scholarly journals Outcome of paediatric rhabdomyosarcoma attended in a tertiary care hospital, Dhaka, Bangladesh

2020 ◽  
Vol 46 (1) ◽  
pp. 17-21
Author(s):  
ATM Atikur Rahman ◽  
Momena Begum ◽  
CSH Kibria ◽  
Mehnaz Akter ◽  
Khurshida Azad Siddiqua ◽  
...  
Keyword(s):  
Survival Rate ◽  
Medical Records ◽  
Clinical Characteristics ◽  
Tertiary Care ◽  
Stage Iv ◽  
Developed Countries ◽  
Multimodality Therapy ◽  
Care Hospital ◽  
Advanced Stage ◽  
Advanced Stages

Background: Rhabdomyosarcoma (RMS) is a malignant tumor of mesenchymal origin, is the most common form of paediatric soft tissue sarcoma. It is the third most common solid tumor comprising 4.5% of all childhood cancer with an annual incidence of 4.5 cases per million children. There is so no statistical data on RMS in Bangladesh because no study has done in Bangladesh. Objective: To evaluate the clinical characteristics and treatment outcome of children with rhabdomyosarcoma among tertiary care. Methods: A retrospective study carried out analysing the medical records of 39 patients with rhabdomyosarcoma from the BSMMU tumor registry. Medical records of children with rhabdomyosarcoma were reviewed over a period of 6 years from June 2011 to May 2017.  Most patients received multimodality therapy (chemotherapy, surgery, radiotherapy). Results: The male female was ratio 1.2:1. More than half of cases presented with a mass at varying sites The predominant complaint 12.0% was pain. The primary site of disease was the head and neck in 46.0% followed by pelvis 40.0%. Pathologically most frequent histological subtype was in 46.0% embryonal rhabdomyosarcoma followed by alveolar rhabdomyosarcoma 23.0%, botryoid type 5.0%, spindle cell type 5.0% and unspecified 21.0%.  At the time of diagnosis 64.0% of patients were TNM stage 3 next frequency is stage IV 23.0%. The survival rate from diagnosis to subsequent demise was poor – between 13 days and 3.5 years. The overall 5-year survival rate was 41.0% which is may be due to advanced stage of disease. Conclusion: The majority of presentations were in the advanced stages of disease but sensitive to multimodality therapy. Poor survival rate is correlated with the advanced stage of the disease. The clinical characteristics of rhabdomyosarcoma at BSMMU Hospital are similar to worldwide countries, but not like developed countries. Further multicentre studies are needed to report our experiences with rhabdomyosarcoma. Bangladesh Med Res Counc Bull 2020; 46(1): 17-21

scholarly journals Gastric Cancer Perforation: Experience from a Tertiary Care Hospital

2013 ◽  
Vol 52 (191) ◽  
Author(s):  
Bishnu Prasad Kandel ◽  
Yogendra Singh ◽  
Keshav Prasad Singh ◽  
Mahesh Khakurel
Keyword(s):  
Gastric Cancer ◽  
Surgical Procedures ◽  
Tertiary Care ◽  
Stage Iv ◽  
Definitive Treatment ◽  
High Morbidity ◽  
Diffuse Peritonitis ◽  
Care Hospital ◽  
Advanced Stage ◽  
Simple Closure

Introduction: Gastric cancer perforation can occurs in advanced stage of the disease and is oftenassociated with a high morbidity and mortality. Peritonitis due to perforation needs emergencylaparotomy and different surgical procedures can be performed for definitive treatment. Surgicalprocedures largely depend on the stage of the disease and general condition of the patient. Thisstudy was carried out to evaluate the outcome and role of different surgical procedures in gastriccancer perforation.Methods: Medical record of patients with gastric perforation, who were treated during ten yearsperiod, was reviewed retrospectively. Data regarding clinical presentation, surgical procedures,staging and survival of patients were obtained.Results: Features suggestive of diffuse peritonitis were evident in all cases. The majority of thepatients underwent emergency surgery except one who died during resuscitation. The majority ofpatients were in stage III and stage IV. Surgical procedure includes simple closure and omental patchin five patients, simple closure and gastrojejunostomy in nine patients, gastrectomy in six patientsand Devine’s antral exclusion in one patient. Surgical site infection was the most common (45.5%)postoperative complication. Four patients died within one month of the surgery. Three patients whounderwent gastrectomy survived for one year and one patient survived for five years.Conclusions: Although gastric cancer perforation usually occurs in advanced stage of the disease,curative resection should be considered as far as possible._______________________________________________________________________________________Keywords: gastric cancer; gastrectomy; laparotomy; perforation; peritonitis.

