scholarly journals A STUDY OF HISTOCYTOLOGICAL FINDINGS OF LUNG LESIONS IN IMAGE GUIDED FNAC AND BIOPSY IN TERTIARY CARE CENTRE

2020 ◽  
pp. 1-3
Author(s):  
Renuka Gahine ◽  
Shashikala Kosam ◽  
Vivek Patre ◽  
Kiranlata Bhagat
Keyword(s):  
Cell Carcinoma ◽  
Predictive Value ◽  
Tertiary Care ◽  
Cost Effective ◽  
Diagnostic Procedures ◽  
Lung Lesion ◽  
Tertiary Care Centre ◽  
Predisposing Factor ◽  
Lung Lesions ◽  
Tertiary Referral Center

Aims and Objectives: To study the cytological and histological findings of lung masses and correlate findings with clinical and radiological findings. Material and methods: The study was an observational study, comprised of two years of prospective from December 2017 to September 2019 and five years of retrospective study between October 2012 to November 2017, conducted in Histopathology & Cytology laboratory, Department of Pathology, Pt. J.N.M. Medical College & Dr. B.R.A.M. Hospital, Raipur, (C.G.), a tertiary referral center. Result: Total 104 cases were studied . Out of 104 lung lesions 74 (71.2%) were males and 30 (28.8%) were females with M:F of 2.46:1. Majority of lung lesions were seen in the age group of 61-70 years i.e. 35 (33.66%) and 51-60 years i.e. 30 (28.85%) followed by 41-50 years 17 (16.35%). Mean age of the patients in our study was 56.4 years. Smoking was the most common predisposing factor for lung carcinoma observed in 58 (55.77%) cases followed by tobacco chewing. Clinically the most common complaint was cough in 65 (62.5%) cases, followed by weight loss. 10 cases were diagnosed as benign and 94 cases as malignant. Among benign lesions most common lung lesions were non-specific inflammatory lesions reported in 6 (5.77%) cases followed by granulomatous lesion in 3 (2.89%), hydatid cyst in 2 (1.93%) and aspergilloma in 1 (0.97%) case. Adenocarcinoma was the most common malignant lung lesion found in 52 (50%) cases followed by Squamous cell carcinoma 20 (24%), Small cell carcinoma 12 (13.04%) and Poorly differentiated carcinoma 6 (5.77%) cases. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of our study was 97.83%, 66.67%, 95.74%, 80.0% and 94.23% respectively. Conclusion: Guided FNAC and biopsy are safe, simple, less invasive, cost effective, well accepted and accurate diagnostic procedures with minimal complications and low morbidity rates.

scholarly journals Evaluation of Truenat MTB/RIF Test in Comparison with Microscopy and Culture for Diagnosis of Extrapulmonary Tuberculosis in a Tertiary Care Centre

2021 ◽  
Author(s):  
Reena Anie Jose ◽  
Krishna Gopal ◽  
Abel K Samuel Johnson ◽  
Jennie Ann Johnson Samuel ◽  
Sherin Susan Abraham ◽  
...  
Keyword(s):  
Predictive Value ◽  
Point Of Care ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Smear Microscopy ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Fitting In

Introduction: Worldwide, Extrapulmonary Tuberculosis (EPTB) accounts for 15-20% of all cases of TB. The diagnosis of EPTB is a big challenge, as the number of Mycobacterium tuberculosis(MTB) bacilli in the tissues and other organs is often very low. Truenat MTB/RIF (rifampicin) is a novel method, which is battery operated, point-of-care and chip-based Real Time Polymerase Chain Reaction (RT-PCR) micro device. Aim: To evaluate Truenat as a screening test in the diagnosis of EPTB in comparison with microscopy and culture. Materials and Methods: A prospective cross-sectional study was carried out over a year in which samples from suspected cases of EPTB fitting in the inclusion criteria were subjected to Ziehl-Neelsen (ZN) staining for smear microscopy, culture on Lowenstein Jensen (LJ) medium and PCR for MTB by Truenat. Comparisons were made between the tests and the data was presented using summary statistics with 95% Confidence Interval (CI). Results: A total of 248 samples were received from suspected cases of EPTB. Out of the different samples tested, 9 (3.6%) were positive with Truenat MTB. The predominant type of EPTB observed in the study was lymph node Tuberculosis (TB) (66.6%) followed by intestinal, pleural and skeletal TB. Out of the 106 samples tested for culture, four were culture positive for MTB and out of 178 samples tested for microscopy, three were positive for acid fast bacilli. Sensitivity, specificity, Negative Predictive Value (NPV), Positive Predictive Value (PPV), observed agreement of Truenat with culture and microscopy were 100%, 95.1%, 100%, 44.4%, 95.3% and 100%, 96.6%, 100%, 33.3%, 96.6%, respectively. Conclusion: Truenat MTB test is a cost-effective rapid molecular test with good sensitivity and specificity for the diagnosis of EPTB in low resource settings.

