scholarly journals Breast cancer in young women: A retrospective study from tertiary care center of north India

2017 ◽  
Vol 06 (02) ◽  
pp. 051-053
Author(s):  
Deepti Sharma ◽  
Garima Singh
Keyword(s):  
Breast Cancer ◽  
Care Center ◽  
Tertiary Care ◽  
North India ◽  
Categorical Variables ◽  
Chi Square ◽  
Biological Behaviour ◽  
Exact Test ◽  
Poor Outcomes ◽  
The Impact

Abstract Aim: Breast cancer is the most common cause of cancer in women worldwide. They have more aggressive clinical behaviour with poor outcomes in younger patients. The aim of this study was to evaluate the impact of age on prognosis of breast cancer in women above and under 40 years of age. Material and Methods: Medical record of 415 patients with invasive breast cancer were analysed from January 2011 to December 2014 in our department.The last was done in December 2015.All cases diagnosed with breast cancer stages I to IV were evaluated, and grouped on the basis of age [less than 40 and above 40 years].Baseline categorical variables were analysed using the Chi-square test or Fisher's exact test. Non categorical variable were analysed using t-test. Result: A total of 372 patients were reviewed because 42 patients defaulted. The median age at the time of diagnosis was 44.6 years (range 23 to 90 years).Metastasis to distant organs were more in women with age <40. Tumour relapse occurred in 131 cases, among which 84 cases died, 35 patients (26.31%) in less than 40 group vs.49 patients (20.50%) in above 40 groups. The estimated median OS in the two groups are 32 and 41 months respectively. Conclusion: The biological behaviour of breast cancer in younger age group has been shown to be associated with aggressive nature and has a worse clinical outcome as compared to that in older group.

Validation of a Breastfeeding History Questionnaire for the Risk of In-Hospital Formula Supplementation Among Multiparous Women

2019 ◽  
Vol 35 (4) ◽  
pp. 665-671
Author(s):  
Whitney R. Bender ◽  
Nathanael C. Koelper ◽  
Mary D. Sammel ◽  
Celeste Durnwald
Keyword(s):  
Hospital Stay ◽  
Care Center ◽  
Tertiary Care ◽  
Categorical Variables ◽  
Chi Square ◽  
Multiparous Women ◽  
Chi Square Test ◽  
Student’S T ◽  
Relationship Of ◽  
The Relationship

Background: A woman’s prior breastfeeding history may influence future decisions regarding infant feeding. Few quantitative tools utilizing this information have been demonstrated to predict breastfeeding success. Research aim: To evaluate the efficacy of a prenatal breastfeeding history (BAP) questionnaire administered in prenatal care to predict in-hospital formula supplementation among multiparous women. Methods: This is a prospective observational study of multiparous women with singleton pregnancies who presented to a Baby-Friendly urban tertiary care center for 1st prenatal visit at < 20 weeks’ gestation. The BAP tool generates a numerical score, with higher score (≥ 2) indicating prior successful breastfeeding experiences. The primary outcome was occurrence of non-medically indicated formula supplementation during the postpartum hospital stay. Student’s t test and Pearson’s chi-square test were used to compare continuous and categorical variables. A multivariable logistic regression was performed to assess the relationship of BAP score to formula supplementation. Of 587 women screened, 433 (73.8%) mother–infant dyads were analyzed. Results: Rates of formula supplementation in women with BAP scores ≤ 1 were 67% (156/234) compared with 37% (73/199) in women with higher scores ( p < 0.0001). After controlling for race/ethnicity, insurance, and obesity, women with BAP scores of ≤ 1 were 2.6 times more likely to supplement formula than women with higher scores (a OR 2.62, 95% CI [1.70, 4.04], p < .0001). Conclusion: In this prospective validation study, women with negative prior breastfeeding experiences, as evidenced by a lower BAP score, were more likely to supplement formula during the postpartum hospital stay.

scholarly journals Changes in Pediatric Faculty Burnout During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Audrey M. Uong ◽  
Michael D. Cabana ◽  
Janet R. Serwint ◽  
Carol A. Bernstein ◽  
Elaine E. Schulte
Keyword(s):  
Emotional Exhaustion ◽  
Tertiary Care ◽  
Categorical Variables ◽  
Academic Rank ◽  
Continuous Variables ◽  
Cross Sectional ◽  
Exact Test ◽  
Faculty Burnout ◽  
Student’S T ◽  
The Impact

