A clinico-pathological study of patients with thyroid swelling and their management in a tertiary care centre in western Uttar Pradesh

Background: Thyroid diseases are common worldwide and in India too there is a significant burden of thyroid disease. Thyroid disease has a reported prevalence of 4-7% in the general population on neck palpation and in autopsy series it may be as high as 50% if subclinical nodules are included. The clinical presentation of thyroid swellings can be very misleading and a definitive diagnosis cannot be done without proper investigations. Aims: To conduct a clinic-pathological study of thyroid swellings along with their management in a tertiary care center. Objectives: 1. To study the various clinical presentations of thyroid swellings 2. To record the FNAC findings in each case. 3. To perform histopathological examination of all operative specimens and compare the results with preoperative diagnosis. Materials and Methods: A one-year prospective study was done in which 50 patients with thyroid swelling were identified. Detailed information regarding all relevant parameters was recorded and treatment was done as per standard protocol. Results: Female preponderance of cases was seen (3.16:1). Maximum cases were in 36-45 year age group and 70% cases were premenopausal females. Multinodular goiter was commonest clinical presentation and colloid goiter was most common FNAC finding. Hemithyroidectomy was the most frequently performed operation. Final results showed that colloid goiter was the most commonly diagnosed benign condition while papillary carcinoma was the commonest malignancy. Conclusion: Most studies show female preponderance of cases. Multinodular goiter is the commonest clinical presentation world-wide. Colloid goiter is the most commonly diagnosed cause of thyroid swelling. Though FNAC is not 100% accurate, it has an important role in the initial evaluation of these patients. Histopathogical examination of specimen is the gold-standard investigation for final diagnosis. Due to the risk of an underlying malignancy, a proper evaluation of thyroid swellings is a must as they have excellent cure rate if treated early.

Download Full-text

Prevalence of non-infectious dermatoses in patients attending a tertiary care center in Rajasthan

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20190244 ◽

2019 ◽

Vol 5 (1) ◽

pp. 192

Author(s):

Bhagirath Singh ◽

Indira Subhadarshini Paul

Keyword(s):

Clinical Evidence ◽

Clinical Presentation ◽

Skin Diseases ◽

Genetic Disorders ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Pigmentary Disorders ◽

Protozoal Infection

Background: Pediatric dermatoses require a separate view from adult dermatoses as there are important differences in clinical presentation, treatment and prognosis. There is very little epidemiological study available on non-infectious childhood dermatoses in India. The aims of the study were to find the prevalence, clinical profile and various etiological factors associated with childhood non-infectious dermatoses and to determine the prevalence of most common non-infectious childhood dermatoses.Methods: This cross-sectional observational study conducted at tertiary care centre in Rajasthan, India. Children with age 13 years and below with clinical evidence of cutaneous disorders were studied. Parents who have not given consent for the study, acutely ill children, Children having infectious dermatoses (bacterial, fungal, viral, arthropods, parasitic and protozoal infection) were excluded from the study.Results: A total of 232 cases were studied which showed a female preponderance of 55.60%. Most of the skin diseases were seen in the 5 to 13 years (school children) age group. The most common dermatoses was eczematous (36.63%), among eczema atopic diathesis was the commonest (17;20%) followed by hypersensitivity dermatoses (21.12%), genetic disorders (13.36%), disorders of genetic disorders (7.4%), sweat gland disorders (8.18%), pigmentary disorders (4.31%), papulo squamous disorders (4.74%), Nevi (6.46%).Conclusions: Eczematous dermatoses were the most commonly noted in the study, followed by hypersensitivity dermatoses. Atopic diathesis was the commonest endogenous eczemas. Acne, insect bite reaction and miliaria were the other common dermatoses. There was no significant association of various dermatoses with systemic diseases in the study.

