Esophageal Cancer in North West India: A Tertiary Care  Center Experience of 5 Year

Background: Incidence of Esophageal cancer (EC) is increasing now a days and it has became a sixth leading cause of cancer related death in world. EC is associated with multiple risk factors. Despite various advances in the treatment of EC, it remains one of the least responsive tumors to cancer therapy, thereby overall prognosis remains poor. The current status of EC in North West India in relation to the demographics, diagnosis, staging, multimodality treatment, and the future perspectives are discussed. Methods and Materials: This is a retrospective analysis of medical records of the EC patients registered in the Department of Radiation Oncology SMS Medical and Attached Hospitals Jaipur from January 2015 to December 2019. Results: Out of 10,464 patients with various malignancies registered in SMS hospital for radiotherapy via Co-60 technique in the previous 5 years from 2015-2019; 449 were having EC. 40.25% patients were in 6th decade and male to female ratio was 1.49:1. EC was most common in farmers (51.79%) and 76.16% patients were the resident of rural areas addicted with smoking (41.4%) and tobacco chewing (24.7%) habit. Dysphagia was the presenting feature in almost all the patients. Most common type and site of involvement were squamous type (75.72%) and middle third (45.43%) part of the esophagus respectively. 39.19% patients presented in stage III and 24.70% patients in stage IVA. The patients were planned with treatment according to their age, performance status, extent of disease and other co-morbidities. Conclusions: At our centre most of the patients landed up in advanced stage poverty, illiteracy, ignorance, late diagnosis. Majority of the EC patient were addicted with smoking and tobacco chewing habit, hence screening of high risk population and lifestyle modifications limiting the use of tobacco, may help in the early detection and can decrease the mortality related to EC. Careful selection of patients for radical treatment is very important for providing relatively longer disease free interval.

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Acute Respiratory Distress and Its Risk Factors among Neonates Admitted in a Tertiary Care Center of Western Nepal

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v15i1.23530 ◽

2017 ◽

Vol 15 (1) ◽

pp. 5-8

Author(s):

Jyoti Adhikari ◽

Sajju Aryal ◽

Veena Gupta

Keyword(s):

Respiratory Distress ◽

Rural Areas ◽

Teenage Pregnancy ◽

Care Center ◽

Tertiary Care ◽

Birth Asphyxia ◽

Early Marriage ◽

Respiratory Pattern ◽

Control Group ◽

Female Ratio

Background: Neonatal period is defined as a period from birth to under 4 weeks (<28 days) of age. It is a highly vulnerable time for an infant, who is completing many of the physiologic adjustments required for extra uterine existence. The term Respiratory distress (RD) is used to indicate signs & symptoms of abnormal respiratory pattern. Methods: All neonates admitted in neonatal intensive care unit of Nepalgunj Medical College, Kohalpur with respiratory distress were included. Same number of age and sex matched controls without RD were selected. Results: The NICU based hospital incidence of RD was 9.1% with male: female ratio 1.4:1 The Most Common etiology was neonatal sepsis (51.6%), followed by hyaline membrane disease (17.8%), TTN (12.7%), meconium aspiration syndrome (6%), birth asphyxia (5.08%), tracheoesophageal fistula (2%) and pneumothorax (2%). Newborns with poor APGAR score requiring resuscitation were more likely to develop RD (p=0.025). Newborns with birth weight <2.5 kg and >4 kg were 2 times likely to develop RD as compared to control group (p<0.012). There was 7 times higher risk of developing MAS when a baby was born through thick MSL as compared to control group (P<0.022). Inadequate ANC visit significantly increased RD in newborns (p<0.001). Babies born to mother with PROM for more than 18 hours were 5.5 times likely to develop RD (p<0.001) whereas those born to mother who had any source of infection were about 6 times at risk of developing respiratory distress than control group (p=0.007). Conclusion: Certain measures that could be taken to reduce the number of RD are: 1. discouraging early marriage and teenage pregnancy. 2. Increasing awareness regarding temporary and permanent contraceptive measures. 3. Promoting education of girls. 4. Increasing coverage of ANC visit in rural areas and 5. formulating integrated plan and policies from the Government level.

