scholarly journals Evaluation of a step-by-step approach to frozen section diagnosis in ovarian masses

2021 ◽  
Vol 12 (12) ◽  
pp. 133-139
Author(s):  
Ashumi Gupta ◽  
Neelam Jain
Keyword(s):  
Sensitivity And Specificity ◽  
Malignant Tumors ◽  
Frozen Section ◽  
Tertiary Care ◽  
False Negative ◽  
Significant Proportion ◽  
False Negative Rate ◽  
Accurate Diagnosis ◽  
Care Hospital ◽  
Ovarian Masses

Background: Ovarian cancer forms a significant proportion of cancer-related mortality in females. It is often detected late due to non-specific clinical presentation. Radiology and tumor markers may indicate an ovarian mass. However, exact diagnosis requires pathological evaluation, which may not be possible before surgery. Intraoperative frozen section (FS) is, therefore, an important modality for the diagnosis of ovarian masses. Aims and Objectives: This study was conducted to study step-by-step approach along with diagnostic utility and accuracy of intraoperative FS in diagnosis of ovarian masses. Materials and Methods: Retrospective comparative analysis was done to determine the diagnostic accuracy of FS as compared to routine histopathology in the pathology department of a tertiary care hospital. Diagnostic categorization was done into benign, borderline, and malignant. Overall accuracy, sensitivity, and specificity of FS technique were calculated. Results: Out of 51 cases, FS analysis yielded accurate diagnosis in 94.1% of ovarian masses. Intraoperative FS had a sensitivity of 94.7%, specificity of 96.9%, 3.1% false-positive rate, and 5.3% false-negative rate in malignant tumors. In benign lesions, FS had 91.7% sensitivity and 100% specificity. FS had 75% sensitivity and 96.4% specificity in cases of borderline tumors. Conclusion: FS is a fairly accurate technique for intraoperative evaluation of ovarian masses. It can help in deciding the extent of surgery. It distinguishes benign and malignant tumors in most cases with high sensitivity and specificity. A methodical approach is useful in determining accurate diagnosis on FS diagnosis.

scholarly journals Pretherapeutic Imaging for Axillary Staging in Breast Cancer: A Systematic Review and Meta-Analysis of Ultrasound, MRI and FDG PET

2021 ◽  
Vol 10 (7) ◽  
pp. 1543
Author(s):  
Morwenn Le Boulc’h ◽  
Julia Gilhodes ◽  
Zara Steinmeyer ◽  
Sébastien Molière ◽  
Carole Mathelin
Keyword(s):  
Systematic Review ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
False Negative ◽  
Significant Proportion ◽  
False Negative Rate ◽  
True Positive Rate ◽  
Axillary Staging ◽  
Positron Emission ◽  
Positive Rate

Background: This systematic review aimed at comparing performances of ultrasonography (US), magnetic resonance imaging (MRI), and fluorodeoxyglucose positron emission tomography (PET) for axillary staging, with a focus on micro- or micrometastases. Methods: A search for relevant studies published between January 2002 and March 2018 was conducted in MEDLINE database. Study quality was assessed using the QUality Assessment of Diagnostic Accuracy Studies checklist. Sensitivity and specificity were meta-analyzed using a bivariate random effects approach; Results: Across 62 studies (n = 10,374 patients), sensitivity and specificity to detect metastatic ALN were, respectively, 51% (95% CI: 43–59%) and 100% (95% CI: 99–100%) for US, 83% (95% CI: 72–91%) and 85% (95% CI: 72–92%) for MRI, and 49% (95% CI: 39–59%) and 94% (95% CI: 91–96%) for PET. Interestingly, US detects a significant proportion of macrometastases (false negative rate was 0.28 (0.22, 0.34) for more than 2 metastatic ALN and 0.96 (0.86, 0.99) for micrometastases). In contrast, PET tends to detect a significant proportion of micrometastases (true positive rate = 0.41 (0.29, 0.54)). Data are not available for MRI. Conclusions: In comparison with MRI and PET Fluorodeoxyglucose (FDG), US is an effective technique for axillary triage, especially to detect high metastatic burden without upstaging majority of micrometastases.

scholarly journals A prospective study of clinical and diagnostic methods of ovarian tumors admitted in a tertiary care hospital and its correlation with histopathology