Download Full-text

A Case Series of Atrial Myxomas – A Tertiary Care Centre Experience

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i57a34015 ◽

2021 ◽

pp. 417-424

Author(s):

Dhanya Menon ◽

P. S. Muthusubramanian ◽

Sonti Sulochana ◽

S. Chitra ◽

K. Meenakshi

Keyword(s):

Clinical Presentation ◽

Histopathological Examination ◽

Recurrent Stroke ◽

Tertiary Care ◽

Cardiac Myxoma ◽

Case Series ◽

Tertiary Care Centre ◽

Histopathological Correlation ◽

One Year ◽

The Right

Aim: The current study aims at highlighting the clinical presentation, echocardiographic profile and histopathological details of the four cases of cardiac myxoma which we had encountered in our institution within a period of one year and to identify a relationship between the clinical behaviour and the histopathological picture. Results: Among the four cases 2 were males and 2 were females and their ages ranged from 36 to 49 years. Two of the four patients presented with chest pain and palpitations , one with dyspnoea and the other case presented with recurrent stroke. Three of the cases were located in the left atrium while one case was in the right atrium. The histopathological examination of all the cases showed stellate , round and polygonal cells surrounded by abundant myxoid stroma. There was no histopathological correlation between the different clinical presentations or locations of the myxomas. Conclusion: Although histopathological examination is necessary along with echocardiography to make a diagnosis of cardiac myxoma , there is no correlation between the different clinical presentation , site and the histopathological examination.

Download Full-text

A prospective observational study on the effectiveness of risk of malignancy index score (RMI 3) in a tertiary care centre in Eastern India

Asian Journal of Medical Sciences ◽

10.3126/ajms.v11i5.29548 ◽

2020 ◽

Vol 11 (5) ◽

pp. 54-60

Author(s):

Apurba Mandal ◽

Shibram Chattopadhyay ◽

Sushanta Mondal ◽

Arunava Biswas

Keyword(s):

Ovarian Cancer ◽

Adnexal Mass ◽

Malignant Tumors ◽

Histopathological Examination ◽

Tertiary Care ◽

Ca 125 ◽

Tertiary Care Centre ◽

Gynecology And Obstetrics ◽

Risk Of Malignancy ◽

Malignant Lesions

Background: Adnexal mass is a common presentation in today’s gynecological practice. The incidence of ovarian cancer is increasing day by day and diagnosis is often difficult to be made pre operatively with inadequate surgical exploration is a regular occurrence. Aims and Objectives: To assess and validate the importance of RMI-3 score as pre-operative diagnostic tool of differentiating benign from malignant adnexal mass for starting first line therapy of ovarian cancer and to find out the incidences of ovarian malignancy among study population. Material and Methods: The study was conducted in the Department of Gynecology and Obstetrics on (n=115) patients attending GOPD and indoor with adnexal mass fulfilling the inclusion and exclusion criteria using purposive sampling technique. All the selected cases underwent ultrasonography and serum CA- 125 level estimation necessary for calculating RMI score. A score of >200 was taken as suggestive of malignancy and confirmatory diagnosis was performed by histopathological examination obtained from staging laparotomy of adnexal mass. The individual scores were then correlated with final outcomes with statistical analyses. Results: The study revealed benign ovarian tumors are more under 50 years (78.46%) and patients with normal BMI are diagnosed with maximum of malignancy (n = 28). History of tubal ligation carried less risk of malignancy (p<0.0001). Histologically malignant tumors found mostly in 71.4% postmenopausal group whereas 94.1% benign pathology were present in perimenopausal group and there is no association found between parity and histopathology (p=0.058). Bilateral (p=0.013), multilocular (p=0.000) tumors with solid areas (p<0.0001) and thick papillary projections (p<0.0001) had statistically significant association with malignant lesions. RMI score (>200) had more efficacy than serum CA-125 level (>46) in differentiating malignant lesions from benign one in terms of specificity (96% vs 83.87%) and positive predictive value (95% vs 79.17%). Conclusions: RMI-3 score is a simple, reliable and effective tool in differentiating benign from malignant adnexal masses thereby help in quick referral and management of cases with increase chances of survival of the patients.

