scholarly journals The COVID-19 Outbreak May Be Associated to a Reduced Level of Care for Breast Cancer. A Comparative Study with the Pre-COVID Era in an Italian Breast Unit

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 474
Author(s):  
Alessandro Fancellu ◽  
Valeria Sanna ◽  
Corrado Rubino ◽  
Maria Laura Ariu ◽  
Claudia Piredda ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Comparative Study ◽  
Tumour Size ◽  
Healthcare Systems ◽  
Lymph Node Status ◽  
Level Of Care ◽  
Nerve Blocks ◽  
Breast Unit ◽  
Group A ◽  
Group B

The recent COVID-19 pandemic has caused profound changes to healthcare systems as well as had deleterious repercussions on the care of cancer patients. In this comparative study, we sought to evaluate the effects of the COVID-19 pandemic on the surgical management of breast cancer in a breast unit in an Italian region with a low incidence of COVID-19 infection. Eighty-three patients were included, of whom 41 received surgery during the height of the pandemic (Group A, operated on between March and April 2020), and 42 during the same period of the year in 2019 (Group B). Clinicopathological characteristics and surgical outcomes were compared between the two groups. There were no significant differences in the baseline characteristics of the two groups with regard to age (p = 0.62), tumour size (p = 0.25), grade (p = 0.27), histology (p = 0.43), positive lymph node status (p = 0.35), and ER positive status (0.35). Waiting time for surgery was slightly longer in Group A (49.11 vs. 46.39 days, p = 0.38). Patients receiving immediate breast reconstruction were significantly less in Group A (p < 0.001). The use of sentinel node biopsy was similar in the two groups (p = 0.84). Hospital stay was longer in patients of Group B (p = 0.008). The use of regional nerve blocks was lower in Group A (p < 0.001). Patients operated on during the height of the pandemic were less likely to receive immediate reconstruction and regional nerve blocks during surgery. These features configure a situation of reduced level of care for patients with breast cancer. Efforts should be taken by the healthcare systems to maintain standard of care, even in case of a new peak in the coronavirus outbreak.

COMPARATIVE STUDY IN BETWEEN INTRALESIONAL VITAMIN D3 AND INTRALESIONAL BLEOMYCIN IN THE TREATMENT OF CUTANEOUS VERRUCAE

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Shrikant . ◽  
R.D. Mehta ◽  
B.C. Ghiya
Keyword(s):  
Partial Response ◽  
Comparative Study ◽  
Recurrence Rate ◽  
Vitamin D3 ◽  
Complete Response ◽  
Recurrence Rates ◽  
Additional Advantage ◽  
Cost Effective Treatment ◽  
Group A ◽  
Group B

Background: Verruca is one of the common dermatopathologies which has multiple therapeutic options but with variable success rates, refractory cases and high recurrence rates. Nowadays, treatment with intralesional injections has gained recognition due to its effectiveness in clearing verrucae. These act by stimulating the cell-mediated immunity. Out of scores of options available for intralesional therapeutics, Vitamin D3 appears to be more promising but least evaluated. Therefore, we planned to evaluate the efficacy of intralesional Vitamin D3 in various types of cutaneous verrucae. Simultaneously the results were compared with intralesional bleomycin, also. Methods: A total of 200 patients of cutaneous verrucae with varying size and duration were included in the experimental randomized comparative study. We divided them into two groups. Group A, comprising of 100 patients, received 0.2-0.5 ml intralesional Vitamin D3 (600,000 IU, 15mg/ml) and Group B, also of hundred subjects, received intralesional Bleomycin (1 mg/ml) into the base of verrucae. A maximum of 5 verrucae were injected per session at 3 weeks interval until resolution or for a maximum of 4 sessions. Patients were followed up for 6 months after the last injection to assess the clearance status and detect any recurrence. Results: In Group A (Vitamin D3), 'Complete response', 'Partial response' and 'No response' were observed in 85.07%, 6.74% and 8.17% respectively after 4 sessions. Recurrence rate was 0.81% after 6 months. In Group B (Bleomycin), 'Complete response', 'Partial response' and 'No response' were found in 77.99%, 10.47% and 11.53% in the series. Recurrence rate was 1.71%, comparatively higher in group B. Conclusion: The efficacy of intralesional Vitamin D3 was found significantly higher as compared to intralesional Bleomycin in the treatment of cutaneous verrucae with less recurrence rates. Vitamin D3 has an additional advantage of cost-effective treatment over Bleomycin. We purpose its use, as a primary mode of treatment in various types of cutaneous verrucae. Keywords: Bleomycin, Vitamin D3, Verrucae.