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THE SPECTRUM OF AUTO-INFLAMMATORY SYNDROMES AT A TERTIARY CARE CENTER IN NORTH WEST INDIA

10.26226/morressier.57bc1756d462b80290b4d9aa ◽

2016 ◽

Author(s):

Deepti Suri

Keyword(s):

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

North West

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TO STUDY THE PREVALENCE AND CLINICAL PROFILE OF CHRONIC ATRIAL FIBRILLATION IN HOSPITALIZED PATIENTS

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1703758 ◽

2014 ◽

Vol 04 (02) ◽

pp. 017-020

Author(s):

Dharma Rao V. ◽

Rajaneesh Reddy M. ◽

Srikanth K. ◽

Raj Kumar Prakash B. ◽

Satya Prasad A. ◽

...

Keyword(s):

Atrial Fibrillation ◽

Heart Disease ◽

Care Center ◽

Tertiary Care ◽

Chronic Atrial Fibrillation ◽

Hospitalized Patients ◽

Clinical Profile ◽

Female Dominance ◽

Elderly Age ◽

Female Ratio

Abstract: Objective: To determine the prevalence of chronic atrial fibrillation (AF) in a tertiary care center and to identify the clinical profile of chronic AF in hospitalized patients. Methods: All patients admitted to Mamata General Hospital in medicine/cardiology wards with chronic AF (persistent and permanent) during the period January 2012 to December 2012 were included into the study. The principal exclusion criteria were new onset AF and acute AF. Results: During the study period, 49 patients were admitted with chronic AF with an average of 45.44 years. A slight female dominance was seen with male: female ratio of 1:1.2. Half of the patients (51%) were below the age 50 years. The elderly age group comprised of only 16.3% of cases. The commonest presenting complaint was dyspnea followed by palpitation. Rheumatic valvular heart disease was seen more commonly in people below the age of 50 years whereas hypertension and ischemic heart disease after 50 years. Heart failure was the commonest condition associated with the chronic AF and was the cause of hospitalization in almost fifty percent of cases Conclusion: Chronic AF is still a cause of concern in India in people below the age of 50 years due to high prevalence of rheumatic fever inspite of advances in the medical field.

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GASTRIC CANCER: A 5 YEAR RETROSPECTIVE ANALYSIS OF CLINICAL, PATHOLOGICAL AND TREATMENT ASPECTS FROM A TERTIARY CARE CENTER IN SOUTH INDIA.

10.36106/gjra/0711411 ◽

2021 ◽

pp. 129-132

Author(s):

B. Ramkumar ◽

J. Kannan ◽

Ingersal. N ◽

Srigopal mohanty ◽

Amit saklani ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

South India ◽

Care Center ◽

Tertiary Care ◽

Tumor Location ◽

Advanced Stage ◽

Tertiary Care Center ◽

Nodal Disease ◽

Female Ratio

Context: Gastric cancer(GC) is fth most common cancer worldwide. Mostly presents with advanced stage and poor overall survival. Methods: Retrospective study on clinical, pathological, pattern of distant metastasis(DM) , treatment aspect of GC treated between January 2014 to December 2018 in a tertiary care center in south India. Statistical analysis : Chi square test and multivariate analysis (MVA) were used for analysis. P <0.05 was considered signicant. Results: Median age at diagnosis is 57 years. Higher male : female ratio. Most common presentation was abdominal pain followed vomiting. Malignant Gastric outlet obstruction(MGOO) was present in 22.7%. Histologically , all patients had adenocarcinoma with predominantly moderate differentiation (51.1%). Liver (19.1%)was most common site of metastasis . Curative surgery was done in 35.5% of patients. D2 lymph node dissection was performed in 12.4% of patient. Patients were given perioperative /preoperative/ adjuvant / palliative chemotherapy. MVA revealed history of tobacco use, body of stomach tumor location, nodal disease were risk factors for DM. Conclusion : The present analysis revealed use of tobacco, alcohol intake were main risk factors for GC. Most of the patients present in advanced stage , so prevention by avoiding risk factors and early detection by signs , symptoms and endoscopy are necessary. Use of tobacco,site of tumor location, nodal disease were factors associated with DM. Aggressive management with both surgery and chemotherapy is warranted for locally advanced disease.