scholarly journals Type and mode of diagnosis of carcinoma lung in a tertiary care centre: one year experience

2017 ◽  
Vol 5 (11) ◽  
pp. 4891
Author(s):  
Jayaprakash Balakrishnan ◽  
Sindhu Nair Prasannakumari ◽  
Ajith Achuthan ◽  
John Mathew
Keyword(s):  
Lung Cancer ◽  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Tertiary Care ◽  
Small Cell ◽  
Common Type ◽  
Ultra Sound ◽  
Tertiary Care Centre ◽  
Easy Method ◽  
One Year

Background: Lung cancer is one of the commonest cancers and cause of cancer related deaths all over the world. The reported incidence of adenocarcinoma is increasing globally and now reported to be the most common type of lung cancer. A panel of investigations are used for the diagnosis of lung cancer. Hence a study was planned to find out the pattern of malignancy and the most appropriate investigation for diagnosis. Objective of present study was to find out the type of carcinoma lung and to find out the best and easy method for diagnosis of carcinoma lung in a tertiary care centre.Methods: A hospital based cross sectional study was conducted in one unit of the Department of Pulmonary Medicine, Government Medical college, Thiruvananthapuram for a period of one year.148 diagnosed cases of carcinoma lung were enrolled. The type and the methods used for diagnosis were analysed.Results: Adenocarcinoma was the commonest malignancy 57 (38.5%), followed by squamous cell carcinoma 44 (29.7%) and small cell carcinoma 10 (6.75%). Rest of the cases 37 (25%) include non small cell carcinoma, poorly differentiated carcinoma and lymphoma. Diagnosis was established by FNA Lung in 46 (31.1%) patients and bronchoscopy and biopsy in 41 (27.7%). Other methods include TBNA 12 (8.1%), lymph node FNA/biopsy 11 (7.4%), pleural fluid cytology 24 (16.2%), sputum cytology and tru cut biopsy 14 (9.5%).Conclusions: The most common type of lung malignancy in present study was adenocarcinoma. Ultra sound guided FNAC lung and bronchoscopy biopsy were the best methods in present study to confirm the diagnosis.

scholarly journals Correlation of clinical and ultrasonographic features with histopathology in post-menopausal bleeding

2020 ◽  
Vol 9 (7) ◽  
pp. 2817
Author(s):  
Meenakshi Vempalli ◽  
Lopamudra B. John ◽  
G. Chandana
Keyword(s):  
Predictive Value ◽  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Tertiary Care ◽  
Statistical Correlation ◽  
Clinical Findings ◽  
Postmenopausal Bleeding ◽  
Tertiary Care Centre ◽  
Post Menopausal ◽  
Sensitivity Specificity

Background: Postmenopausal bleeding is generally regarded as an ominous alarm of genital pathologies which requires a thorough evaluation clinically and pathologically to exclude carcinoma as the cause and ensure a benign pathology. This study aims at finding out whether clinical diagnosis and ultrasonographic features can be reliable parameters for the diagnosis of causes and whether the findings correspond with histopathology reports.Methods: This observational study was conducted in a tertiary care centre in Pondicherry between January 2018 to August 2019. 114 women were enrolled for whom detailed history taking and clinical examination was done. All the patients were subjected to transvaginal ultrasonography. Patients with clinically visible lesions on cervix and vulva were subjected to biopsy and the rest underwent fractional curettage and the sample was sent for histopathological examination. Finally, histopathology report was compared with clinical and ultrasonographic findings.Results: With endometrial thickness cut off of 4 mm, the sensitivity, specificity, positive predictive value and negative predictive value in predicting malignancy by ultrasonography were 100%, 12.3%, 4.5% and 100%. Histopathology showed atrophic endometrium (43.8%), endometrial hyperplasia (8%), endometrial polyp (7.9%) and endometrial carcinoma (3%). Clinical and ultrasonographic findings did not show any statistical correlation with histopathology.Conclusions: Authors conclude that clinical findings and ultrasonographic features do not correlate with histopathology in cases of postmenopausal bleeding for which atrophic endometrium was the commonest etiology. However, ultrasound should be done routinely before endometrial sampling as the sensitivity for predicting malignancy was 100% for endometrial thickness cut off of 4 mm.

