PAEDIATRIC POSTERIOR FOSSA TUMORS : AN EPIDEMIOLOGICAL AND ANALYTICAL STUDY AT TERTIARY CARE CENTRE IN EASTERN INDIA

2021 ◽  
pp. 54-56
Author(s):  
S. I. Sadique ◽  
Md. Shahid Alam ◽  
S. Chatterjee ◽  
S. Ghosh
Keyword(s):  
Early Diagnosis ◽  
Posterior Fossa ◽  
Tertiary Care ◽  
Male Dominance ◽  
Morbidity And Mortality ◽  
Posterior Fossa Tumors ◽  
Tertiary Care Centre ◽  
Therapeutic Modalities ◽  
Common Location ◽  
Group 5

Introduction: Posterior fossa is the commonest site of primary intracranial tumors in children, accounting for 45-60% of 1 all pediatric tumors . The aims and objectives of the study is to analyse the incidence, clinical features, surgical outcome and complications in paediatric patients with posterior fossa tumor. Material and Methods: The present study is a non-randomized prospective observational study, conducted in the department of neurosurgery, Bangur Institute of Neurosciences (B.I.N), IPGME & R, Kolkata from January 2019 to December 2020. Sample size is 50. Observations & Results: Out of 480 cases of total CNS tumors who presented in the study period, 96 cases(20%) were of paediatric posterior fossa tumors. Male dominance was seen i.e. 32 cases(64%). Most of them were in the age group 5-12 years i.e. 30 cases(60%). Headache and vomiting was the most common presenting complain present in 41 cases(82%). Fourth Ventricle was the most common location, 30 cases(60%) with Medulloblastoma being the most common tumor, 24 cases(48%). Brainstem involvement was seen in 22 cases(44%). Post-op hydrocephalus and cerebellar mutism were seen in 6 cases(12%) each. Overall mortality was 8%(4 cases). Conclusion: Posterior fossa tumors are critical brain lesions with signicant neurological morbidity and mortality. Early diagnosis of posterior fossa tumors is vital to prevent potential risks of Brain stem compression, herniation, hydrocephalus and death. With rapid advancement in radiology and the advent of modern therapeutic modalities, early diagnosis and treatment reduced the morbidity and mortality rate and improved prognosis among the patients.

scholarly journals A Study on Shock Index in Early Diagnosis of Sepsis in Emergency Department of Tertiary Care Centre of Nepal

2019 ◽  
Vol 2 (2) ◽  
pp. 37-42
Author(s):  
Manish Nath Pant ◽  
Subash Dawadi ◽  
Ashish Thapa
Keyword(s):  
Emergency Department ◽  
Heart Rate ◽  
Severe Sepsis ◽  
Early Diagnosis ◽  
Blood Lactate ◽  
Lactate Level ◽  
Tertiary Care ◽  
Serum Lactate ◽  
Shock Index ◽  
Tertiary Care Centre

Introduction: Sepsis and its consequences, severe sepsis and septic shock is at menace in country like ours where infectious disease are at toll. Early diagnosis and treatment is very important to decrease the morbidity and mortality. Shock index is one of such tool that is very handy in these situations as this is just a mathematical calculation using heart rate(HR) and systolic blood pressure(SBP). The main aim of this study was to find the effectiveness of using SI as an adjunct to blood lactate in diagnosing patients in sepsis. Methods: This was an observational hospital-based study conducted at Emergency Department of TUTH, Maharajgunj on 104 patients, obtained by purposive sampling method, who had presented to the “Red Area”, aged between 18 to 65 years. These patients were screened for severe sepsis using triage vital signs, basic laboratory tests and an initial serum lactate level. Test characteristics were calculated for hyperlactatemia. I considered the following covariates in our analysis: heart rate >90 beats/min; mean arterial pressure <65 mmHg; respiratory rate > 20 breaths/min; ≥2 SIRS including white blood cell count; SI <0.6; SI 0.6 to 1; SI 1 to 1.4and SI ≥ 1.4.  Results: There was a positive correlation between shock index and blood lactate level, r=0.2, n=104, p=0.042. No relationship was found between SI>=1 and hyperlactemia, X2 (.285, N = 104) = 1, p =.594 and relationship was found between SI >=0.7 and hyperlactemia, X2 (4.1, N = 104) = 1, p =.04. sensitivity and specificity for detecting hyperlactemia of SI>=1, SI.=0.7, SIRS was 84% and 20%, 93% and 0%, 79% and 20% respectively. Conclusions: There was weak correlation between the lactate level and shock index with statistically significant correlation between the shock index grouped >=0.7 and hyperlactatemia with high sensitivity and very low specificity.