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Clinical and laboratory profiles of genital ulcers (sexually transmitted diseases) in a tertiary care center in northeastern India

Our Dermatology Online ◽

10.7241/ourd.20212.4 ◽

2021 ◽

Vol 12 (2) ◽

pp. 120-129

Author(s):

Romita Bachaspatimayum ◽

Zamzachin Guite ◽

Thangjam Bijayanti Devi

Keyword(s):

Care Center ◽

Tertiary Care ◽

Herpes Genitalis ◽

Tertiary Care Center ◽

Cross Sectional ◽

Female Ratio ◽

Ulcer Disease ◽

Sexually Transmitted ◽

Northeastern India ◽

Genital Ulcers

Background: Genital ulcers are defined as breaches in the continuity of the genital mucosa and/or skin. Sexually transmitted infections (STIs) that cause genital ulcer disease (GUD) are syphilis, chancroid, donovanosis, lymphogranuloma venereum (LGV), and herpes genitalis. This study aimed to investigate the clinical and laboratory profiles of STI-related genital ulcers. Materials and Methods: A cross-sectional two-year study was conducted on patients attending the Outpatient Department of Dermatology, Venereology and Leprosy in a tertiary care center in northeastern India. Selected were 95 patients who presented themselves with STI-related genital ulcers. Detailed history taking and examination were conducted with basic tests to assist the diagnosis. Results: The male-to-female ratio was 3.32:1, and the most common site was the glans and prepuce in males (28.77%) and the labia majora and minora in females (36.36%). 96.84% of patients had superficial ulcers. The KOH mount was positive in 26 patients. The Tzanck smear was positive in 31 patients. RPR was positive in four. HIV was positive in eleven. Herpes genitalis (96.84%) was the most common GUD. Mixed STIs were attested in 41.05% of patients. Conclusion: GUD can take various forms of presentation. The available laboratory tests should be utilized. The possibility of mixed infections should always be kept in mind.

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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.

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Surgical Management and Early Outcome of Encephalocele

Journal of Nobel Medical College ◽

10.3126/jonmc.v10i1.37946 ◽

2021 ◽

Vol 10 (1) ◽

pp. 42-45

Author(s):

Prakash Kafle ◽

Mohan Raj Sharma ◽

Sushil Krishna Shilpakar ◽

Gopal Sedain ◽

Amit Pradhanang ◽

...

Keyword(s):

Cleft Lip ◽

Care Center ◽

Tertiary Care ◽

Surgical Excision ◽

Clinical Profile ◽

Bony Defect ◽

Female Ratio ◽

Early Outcome ◽

Good Outcome ◽

Occipital Encephalocele

Background: There are limited studies pertaining to management of encephalocele in Nepal. So the present study seems justifiable to bridge the gap in the literature on encephalocele from Nepal on its clinical profile and early outcome. This study aims to characterize the clinical profile, management and outcome of largest series of encephalocele at tertiary care center in Nepal. Materials and Methods: A retrospective analysis of encephalocele, managed surgically at two tertiary care centers between 2015 and 2020, was performed. Results: Total of 25 cases was surgically managed in the present study. The median age of study population was 2.5 months. There were 11 male and 14 female with male to female ratio of 1:1.26. Occipital encephalocele was the most common variant. Lump in the head (n=11) was the commonest clinical presentation followed by hyperteliorism (n=10). One patient presented with cleft lip and one had CSF discharge in a case of occipital encephalocele. Bony defect was the common radiological findings. Excision and repair was the most common mode of surgery leading to good outcome. Mortality rate was 4% with morbidity of 20%. Conclusion: Early surgical excision and tight dural closure with repair of bony defect is the standard treatment with relatively good outcome.

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