scholarly journals Mammography Trends in a Tertiary Care Hospital in Nepal

2021 ◽  
Vol 18 (4) ◽  
pp. 667-671
Author(s):  
Anamika Jha ◽  
Ranjit Kumar Chaudhary
Keyword(s):  
Breast Cancer ◽  
Breast Density ◽  
Breast Imaging ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Developed Countries ◽  
Diagnostic Group ◽  
University Teaching ◽  
Care Hospital ◽  
Screening Programs

Background: Mammography is an established screening tool for early detection of breast cancer, with several protocols used worldwide. Such screening programs and related data are lacking in less developed countries. We documented and analyzed the mammographic trends at Tribhuvan University Teaching Hospital, a tertiary care referral center, in Kathmandu, Nepal, to develop baseline data which may be helpful in further researches.Methods: In this descriptive study, imaging findings of consecutive patients who had undergone mammography between July 2016 and March 2018 were reviewed after obtaining ethical clearance from the Institutional Review Committee. Ultrasonography and histopathological examination were done as needed. Demographics, presenting complaints, breast density, Breast Imaging, Reporting, Assessment and Data System category and final diagnosis were recorded and analyzed using appropriate statistical methods.Results: There were more diagnostic mammograms (62%) than screening with mastalgia the most common presenting complaint. Breast density was less in screening group. Overall, there were more benign lesions with incidence of breast cancer being 4.4% more in the diagnostic group. The age range varied from 22 to 86 years, with 15% (n=219) below 40 years age accounting for one-third of the cases of extremely dense breast and one-fourth of the suspicious lesions. Nearly 50% of breast cancers were seen in patients less than 50 years of age.Conclusions: The study showed greater number of diagnostic than screening mammograms, with malignancies detected more often in the diagnostic group and younger age. Fewer screening studies suggest a lack of breast cancer awareness in our population who seek medical help only when symptomatic. Keywords: BIRADS; Breast Cancer; Mammography

scholarly journals Incidence of Thyroid Cancer in Thyroid Swelling, Study of 200 Cases

2021 ◽  
Vol 27 (1) ◽  
pp. 12-16
Author(s):  
MA Matin ◽  
Mohammad Saiful Islam ◽  
Md Abdur Razzak ◽  
Mohosana Khanam ◽  
Md Abdullah Al Harun ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Surgery ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Developed Countries ◽  
The United States ◽  
Care Hospital ◽  
Thyroid Malignancy ◽  
True Incidence ◽  
Thyroid Swelling

Objective: The incidence of thyroid cancer has rapidly increased in the United States (US) and other developed countries over the past 30 years but there is no study to find out the true incidence of thyroid cancer in Bangladesh. The aim of this study is to compare FNAC with histopathology reports and to find out the true incidence of thyroid malignancy in thyroidectomy patients presenting with thyroid swelling. Methods: This is a prospective study of 200 thyroid swelling patients underwent thyroid surgery done at Shaheed Suhrawardy Medical College Hospital, a tertiary Care Hospital in Dhaka from July 2017 to December 2020. FNAC and histopathology reports were studied to find out the incidence of benign and thyroid malignancy among the thyroid swelling. Results: The age of the patients ranged from 8 to 75 years. The mean age was 37.2 years. There were 156 female and 44 male patients with female male ratio 3.54:1. Diagnostic categorization of 200 thyroid swelling underwent surgery, FNAC based on Bathesda classification showed that 163 (81.5%) cases were cytologically benign, 37 (18.5%) cases were malignant category. Out of 200 cases histopathology showed134 cases(67.0%) are benign and 66(33.0%) are malignant thyroid swelling. Among the benign lesions96.31% are colloid goiter and among the malignant lesions 93.4% are papillary thyroid carcinoma. Conclusion: Although FNAC is an essential diagnostic test to rule out thyroid malignancy but histopathological examination is the only way to give true incidence of thyroid malignancy among the thyroid swelling and it is observed that there is high incidence of thyroid malignancy(33.0%) among the thyroid swelling patient underwent thyroid surgery. Bangladesh J Otorhinolaryngol; April 2021; 27(1): 12-16

scholarly journals Risk factors associated with carcinoma breast: a case control study

2017 ◽  
Vol 4 (9) ◽  
pp. 3136 ◽  
Author(s):  
Palachandra A. ◽  
Ishwaraprasad G. D. ◽  
Sreelatha C. Y. ◽  
Sumana M.
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Case Control Study ◽  
Tertiary Care ◽  
Reproductive Factors ◽  
Developed Countries ◽  
Case Control ◽  
Age At Menarche ◽  
Care Hospital ◽  
Control Study

