre-C19). Results In total, 181 and 49 patients presented during the pre-C19 and Y2020 periods, respectively. In Y2020, concurrent ocular trauma (16.3% vs. 5.5%, p = 0.030) and immunosuppression use (12.2% vs 1.7%, p = 0.004) were more prevalent. Despite proportionately fewer ward admissions during the pandemic (8.2% vs 32.6%, p<0.001), no differences were observed in baseline demographics; presenting visual acuity (VA; median 0.6 vs 0.6 LogMAR, p = 0.785); ulcer area (4.0 vs 3.0mm2, p = 0.520); or final VA (0.30 vs 0.30 LogMAR, p = 0.990). Whilst the overall rates of culture positivity were similar in Y2020 and pre-C19 (49.0% vs. 54.7%, p = 0.520), there were differences in the cultures isolated, with a lower rate of poly-microbial cultures in Y2020 (8.3% vs. 31.3%, p = 0.022). Conclusions Patient characteristics, MK severity and final visual outcomes did not appear to be affected in the first UK lockdown, despite fewer patients being admitted for care. Concurrent trauma and systemic immunosuppression use were greater than in previous years. The difference in spectra of isolated organisms may relate to behavioural changes, such as increased hand hygiene.

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