2021 ◽  
Author(s):  
Silika Madria ◽  
Vineeta Ghanghoriya ◽  
Kavita N. Singh ◽  
Manisha Lokwani ◽  
Ranu Tiwari
Keyword(s):  
Clinical Diagnosis ◽  
Sensitivity And Specificity ◽  
Tertiary Care ◽  
Ovarian Tumors ◽  
Diagnostic Methods ◽  
Care Hospital ◽  
Ultrasound Score ◽  
Benign Ovarian Tumors ◽  
Sensitivity Specificity ◽  
Ovarian Masses

Background: Aim of the study was to study demographic profile and diagnostic modalities of ovarian tumors and their correlation with histopathological report (HPR).Methods: Prospective observational study conducted in NSCB medical college, Jabalpur from February 2019 to July 2020 on subjects with ultrasonographically diagnosed ovarian tumors. Relevant history obtained, gynecologic examination, investigations recorded. Subjects followed up to collection of HPR and correlation with histopathology done.Results: Out of 120 cases of ovarian tumors, 39.16% were malignant and 60.83% were benign ovarian tumors. Out of 80 premenopausal females, majority (78.75%) had benign ovarian masses. Amongst 40 postmenopausal females, 75% of ovarian masses were malignant. CA125 had sensitivity 76.59%, specificity 76.71% and accuracy 76.66% in diagnosing ovarian malignancy. Amongst 4 RMI scores, RMI 1 has the highest sensitivity and specificity 85.10%, 86.30% respectively. Sensitivity, specificity, and accuracy of ultrasound score was 65.21%, 86.30% and 77.5% respectively. Sensitivity and specificity of clinical diagnosis was 83% and 95.89% respectively and ROC analysis showed clinical diagnosis can accurately predict benign and malignant ovarian tumors in 89% cases.Conclusions: RMI 1 score has the highest sensitivity and specificity in our study. When all 4 methods of diagnosis i.e., RMI Score, ultrasound score, CA125 and clinical diagnosis were compared, clinical diagnosis has highest prediction of malignancy.

scholarly journals A comparative study between abdominal plain radiography and ultrasonography in non-traumatic acute abdominal emergencies in tertiary care hospital

2016 ◽  
Vol 5 (1) ◽  
pp. 113 ◽  
Author(s):  
Chiranjeev Kumar Gathwal ◽  
Monika B. Gathwal ◽  
Shreya Garg ◽  
Yogita Kumari ◽  
Kulvinder Singh
Keyword(s):  
Comparative Study ◽  
Acute Abdomen ◽  
Tertiary Care ◽  
False Negative ◽  
False Negative Rate ◽  
Plain Radiography ◽  
Radiographic Evaluation ◽  
Care Hospital ◽  
X Rays ◽  
Abdominal Emergencies

Background: Acute abdomen is a loose term frequently used to describe the acute abdominal pain in a subgroup of patients who are seriously ill developing suddenly, over a period of several hours or few days.Methods: It was a prospective comparative study between abdominal plain radiography and ultrasonography in non-traumatic acute abdominal emergencies in Tertiary Care Hospital.Results: All the included patients (140) were imaged with abdominal X-rays series (AAS) and Ultrasonography (US) by different blinded radiologists without conveying results to either. Final diagnosis was made on the basis of clinical findings / laboratory or biochemical findings /radiological evaluation /therapeutic response / operative findings / histopathological examination. The entire data was collected, recorded and statistically analyzed as per objectives. GIT system was most commonly involved, in 75/140 cases (53.57%). Most common diagnoses were acute appendicitis, KUB calculus disease and acute cholecystitis seen in 32/140 (22.86%), 24/140 (17.14%) and 21 (15%) cases respectively. US supersedes Provisional clinical diagnosis and Radiographic evaluation in diagnosing acute abdominal conditions with Sensitivity, Positive Predictive Value, False positive rate, False Negative rate and Diagnostic Accuracy as 90.71, 100, 0 ,9.28 and 90.71 percent respectively.Conclusions: We concluded that Plain X rays can be used as screening modality in the diagnosis of acute abdominal emergencies; however ultrasound examination is cheaper, non-invasive, quick, reliable and highly accurate modality in diagnosing the exact cause of pain and its origin in a patient presenting with an acute abdomen and thus helps the physician or surgeon to plan the timely management.

scholarly journals Different types of tumors in perimenopausal women presenting with ovarian masses at A Tertiary Care Hospital.