scholarly journals The ten group Robson classification: an institutional study to analyse the caesarean section rates

2021 ◽  
Author(s):  
Lekshminath Gopinath ◽  
Rajani Vaidya
Keyword(s):  
Caesarean Section ◽  
Policy Making ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Robson Classification ◽  
Relative Contribution ◽  
Obstetrics And Gynaecology ◽  
Vaginal Deliveries ◽  
Group 5

Background: Over the last few decades, there has been an alarming increase in the rate of deliveries by caesarean section (CS) in most of the countries, though the drivers of this trend are not completely understood. In 1985, WHO had proposed that ideal rate for regional CS rates should not exceed 10-15%. The Robson’s classification system is simple, robust and flexible. The study was done as it was important to have a tool to monitor, compare the CS rates in a same setting and between different settings over a period of time and to optimise the CS rates.Methods: It was a retrospective study conducted in the department of obstetrics and gynaecology in a tertiary care centre. The hospital delivery records were reviewed for a period of 15 months from April 2020 to June 2021.Results: The total number of deliveries during the study period was 1016. The total number of CSs was 441 and the total number of vaginal deliveries was 575.The CS rate was 43.4%. The relative contribution from groups 1, 2 and 5 in our study accounted for 76.36% and group 5 accounted for 44.4% of the total CSs. These 3 groups should be the focus of attention to reduce the overall CS rates.Conclusions: It is advisable that all institutions can use the Robson’s report table to analyse the population catered by them and to make institutional specific policies. This will allow comparing the data amongst the different institutions and countries which can help in policy making.

scholarly journals Impact of changing trends of treatment on outcome of cerebral gliosarcoma: A tertiary care centre experience

2015 ◽  
Vol 04 (01) ◽  
pp. 015-017 ◽  
Author(s):  
Kumar Narendra ◽  
Tapesh Bhattacharyya ◽  
Chanchalani Karan ◽  
Praveen Shalunke ◽  
B D Radotra ◽  
...  
Keyword(s):  
Overall Survival ◽  
Median Overall Survival ◽  
External Beam Radiotherapy ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Changing Trends ◽  
Common Location ◽  
Male Preponderance ◽  
Radiotherapy Alone

Abstract Aim: To assess clinicopathological features and outcomes in patients of primary gliosarcoma with changing trends of treatment. Materials and Methods: Medical records were reviewed and data collected on primary gliosarcoma over a 5-year period (2009–2013) from the departmental case files. Results: A total 27 patients were included in this study. The median age of presentation was 54 years. There was a slight male preponderance, with male to female ratio of 1.25:1. The most common location of the tumor was temporal lobe (44.4%). Gross total resection was possible in 19 cases, near total excision was done in five cases, and only partial excision with decompression in three cases. Of the 27 patients, 80.8% patients received post-operative radical external beam radiotherapy of 60 Gy/30#/6 weeks. Concurrent and adjuvant temozolomide was used in 42.3% cases, depending on affordability and tolerance. Median overall survival was 9 months. On subgroup analysis, median overall survival in the radiotherapy plus temozolomide group was 10 months as compared to 9 months in the radiotherapy alone group; however, this was not statistically significant.(P = 0.244). Conclusion: Treating Gliosarcoma is a major therapeutic challenge for a clinician because of its poor prognosis, aggressive clinical behavior, rarity, and limited clinical experience. With surgery and concurrent chemoradiation, we were able to achieve a median overall survival of 9 months. Addition of temozolomide has shown a better trend in survival though it is not statistically significant.

scholarly journals ROLE OF HEMATOLOGICAL PARAMETERS IN EARLY DIAGNOSIS OF COVID-19 IN A TERTIARY CARE CENTRE

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Angira Saha ◽  
Sakar Saxena ◽  
Romi Srivastava ◽  
Sanjeev Narang
Keyword(s):  
Early Diagnosis ◽  
Hematological Parameters ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Significant Difference