Download Full-text

Detection and Enumeration of the Commonest Stool Parasites Seen in a Tertiary Care Center in South India

ISRN Tropical Medicine ◽

10.1155/2013/808571 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6

Author(s):

Vani Chandrashekar

Keyword(s):

Entamoeba Histolytica ◽

South India ◽

Care Center ◽

Tertiary Care ◽

Age Group ◽

Tertiary Care Center ◽

Care Centre ◽

Tertiary Care Centre ◽

Stool Samples

The aim of this study was to identify common stool parasites in patients attending a tertiary care centre in South India. We evaluated 2355 stool samples and parasites were detected in 7.9% of samples. 41.1% of our patients were in the 45–58-year age group. Protozoal infections were the commonest seen in 7.8% of samples. Entamoeba histolytica was the commonest protozoa (4.6%) followed by Entamoeba coli (1.2%) and Giardia (0.8%). Entamoeba histolytica and Entamoeba coli were together seen in 0.63%, and they were the commonest organisms seen in samples with multiple-organism infection. Both were equally detected in diarrheal samples.

Download Full-text

HISTOPATHOLOGICAL EVALUATION OF WHO CLASSIFIED MULTIBACILLARY LEPROSY CASES IN A TERTIARY CARE CENTRE, SOUTH KERALA

10.36106/ijsr/9403958 ◽

2021 ◽

pp. 32-34

Author(s):

Anita Sanker ◽

G Nandakumar ◽

Swapna Balkrishnan

Keyword(s):

Immune Response ◽

Histopathological Examination ◽

Tertiary Care ◽

Newly Diagnosed ◽

Epithelioid Cells ◽

Tertiary Care Centre ◽

Medical College ◽

Leprosy Patients ◽

Epidermal Atrophy ◽

Multibacillary Leprosy

There are signicant differences in the histopathology of leprosy lesions which is inuenced by the host immune response to Mycobacterium leprae. Objective - To nd the histopathological changes in newly diagnosed multibacillary leprosy(MB) cases registered in the skin department Government Medical College, Thiruvananthapuram. Method- skin biopsy performed in 40 multibacillary leprosy cases and histopathological ndings were evaluated. 70% showed epidermal atrophy. Granulomas, composed of sheets of foamy macro Results- phages, lymphocytes and epithelioid cells, were seen in 21 cases & twenty two cases were AFB positive. Eight cases each were lepromatous, borderline tuberculoid, mid boderline, borderline lepromatous types. Conclusion- Presence of 60% cases of borderline leprosy indicates the unstable immune response in leprosy patients. Majority were either borderline lepromatous or lepromatous showing the infective nature of multibacillary leprosy. Histopathological examination with Fite- Foroco staining is a crucial method and the gold standard for accurate diagnosis and typing of leprosy.

Download Full-text

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

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/557 ◽

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

Download Full-text

Thyroid status and Treatment Response of Hypothyroid Infertile Women in Tertiary Care Center of Bangladesh

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v31i2.34216 ◽

2017 ◽

Vol 31 (2) ◽

pp. 86-89

Author(s):

Farzana Deeba ◽

Parveen Fatima ◽

Jesmine Banu ◽

Shakeela Ishrat ◽

Nurjahan Begum ◽

...