OBJECTIVES To examine the impact of the coronavirus disease 2019 (COVID-19) pandemic and associated workflow changes, such as deployment on pediatric faculty burnout in an early epicenter of the pandemic. We hypothesized burnout would increase during the COVID-19 surge. METHODS We conducted serial cross-sectional surveys of pediatric faculty at an academic, tertiary-care children’s hospital that experienced a COVID-19 surge in the Northeastern United States. Surveys were administered pre-surge (February 2020), during the surge (April 2020), and postsurge (September 2020). The primary outcome was burnout prevalence. We also measured areas of worklife scores. We compared responses between all 3 survey periods. Continuous variables were analyzed by using Student’s t or Mann–Whitney tests, and categorical variables were analyzed by using χ2 or Fisher’s exact test, as appropriate. RESULTS Our response rate was 89 of 223 (40%) presurge, 100 of 267 (37%) during the surge, and 113 of 275 (41%) postsurge. There were no differences in demographics, including sex, race, and academic rank between survey periods. Frequency of burnout was similar in all 3 periods (20% to 26%). The mean scores of emotional exhaustion improved during the surge (2.25 to 1.9; P = .04). CONCLUSIONS Contrary to our hypothesis, we found no changes in pediatric faculty burnout after a COVID-19 surge. Emotional exhaustion improved during the COVID-19 surge. However, these findings represent short-term responses to the COVID-19 surge. Longer-term monitoring of the impact of the COVID-19 surge on pediatric faculty burnout may be necessary for health care organizations to mitigate burnout.

scholarly journals Comparison of intravenous hydralazine and intravenous labetalol in the management of severe hypertensive disorders of pregnancy: a tertiary care centre study

2018 ◽  
Vol 7 (6) ◽  
pp. 2251
Author(s):  
Manvi Verma ◽  
Shashi Gupta ◽  
B. R. Bhagat ◽  
Aakanksha Mahajan ◽  
Baseerat Kaur
Keyword(s):  
Adverse Effects ◽  
Severe Hypertension ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Categorical Variables ◽  
Tertiary Care Centre ◽  
Low Birth Weight Infants ◽  
Chi Square ◽  
Exact Test ◽  
Student’S T

Background: Severe hypertension in pregnancy (SBP ≥160 mmHg &/or DBP ≥ 110 mmHg) must be treated judiciously to prevent maternal and fetal complications. The study was conducted to compare the efficacy, adverse effects, maternal and fetal outcome between Hydralazine and Labetalol which are the most commonly used drugs for the purpose.Methods: In a prospective study, 130 pregnant patients each with severe hypertension presenting to SMGS Hospital Jammu were randomized in 2 groups and administered hydralazine or labetalol intravenously. The efficacy of the two drugs was measured in terms of number of doses required to obtain target BP and the timing to achieve the same. The incidence of adverse effects, maternal and fetal outcomes were also compared. Comparisons among the two groups was performed by using independent Student’s t test for normally distributed variables, Fishers’ exact test, and Pearson Chi Square test for categorical variables. The level of significance was set at p<0.05 for all analysis.Results: There was no statistical difference between the two drugs in terms of efficacy. Significantly more low-birth weight infants were born in the hydralazine group. Also, the adverse effects were significantly more in the hydralazine group.Conclusions: Both hydralazine and labetalol can be used to treat hypertensive emergencies of pregnancy but hydralazine is associated with more side effects.

scholarly journals A study on EEG findings: An Experience from a Tertiary Care Center of Nepal

2017 ◽  
Vol 5 (1) ◽  
pp. 32-36
Author(s):  
S. Joshi ◽  
R. Shakya
Keyword(s):  
Electrical Activity ◽  
Detection Rate ◽  
Care Center ◽  
Tertiary Care ◽  
Continuous Variable ◽  
Seizure Disorder ◽  
Categorical Variables ◽  
Chi Square ◽  
Statistical Tool ◽  
Invasive Test

Introduction: The electroencephalography (EEG) is the recording of brain’s spontaneous electrical activity over a period of time (15-20) minutes recorded from multiple electrodes placed on the scalp. It is used in seizure disorder, organicity, and psychiatric conditions. There is a paucity of literature with regard to the application of EEG in various conditions in our setting.Objective: The current study aims to explore the EEG findings of different cases and their associations in various clinical scenarios.Method: It is a retrospective study on the patients who underwent EEG in the EEG room of Department of Psychiatry at Patan Academy of Health Sciences (PAHS), Nepal for a year. Information was obtained from EEG register and reports. Data were analyzed using IBM SPSS version 23. Frequency distribution was studied and Chi Square test was applied for categorical variables. The only continuous variable studied was the age for which mean, median and standard deviation were computed and the suitable statistical tool was applied after normality testing.Result: Of the total 164 patients studied, mean age was 21.93 years and 51.2% were male. The common reason for EEG referral was to rule out seizure disorder (80.5%), requested mostly from the department of Psychiatry. EEG abnormality was seen in 43.3% with EEG diagnosis of generalized epilepsy in 26.21% and slow wave (46.2%) as the most common EEG finding. Abnormal EEG detection rate was almost similar in both the genders and predominant in those with a clinical diagnosis of seizure disorder (47.88%). The EEG abnormality detection rate was significant in those referred from the Department of Psychiatry and Paediatrics.Conclusion: EEG is a relatively inexpensive and non-invasive test for detection of electrical activity in the brain. Though requested for seizure or related disorders, it can also find its place in organic pathology, monitoring treatment response among others.