Aim: To evaluate the role of biomarkers from blood samples of COVID-19 patients admitted in Index Medical College Hospital & R.C. Material & Methods: Hematological parameters such as Neutrophil lymphocyte ratio (NLR), Platelet lymphocyte ratio (PLR) & Systemic Inflammatory Index (SII) were studied in RT-PCR positive patients to evaluate the utility of these parameters for early diagnosis of COVID-19. Results: The study showed that there was statistically significant difference in test groups in reference to Neutrophil lymphocyte ratio (NLR) & SII values (p<0.05). But no statistically significant difference was observed between test groups in reference to Platelet lymphocyte ratio (PLR) values (p>0.05). Conclusion: Leukocyte, Neutrophil, NLR & SII values can be used in the early diagnosis of COVID-19. Keywords: NLR, SII, Leukocyte, Neutrophil

scholarly journals Lower Genital Tract Trauma in a Tertiary Care Centre in Mid-Western Nepal

2017 ◽  
Vol 56 (205) ◽  
pp. 137-140
Author(s):  
Anil Kumar Adhikari ◽  
Mahuya Dutta ◽  
Chittra Ranjan Das
Keyword(s):  
Genital Tract ◽  
Surgical Intervention ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Lower Genital Tract ◽  
Clinical Presentations ◽  
Fall From Height

Introduction: The study of lower genital tract trauma has become important in gynaecological practice. There is paucity of reports on this clinical entity from our settings. The main aim of this study is to document injuries in female lower genital tract in Mid-Western Nepal. Methods: Sixty female patients admitted to the hospital with genital tract injuries caused by coitus or accidents were included in the study. Details of the causes of trauma clinical presentations and management were recorded. Results: These injuries were grouped according to etiological factors. This study included 33 (55%) coital injuries and 27 (45%) non- coital injuries. Out of coital injury, 12 cases were criminal assault (rape) in age group of 4 to 18 years. Four unmarried girls had consensual sex. Non-coital injuries were due to fall from height, cattle horn injuries, straddle type of trauma, vulvar haematoma and anorectal injuries. Conclusions: Appropriate surgical intervention can avert morbidity and mortality. Keywords: accident; lower genital tract; Nepal; trauma.

Permanent Cerebrospinal Fluid Diversion in Adults With Posterior Fossa Tumors: Incidence and Predictors

Neurosurgery ◽  
2021 ◽  
Author(s):  
Hassan Saad ◽  
David P Bray ◽  
J Tanner McMahon ◽  
Brandon D Philbrick ◽  
Reem A Dawoud ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Posterior Fossa ◽  
Surgical Complications ◽  
External Ventricular Drain ◽  
Tertiary Care ◽  
Extent Of Resection ◽  
Subtotal Resection ◽  
Central Nervous System Tumor ◽  
Posterior Fossa Tumors ◽  
Csf Diversion

Abstract BACKGROUND Posterior fossa tumors (PFTs) can cause hydrocephalus. Hydrocephalus can persist despite resection of PFTs in a subset of patients requiring permanent cerebrospinal fluid (CSF) diversion. Characteristics of this patient subset are not well defined. OBJECTIVE To define preoperative and postoperative variables that predict the need for postoperative CSF diversion in adult patients with PFTs. METHODS We surveyed the CNS (Central Nervous System) Tumor Outcomes Registry at Emory (CTORE) for patients who underwent PFT resection at 3 tertiary-care centers between 2006 and 2019. Demographic, radiographic, perioperative, and dispositional data were analyzed using univariate and multivariate models. RESULTS We included 617 patients undergoing PFT resection for intra-axial (57%) or extra-axial (43%) lesions. Gross total resection was achieved in 62% of resections. Approximately 13% of patients required permanent CSF diversion/shunting. Only 31.5% of patients who required pre- or intraop external ventricular drain (EVD) placement needed permanent CSF diversion. On logistic regression, size, transependymal flow, use of perioperative EVD, postoperative intraventricular hemorrhage (IVH), and surgical complications were predictors of permanent CSF diversion. Preoperative tumor size was only independent predictor of postoperative shunting in patients with subtotal resection. In patients with intra-axial tumors, transependymal flow (P = .014), postoperative IVH (P = .001), surgical complications (P = .013), and extent of resection (P = .03) predicted need for shunting. In extra-axial tumors, surgical complications were the major predictor (P = .022). CONCLUSION Our study demonstrates that presence of preoperative hydrocephalus in patients with PFT does not necessarily entail the need for permanent CSF diversion. We report the major predictive factors for needing permanent CSF diversion.