scholarly journals Management of Gastroschisis in a Tertiary Care Hospital

2013 ◽  
Vol 36 (3) ◽  
pp. 133-138
Author(s):  
MA Rashid ◽  
MM Hoque ◽  
AA Mamun ◽  
A Kabir ◽  
M Ibrahim ◽  
...  
Keyword(s):  
Birth Weight ◽  
Survival Rate ◽  
Abdominal Wall Defect ◽  
Operative Procedure ◽  
Tertiary Care ◽  
Developed Countries ◽  
Management Plan ◽  
Care Hospital ◽  
Number Of Patients ◽  
Neonatal Icu

Background : Gastroschisis is a congenital abdominal wall defect with high mortality in developing countries. In developed countries their survival rate is more than ninety percent. This is due to appropriate information about the disease and adequate management plan. We have a good number of patients, but majority of us are lacking appropriate information about this disease. Objectives: This study was done to give some information to our medical personals about this disease and to evaluate the out come of gastroschisis in relation to birth weight, age of neonate and procedure of closure of the defect. Methodology: This prospective observatinal study was done in the surgery department of Dhaka Shishu Hospital (DSH) in a period of two years. All gastroschisis patients admitted during this period were enrolled and their mortality were analyzed in relation to weight, age and operative procedure. Minimal intervention management of gastroschisis (MIMG) were performed in suitable cases. Results: A total of 32 patients were admitted. Mortality were significantly high among the VLBW babies than babies whose birth weight > 1500 gm (88.9% vs17.4%) and those who were admitted after 24 hours of age than who admitted before 24 hours of age (66.7% vs26.1%). Overall survival rate was 62.5% and after surgery 71.5%. Conclusion: Gastroschisis is not rare in our population. Birth weight, early hospitalization with primary closure as early as possible, proper selection of patient for MIMG effect outcome. Adequate supportive measures like TPN, neonatal ICU and information about the disease will further increase the survival rate. DOI: http://dx.doi.org/10.3329/bjch.v36i3.14276 BANGLADESH J CHILD HEALTH 2012; VOL 36 (3) : 133-138

High survival rate in advanced-stage B-cell lymphomas and leukemias without CNS involvement with a short intensive polychemotherapy: results from the French Pediatric Oncology Society of a randomized trial of 216 children.

1991 ◽  
Vol 9 (1) ◽  
pp. 123-132 ◽  
Author(s):  
C Patte ◽  
T Philip ◽  
C Rodary ◽  
J M Zucker ◽  
H Behrendt ◽  
...  
Keyword(s):  
Survival Rate ◽  
B Cell ◽  
Pediatric Oncology ◽  
Stage Iv ◽  
High Dose ◽  
High Survival ◽  
Advanced Stage ◽  
High Survival Rate ◽  
Cns Involvement