Clinicopathologic and survival analysis of patients with lung cancer treated at a tertiary care centre in India.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e17505-e17505
Author(s):  
Vinod Raina ◽  
Prabhat Singh Malik ◽  
B. K Mohanti ◽  
Mehar C Sharma ◽  
Anant Mohan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
Survival Analysis ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Tertiary Care ◽  
Line Treatment ◽  
First Line ◽  
Tertiary Care Centre ◽  
First Line Treatment

e17505 Background: Lung cancer ranks among the most common and lethal malignancies worldwide and also in India. There are geographic and ethnic variations in incidences, clinical and pathological profile of lung cancer. There is paucity of data of changing trend of pathological and clinical profile from this part of the world. Methods: A total of 434 patients with lung cancer were analyzed who were registered at All India Institute of Medical Sciences, over a 3 year period, from July 2008 till June2011, based on information in hospital records. Survival analysis was performed on 310 patients who have received at least one modality of treatment. Results: Median age of the whole cohort was 55 years (23-84 years). There were 357 (82.26%) males and 77 (17.74%) females, 295(69.91%) smokers and 127 (30.09%) non smokers. 370 (85.25%) patients had NSCLC and 64 (14.74%) had SCLC. Among NSCLC, adenocarcinoma was the commonest histology (45.41%) followed by squamous cell carcinoma (29.46%) and unclassified NSCLC (20.54%). Majority (66.13%) of the diagnosis were based on biopsy (needle or bronchoscopic). Among NSCLC, 26.3% patients were of stage 1-3A and 73.7% were of stage 3B and 4. Among SCLC 25% patients were of limited stage and 75% patients were of extensive stage. 73.18% of NSCLC patients received chemotherapy, 19.15% received TKI and 5.75% received RT as first line treatment modality. Among SCLC 93.88% received chemotherapy and 6.12% received RT as first line treatment. Median PFS and OS of patients with NSCLC were 7.8 months and 13.2 months respectively while that of SCLC were 6.1 months and 9.2 months respectively. Conclusions: Pathological profile of lung cancer has changed in India. Adenocarcinoma has become the commonest histology, contrary to the older reports when squamous cell carcinoma was more common. Majority of the patients are diagnosed in advanced stage and survival of these patients remains poor.

Concurrent surgeries in ENT: a cost-effective and safe approach in patients requiring multiple definitive procedures

2004 ◽  
Vol 118 (1) ◽  
pp. 31-33 ◽  
Author(s):  
Achamma Balraj ◽  
Mary Kurien ◽  
Anand Job
Keyword(s):  
Surgical Procedures ◽  
Tertiary Care ◽  
Case Series ◽  
Cost Effective ◽  
Definitive Treatment ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
Average Hospital ◽  
Duration Of Surgery

Treatment of the predisposing factors that are identified in the nose and throat in several ENT diseases is mandatory prior to the definitive management of the latter. When surgical management is indicated it has been traditional to use staged procedures. This study was undertaken to assess the role of concurrent surgical procedures in ENT and evaluate their cost-effectiveness compared to similar staged procedures. This was a retrospective case series of 100 consecutive patients undergoing concurrent and similar staged ENT surgical procedures. On analysis, it was noted that the average duration of surgery, anaesthesia and hospital stay was significantly less in the concurrent procedures group than in the staged procedures (2.35/3.1.hours; 3.05/3.30.hours and 2.5/6.5 days, respectively). The average hospital bill for the concurrent procedures was also lower than for the staged procedures. Hence, in patients requiring multiple ENT surgical procedures for definitive treatment, concurrent procedures are more cost-effective than staged procedures and should be considered the treatment of choice in a tertiary care centre.