Radiotherapy in desmoid fibromatosis: a 10-year experience from a tertiary care centre

2019 ◽  
Vol 19 (3) ◽  
pp. 259-264
Author(s):  
Sunitha S. Varghese ◽  
Sharief Sidhique ◽  
Anne J. Prabhu ◽  
Simon P. Pavamani ◽  
B. Antonysamy ◽  
...  
Keyword(s):  
Local Control ◽  
Tumour Size ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Complete Resection ◽  
Tertiary Care Centre ◽  
Complete Excision ◽  
Desmoid Fibromatosis ◽  
Kaplan Meier ◽  
Common Location

AbstractAim of the study:To assess the relapse-free survival (RFS) and the factors influencing local recurrence in patients with desmoid fibromatosis (DF) treated at our centre and to determine the role of post-operative radiotherapy (RT) in improving local control.Methods:A retrospective analysis of 51 patients treated for DF from January 2004 to December 2013 was undertaken. The RFS was calculated using the Kaplan–Meier curve. Univariate analysis was done to assess correlation with tumour size, site, the extent of surgery, margin status and adjuvant RT with RFS.Results:The median age was 28 years with a male:female ratio of 1:3. The most common location of the tumour was anterior abdominal wall (47%). The median tumour size was 10 cm. Wide local excision was done in most patients. Complete resection with negative margin was achieved in eight patients. Post-operative RT was indicated for 43 patients of whom 19 received RT. At a median follow-up of 37 months, RFS in the complete resection with margin negative group was 100%. RFS for the patients with positive or close margins who received RT was 79% and for those who did not receive RT, it was 87%.Conclusions:Complete excision with negative margins gives the best local control in DF. The benefit of post-operative RT could not be ascertained.

scholarly journals Management of visceral arterial pseudoaneurysms in patients with acute and chronic pancreatitis: a retrospective study from South Indian tertiary care centre

2021 ◽  
Vol 8 (10) ◽  
pp. 2980
Author(s):  
Afroj Ismail Bagwan ◽  
Kalyansundarbharathi Chidambaram ◽  
Sugaprakash Sankareswaran ◽  
Prabhakaran Raju ◽  
Sugumar Chidambaranathan ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Tertiary Care ◽  
Mesenteric Arteries ◽  
Visceral Artery ◽  
Common Symptom ◽  
Angiographic Embolization ◽  
Tertiary Care Centre ◽  
Therapeutic Modalities ◽  
South Indian ◽  
Acute And Chronic Pancreatitis

Background: Visceral artery pseudoaneurysms (VAP) are defined as those affecting celiac, superior or inferior mesenteric arteries and their branches. In this study, role of various therapeutic modalities in the management of VAP caused by acute and chronic pancreatitis were analysed which can influence choice of treatment for a given patient.Methods: The study was conducted in institute of surgical gastroenterology, Madras medical college and Rajiv Gandhi government general hospital Chennai, based on retrospective analysis of 41 patients diagnosed with VAP caused by acute and chronic pancreatitis admitted between the periods of September 2014 and January 2020. The medical records of all patients were retrieved and descriptive statistical analyses was carried out regarding various details including demographics, presentation, management and complications.Results: This study includes 41 patients with mean age of 39.73±10.54 (SD) years and 40 (97.56%) of them were males. Fifteen patients (36.59%) had acute pancreatitis and 26 patients (63.41%) had chronic pancreatitis. Pseudocysts were found in 25 (60.98%) patients. Pseudoaneurysm arose most commonly from splenic artery (n=32; 78.04%). The most common symptom was abdominal pain (n=40) followed by gastrointestinal bleeding (n=28). Sixteen patients (39%) received primary radiological reintervention (n=16). Twenty-five patients (60.98%) underwent primary surgical treatment (n=25). Rebleeding was seen in 3 patients (7.32%). Twenty-three patients (56.1%) developed complications. Mortality rate was 5/41 (12.2%).Conclusions: Pseudoaneurysms are fatal complications of pancreatitis. Angiographic embolization, when available, is the initial treatment of choice in hemodynamically stable patients. Surgery in experienced hands will still remain main modality in treating these patients in centres that lack a full-fledged angiographic facility with acceptable outcomes. 

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