Comparative Study Between Clean Intermittent Self-Catheterization (Cisc) and Continuous Indwelling Catheterization (Cidc) in Relieving Acute Refractory Retention of Urine Due to Benign Enlargement of Prostate (Bep)

2020 ◽  
Vol 21 (2) ◽  
pp. 105-110
Author(s):  
Md Shawkat Alam ◽  
Sudip Das Gupta ◽  
Hadi Zia Uddin Ahmed ◽  
Md Saruar Alam ◽  
Sharif Muhammod Wasimuddin
Keyword(s):  
Comparative Study ◽  
Acute Urinary Retention ◽  
Bladder Capacity ◽  
Inclusion Criteria ◽  
College Hospital ◽  
Medical College ◽  
High Incidence ◽  
Group A ◽  
Group B ◽  
Better Than

Objective: To compare the clean intermittent self-catheterization (CISC) with continuous indwelling catheterization (CIDC) in relieving acute urinary retention (AUR) due to benign enlargement of prostate (BEP). Materials and Methods :A total 60 patients attending in urology department of Dhaka Medical college hospital were included according to inclusion criteria ,Patients were randomized by lottery into two groups namely group –A and group –B for CISC and IDC drainage respectively . Thus total 60 patients 30 in each group completed study. Results : Most men can safely be managed as out-patients after AUR due to BPH. The degree of mucosal congestion and inflammation within the bladder was found to be lower in those using CISC and the bladder capacity in these patients was also found higher.Patients with an IDC had a high incidence of UTIs then that of patients with CISC. During the period of catheterization the incidence of UTI was 43.3% in group B in comparison to 40% in group A; before TURP 36% in group B in comparison to 10% incidence in group A.According to patient’s opinion CISC is better than IDC in the management of AUR. Experiencing bladder spasm, reporting blood in urine, management difficulties, incidence and severity of pain were less in CISC group, and the method of CISC was well accepted by patients as well as their family members. Conclusion: From the current study it may be suggested that CISC is better technique for management of AUR patient due to BPH than IDC. It can also be very helpful when surgery must be delayed or avoided due to any reasons in this group of patients. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.105-110

scholarly journals Prospective study of hair recovery after (neo)adjuvant chemotherapy with scalp cooling in Japanese breast cancer patients

2021 ◽  
Author(s):  
Shozo Ohsumi ◽  
Sachiko Kiyoto ◽  
Mina Takahashi ◽  
Seiki Takashima ◽  
Kenjiro Aogi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Prospective Study ◽  
Cancer Patients ◽  
Scalp Cooling ◽  
Breast Cancer Patients ◽  
Chemotherapy Infusion ◽  
Group A ◽  
Neo Adjuvant Chemotherapy ◽  
Group B

Abstract Purpose Scalp cooling during chemotherapy infusion to mitigate alopecia for breast cancer patients is becoming widespread; however, studies regarding hair recovery after chemotherapy with scalp cooling are limited. We conducted a prospective study of hair recovery after chemotherapy with scalp cooling. Patients and methods One hundred and seventeen Japanese female breast cancer patients who completed planned (neo)adjuvant chemotherapy using the Paxman Scalp Cooling System for alopecia prevention were evaluated for alopecia prevention in our prospective study. We evaluated their hair recovery 1, 4, 7, 10, and 13 months after chemotherapy. Primary outcomes were grades of alopecia judged by two investigators (objective grades) and patients’ answers to the questionnaire regarding the use of a wig or hat (subjective grades). Results Of 117 patients, 75 completed scalp cooling during the planned chemotherapy cycles (Group A), but 42 discontinued it mostly after the first cycle (Group B). Objective and subjective grades were significantly better in Group A than in Group B throughout 1 year, and at 4 and 7 months after chemotherapy. When we restricted patients to those with objective Grade 3 (hair loss of > 50%) at 1 month, Group A exhibited slightly faster hair recovery based on the objective grades than Group B. There was less persistent alopecia in Group A than in Group B. Conclusions Scalp cooling during chemotherapy infusion for Japanese breast cancer patients increased the rate of hair recovery and had preventive effects against persistent alopecia.

scholarly journals A comparative study between the effect of verapamil versus nalbuphine as an adjuvant in supraclavicular brachial plexus block