scholarly journals A study to assess vaccine wastage in an immunization clinic of tertiary care centre, Gwalior, Madhya Pradesh, India

2017 ◽  
Vol 5 (6) ◽  
pp. 2472 ◽  
Author(s):  
Ranjana Tiwari ◽  
Shatkratu Dwivedi ◽  
Piyush Swami ◽  
Rakesh Mahore ◽  
Sakshi Tiwari
Keyword(s):  
Hepatitis B ◽  
Tertiary Care ◽  
Cost Effective ◽  
Economic Benefits ◽  
Madhya Pradesh ◽  
Positive Health ◽  
Tertiary Care Centre ◽  
Tertiary Center ◽  
Wastage Rate ◽  
Key Factor

Background: Vaccines are one of the most successful and cost-effective health intervention. It becomes imperative that use of vaccine was done through a proper framework of practical decision-making that confers positive health and economic benefits to the society of which Vaccine Wastage was a key factor. The aim of the study is to assess “Vaccine Wastage Rate” and “Wastage Factor” of different vaccines given to beneficiaries in Immunization Clinic and based on the above data, recommend measures to reduce it in the Immunization clinic  Methods: The present study was a Record Based Retrospective study carried out in Immunization Clinic in Madhav Dispensary of tertiary center at Gajra Raja Medical College, Gwalior, Madhya Pradesh, India. The data was collected from 1 April 2015 - 31 March 2016.Results: Immunization Sessions were conducted in Immunization clinic during reference period and 7 vaccines BCG, OPV, DPT, Hepatitis B, pentavalent, measles and TT were given. Among individual vaccines, wastage rate and wastage factor in BCG (20.71 and 1.26), OPV (14.65 and 1.17), DPT (15.6 and 1.18), Hepatitis B (10.56 and 1.12), Pentavalent (5.2 and 1.05), Measles (21.68 and 1.28), TT (7.09 and 1.08), and IPV (10.49 and 1.12) was respectively.Conclusions: Vaccine wastage could be expected in all programmes and there should be an acceptable limit of wastage. Innovative techniques to be developed not only to reduce wastage but also the operational cost for convenience of children who were to be vaccinated and parents who bring their children for vaccination without compromising coverage. 

scholarly journals Establishing an alternative accommodation for stable hospitalised antepartum patients: barriers and challenges

2022 ◽  
Vol 11 (1) ◽  
pp. e001625
Author(s):  
M Brad Sullivan ◽  
Abby Rentz ◽  
Pamela Mathura ◽  
Megan Gleddie ◽  
Tania Luthra ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Swot Analysis ◽  
Tertiary Care ◽  
Physical Space ◽  
Patient Discharge ◽  
Cost Effective ◽  
Premature Delivery ◽  
Care Centre ◽  
Outpatient Management ◽  
Tertiary Care Centre

BackgroundPatients in remote communities who risk premature delivery require transfer to a tertiary care centre for obstetric and neonatal care. Following stabilisation, many patients are candidates for outpatient management but cannot be discharged to their home communities due to lack of neonatal intensive care unit (ICU) support.ProblemWithout outpatient accommodation proximal to neonatal ICU, these patients face prolonged hospitalisation—an expensive option with medical, social and psychological consequences. Therefore, we sought to establish an alternative accommodation for out-of-town stable antepartum patients.MethodsQuality Improvement approaches were used to identify process strengths and opportunities for improvement on the antepartum ward in a tertiary care centre. Physician and patient surveys informed outpatient accommodation programme development by a multidisciplinary team. The intervention was implemented using a plan–do–study–act cycle. Barriers to patient discharge and enrolment in the programme were analysed by completing thematic and strengths–weaknesses–opportunities–threats (SWOT) analysis.ResultsPhysicians broadly supported safe outpatient management, whereas patients were hesitant to leave the hospital even when physicians assured safety. Our alternative accommodation was pre-existing and cost-effective, however, we encountered significant barriers. The physical space limited family visits and social interaction, lacked desired amenities,and the programme proved inconvenient to patients. The thematic and SWOT analysis identified aspects of the intervention which can be optimised to develop future actionable strategies.ConclusionThe utilisation of acute care beds is costly for the healthcare system and must be allocated judiciously. Patient needs, experience and health system barriers need to be considered when establishing alternative outpatient accommodations and strategies for stable antepartum patients.