Keyword(s):

Subclinical Hypothyroidism ◽

Early Stage ◽

Care Center ◽

Tertiary Care ◽

Target Population ◽

Fertility Treatment ◽

Tertiary Care Centre ◽

Infertile Women ◽

The Mean ◽

Tsh Levels

Objective(s): Aim of this study was to find out the prevalence of hypothyroidism in infertile women as well as to assess their response to treatment.Materials and methods: This descriptive study was conducted in Infertility unit of Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Bangladesh, a tertiary care centre from January 2014 to December 2014. Four hundred women who visited infertility clinic of the department for fertility treatment were the target population for this study. Routine investigations such as CBC, Blood sugar 2 hours postparandial or GTT, TSH and Prolactin was done. Subclinical hypothyroidism was diagnosed when there was increased TSH and normal FT4. Hypothyroid patients were given Levothyroxin depending upon TSH levels and continued until end of the study. Patients were followed up for six months even if pregnancy was attained.Results: Out of 400 women 55% were primary and 45% were secondary subfertility. Mean duration of infertility was 4.5 ± 1.2 years. Ninety two (23%) patients were hypothyroid. Among them 66 (16.5%) were subclinical hypothyroid and 26 (6.5%) were frank hypothyroid. The mean TSH levels were 7.34 ± 2.13 ìIU/ml, and the mean PRL levels were 52.46 ± 11.17 ng/ml. Out of 92 infertile women diagnosed as hypothyroidism 75 (81.52%) women conceived after treatment with drugs for hypothyroidism (dose depending upon severity of hypothyroidism, i.e. TSH levels). More than 90% women had regular ovulation for consecutive three cycles after initiation of treatment.Conclusion: The normal TSH levels are the pre-requisite for fertilization. The decision to initiate thyroid replacement therapy in both clinical and subclinical hypothyroidism at early stage is justified in infertile women.Bangladesh J Obstet Gynaecol, 2016; Vol. 31(2) : 86-89

Download Full-text

Clinico-Pathological Study of Ocular Surface Squamous Neoplasia in a Tertiary Care Centre of Western Region of Nepal

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v7i1.24677 ◽

2019 ◽

Vol 7 (1) ◽

pp. 9-13

Author(s):

Sushila Patel ◽

Binita Bhattarai Pokharel ◽

Anita Shah ◽

Manita Sunam Goda ◽

Saraswati Khadka Thapa

Keyword(s):

Ocular Surface ◽

Histopathological Examination ◽

Tertiary Care ◽

Western Region ◽

Invasive Squamous Cell Carcinoma ◽

Care Centre ◽

Ocular Surface Squamous Neoplasia ◽

Tertiary Care Centre ◽

Male Predominance ◽

Wide Range

INTRODUCTION: Ocular surface squamous neoplasia (OSSN) consists of a wide range of conjunctival and corneal lesions ranging from dysplastic lesions to invasive squamous cell carcinoma. In recent times, the incidence of OSSN seems to be on the rise, especially in developing countries. The present study was aimed to analyse demographic pattern, clinical characteristics, and histopathology findings of OSSN in a tertiary care centre of western region of Nepal. MATERIAL AND METHODS: It was a retrospective study. We analyzed 94 cases of OSSN who presented to cornea department of Lumbini Eye Institute, Bhairahawa, Nepal over a period 1.5 years from 1st July 2017 to 31st December 2018. All the patients with OSSN, detailed clinical history and examination were recorded. Lesions were excised with a 3 mm margin clearance and sent for histopathological examination. RESULTS: Mean age of our patients with OSSN was 48.89±17.955 years ranging from 17 to 85 years. There were 52 (55.32%) male and 42 (44.68%) female. Mean duration of presentation was 6.34±6.17 months. A solitary nodule at the limbus was the commonest presentation. Right eyes were involved more than left eyes. Lesions were found most commonly on temporal site 52 (55.32%) followed by nasal 36 (38.30%). On histopathological examination benign lesions were found in 31 (32.98%) eyes, preinvasive lesion in 50 (53.19%) eyes and invasive lesions in 13 (13.83%) eyes. CONCLUSION: OSSN were seen more commonly in young adults with male predominance. Benign and pre invasive lesions are found more commonly than invasive lesions.