Background: The burden of breast cancer is increasing in both developed and developing countries; the peak occurrence of breast cancer in developed countries is above the age of 50 whereas in India it is above the age of 40. Reproductive factors contribute most to the development of breast cancer. Nulliparity, more age at first live birth and no breastfeeding are major reproductive risk factors for breast cancer in the developed countries. The role of reproductive factors in the development of breast cancer in Indian population is different as compared with that seen in the western population. Objective of this study was to find out some of the various risk factors of breast cancer among patients attending the tertiary care hospital in Hassan.Methods: The case control study was conducted at surgery wards of Sri Chamarajendra district hospital which is a teaching hospital. The calculated number of cases was 110, including 110 controls total 220 individuals were included in the study. A case was defined as any female patient histopathologically confirmed to have breast cancer.Results: The maximum cases (38%) were between 51 to 60 years of age group. Age at menarche, age at first child birth, age at marriage and age at menopause reported significant risk for breast cancer.Conclusions: Information, education and communication activities regarding these risk factors, early signs and symptoms of breast carcinoma, and breast self‑examination should be imparted to the women to create awareness about this fatal disease.

scholarly journals RETROSPECTIVE ANALYSIS OF MAMMOGRAM, SONOMAMMOGRAM AND ITS HISTOPATHOLOGICAL CORRELATION AS AN AID FOR DIAGNOSIS OF BREAST LESIONS

2021 ◽  
pp. 1-4
Author(s):  
Sathish babu ◽  
Arifkhan Sainudeen ◽  
Abdul Eksana
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Ductal Carcinoma ◽  
Histopathological Examination ◽  
Benign Lesion ◽  
Malignant Lesion ◽  
Breast Lesions ◽  
Care Hospital ◽  
Malignant Breast ◽  
Malignant Lesions

INTRODUCTION: Breast cancer is the most common cancer impacting 2.1 million women each year and also relates to the most cancer related deaths in women. In 2018, it was estimated that 627,000 women died from breast cancer which approximates to 15 % of all cancer related deaths among women [1]. The triple test– clinical examination, mammography and core biopsy helps in differentiating benign and malignant lesions. Histopathological examination is considered being the gold standard test for confirming malignant lesions and forms the basis of management. AIM: To assess sensitivity of mammogram with ultrasonography in diagnosing various breast lesions and to correlate the categorized breast lesions (BI-RADS) with histopathology reports and thereby obtain specificity and NPV of evaluation using Mammogram and ultrasonography. STUDY DESIGN: Retrospective analytical study. Study Period: July 2018 – July 2019. METHODS: The results of ultrasonography and mammography of 72 cases diagnosed clinically with breast lesions over the period of one year in tertiary health care hospital were compared with histopathology reports. RESULTS: The mean age of the patients was 45.65 ± 3.19. Our results showed that in histopathology reports in 20 patients (27.78%) were malignant, 51 cases (70.83%) had benign disease and 1 case 1.39% was borderline malignant. Fibroadenoma was the commonest benign lesion whereas infiltrating ductal carcinoma was the most common malignant lesion. Breast Imaging – Reporting and Data System (BIRADS) by mammogram revealed category II in 54.1%, III in 20.8%, IV in 16.6% and V in 8.3%. The specificity of mammography alone in diagnosing malignant breast lesions was 90.1%. When combined (ultrasound and mammogram), the specificity in diagnosing malignant breast lesion was 98.5% CONCLUSION: Mammography and sono-mammogram plays an important role in the diagnostic and surgical management of breast lesions with correlative histopathology evaluation. The diagnostic accuracy shows significant improvement when mammogram was combined with ultrasound correlation and thereby improving sensitivity and specificity of diagnosing malignant breast lesions.

scholarly journals Extra intestinal manifestation of Crohn’s disease in a university teaching hospital, Nepal

2015 ◽  
Vol 1 (2) ◽  
pp. 39-41
Author(s):  
Yuba Raj Sharma
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Tertiary Care Hospital ◽  
Gastrointestinal Disease ◽  
Tertiary Care ◽  
Developed Countries ◽  
University Teaching ◽  
Asia Pacific ◽  
Aphthous Ulcer ◽  
Care Hospital

Introductions: Crohn’s disease relatively uncommon gastrointestinal disease in Asia pacific region. There is increasing reports of this disease in the region. Aim of this study was analyze the demographics and extraintestinal manifestation of Crohn’s disease in tertiary care hospital setup in Nepal.Methods: This was a retrospective study of patients with Chron’s disease seen in gastroenterology unit of Patan Hospital from 2009 to 2014. Case records were analyzed for age, gender, geography and extra intestinal manifestations.Results: Eighteen patients with Crohn’s disease were identified, 13 male and five female. Age ranged from 14 to 70 years, with peak during 21-30 years. There were seven (39%) patients with extra intestinal manifestations of arthritis, aphthous ulcer in oral cavity, erythema nodosum and episcleritis in descending order.Conclusions: Threre were 18 cases in five years from in our tertiary care hospital and seven patients had extra intestinal presentation mainly arthritis and oral aphthous ulcer. Clinicians in Asian region need to be vigilant of Chron’s, once thought be the disease of developed countries.