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Mohammed Ibrahim Khamis ◽  
Ahmed Saeed Mohamed ◽  
Hesham Mohamed El Azazy ◽  
Hala Salah El Ozairy ◽  
Mohamed Moien Mohamed
Keyword(s):  
Comparative Study ◽  
Brachial Plexus ◽  
Normal Saline ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Motor Blockade ◽  
Group A ◽  
Group B ◽  
Plexus Block

Abstract Background Brachial plexus block has substituted general anesthesia in the majority of patients planned for upper limb surgeries as it avoids the undesired effects of the medications used in general anesthesia as well as the stress response associated with airway manipulation. Opioid agonist–antagonists such as nalbuphine are used as adjuvant to improve the anesthetic properties of bupivacaine. Verapamil has an additive effect in brachial plexus blockade in the form of decreasing the consumption of analgesics in the postoperative period with reducing onset time and extending the duration of motor and sensory blockade. The aim of this study is to investigate the adjuvant effect of verapamil versus nalbuphine to 0.5% bupivacaine in brachial plexus block as regards onset, duration of sensory and motor blockade and postoperative analgesic augmentation. The study is randomized, prospective, double-blinded, comparative study where 90 patients subjected to arm, forearm and hand surgeries were randomized into three groups, group A received 30 ml of plain bupivacaine 0.5% plus 2 ml of normal saline, group B received 30 ml of bupivacaine 0.5% plus 2 ml verapamil equivalent to 5 mg, group C received 30 ml of bupivacaine 0.5% plus 10 mg of nalbuphine diluted in 2 ml of normal saline. Results Results of this study showed that group C and group B sensory block time onset was 7.25 ± 1.5 vs. 10.92 ± 3.84 min, P < 0.001 and was shorter than that in group A (13.2 ± 2.66 min). In addition, the motor block onset was (11.10 ± 1.24 vs. 13.50 ± 3.77 min, P < 0.001) shorter than group A (17.16 ± 1.30 min). In group C and group B, sensory block duration was 396 ± 32.17 vs. 355.83 ± 18.48 min, P < 0.001, respectively and was longer than that in group A (321.13 ± 25.08 min). Also, there was prolonged motor block duration in group C and group B recording (338.92 ± 25.2 vs. 302.93 ± 15.24 min, P < 0.001) and was longer than that in group A (280.70 ± 32.35 min). Time of demand of rescue analgesia dose was significantly long in group C and group B (449.53 ± 52.45 vs. 418.13 ± 41.12 min, P < 0.001) and was longer than group A (361.31 ± 21.42 min). Both verapamil and nalbuphine have additive effect to bupivacaine improving the all anesthetic parameters of the block. Conclusion Both drugs produce favorable enhancement of time onset and effective prolongation of duration of sensory and motor blockade and extend the period of postoperative analgesia with superiority to nalbuphine over verapamil.

Totally Implantable Venous Access Port Systems: Implant Depth-based Complications in Breast Cancer Therapy - A Comparative Study

2021 ◽  
Vol 27 ◽  
Author(s):  
Kuo Chen ◽  
Narasimha M. Beeraka ◽  
Yuanting Gu ◽  
Jingruo Li ◽  
Mikhail Sinelnikov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Therapy ◽  
Venous Access ◽  
Breast Cancer Patients ◽  
Breast Cancer Therapy ◽  
Access Port ◽  
Group A ◽  
Venous Access Port ◽  
Group B ◽  
Group D

Background: Totally implantable venous access port system (TIVAPS) is widely used in breast cancer therapy; TIVAPS has several associated complications depending on the depth of implantation in breast cancer (BC) patients during continuous infusional chemotherapy regimens. The purpose of this study is to find out the optimal depth of TIVAPS implantation to reduce the incidence of complications during infusional chemotherapy. Methods: This study reviewed the depth TIVAPS implantation in the internal jugular vein in 1282 breast cancer patients over a ten-year period (2009-2019), and associated complications. We segregated the patients as 5 groups: ‘Group A (depth < 4 mm), Group B (depth of 4-8 mm), Group C (depth of 8-12 mm), and Group D (depth of 12-16 mm), and Group E (depth of > 16 mm)’. Consequently, the ‘internal complications’ such as infection, venous thrombotic syndrome, catheter folding & migration, extravasation, whereas the ‘external complications’ viz., inflammation, local hematoma, local cutaneous reactions, and port exteriorization were significantly analyzed during TIVAPS implantation at different depths in BC patients. Results: Overall incidence of ‘internal complications’ such as infections, venous thrombotic syndrome, catheter folding & migration, and extravasation was comparatively lesser in Group C (8-12 mm) than Group A, Group B, Group D, and Group E, respectively. Mainly, the external complications such as inflammation Group C (8-12 mm) (p<0.01) were lesser (6.8%, 3/44 cases) than Group A, Group B, Group D, Group E. On a similar note, the local hematoma, and local cutaneous reaction, and port exteriorization were observed as ‘5% (1/20 cases), 4.2% (2/47 cases), and (3.2%, 1/31 cases)’ in Group C patients (p<0.01), which were comparatively lesser than the other groups. Conclusion: Subcutaneous implantation of TIVAPS at a depth of 8-12 mm could be preferred due to the lowest incidence of internal and external complications compared to the incidence of these complications in other groups; this depth could be referred to as the safe and convenient implantation depth for the effective delivery of chemotherapy regimen in BC patients without difficulty in transcutaneous access to the port.

