scholarly journals Symptomatology of Advanced Gastrointestinal and Hepatobiliary Cancers in Palliative Care: Single Center Tertiary Care Experience from Eastern India

2021 ◽  
Vol 3 (3) ◽  
pp. 131-133
Author(s):  
Chaitanya Patil ◽  
Shrikant Atreya
Keyword(s):  
Palliative Care ◽  
Abdominal Pain ◽  
Gall Bladder ◽  
Medical Center ◽  
Neuropsychiatric Symptoms ◽  
Tertiary Care ◽  
Eastern Cooperative Oncology Group ◽  
Histopathological Diagnosis ◽  
Common Symptom ◽  
Female Ratio

The spectrum of symptoms for an oncologist or oncosurgeon about gastrointestinal (GI) and hepatobiliary (HB) cancers varies from the spectrum of symptoms that a palliative care physician ascertains. There is a paucity of data regarding GI and HB cancer symptomatology in a palliative care outset. Hence, we conducted this study to understand the same and identify the most common symptom clusters among these cancers. The present study was retrospective observational study conducted on patients referred to palliative care department of Tata medical center, Kolkata, India. A total of 495 patient’s case records were reviewed with GI and HB cancers. Age, gender, co-morbidities, Eastern Cooperative Oncology Group (ECOG) status, symptomatology, physical examination findings, and histopathological diagnosis were reviewed from the case records and documented. Symptomatology included pain, nausea, vomiting, anxiety, depression, constipation, anorexia, early satiety and loose stools. The mean age of the patients was 57.73 ± 12.50 years with male: female ratio of 1.60. The most common organ system involved was gall bladder (22.63%) followed by pancreas (16.97%). The most common symptom was abdominal pain (63.64%) followed by anorexia (28.08%) and constipation (21.62%) and the least common ones were loose stools (3.84%) and neuropsychiatric symptoms (4.85%). Nausea-vomiting cluster (38.10%) and abdominal pain-nausea/vomiting (28.38%) cluster were most common among stomach carcinomas. Abdominal pain-constipation cluster (23.21%) was more common among gall bladder carcinomas. Future studies directing to identify these symptoms and clusters over the quality of life of advanced cancer patients are warranted.

scholarly journals Clinicopathological study of gall bladder carcinoma with special reference to its management in a tertiary care hospital

2020 ◽  
Vol 7 (12) ◽  
pp. 4120
Author(s):  
Debmalya Saha ◽  
Saket Jha ◽  
Sukalyan Chhaule ◽  
Rabin Mandal ◽  
Anadi Acharya ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Gallbladder Cancer ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Treatment Protocol ◽  
Rank Test ◽  
Common Symptom ◽  
Care Hospital ◽  
Female Ratio ◽  
Mortality And Morbidity

Background: Incidence of gallbladder carcinoma is increasing progressively among Indians and is regarded as a major cause of mortality and morbidity. In spite of this, limited studies have been conducted so far. Objective of the study was to know the prevalence, clinicopathological aspects, and prevalent treatment protocol of gall bladder cancer in a tertiary care hospital in Eastern India.Methods: 64 cases of histologically proven gallbladder cancer patients were studied. Patient characteristics were recorded using pretested proforma along with relevant investigations, and histopathology and treatment provided were recorded.Results: Our study reveals that gallbladder cancer has a prominent peak in the 7th decade of life with male: female ratio of 1:2.2. Most of the patients were having body mass index between 20.0 and 24.99, which is in sharp contrast to the available literatures. Pain is the most common symptom followed by constitutional symptoms. Majority of cases presented at advanced stage (64.1%) with significantly elevated CA19.9 level, and were managed with palliative chemotherapy.35.9% of our cases were respectable at the time of diagnosis, and extended cholecystectomy could be performed in 31.3%. Log rank test showed pattern of survival of the patients who were resected was significantly better than those of who were not resected.Conclusions: We know gallbladder cancer is a disease with very few patients amenable to surgery at the time of presentation. Thus, instead of retrospectively analyzing individual institutional data, high volume institutions with the necessary expertise for treating gallbladder cancer should collaborate with a view of generating strong evidence-based surgical guidelines.

scholarly journals OVARIAN MASSES IN WOMEN: A RETROSPECTIVE ANALYSIS IN TERTIARY CARE CENTER

2021 ◽  
Vol 71 (2) ◽  
pp. 549-52
Author(s):  
Uzma Urooj ◽  
Sadaf Zohra ◽  
Rabiya Jalil ◽  
Asifa Siraj ◽  
Sumaira Khan ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Physical Examination ◽  
Tertiary Care ◽  
Abdominal Distention ◽  
Military Hospital ◽  
Histopathological Diagnosis ◽  
Common Symptom ◽  
Duration Of Symptoms ◽  
Presenting Symptoms ◽  
Ovarian Masses