2020 ◽  
Vol 27 (11) ◽  
pp. 2469-2473
Author(s):  
Maria Akmal ◽  
Mahham Janjua ◽  
Rabia Wajid ◽  
Maria Imran ◽  
Zobia Jawad
Keyword(s):  
Family History ◽  
Tertiary Care Hospital ◽  
Malignant Tumors ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Detailed Medical History ◽  
Perimenopausal Women ◽  
Ovarian Masses

Objectives: To determine frequency of benign and malignant tumors among perimenopausal women presenting with ovarian masses at a tertiary care Hospital. Study Design: Descriptive Cross Sectional study. Setting: Department of Obstetrics & Gynecology, Jinnah Hospital, Lahore. Period: Six Months from August 2017 to January 2018. Material & Methods: A total 127 premenopausal females with ovarian masses visiting Obstetrics & Gynaecology Department, Jinnah Hospital, Lahore were selected. After detailed medical history and clinical examination patients underwent ultrasonography to diagnose status of ovarian masses. Data was entered in self-made proforma. Results: Total 127 patients were selected. Mean age of cases was 48.87 ± 3.04 years, with mean BMI of 26.52±2.43 kg/m2 and obese patients were 30.7%. Out of all 73.2% patients had benign masses and 26.8% patients had malignant masses. Obesity and family history were significantly correlated with malignant tumors among premenopausal women having ovarian masses p-value 0.001. Conclusion: It was observed that the malignant tumors are frequently linked to pre-menopausal women with ovarian masses. Obese and family history positive patients are on high risk of malignant tumors.

scholarly journals A retrospective evaluation of Alvarado score in diagnosing acute appendicitis in a tertiary care hospital at Pondicherry

2021 ◽  
Vol 8 (4) ◽  
pp. 1089
Author(s):  
G. Ray ◽  
S. Selvakumaran
Keyword(s):  
Acute Appendicitis ◽  
Laboratory Finding ◽  
Tertiary Care ◽  
False Negative ◽  
Age Groups ◽  
False Negative Rate ◽  
Care Hospital ◽  
Alvarado Score ◽  
Diagnostic Skills ◽  
One Year

Background: Acute appendicitis is a common and sometimes confusing cause of acute abdomen in all age groups. Diagnosis of appendicitis can be difficult, occasionally taxing the diagnostic skills of even the most experienced surgeon. Despite the increased use of USG, CT, the rate of misdiagnosis of appendicitis has remained the same (15.3%). To evaluate the usefulness of the Alvarado score as a simple and reliable tool in preoperative diagnosis of acute appendicitis.Methods: This retrospective study conducted on 97 cases includes all patients who were admitted with a clinical diagnosis of acute appendicitis for a period of one year from February 2019 to January 2020 at IGMCRI Pondicherry with clinical suspicions of acute appendicitis were included in the study. The modified scoring system is based on 3 signs, 3 symptoms, and 1 laboratory finding. The patient was classified as males, females, and children (<12 years). These were further grouped based on the scores 7-9, 5-6, and <5.Results: A total of 80 patients with a score of 7-9 and 5-6 were operated on. Among males with a score of 7-9, 35 patients were operated and 34 were found to have an inflamed appendix. Females with scores 7-9, 16 were operated and 11 were found to have an inflamed appendix.Conclusions: Alvarado scores significantly reduce the number of negative laparotomies without increasing the overall rate of appendicular perforation. It is very effective in men and children but diagnostic laparoscopy or ultrasonography is advised to minimize the high false-negative rate in women.

scholarly journals External validation for sensitivity of the Ottawa subarachnoid hemorrhage rule in a Japanese tertiary teaching hospital

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tomoharu Suzuki ◽  
David Itokazu ◽  
Yasuharu Tokuda
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
External Validation ◽  
False Negative ◽  
False Negative Rate ◽  
Prediction Rule ◽  
Japanese Patients ◽  
Inclusion Criteria ◽  
Tertiary Teaching