A CLINICO-COMPARATIVE STUDY ON THE EFFECT OF LASHUNA SIDDHA TAILPANA POORVAK VAMANA KARMA AND NITYA VIRECHANA BY GOMUTRA HARITAKI IN THE MANAGEMENT OF HYPOTHYROIDISM

2021 ◽  
Vol 12 (4) ◽  
pp. 49-55
Author(s):  
Sheetal R Tokle
Keyword(s):  
Comparative Study ◽  
Thyroid Stimulating Hormone ◽  
Normal Range ◽  
End Of Treatment ◽  
Group A ◽  
Insignificant Difference ◽  
Randomized Control ◽  
Drug Dependent ◽  
Group B ◽  
Stimulating Hormone

Hypothyroidism is a condition in which thyroid gland doesn’t produce enough thyroid hormone. This is more prevalent among women. Management through levothyroxine is safe & may bring the value of Thyroid stimulating hormone and thyroxine to normal range but the increased dosage and continuous medication are cost expensive and make the patient into drug dependent till the end of mortal life. So, better, therapy is needed for the society through the heritage of Ayurveda especially with Shodhana therapy. Aim of Clinico-comparative study was to evaluate and compare the efficacy of Lashuna siddha Tailpana Poorvak Vamana Karma and Nityavirechana by Gomutra Haritaki in the management of Hypothyroidism. Study was conducted at Govt. Akhandanada Ayurvedic hospital, Ahmedabad, Gujarat. This study was Open labelled parallel randomized control trial. 15 patients were treated with Lashuna siddha Tailpana Poorvak Vamana Karma in group A. 15 patients was treated with Nitya Virechana by Gomutra Haritaki in group B. Washout period was 14 days. Triiodothyronine and thyroxine were compared at the end of treatment by paired t-test and Mann Whitney-U test. Lashuna siddha Tailpana Poorvak Vamana Karma was more beneficial than Nitya Virechana by Gomutra Haritaki. Insignificant difference was found on subjective and objective parameters (Weight gain, Basal metabolic rate, Serum triiodothyronine) but significance difference found on objective parameters (Thyroid stimulating hormone, Serum thyroxine).

Comprehensive Nursing can Relieve the Negative Emotions of Patients undergoing Breast Cancer Resection and Reduce Postoperative

2021 ◽  
Vol 7 (5) ◽  
pp. 4234-4243
Author(s):  
Xiaoxia Lv ◽  
Lihua Wang ◽  
Yan Zhai
Keyword(s):  
Breast Cancer ◽  
Postoperative Complications ◽  
Quality Score ◽  
Cancer Resection ◽  
Upper Limb Function ◽  
Sf 36 ◽  
Group A ◽  
Group B ◽  
Nursing Quality

To explore the effect of comprehensive nursing on adverse emotions and postoperative complications of breast cancer patients undergoing mastectomy. Altogether 180 patients who received treatment in our hospital from May 2017 to May 2019 were selected as the research participants and divided into group A and group B. Among them, 100 cases in group A received comprehensive nursing, 80 cases in group B received routine nursing. The surgical indications, upper limb function, serum NGF, TK1 and CA15-3 expression level, VAS score, SAS, SDS score, quality of life SF-36 score were detected, and the incidence rate of postoperative complications and nursing quality score were compared. Compared with group B, group A had less postoperative bed time, intraoperative blood loss, length of hospital stay, better recovery of upper limb function, lower expression levels of serum NGF, TK1 and CA15-3, lower VAS score, SAS and SDS score, higher quality of life SF-36 score, lower incidence of postoperative complications and higher nursing quality score. Comprehensive nursing can relieve the negative emotions of patients undergoing breast cancer resection and reduce the incidence of postoperative complications.