Download Full-text

Accidental tramadol ingestion in children admitted in tertiary care centre

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20195200 ◽

2019 ◽

Vol 8 (12) ◽

pp. 2661

Author(s):

Vadlakonda Sruthi ◽

Annaladasu Narendra

Keyword(s):

Pediatric Population ◽

Care Center ◽

Tertiary Care ◽

Ventilatory Support ◽

Case Series ◽

Pediatric Intensive Care ◽

Hemodynamic Instability ◽

Tertiary Care Centre ◽

Medical College ◽

History Of

Background: Tramadol use has been increasing in the adult and pediatric population. Practitioners must be alert because Tramadol misuse can lead to severe intoxication in which respiratory failure and seizures are frequent. Overdoses can lead to death. We report 47 pediatric cases with history of accidental tramadol exposure in children.Methods: An observational, retrospective, single center case -series of children with a history of accidental tramadol exposure in children admitted in pediatric intensive care unit of tertiary care center, Niloufer Hospital (Osmania Medical College) Hyderabad, Telangana India.Results: Of 47 children, 22 (47%) are male and 25 (53%) were female. At presentation 11 (23%) had loss of consciousness, 14 (29%) seizures, 17 (36%) hypotonia was noted. Pupils were miotic in 22 (47%) mydriatic in 2 (4.2%) normal in rest of children. Hemodynamic instability noted in 13 (27.6%). Serotonin syndrome (tachycardia, hyperthermia, hypertension, hyper reflex, clonus) was noted on 5 (10.6%) children. Respiratory depression was seen in 4 (8%) children who needed ventilatory support. Antidote Naloxone was given in 7 children. No adverse reaction was noted with Naloxone. All 47 children were successfully discharged.Conclusions: Overdoses can lead to death and practitioners must be alert because of the increasing use of tramadol in the adult and pediatric population. The handling of the tramadol should be explained to parents and general population and naloxone could be efficient when opioid toxicity signs are present.

Download Full-text

Descriptive study of clinical profile and outcome in patients of acute on chronic liver failure, at a tertiary care center in Northern India

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20204521 ◽

2020 ◽

Vol 7 (11) ◽

pp. 1687

Author(s):

Rakesh Kumar ◽

Vandana Rana ◽

Varghese Koshy ◽

Vandana Gangadharan ◽

George Koshy

Keyword(s):

Liver Failure ◽

Care Center ◽

Tertiary Care ◽

Descriptive Study ◽

Chronic Liver ◽

Clinical Profile ◽

Chronic Liver Failure ◽

Tertiary Care Centre ◽

Female Ratio ◽

Common Cause

Background: Acute-on-chronic liver failure (ACLF) is a recently described syndrome that is characterized by abrupt deterioration in patients with chronic liver disease (CLD) and has high short-term mortality. The aim of this study was to describe the clinical profile, causes and outcomes of ACLF at a tertiary care centre in Northern India.Methods: In this descriptive study of 50 consecutive patients, were included, between August 2015 to January 2018, who were admitted and diagnosed as ACLF as defined by APASL. Causes of acute precipitating event and CLD and outcomes were assessed.Occurrence and severity of organ failure was also assessed.Results: 48 (96 %) were males and 2 (4%) were females with male to female ratio was 24:1. The mean age of male and female subjects was similar, 40.7±9.9 years and 39.2±9.4 years respectively. The most common cause of CLD was alcohol in 50% cases and next most common cause was hepato-tropic viruses HBV infection in 20%, HCV in 6% cases and there was unknown cause in 12 % cases. The most common precipitating factor of acute decompensation was alcohol in 50% cases, hepatotropic viruses in 30% cases. Excluded sepsis and GI bleed as precipitating events. The combined mortality at the end of 1-month and 3-months, in our study was 60%. CLIF-SOFA score was found to be the most reliable scoring system to discriminate between survivors and non survivors. Conclusions: Alcohol was the commonest precipitating cause of ACLF. Organ failures (OFs) are independently predictive of mortality.

Download Full-text