AbstractThe Ottawa subarachnoid hemorrhage (OSAH) rule is a validated clinical prediction rule for ruling out subarachnoid hemorrhage (SAH). Another SAH rule (Ottawa-like rule) was developed in Japan but was not well validated. We aimed to validate both rules by examining the sensitivity for ruling out SAH in Japanese patients diagnosed with SAH. We conducted a retrospective cohort study by reviewing the medical records of consecutive adult patients hospitalized with SAH at a tertiary-care teaching hospital in Japan who visited our emergency department between July 2009 and June 2019. Sensitivity and its 95% confidence interval (CI) were estimated for each rule for the diagnosis of SAH. In a total of 280 patients with SAH, 56 (20.0%) patients met the inclusion criteria and were analyzed for the OSAH rule, and a sensitivity of the OSAH rule was 56/56 (100%; 95% CI 93.6–100%). While, 126 (45%) patients met the inclusion criteria of the Ottawa-like rule, and the rule showed a sensitivity of 125/126 (99.2%; 95%CI 95.7–100%). The OSAH rule showed 100% sensitivity among our Japanese patients diagnosed with SAH. The implementation of the Ottawa-like rule should be cautious because the false-negative rate is up to 4%.

scholarly journals ROLE OF ULTRASOUND AS AN IMAGING MODALITY IN NEOPLASTIC OVARIAN MASSES IN A TERTIARY CARE HOSPITAL

2017 ◽  
Vol 6 (94) ◽  
pp. 6858-6862
Author(s):  
Singhal R P ◽  
Pardaman Singh Setia ◽  
Kawal Preet Kaur ◽  
Virinder Mohan ◽  
Payal Bansal
Keyword(s):  
Tertiary Care Hospital ◽  
Imaging Modality ◽  
Tertiary Care ◽  
Care Hospital ◽  
Ovarian Masses

scholarly journals Knowledge, Attitude, Practices and Obstacles to Provide Urinary incontinence Care among Nurses

2021 ◽  
Vol 3 (1) ◽  
pp. 65-73
Author(s):  
Akmal Shehzad ◽  
Kausar Parveen ◽  
Muhammad Afzal
Keyword(s):  
Urinary Incontinence ◽  
Positive Attitude ◽  
Pearson Correlation ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Good Knowledge ◽  
Unique Contribution ◽  
Care Hospital ◽  
Study Objective ◽  
Attitudes And Practices

Purpose: Nurses are personalities who stand with patients at all times to listen and solve their problems. Excellent knowledge, good practices and positive attitude of nurses proves very effective for improving patients with urinary incontinence in a mannered way. The study objective was, (a) evaluate the knowledge, attitudes and practices among nurses of urinary incontinence, (b) reveal the relationship between knowledge, attitudes and demographic characteristics and (c) evaluate obstacles faced by nurses during urinary incontinence care. Methodology: A cross-sectional study was accompanied in a government tertiary care hospital in Lahore, Pakistan. To analysis the variables statistical packages for social sciences version 25 was used. Pearson correlation test was used to correlate the knowledge, attitude and practices regarding urinary incontinence. Less than P>0.05 is significant. Findings: 164 nurses contributed in the studies and 157 completed and return the survey questioner, with return rate of 95.7%. Of those, 117(74.5%) were female nurses and 40(25.5%) were male nurses. There is a significant correlation found between knowledge with attitude items 0.046 and knowledge with practice items 0.039. The study respondents have good knowledge, positive attitude but wrong practices regarding urinary incontinence. Unique contribution to theory, practice and policy: It is concluded that Nurses have good knowledge, positive attitude but wrong practices that require special training or workshops to managing and treating incontinence more efficiently. This helps to bring significant improvement in urinary incontinence care and helps to lower the heath care cost. Such clinical guidelines need to be made within the organizations to manage a significant proportion of patients with urinary incontinence. Keywords: Knowledge, Attitude, Practices, Obstacles, Urinary incontinence, Nurses

scholarly journals Efficacy of Bortezomib plus dexamethasone as a first line treatment in newly diagnosed cases of Multiple Myeloma: A Single Centre Study in a Tertiary Care Hospital

2020 ◽  
Vol 28 (1) ◽  
pp. 34-41
Author(s):  
Mahbuba Sharmin ◽  
Mohammad Manirul Islam ◽  
Abdul Aziz ◽  
Salauddin Shah ◽  
Md Jalilur Rahman ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Partial Response ◽  
Intracranial Haemorrhage ◽  
Response Rate ◽  
Malignant Tumors ◽  
Tertiary Care ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
Overall Response ◽  
Highly Effective