Objective: To describe the presenting signs and symptoms, clinic-pathological findings of ovarian masses and to establish diagnostic value of clinical examination, ultrasonography and its correlation with histopathological diagnosis. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Jun 2017 May 2018. Methodology: Women who underwent surgery for ovarian masses were included. Data was collected from hospital records including; age, presenting symptoms, duration of symptoms, changes in menstrual cycle, and the results of the physical examination. The preliminary diagnoses as well as the final diagnosis were noted. Results: A total of 83 patients with ovarian masses, who underwent surgery over the period of a year, were included. The most common symptom was abdominal pain in 56 (67.5%) followed by abdominal distention 9 (10.8%), dysmenorrhea 8(9.6%). When both clinical and sonological diagnosis were combined, the overall sensitivity, specificity, positive and negative predictive value for diagnosis and discriminating benign and malignant ovarian neoplasms were 87.5%, 96.7%, 70%, and 98.88%, respectively. Conclusion: In this study most, common symptom was abdominal pain both in benign and malignant ovarian masses. Whereas, abdominal distention was more common in malignant masses. Preoperative diagnostic approach should always include careful history taking, physical examination, imaging and evaluation of tumor markers. Early detection, thorough treatment and regular follow-up are the need of time to reduce the morbidity and mortality.

Histopathological Study of Lesions of the Nasal Cavity, Paranasal Sinuses and Nasopharynx in a Tertiary Care Centre, Visakhapatnam over a Period of 2 Years

2021 ◽  
Vol 8 (33) ◽  
pp. 3054-3059
Author(s):  
Rajendra Prasad Jagannadham ◽  
Lakshmi Latchupatula ◽  
Sravani Ponnada ◽  
Neelima Lalam ◽  
Raghunadhababu Gudipudi ◽  
...  
Keyword(s):  
Nasal Cavity ◽  
Paranasal Sinuses ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Histopathological Study ◽  
Histopathological Diagnosis ◽  
Malignant Tumours ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Male Predominance

BACKGROUND A variety of non - neoplastic and neoplastic conditions involve the nasal cavity, paranasal sinuses and nasopharynx and these are very common lesions encountered in clinical practice. Histopathological examination of these lesions is the gold standard for diagnosis because management and prognosis vary among different lesions. The aim of the present study was to evaluate the histopathological study of the lesions of the nasal cavity, paranasal sinuses and nasopharynx in relation to their incidence, age, gender and site wise distribution and to compare the results with the available data. METHODS A study of 88 cases was conducted for a period of 2 years from August 2017 to July 2019. After fixation, Processing and Haematoxylin and Eosin staining and special stains histopathological diagnosis was made. RESULTS Among 88 total cases, 58 were males and 30 were females. A male predominance was observed with a male to female ratio of 1.93 : 1. They were more common in third, fourth and fifth decade of life. Malignant nasal lesions were seen after fourth decade of life. Nasal lesions were more common in nasal cavity (67.05 %), followed by paranasal sinuses (18.18 %) and nasopharynx (14.75). Out of 88 total cases, 39 (44.32 %) were non - neoplastic, 30 (34.09 %) were benign and 19 (21.59 %) were malignant nasal lesions. CONCLUSIONS Sinonasal lesions and nasopharyngeal lesions can have various differential diagnoses. A complete clinical, radiological and histopathological correlation helps to categorize these sinonasal lesions into various non - neoplastic and neoplastic types. But histopathological examination remains the mainstay of definitive diagnosis. KEYWORDS Nasal Cavity, Paranasal Sinuses, Nasopharynx, Benign Tumours, Malignant Tumours, Histopathological Examination

scholarly journals Histopathological Spectrum of Upper Gastrointestinal Endoscopic Biopsies in a Tertiary care centre

2021 ◽  
Vol 8 (6) ◽  
pp. A158-163
Author(s):  
Anjana M.L ◽  
Kavitha Yevoor
Keyword(s):  
Tertiary Care ◽  
Common Symptom ◽  
Female Ratio ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Wide Range ◽  
Neoplastic Lesions ◽  
Upper Gi Endoscopy ◽  
H Pylori ◽  
Duodenal Biopsies