From April 1984 to December 1987, the French Pediatric Oncology Society (SFOP) organized a randomized trial for advanced-stage B-cell lymphoma without CNS involvement to study the possibility of reducing the length of treatment to 4 months. After receiving the same three intensive six-drug induction courses based on high-dose fractionated cyclophosphamide, high-dose methotrexate (HD MTX), and cytarabine in continuous infusion, patients were evaluated for remission. Those who achieved complete remission (CR) were randomized between a long arm (five additional courses with two additional drugs; 16 weeks of treatment) and a short arm (two additional courses; 5 weeks). For patients in partial remission (PR), intensification of treatment was indicated. Two hundred sixteen patients were registered: 15 stage II nasopharyngeal and extensive facial tumors, 167 stage III, and 34 stage IV, 20 of the latter having more than 25% blast cells in bone marrow. The primary sites of involvement were abdomen in 172, head and neck in 30, thorax in two, and other sites in 12. One hundred sixty-seven patients are alive in first CR with a minimum follow-up of 18 months; four are lost to follow-up. Eight patients died from initial treatment failure, 14 died from toxicity or deaths unrelated to tumor or treatment, and 27 relapsed. The event-free survival (EFS), with a median follow-up of 38 months, is 78% (SE 3) for all the patients, 73% (SE 11) for the stage II patients, 80% (SE 3) for the stage III patients, and 68% (SE 8) for the stage IV and acute lymphoblastic leukemia (ALL) patients. One hundred sixty-six patients were randomized: 82 in the short arm and 84 in the long arm. EFS is, respectively, 89% and 87%. Statistical analysis confirms equivalence of both treatment arms with regard to EFS. Moreover, morbidity was lower in the short arm. This study confirms the high survival rate obtained in the previous LMB 0281 study without radiotherapy or debulking surgery and demonstrates the effectiveness of short treatment.

Caveat Emptor: The Role of Suboptimal Bronchoscope Repair Practices by a Third-Party Vendor in a Pseudo-Outbreak ofPseudomonasin Bronchoalveolar Lavage Specimens

2012 ◽  
Vol 33 (3) ◽  
pp. 224-229 ◽  
Author(s):  
Sara E. Cosgrove ◽  
Polly Ristaino ◽  
Anne Caston-Gaa ◽  
Donna P. Fellerman ◽  
Elaine F. Nowakowski ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Medical Records ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Third Party ◽  
Healthcare Personnel ◽  
Care Hospital ◽  
Caveat Emptor ◽  
Proprietary Information

Objective.To describe a pseudo-outbreak associated with loose bronchoscope biopsy ports caused by inadequate bronchoscope repair practices by third-party vendors and to alert healthcare personnel to assess bronchoscope repair practices.Design.Outbreak investigation.Setting.A 925-bed tertiary care hospital in Baltimore, Maryland.Patients.Patients who underwent bronchoscopy with certain bronchoscopes after they had been repaired by a third-party vendor.Methods.An epidemiologic investigation was conducted to determine the cause ofPseudomonas putidagrowth in 4 bronchoalveolar lavage (BAL) specimens within a 3-day period in May 2008. All bronchoscopes were inspected, and cultures were obtained from bronchoscopes and the environment. Bronchoscope cleaning and maintenance practices were reviewed. Microbiologic results from BAL specimens and medical records were reviewed to find additional cases.Results.All 4 case patients had undergone bronchoscopy with one of 2 bronchoscopes, both of which had loose biopsy ports. Bronchoscope cultures grewP. putida, Pseudomonas aeruginosa,andStenotrophomonas.TheP. putidastrains from the bronchoscopes matched those from the patients. Specimens from 12 additional patients who underwent bronchoscopy with these bronchoscopes grewP. putida, P. aeruginosa,orStenotrophomonas.No patients developed clinical signs or symptoms of infection, but 7 were treated with antibiotics. Investigation revealed that the implicated bronchoscopes had been sent to an external vendor for repair; examination by the manufacturer revealed irregularities in repairs and nonstandard part replacements.Conclusions.Third-party vendors without access to proprietary information may contribute to mechanical malfunction of medical devices, which can lead to contamination and incomplete disinfection.Infect Control Hosp Epidemiol2012;33(3):224-229

scholarly journals Retrospective analysis of the most common cause of rejection of donors for blood donation

