scholarly journals Clinical Presentation of Carcinoma of Thyroid and Its Treatment Options

2021 ◽  
pp. 1-6
Author(s):  
Ahsan Ali Laghari ◽  
Ghulam Akbar Khaskheli ◽  
Aijaz Ahmed Shaikh ◽  
Ambreen Munir ◽  
Tufail Ahmed Baloch ◽  
...  
Keyword(s):  
Data Analysis ◽  
Clinical Presentation ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Tertiary Care ◽  
Stage I ◽  
Stage Iii ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Neck Swelling ◽  
Toxic Goiter

Objective: To determine the clinical presentation of carcinoma of thyroid and its treatment modalities at tertiary care Hospital. Study Design: Prospective observational study. Place and Duration: This study was conducted in Liaquat university of Medical and health sciences Jamshoro/Hyderabad, Pakistan, during two years from July 2017 to June 2020. Patients and Methods: All the patients with age range between 20 to 80 years having swelling in front of neck according to clinical examination with hard inconsistency along with change of voice lymphadenopathy, difficulty in swallowing and breathing, patients diagnosis with malignancy according to FNAC and CT, and either of gender were included. FNAC was done in each patient except toxic goiter, diffuse goiter and multinodular goiter with dominant nodules. Patients those were diagnosed with stage I and II, underwent surgical treatment and remaining were referred to oncology department for new adjuvant therapy and then surgeries were done if possible. All the data was recorded in study proforma and data analysis was done by using SPSS data analysis software version 20. Results: Out of all cases of suspicious of carcinoma thyroid, 70% were females. Neck swelling was in all of the cases, followed by pain, cervical lymphadenopathy, recurrent laryngeal nerve palsy with change of voice, swallowing difficulty, cyanosis and pathological fracture. According to tumor staging, most of the cases were found with benign tumor, followed by 5 cases with stage I, three cases with stage II, three patients presented with stage IV and one was seen with secondary’s from malignant melanoma. Most of the cases 70.0% underwent subtotal and near total thyroidectomies Eight patients were initially operated having stage I and II of malignancy and remaining 7 patients of stage III and IV were referring to oncology department for further management. Conclusion: In the conclusion of this study the neck swelling was the commonest clinical presentation. Surgical decision making and the operative planning is one of the new challenges. Mostly patients underwent subtotal and near total thyroidectomies having benign presentation and patients those had stage I and II of malignancy were initially operated, while patients of stage III and IV including secondary were referred to oncology.

scholarly journals Long term outcome of Wilms' tumor in tertiary care hospital

2020 ◽  
Vol 7 (10) ◽  
pp. 3234
Author(s):  
Jeevarathi T. ◽  
Gomathi Vadivelu
Keyword(s):  
Wilms Tumor ◽  
Tertiary Care ◽  
Fumarate Hydratase ◽  
Stage I ◽  
High Rate ◽  
Stage Iii ◽  
Care Hospital ◽  
Term Outcome ◽  
Long Term Outcome

Background: Nephroblastoma, or Wilms’ tumor, is an embryonal tumor that develops from remnants of the immature kidney. It is the most common renal tumor of childhood. The aim is to analyze the long term outcome in Wilms’ tumor in perplex situations as double moiety and to correlate with multiple organ defects.Methods: It is a combined perspective and retrospective study that pediatric urology outpatient department (OPD) at the Institute of Child Health and Hospital for Children, Madras Medical College, Chennai. The study included patients with Wilms, who attended the pediatric surgery during the ten years, from March 2008 to February 2011. The patients were subjected to detailed clinical examination and relevant investigations were performed.Results: Among patients with stage I–II fumarate hydratase (FH) tumors, the relative risk (RR) of relapse and death were increased for loss of heterozygosity (LOH) 1p only (RR=2.2 for relapse; RR=4.0 for death), for LOH 16q only (RR=1.9 and RR=1.4), and LOH for both regions (RR=2.9 and RR=4.3) in comparison with patients lacking LOH at either locus.Conclusions: Stage I and II have a good prognosis. Stage III and IV need close surveillance since they have a high rate of recurrence. Stage V has a bad prognosis. Stage IV Wilms need lung irradiation. Neoadjuvant chemotherapy reduces tumor spillage in stage III and IV. 

scholarly journals A clinical study on ectopic pregnancy in tertiary care hospital Imphal

2021 ◽  
Vol 10 (2) ◽  
pp. 562
Author(s):  
Naorem Sunanda Chanu ◽  
Vinodkumar Suresh Basavaradder ◽  
Cibi Darsani ◽  
Ahanthembi Sanaton
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
First Trimester ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Grey Zone ◽  
Age Group ◽  
History Of

Background: Ectopic pregnancy is one of the most common life-threatening emergencies in early trimester of pregnancy. The aim of this study was to determine the incidence, age group, gravidity, parity, risk factors, clinical presentation, treatment modalities associated with ectopic pregnancy in the current scenario.Methods: We conducted a prospective study for the period of two years starting from Aug 2017 to Aug 2019 at JNIMS OBG Department.Results: A total of 94 patients who were diagnosed as ectopic pregnancy and they were analysed for clinical presentation, risk factors, operative findings and treatment modality. Majority of patients were in the age group of 25 to 30 years. Ectopic pregnancy was more commonly associated with history of prior abortions, prior LSCS and PID. Commonly presented with amenorrhea of 6-8 weeks with abdominal pain and bleeding PV, most common site being ampulla followed by isthmus. Most of the patients had ruptured pregnancy at presentation. Majority of the patients underwent salpingectomy and salpingectomy with contralateral tubectomy.Conclusions: Ectopic pregnancy diagnosis is a grey zone and challenging. Early diagnosis by keeping suspicion in first trimester with PV bleeding and pain abdomen with history of amenorrhea about ectopic pregnancy, which helps in management to reduce maternal morbidity and even mortality.