Modified Lift Versus Cutting Seton for Transphincteric Fistula -Experience at Tertiary Care Hospital

2021 ◽  
Vol 15 (12) ◽  
pp. 3257-3260
Author(s):  
Muhammad Najam Iqbal ◽  
Ashfaq Nasir
Keyword(s):  
Comparative Study ◽  
Anal Incontinence ◽  
Complete Healing ◽  
Fistula Tract ◽  
Fistula Closure ◽  
Fistula In Ano ◽  
Group A ◽  
Prospective Comparative Study ◽  
Cutting Seton ◽  
Group B

Background: Fistula in ano is a common disease which has high recurrence rate and high fecal incontinence rate after surgery. We compared modified LIFT (Ligation of the intersphincteric fistula tract (LIFT) through lateral approach ) with cutting seton for transphincteric fistula. Aim: This study is aimed at which procedure is better with respect to postoperative complications Study design: It was a prospective comparative study. Methods: This was a prospective comparative study from 01-01-2019 to 30-06-2021 which was conducted on 50 patients who presented with transsphincteric fistula in ano (FIA) in surgical ward of Bahawal Victoria Hospital Bahawalpur. Patients were divided into two groups .Patients of Group A underwent modified lift procedure and patients of group B underwent cutting seton procedure. Data was collected on a proforma which included patients’ name ,age ,sex, age group, comorbid disease like diabetes mellitus ,chronic liver disease, cardiovascular disease and chronic renal failure, fistula tract involving less than 50% or more than 50% external sphincter ,procedure done, healing time of wound, complications like recurrence and incontinence. Patients were followed for 6 months for healing rate ,recurrence and incontinence. Data was analysed on spss 22 version Results: In Group A, complete healing (fistula closure without recurrence) was achieved in 20 patients (80%) out of 25. There was no case of anal incontinence after the procedure. 5 (20%) patients experienced recurrence in 6 months . In Group B, complete healing (fistula closure without recurrence) was achieved in 21 patients (84%), in 6 months follow up . 4(16%) patients were diagnosed as a case of anal incontinence. There were 4 (16%) patients with recurrence. Conclusion: Modified LIFT is better in terms of incontinence where as cutting seton is better in terms of recurrence.it is suggested that for high lying fistula modified LIFT is better procedure and for low lying fistula involving less than 50% sphincter cutting seton is better procedure.. Keywords: Modified LIFT (ligation of ineter sphincteric fistula tract) ,Cutting seton , transphincteric fistula.

A Comparative Study on Engineering Student's Performance between the Single-Gender Classroom and Co-educational Classroom: A Case Study of Islamic University of Technology

2021 ◽  
Vol 1 (3) ◽  
pp. 20-24
Author(s):  
Faruq Bashir ◽  
Farouque Ahmed Haolader
Keyword(s):  
Comparative Study ◽  
Descriptive Analysis ◽  
Research Process ◽  
Male Students ◽  
Single Gender ◽  
Arithmetic Means ◽  
University Of Technology ◽  
Quasi Experimental ◽  
Group A ◽  
Group B

The purpose of this research was to conduct a comparative study to find out which setting performs better between students in the Co-educational Instruction setting and Students in the Single-gender Instruction set. In this research process, the researchers compared the performance of students who receive instruction in a single-gender classroom with the performance of other students who receive instruction in a co-educational classroom. The study population was 756 students of single and mixed-gender streams, classified into two groups (A & B). Out of this, one single-gender male class of 268 students (group A) and one COED class of 488 students (group B) were sampled from the Islamic University of Technology (IUT) in Bangladesh. The research adopted a quasi-experimental research design. The instruments used for data collection were the summative assessment of both groups' first and second-semester results that serve as test instruments. Frequency counts and the Arithmetic means were used for descriptive analysis. The independent sample t-test was used to test the hypotheses. Social learning theory emphasizes the importance of biological, social, and cultural impacts on human behavioral development and learning, especially on gender and genders specific traits and roles. Based on the analyses and interpretation of the data, the researcher found that male students perform better academically in single-gender classes, contrary to their academic performance when mixed with females in the same classes. Thus, single-gender instruction could be a more favorable environment for male students than a co-educational instruction environment.

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