2021 ◽  
Vol 8 (3) ◽  
pp. 444
Author(s):  
Garima Vijayvergiya ◽  
Parag Fulzele ◽  
Naveen Vairyamoorthy
Keyword(s):  
Blood Pressure ◽  
Blood Donor ◽  
Blood Donation ◽  
Tertiary Care ◽  
Geographical Area ◽  
Rejection Rate ◽  
Developed Countries ◽  
Care Hospital ◽  
Systemic Examination ◽  
Safe Blood

Background: A significant imbalance in access to safe blood is seen between the developing and developed countries. Donor selection has a pivotal role in preventing transfusion related complications and provide safety to the recipients. In this study, we aimed to find out rate and causes of blood donor rejection in our hospital.  Methods: A retrospective study conducted in a tertiary care hospital involving both the voluntary and replacement donors during the period September 2017 to December 2018. We included all those donors who were considered unfit for blood donation. All those who came for blood donation at our hospital were asked to fill up an enrolment form for a blood donor. A general and systemic examination were done. We calculated the rejection rate, listed the reasons for donor rejection, and analyzed the data.Results: Among 150 rejected blood donors, most were males [129 (86%)], and the rest were females [21 (14%)]. The rejection rate in our study was 3.29%. We found that the rejection rate of donors was different among voluntary and replacement donors. It showed that the most common reason for the temporary rejection of blood donation was low hemoglobin level, followed by abnormal blood pressure.  Conclusions: A vast majority of donors were rejected temporarily [132 (88%)], while the rest of them were rejected permanently [18 (12%)]. Low Hb in females and abnormal blood pressure in males were the commonest causes of blood donor rejection. Many factors affect the similarities and variations between the most typical causes of blood donor rejection, such as geographical area, cultural, socio-economic, and educational factors.  

scholarly journals Gynecological malignancies at tertiary care hospital, Pakistan: A five-year review

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Tayyiba Wasim ◽  
Javeria Mushtaq ◽  
Ahmad Zunair Wasim ◽  
Gul e Raana
Keyword(s):  
Risk Factors ◽  
Ovarian Cancer ◽  
Cervical Cancer ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Advanced Stage ◽  
Gynecological Malignancy ◽  
Abdominal Symptoms ◽  
Gynecological Malignancies

Background & Objective: Gynecological malignancies are important cause of female morbidity and mortality. They pose significant burden on health resources in low middle-income countries. Data on presentation and risk factors can help in early identification and reduce this burden. Our objective was to evaluate frequency, stage of presentation and risk factors of gynecological malignancies in a tertiary care setting. Methods: It was cross sectional study done in Gynecology Department, Services Institute of Medical Sciences, Services Hospital, Lahore from January 2015- December 2019. The records of the patients were retrospectively reviewed to include all cases of gynecologic malignancies. Demographic information, frequency, risk factors, symptoms, grade and stage of tumor was collected. Results: There were 122 patients diagnosed with gynecological malignancy during the study period. Ovarian cancer was seen in 60 (49.18%) patients followed by cervical cancer in 29(23.7%), endometrial cancer 27(22.1%) and vulva 06(4.9%). Mean age for all cancers was 51±12.7 to 55±9.3 except cervical cancer which was seen in 43±8.9 years. Patients with ovarian cancer had significantly more hypertension and diabetes (p<0.05). Heavy menstrual bleeding and postmenopausal bleeding was significantly seen in patients of endometrial and cervical cancer (p<0.05). Abdominal symptoms of pain, mass and distension were seen in patients with ovarian cancer (p<0.05). Majority patients presented in advanced stage. Among ovarian cancer, 52/60(86.6%) were epithelial in origin while 25(86.2%) cervical cancer and all vulva cancers were squamous cell carcinoma. Conclusion: Ovarian cancer was commonest gynecological malignancy followed by cervical cancer. Late presentation with advanced stage was seen in majority of all cancers. doi: https://doi.org/10.12669/pjms.37.3.3596 How to cite this:Wasim T, Mushtaq J, Wasim AZ, Gul-e-Raana. Gynecological malignancies at tertiary care hospital, Pakistan: A five-year review. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3596 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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