Background: Multiple Myeloma (MM) accounts for 1% of malignant tumors and 10%–15% of hematopoietic neoplasms. Bortezomib, a first in class proteasome inhibitor, induces apoptosis and growth arrest and reverse chemoresistence in Myeloma cell and has demonstrated no irreversible adverse effect on haemopoietic stem cell. Dexamethasone increases the response rate. Thus, Bortezomib plus dexamethasone represent highly effective regimen for previously untreated Multiple Myeloma cases and significantly higher response rates approximately 70%– 90% have been observed.This combination thus may serve the basis of future strands of care in Multiple Myeloma patients. Objective: The aim of the study was to assess the efficacy , safety and tolerability of Bortezomib in newly diagnosed cases of Multiple Myeloma patients in Bangladesh. Materials & Methods: This prospective observational study was carried out in the Haematology department of BSMMU from June 2017 to December 2018. Patients received inj. Bortezomib (1.3mg/m2 ) 4 cycles as an intravenous bolus on days 1,4,8,11 in a three week cycle (twice weekly administration) in indoor and same patients as day care basis in outpatients department. Dexamethasone at 40 mg was given intravenously or orally on the day of and day after inj Bortezomib.A self administered questionnaire containing different set of questions regarding Multiple Myeloma were used for data collection. Results: Among the study population, 93% of patients had anaemia followed by bone pain (86%) and renal impairment (39%). Out of 25 patients,complete response achieved in 13 patients (52%), where 4 patients(16%) showed partial response,6 (24%) showed very good partial response and 2 (8%) patients showed no response. The overall response rate was 92% belonged to partial,very goofd partial and no respone respectively. Death occurred in 3 cases (12%). 5 patients (20%) developed Bortezomib induced peripheral neuropathy.Life threatening intracranial haemorrhage occurred in two patients (8%). Death occurred in 3 cases (12%),2 patients due to intracranial haemorrhage and another from cardiac arrest. In this study,S. creatinine, â2 microglobulin and bony lesion variables showed significant association with treatment response. Conclusion: Bortezomib plus dexamethasone is a highly effective and safe regimen for previously untreated multiple myeloma patients. This novel therapy in myeloma represent a new trearment paradigm targeting both tumor and microenvironment which has markedly improve overall response(OR), long progression free survival (PFS) and overall survival (OS)across in all risk groups. Moreover,it can be administered safely in the outpatient setting provided by clinicians. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 34-41

scholarly journals A comparative study of parapharyngeal space tumors over a 7 year period experience in tertiary care hospital

2018 ◽  
Vol 4 (5) ◽  
pp. 1167
Author(s):  
Athiyaman K. ◽  
Gowri Shankar M. ◽  
Suresh V. ◽  
Natarajan S. ◽  
Malarvizhi R.
Keyword(s):  
Parapharyngeal Space ◽  
Malignant Tumors ◽  
Tertiary Care ◽  
Direct Access ◽  
Vascular Lesions ◽  
Care Hospital ◽  
Neurogenic Tumors ◽  
Parapharyngeal Space Tumors ◽  
First Choice ◽  
Cervical Approach

<p class="abstract"><strong>Background:</strong> Tumors of the parapharyngeal space (PPS) are rare, accounting for 0.5–1.5% of all head and neck tumors. The<strong> </strong>anatomy of the PPS is responsible for a wide variety of tumors arising from the PPS. Our series of 10 PPS tumors provides an overview of the clinical course and management of PPS tumors.</p><p class="abstract"><strong>Methods:</strong> This retrospective study included clinical data from patients treated for PPS tumors from 2011 to<strong> </strong>2018 at the Stanley medical college hospital, Chennai.  </p><p class="abstract"><strong>Results:</strong> After careful analysis of the outcome of the study, we have found out that there was no local recurrence in any patient during the follow-up period. Though few approaches are advised in the literature, In our study transoral approach may be advocated as the first choice for excision of parapharyngeal space tumors, except for malignant tumors and neurogenic tumor. Trans cervical approach is used for malignant and neurogenic tumors, considering its advantages of providing direct access to the neoplasm, adequate control of neurovascular structures from the neck.</p><p class="abstract"><strong>Conclusions:</strong> In our study, middle aged male population was most commonly affected. Pleomorphic adenoma is the most common PPS tumor; prestyloid compartment is mostly affected by these tumors. As per the previous studies, trans cervical approach is first choice for excision of parapharyngeal space tumors. In our study, trans oral approach is also a suitable, safe approach for pre styloid non vascular lesions and trancervical approach can be reserved for postsyloid and malignant lesions.</p>

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