Background: Upper GI endoscopy is an established procedure for investigating a wide range of upper GI conditions especially inflammatory and malignant diseases of stomach and esophagus. A good correlation in diagnosis can be achieved by complementing endoscopic findings with histopathology of biopsy specimens. Methods: Both retrospective and prospective study of upper GI endoscopic biopsy was carried out at department of pathology, KIMS, Hubli during January 2016 to December 2018. Samples were received in 10% formalin; routine processing was followed with H & E staining. Special stain like Giemsa was done for detection of H. Pylori. 396 endoscopic mucosal biopsies were analyzed and evaluated. Result: Out of 396 cases, 250 cases were esophageal biopsies, 104 cases were gastric biopsies & 42 cases were duodenal biopsies. The male: female ratio was 1:9:1. The highest number of cases was seen between 61 to 70 years. Dyspepsia was the common symptom seen in 61.3%. The most common lesions encountered in the esophagus were carcinomas (67%) followed by esophagitis (16%). The commonly encountered gastric lesion was chronic gastritis in 54.8% with H. pylori gastritis being positive in 38.18%. Among the duodenal biopsies, non-neoplastic lesions were most common (59.5%) followed by neoplastic lesions (26%). Conclusion: Upper GI endoscopy is an effective and appropriate preliminary investigation to assess patients with dysphagia, dyspepsia, vomiting. Endoscopy without biopsy is incomplete and that the combination of methods offers a strong diagnostic tool for better patient care.

Clinical Manifestations of Cholelithiasis in Quito, Ecuador. A Cohort Study

2021 ◽  
pp. 12
Author(s):  
◽  
◽  
Keyword(s):  
Epigastric Pain ◽  
Medical Center ◽  
Clinical Manifestations ◽  
Abdominal Ultrasound ◽  
Common Symptom ◽  
Low Back ◽  
Female Ratio ◽  
Male Female Ratio ◽  
The Right ◽  
A Prospective Study

Introduction: A prospective study was carried out, with the aim of establishing the clinical manifestations of cholelithiasis in the population of Quito, Ecuador. Methods: During the period from January 2012 to October 2017, 534 patients were referred from different outpatient clinics of the Ecuadorian Institute of Social Security to the Batan Medical Center with the diagnosis of cholelithiasis after a clinical assessment and abdominal ultrasound, to be treated surgically. Results: Sixty-nine percent of patients were female with a male-female ratio of 1:2.21. Mean age was 44.9 years. Pain was the most common symptom in our study: 95.7%. Among these patients, pain was located in the epigastrium in 49.8%, in the right hypochondrium in 45.1% and only 0.8% had low back pain. Pain ranged from moderate and even severe. The remaining 4.3% of patients had dyspepsia or were asymptomatic. Conclusions: This finding highlights the fact that epigastric pain must be always considered as a clinical manifestation on cholelithiasis.

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.

scholarly journals Prevalence, knowledge, attitude and practice regarding self-medication among medical, dental and paramedical students in a tertiary care hospital

2018 ◽  
Vol 7 (9) ◽  
pp. 1822
Author(s):  
Madhulika Johnson ◽  
Dinesh Kumar Badyal
Keyword(s):  
Medical Students ◽  
Information Source ◽  
Tertiary Care ◽  
Common Symptom ◽  
Care Hospital ◽  
Self Medication ◽  
Cross Sectional ◽  
Female Ratio ◽  
Group A ◽  
Group B

Background: Self-medication is practiced universally. Having medical knowledge plays a vital role in its prevalence. It is more prevalent in higher education course students especially medical students. However, it is increasing in dental and paramedical students. Hence, this study was conducted to evaluate self-medication among medical, dental and para-medical students in a tertiary care hospital.Methods: A cross sectional questionnaire based study was conducted among 449 undergraduate students. They were divided into three groups. A questionnaire was developed based on literature. The questionnaire was validated and finalised. The paper questionnaire was administered to students. The data collected from questionnaires was analysed. The results were expressed as percentages and frequencies.Results: The male female ratio of students who filled questionnaire was 65:35. All the students (100%) reported that they practice self-medication. The most common reason for self-medication was prior experience (36%) in group A as well as in group B (46%), but in group C, 39% mentioned no serious problem. Main information source was family members in all the groups (A 57%, B 53%, C 29%) followed by advice from senior/friends. Fever was most common symptom reported (29%) by group A followed headache (28%) in group C and cough and cold (23%) in group B. The commonest group of drugs used is cough syrups (25%) in group B, followed by analgesics (23%) in group C and antipyretics (21%) in group A.Conclusions: Self-medication is growing among dental and paramedical students too. It is necessary to educate them about self-medication to prevent future disastrous consequences as well as to make them aware of appropriate use of self-medication.

scholarly journals Knowledge, attitude and practice regarding tuberculosis among the patients attending a tertiary care hospital in Maharashtra, India: a cross sectional study

2019 ◽  
Vol 6 (2) ◽  
pp. 371
Author(s):  
Nilesh S. Sonawane ◽  
Chaitanya R. Patil
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Common Symptom ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