Male breast cancer: A 10-year experience of a tertiary care center in North India

2016 ◽  
Vol 5 (6) ◽  
pp. 521 ◽  
Author(s):  
Asifa Andleeb ◽  
MohammadMaqbool Lone ◽  
HakimIrfan Ahmad ◽  
Fir Afroz ◽  
Arshid Manzoor ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Male Breast Cancer ◽  
Care Center ◽  
Tertiary Care ◽  
Male Breast ◽  
North India ◽  
Tertiary Care Center

scholarly journals Clinicopathological study of Meningiomas in a tertiary care center

2020 ◽  
Vol 11 (SPL2) ◽  
pp. 187-193
Author(s):  
Rashmi Raveendran ◽  
Sridevi M ◽  
Chitra Srinivasan ◽  
Ganthimathy Sekhar
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Management Plan ◽  
Current Treatment ◽  
Treatment Modalities ◽  
Grading System ◽  
Proliferative Potential ◽  
Biological Behaviour ◽  
Brain Invasion ◽  
The Impact

Meningiomas are a group of common, predominantly benign and slow growing tumours of the meninges. The revised 4th edition of WHO classification of Central Nervous system tumours (2016) has classified them into Grades I, II and III based on their biological behaviour as well as proliferative potential. Recurrence and brain invasion are commonly considered to be found in higher grades. Recent studies have shown that high grade tumours have also been associated with clinical findings such as peri-tumoural brain edema. The purpose of the grading system is to aid in formulating an appropriate management plan. The aim of our study was to analyse the clinical and histomorphological features of meningiomas and evaluate the impact of the current grading system in tumour prognosis. A total of 60 cases were included in our study. They were seen predominantly in females and in the 5th and 6th decades of life, with a propensity to occur in the convexities. The commonest variant was meningothelial meningioma and the commonest grade was Grade I. However, we also noted an increase in Grade II meningiomas due to the definition of brain invasion as an atypical feature in the latest classification. Malignant phenotype such as recurrence was seen in all 3 grades. Hence, we conclude that constant revision of the grading system is necessary to maintain diagnostic accuracy and improve current treatment modalities.

scholarly journals Cardiotoxicity in patients on trastuzumab in HER2-positive breast cancer – A retrospective analysis from a center in North India

2020 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Anjali Aggarwal ◽  
Pratik Patil ◽  
Ranga Rao Rangaraju ◽  
Waseem Abbas ◽  
Sunny Garg
Keyword(s):  
Breast Cancer ◽  
Care Center ◽  
Tertiary Care ◽  
Left Ventricular ◽  
North India ◽  
Left Ventricular Ejection ◽  
Eligibility Criteria ◽  
Ventricular Ejection Fraction ◽  
Positive Breast Cancer

Objectives: Cardiotoxicity has been associated with trastuzumab for long and its relation with anthracyclines has also been well established. The study aims to assess the cardiotoxicity in patients on trastuzumab in human epidermal growth receptor 2-positive breast cancer. Material and Methods: This retrospective study consisting of a 3 years database of 112 patients with breast cancer from a tertiary care center in India. A total of 64 patients were scrutinized meeting the eligibility criteria. The primary eligibility criteria were availability of baseline, 3 monthly, end of treatment, and 3 months post-treatment left ventricular ejection fraction (LVEF) profile data. Results: 41/62 patients (66.1%) showed decrease in the LVEF profiles having mean reduction of 6%. Of these 41 patients, 34 (53.1%) patients exhibited a drop of 0–5%, 4 (6.2%) showed a drop of 6–10%, and 3 (4.6%) patients showed a drop of more than 10%. A significant drop (more than 10%) in the LVEF profile was observed in mean time of 6 months (8 cycles) which recovered to baseline value with the median follow-up of 3 months post-cessation of trastuzumab. Most of patients in the LVEF drop >10% group (70%) had received an anthracyclines based regimen. Conclusion: Our study demonstrated a mean drop of >10% in the LVEF profiles (4.6%) patients after mean follow-up of 6 months after starting therapy with trastuzumab and reverted back to baseline value after over a mean of 3 months post completing therapy with trastuzumab. This warrants regular and strict surveillance for the first 6 months and thereafter also after starting therapy with trastuzumab.