scholarly journals Histopathological Spectrum of Cutaneous Basal Cell Carcinoma- An 11 Year Retrospective Study in a Tertiary Care Hospital in Southern Karnataka

2021 ◽  
Author(s):  
Namratha Ravishankar ◽  
Vijaya Basavaraj ◽  
Reshma Raju
Keyword(s):  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Clinical Data ◽  
Basal Cell ◽  
Tertiary Care ◽  
Histological Evaluation ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Pigmented Lesions ◽  
Malignant Skin

Introduction: Basal Cell Carcinoma (BCC) is a slow growing, locally invasive, malignant skin tumour with increasing incidence in recent decades. Various histological subtypes of BCC have been described which include nodular, superficial, adenoid, keratotic, basosquamous, and morpheiform. Aim: To analyse the clinical data of patients with BCC and the histomorphological spectrum of BCCs in a population of Southern Karnataka. Materials and Methods: This was an 11 year retrospective descriptive observational study of all histologically confirmed BCCs diagnosed in the Department of Pathology in a tertiary care centre in Southern Karnataka from January 2010 to January 2021. Detailed clinical data of 64 patients including age, gender, clinical diagnosis and anatomic location were analysed. Results: The maximum number of BCCs occurred in the sixth decade with a slight female preponderance. Head and neck lesions were the most common and uncommon sites noted included the vulva and axilla. Most cases presented as an irregular plaque followed by presentation as an ulcerative lesion. Pigmentation was noted in 18 (28%) cases clinically. Majority of patients (63/64 or 98.4%) had a single lesion. Histological types included nodular, superficial, adenoid, basosquamous and BCC with sebaceous differentiation. Nodular BCC was the most commonly encountered type in our setting, followed by superficial BCC. Only one case of basosquamous carcinoma showed evidence of metastasis to lymph nodes. Conclusion: Histological evaluation of BCC is of paramount importance not only to establish the diagnosis but also to predict behaviour and risk of recurrence. In addition to the diagnosis, pathologist should also describe subtypes of the tumour which has a prognostic implication. This study reveals the morphological spectrum of BCC in the population of southern Karnataka and reveals significant patterns in anatomical distribution of BCC. It also highlights a significant percentage of BCCs presenting as pigmented lesions in the Indian population.

scholarly journals Gallbladder perforation: management in a tertiary care centre

2018 ◽  
Vol 5 (10) ◽  
pp. 3346
Author(s):  
Prashant Tubachi ◽  
K. Sphurti Kamath ◽  
Mallikarjun Desai ◽  
Harsha Kodliwadmath
Keyword(s):  
Surgical Treatment ◽  
Acute Cholecystitis ◽  
Computerized Tomography ◽  
Open Cholecystectomy ◽  
Tertiary Care ◽  
Diagnostic Procedures ◽  
Gallbladder Perforation ◽  
Type I ◽  
Tertiary Care Centre ◽  
Intravenous Antibiotics

Background: Retrospective study in the management of perforated gallbladder and clinical outcome in a tertiary care centre.Methods: Total of 583 patients underwent laparoscopic or open cholecystectomy between 2015 to 2017. Out of these eleven patients had perforated gallbladder (1.9%). Niemeier’ classification used for gallbladder perforation. Both Ultrasonography and Abdominal computerized tomography was used in this study. The parameters like age, gender, method of management, diagnostic procedures, time between date of admission to time of surgery, surgical treatment, duration of hospital stay and post-operative morbidity were evaluated.Results: Out of the eleven cases, eight patients were male and three were female. Nine patients were above the age of fifty years. According to Niemer classification, seven patients had type I perforation, three patients had type II perforation and one had type one perforation. Out of the eleven cases, eight were clinically diagnosed to be acute cholecystitis and three were clinically diagnosed to have peritonitis. The cases diagnosed to have peritonitis- underwent immediate intervention. The remaining eight cases were initially managed conservatively with intravenous antibiotics, imaging and workup was done, following which intervention was done.Conclusions: Early diagnosis and emergency surgical treatment of gallbladder perforation with peritonitis is of crucial importance. If the patient is stable then intervention after optimising has better outcome. Abdominal computerized tomography for acute cholecystitis patients may contribute to the preoperative diagnosis of gallbladder perforation. 

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