Background: Tuberculosis is major public health problem especially in the low and middle income countries like India. We conducted a study to assess the knowledge, attitude and practice related to tuberculosis among the patients attending our tertiary care institute.Methods: A cross sectional study was conducted in a tertiary care hospital on the patients attending OPD of tertiary care hospital in Maharashtra. The patients with debilitating illness or bed bound patients and those diagnosed and cured of tuberculosis or were on treatment of tuberculosis were excluded from the study. A pretested and designed questionnaire was used to assess the knowledge, attitude and practice about the cause, clinical features and treatment of tuberculosis.Results: The mean age of the study subjects was 43.34±11.23 years with male: female ratio of 1.45. About 16.67% of the subjects stated that cause of TB is bacteria, 51.33% reported that cough was the most common symptom, 58.67% believed that it spreads from person to person and among the people who said it spreads 58.67% said that it can be preventable.Conclusions: About 1/5th of the study subjects expressed the cause of TB is bacteria or germs, and more than ½ believed that TB spreads from person to person. About 2/3rd of the patients felt that TB was a very serious disease; more than ½ of them expressed fear if they were diagnosed with TB but more than ½ of them also expressed rejection if they have a TB patient as a closed one.

scholarly journals An overview of endoscopic stapedotomy in a tertiary care centre

2020 ◽  
Vol 6 (6) ◽  
pp. 1102
Author(s):  
Atish B. Gujrathi ◽  
Siddharth A. Shroff ◽  
Nishikant Gadpayale ◽  
Naman Agarwal
Keyword(s):  
Hearing Loss ◽  
Intraoperative Complications ◽  
Adult Population ◽  
Tertiary Care ◽  
Case Series ◽  
Anatomical Variations ◽  
Common Symptom ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Endoscopic Stapedotomy

<p class="abstract"><strong>Background:</strong> Stapedotomy is now one of the most popular and common surgeries done worldwide. Otosclerosis remains the most common single cause of conducting hearing loss in adult population. Females are more frequently affected than males with an approximate 2:1 ratio.</p><p class="abstract"><strong>Methods:</strong> This study consists of 30 patients who underwent stapedotomy for otosclerosis. This study was conducted at Dr Shankarrao Chavan Government Medical College, Nanded, during the period of 2 years (2017-2019). Patients were evaluated and operated. The various anatomical variations, diagnostic dilemmas, intraoperative complications, its management and follow-up were done systematically.  </p><p class="abstract"><strong>Results:</strong> Age of patients included in this study ranged from 15 to 50 years. Youngest patient was a 17-year-old male. Age of presentation was most commonly seen in third decade of life. Male to female ratio was 1:2. The most common symptom was hard of hearing followed by tinnitus. In this study, 76.67% of the patient’s had bilateral disease. 66.66% of patients had hearing loss between 41-55 dB with mean pre-operative pure tone average was 51.16 dB. About 80% of patients had successful air bone closure between 0-10 dB after the surgery.</p><p class="abstract"><strong>Conclusions:</strong> Endoscopic stapedotomy seems a feasible and relatively safe surgical technique in limited case series. Cosmetically this procedure was more compliant by the patients however endoscopic stapedotomy requires a significant learning curve and an extreme expertise.</p>

scholarly journals Comparative analysis of clinical, radiological and operative findings in acute abdomen

2019 ◽  
Vol 6 (3) ◽  
pp. 806
Author(s):  
Mir Zeeshan Ali ◽  
Vamsee Krishna Maddu
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Acute Abdomen ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
Diagnostic Utility ◽  
Common Symptom ◽  
Care Hospital ◽  
Hollow Viscus ◽  
Hollow Viscus Perforation

Background: The term acute abdomen refers to signs and symptoms of abdominal pain and tenderness that often requires emergency surgical therapy. The objective of the present study is to compare pre-operative diagnosis based on clinical examination with the operative diagnosis in acute abdomen.Methods: Total 60 cases of acute abdomen who underwent laparotomy in a tertiary care hospital   were analysed prospectively regarding clinical features and also assessed the diagnostic utility of radiological investigations like plain abdominal radiographs, ultrasonography and computed tomography.Results: Acute abdomen was most common in males and 2nd to 5th decade of life. Appendicitis was most common cause of acute abdomen followed by hollow viscus perforation and intestinal obstruction. Abdominal pain was the most common symptom. Tenderness was the most common sign. Diagnostic utility of x-ray is more in hollow viscus perforation and intestinal obstruction, whereas ultrasonography is diagnostic in 64.3%. Ultrasonography accurately diagnosed acute appendicitis in 74.2%, hollow viscus perforation in 50%, and intestinal obstruction in 60% of patients. 95% clinical accuracy was found when compared to intra operative diagnosis. Kappa is 0.912 (p<0.0001).Conclusions: Clinical judgement is key to diagnosis of acute abdomen and investigations are only supplementary and cannot replace the clinical decision.

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