scholarly journals 862. Impact of Caregiver Health on Pediatric Healthcare-Associated Viral Respiratory Infections (HAVRIs): A Retrospective Study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S470-S470
Author(s):  
Maude Paquette ◽  
Allyson Shephard ◽  
Pat Bedard ◽  
Nisha Thampi ◽  
Nisha Thampi
Keyword(s):  
Respiratory Infections ◽  
Care Center ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Prevention Measures ◽  
Poor Outcomes ◽  
Viral Respiratory Infections ◽  
Healthcare Associated ◽  
The Impact ◽  
Viral Respiratory

Abstract Background The burden of healthcare-associated viral respiratory infections (HAVRIs) in children is significant, with increased healthcare costs and risk of poor outcomes. However, while healthcare workers are the main target of infection prevention measures, little is known about the impact of sick contacts during hospitalization on the incidence of HAVRIs. The objective of our study was to determine the proportion of pediatric HAVRIs following contact with an ill caregiver or visitor. Secondary objectives were to describe the characteristics of affected patients as well as the complications associated with the HAVRI episodes. Methods This is a retrospective chart review that took place in a pediatric tertiary care center with both multiple and single-bed rooms. All cases of HAVRIs that occurred between December 2017 and July 2019 in patients aged less than 18 years old were included in the study. HAVRIs were defined as a laboratory confirmed respiratory viral illness occurring after 72 hours of admission. Results Forty-four HAVRIs were included in the analysis. The majority (n=32, 72.7%) were among patients aged less than 24 months. Only 2 patients had no comorbidities and almost half (n=21, 47.7%) had multiple complex medical conditions. Rhinovirus was the most frequently isolated virus (n=20, 45.5%). Nine patients (20.5%) had a documented contact with a sick caregiver (n=8, 88.9%) or sick visitor (n=2, 22.2%) in the 7 days prior to the onset of new respiratory symptoms and subsequent HAVRI diagnosis. In the 72 hours prior to HAVRI onset, 18 patients (40.9%) were in a single-bed room and 6 patients (13.6%) were already under droplet/contact precautions. Twelve patients (27.3%) had new or increased O2 requirements and 4 (9.1%) were transferred to the intensive care unit. There were no associated deaths. Conclusion Our study suggests that having a contact with a sick caregiver or visitor is a potential risk factor for acquiring a HAVRI. This reinforces the relevance of a strict visitor-screening policy and of educating caregivers on the importance of appropriate hand hygiene when caring for their child. Of note, more than one third of HAVRI cases occurred in patients already in a single-bed room, with or without additional precautions, suggesting that those measures are not entirely protective. Disclosures All Authors: No reported disclosures

scholarly journals Venomous snakebite — Significance of the bite site and local reaction

2021 ◽  
Vol 6 (2) ◽  
pp. 47-51
Author(s):  
Ajith Venugopalan ◽  
Smrithi Vijaykumar ◽  
G. Sreekumar ◽  
Kripanadhi Karunanithi ◽  
Bharath Prasad ◽  
...  
Keyword(s):  
Preventive Measures ◽  
Local Reaction ◽  
Monsoon Season ◽  
Care Center ◽  
Tertiary Care ◽  
Snake Bite ◽  
Categorical Variables ◽  
Venomous Snake ◽  
Snake Bites ◽  
The Impact

Snakebite is an environmental and occupational hazard in India. Death and disabilities due to snakebite remains a major public health challenge. For the fight against this battle a greater investment should be focused on the preventive measures. This includes understanding of the common seasons of snake bites, location and also the site of snake bite. Understanding these will help in taking better preventive measures. This is a 6-year retrospective observational study of 70 venomous snake bite cases admitted to a tertiary care center in South India. Inclusion criteria has been all confirmed case of envenomation by venomous snake bite. Chi square test was done to find the association between categorical variables. The study sample size is 70. Mean age in our study is 34.66 ± 18.57 years. 57.1% were male. 79% snake bites occurred outdoor. 57.1 % patients had local reaction along with hemotoxic/neurotoxic symptoms. 28.5% patients had only local reaction. 84% bites occurred in lower limb. 43% bites occurred in the foot. Statistically borderline significant correlation between site of bite and local reaction alone (p=0.05). We could not find a statistically significant correlation between site of bite and local reaction with hemotoxic / neurotoxic symptoms (p=0.236). 59% snake bites occurred during Monsoon season this was followed by post monsoon season. Snakebite is a neglected tropical disease and remains as an underestimated cause of accidental death in modern India. Significance of bite site along with seasonal variations in snakebites helps in formation of effective preventive strategies, which along with prompt primary treatment holds the key in reducing the impact of venomous snakebite.

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