scholarly journals An Audit of An Intensive Care Unit of A Tertiary Care Hospital

2018 ◽  
Vol 56 (212) ◽  
pp. 759-762 ◽  
Author(s):  
Subash Prasad Acharya ◽  
Adheesh Bhattarai ◽  
Binita Bhattarai
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care ◽  
Developed Countries ◽  
University Teaching ◽  
Care Hospital ◽  
Cross Sectional ◽  
Tertiary Referral Center ◽  
Primary Specialty ◽  
Neurosurgical Patients

Introduction: The patients with the most severe and life threatening illnesses requiring constant monitoring and support are admitted in the intensive care unit. Tribhuvan University Teaching Hospital is the oldest and tertiary referral center hospital in the country with eleven-bedded level III mixed medical surgical ICU. This audit was performed to study the profile of critically ill patients under different headings like diagnosis at admission, primary specialty, outcome of the patients, etc. Methods: A descriptive cross-sectional study was designed and all patients admitted to the intensive care unit of our center between 13 April 2017 and 13 April 2018 (1st Baisakh 2074 to 30th Chaitra 2074) were selected for this study. Results: A total of 813 patients were admitted in TUTH ICU over a period of one year (2074 B.S.) with male patients being more common. Neurosurgical cases were most common at 199 (24.48 %), followed by respiratory cases at 149 (18.32%) and so on. The overall mortality was 246 (32.8%). The overall surgical cases were more common than medical cases with better outcomes. Conclusions: This audit presents the profile of patients admitted in a tertiary level hospital in Nepal, their indications and mortality. The most common patients being admitted were Neurosurgical patients and the mortality was significantly higher compared to ICUs in developed countries.

The role of the clinical pharmacist in guiding adjuvant hormonal therapy in patients with breast cancer

2021 ◽  
pp. 107815522110293
Author(s):  
Amanda V Pirolli ◽  
Tatiana Brusamarello ◽  
Stella S Everton ◽  
Vânia M S Andrzejevski
Keyword(s):  
Breast Cancer ◽  
Hormone Therapy ◽  
Hormonal Therapy ◽  
Clinical Pharmacist ◽  
Tertiary Care ◽  
Structured Interview ◽  
Care Hospital ◽  
Adjuvant Hormonal Therapy ◽  
Breast Cancers

Breast cancer is the most prevalent type of cancer among women, affecting about 2.1 million worldwide and is responsible for the highest number of cancer-related deaths among women. Approximately 80% of breast cancers express on the surface of hormone receptor cells, such as progesterone and estrogen. In these cases, Adjuvant Hormonal Therapy (AHT) is indicated for a period of five to ten years and consists of taking a daily oral pill. The two most used drugs in AHT are tamoxifen and Aromatase Inhibitors. One of the issues most faced by individuals who are subjected to long periods of treatment is the lack of medication adherence and, consequently, therapeutic inefficiency. It is believed that the monitoring by the pharmacist can contribute to the reduction of errors inherent to the medication, making the treatment more effective and improving the patient's quality of life. The present study aimed to know the perception of patients who live with breast cancer and who do AHT in relation to the educational performance of the clinical pharmacist. This is a qualitative, descriptive and exploratory study, carried out from March to October 2020, with 15 women undergoing treatment at the oncology unit of a tertiary-care hospital in south of Brazil. The data were obtained through a semi-structured interview using an instrument composed of two parts, one referring to the characterization of the participants and the other with the guiding question of the research: "How do you perceive the role of the pharmacist in relation to the guidelines for the use of adjuvant hormonal therapy?". The method of theoretical saturation was used to perform the sample closure and the thematic analysis was used to analyze the data. The participants were between 32 and 74 years old, seven were on tamoxifen therapy and eight on anastrozole, ten were on the first year of treatment, two on the second and three on the third year. The themes that emerged were: pharmacist-patient interaction as a safety factor in hormone therapy; role of the pharmacist in the development of strategies for self-management of the patients during hormone therapy; and, challenges for the pharmacist in relation to hormone therapy through continued guidance. It was evident that the pharmacist's educational action encouraged the participants to carry out the treatment in a more confident and assertive manner according to their particularities and beliefs.

Carbapenem-Resistant Enterobacteriaceae Rectal Screening during an Outbreak of New Delhi Metallo-β-Lactamase–Producing Klebsiella pneumoniae at an Acute Care Hospital

2014 ◽  
Vol 35 (4) ◽  
pp. 434-436 ◽  
Author(s):  
Larissa M. Pisney ◽  
M. A. Barron ◽  
E. Kassner ◽  
D. Havens ◽  
N. E. Madinger
Keyword(s):  
Klebsiella Pneumoniae ◽  
Acute Care ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Acute Care Hospital ◽  
University Teaching ◽  
New Delhi ◽  
Care Hospital ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

We describe the results of carbapenem-resistant Enterobacteriaceae (CRE) screening as part of an outbreak investigation of New Delhi metallo-β-lactamase–producing CRE at a tertiary care university teaching hospital. The manual method for CRE screening was useful for detecting patients with asymptomatic CRE carriage but was time-consuming and costly.

To Determine the Prevalence of Obesity in Breast Cancer Patients

2021 ◽  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Cancer Patients ◽  
Body Mass ◽  
Tertiary Care ◽  
Overweight And Obesity ◽  
World Health ◽  
Care Hospital ◽  
Breast Cancer Patients ◽  
Prevalence Of Obesity

Background: Breast Cancer is one of the leading causes of death worldwide. Pakistan alone has the highest rate of Breast Cancer than any other Asian country as approximately 90000 new cases are diagnosed every year out of which 40000 dies. Obesity is also a critical public health problem growing with every passing year in Pakistan and worldwide. Research studies are being conducted worldwide regarding the relation between the two problems. Objective: The objective of this study is to determine the prevalence of obesity in breast cancer patients in a tertiary care hospital in Karachi, Pakistan. Methods: BMI is used as a screening tool for overweight and obesity. According to World Health Organization, a body mass index (BMI) over 25 is considered overweight, and over 30 is obese. A retrospective analysis of 262 patients diagnosed with Breast Cancer during 2019 and 2020 was performed. Patients’ hospital records in Oncology were reviewed. The weight in kilograms and height in centimeters of patients were reviewed. Their BMI was calculated and recorded using the SPSS system. Results: The median BMI was 28.25 kg/m2 with an interquartile range of 25.15 - 31.99 kg/m2. Nearly 80% of the study participants had body mass index higher than normal levels (n=203, 77.5%) and out of them approximately half were overweight (n=104, 51.2%) and the remaining were obese (n=99, 48.7%). Conclusion: We conclude from our study that body mass index is positively correlated with breast cancer occurrence and thus the proportion of females having BMI >= 25 was significantly higher among patients.

scholarly journals Taxane therapy in the adjuvant treatment of breast cancer in Italy: economic evaluation

2006 ◽  
Vol 7 (1) ◽  
pp. 63-69
Author(s):  
Simona Ravera ◽  
Lorenzo G. Mantovani
Keyword(s):  
Breast Cancer ◽  
Cost Minimization ◽  
Disease Free Survival ◽  
Developed Countries ◽  
Preventive Therapy ◽  
Point Of View ◽  
Adjuvant Setting ◽  
Screening Programs ◽  
Equivalent Efficacy ◽  
Dosing Regimens

Breast cancer (BC) is one of the leading cause of death in developed Countries and every year more than a million new cases are diagnosed worldwide. In Italy the prevalence of BC was estimated to be 1,070 per 100,000 at 31 December 1992. Nevertheless, despite the increase in incidence, mortality rate for BC are decreased in the last decades probably due to several factors such as implementation of screening programs, early diagnosis and new adjuvant therapies. Important types of adjuvant chemotherapy include anthracyclines and taxanes and these treatments continue to be evaluated to determine optimal combinations and dosing regimens. The efficacy of paclitaxel and docetaxel in adjuvant setting for the treatment of early BC has been assessed in different trials where the two taxanes showed a significant increase in both Disease Free Survival (DFS) and Overall Survival (OS) in comparison with nontaxane therapy. In particular results from one of the last studies comparing paclitaxel and docetaxel show equivalent efficacy for both drugs. At the light of the recent findings, the objective of this work is to perform a cost minimization analysis of paclitaxel vs docetaxel in the adjuvant setting for treatment of early BC in Italy. The analysis was conducted from the National Health Service’s point of view, assuming equivalent efficacy in terms of DFS and OS for both taxanes. Costs were evaluated on the basis of therapeutic schemes used in the analyzed trials. Results show that paclitaxel, administered every 3 weeks for 4 cycles after doxorubicin and cyclophosphamide, represents the less costly therapy. This is a conservative costs estimate based on data from literature that does not take into account possible additional costs associated to the treatment of febrile neutropenia (FN) as adverse event related to chemotherapy. Since, on the basis of scientific literature data, FN seems to be more related with docetaxel than with paclitaxel administration, it is likely that in clinical practice the Growth–Colony Stimulating Factor is often prescribed as a preventive therapy when Docetaxel is administred, giving rise to treatment costs.

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