scholarly journals A Case of Congenital Tuberculosis in a Tertiary Care Hospital

2012 ◽  
Vol 1 (2) ◽  
pp. 85-87
Author(s):  
Ishrat Jahan ◽  
Mehedi Parvez ◽  
Laisha Yeasmin
Keyword(s):  
Clinical Presentation ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Male Infant ◽  
Abdominal Distension ◽  
Drug Regimen ◽  
Care Hospital ◽  
Gastric Aspirate ◽  
Congenital Tuberculosis ◽  
Low Weight

Congenital tuberculosis is an unusual and severe clinical presentation of Mycobacterium tuberculosis (MTB) infection. It is usually difficult to diagnose and treat. We report a tenweek-old male infant who had presented with fever, difficulty in breathing, abdominal distension, convulsion, low weight gain since one month of his age. The diagnosis was made by demonstration of MTB bacilli in the gastric aspirate of baby and chest radiography. Treatment with the four drug regimen including streptomycin was initiated, but the baby died   on the third day of ATT. This case gives an account of difficulties in diagnosis and therapeutic   management of congenital tuberculosis and alerts for development of protocols that foresee   these difficulties. DOI: http://dx.doi.org/10.3329/jemc.v1i2.11469   J Enam Med Col 2011; 1(2): 85-87  

scholarly journals APPROACH TOWARDS DEVELOPING AN ALGORITHM FOR GAP NONUNION

2020 ◽  
pp. 1-6
Author(s):  
Nirjhar Maji
Keyword(s):  
Tertiary Care ◽  
Functional Results ◽  
Time Frame ◽  
Activity Level ◽  
Treatment Modalities ◽  
Long Bone ◽  
Care Hospital ◽  
Non Union ◽  
Formidable Challenge ◽  
Back Ground

Back ground and objectives The treatment of Gap or Defect non-union presents a formidable challenge to Orthopaedic surgeons. Not only a union but also good functional outcome is the target of modern-day Orthopaedics. The objective of this study is to consider knowledge of all treatment modalities, time frame, and functional results of long bone defects and develop an algorithm. Summary The study is designed as retrospective, prospective observational study. It is conducted in tertiary care hospital (MIOT Hospitals, Chennai). Initial evaluation of all cases were done by Maurizio Catagni’s Classification. Type of surgeries, time spent in hospital, union time were calculated. Patients were followed up for a period of 1year. Patients with average defect size of 6.29cm on an average underwent 4.47 procedures and for an overall time of 17.8 weeks with around 83.80 % of individuals were able to return to their preinjury activity level. Analysis of all data was done and algorithm developed.

scholarly journals Microbiological Screening and Antimicrobial Sensitivity Profiling of Wound Infections in a Tertiary Care Hospital of Bangladesh

2020 ◽  
pp. 101-106
Keyword(s):  
Wound Infection ◽  
Primary Care Physicians ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
Gram Positive ◽  
Gram Negative ◽  
Antimicrobial Sensitivity

Wound infection is a major problem in hospitals in developing countries. Wound infection causes morbidity and prolonged hospital stay thus this prospective study was conducted for a period of seven months (January 2019 to July 2019). A total of 217 specimens (wound swabs and pus exudates) from wound infected patients in a Tertiary Care Hospital in Bangladesh. A retrospective study of the microbiological evaluation was done by cultural growth as well as Gram staining and biochemical examination to identify the bacterial isolates. Finally, the antimicrobial vulnerability testing was performed by Kirby-Bauer disc diffusion conventional method. A total of 295 samples were tested. Out of which 217 (73.5%) were found culture positive. E. coli was the most predominant gram-negative isolates whereas Staphylococcus aureus and Coagulase-negative Staphylococcus were the most commonly isolated gram-positive organisms. Antimicrobial sensitivity profile of bacterial isolates revealed imipenem, meropenem, amikacin, and nitrofurantoin to be the most effective antimicrobials against gram-negative isolates, whereas imipenem, meropenem, amikacin, nitrofurantoin, amoxiclav, and gentamicin were the most effective drugs against gram-positive isolates. The result of this examination contributes to the identification of basic causative microbes involved in wound infection and findings of antibiotic susceptibility patterns can be helpful for primary care physicians to optimize the treatment modalities, articulate policies for empiric antimicrobial therapy, and to minimize the rate of infection among wound infected patients.

scholarly journals Clinicopathological profile of squamous cell carcinoma presenting in Tertiary Care Hospital, Karachi.

2020 ◽  
Vol 27 (05) ◽  
pp. 939-943
Author(s):  
Sameera Asif ◽  
Summera Kanwal ◽  
Tahera Ayub ◽  
Zafar Abbas ◽  
Batool Vazir ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Buccal Mucosa ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Stage Iv ◽  
Stage Ii ◽  
Stage Iii ◽  
Care Hospital

Objectives: Oral Squamous cell carcinoma (OSCC) is the most common malignant tumor of the oral cavity. The study was done with the aim to determine the clinical pattern of OSCC seen in tertiary care hospital of Karachi, Pakistan. The frequency of neck metastasis in different staging of squamous cell carcinoma was also recorded. Study Design: Retrospective study. Setting: Department of Oral & Maxillofacial Surgery Liaquat College of Medicine and Dentistry. Period: June 2013- July 2016. Material & Methods: It included 35 males and 25 females which presented with different sites and stage of squamous cell carcinoma. Clinically patients were staged as stage I, stage II, stage III and stage IV and comprised of 3, 8, 30 & 19 patients respectively. Patients presented with cancer of buccal mucosa (31 patients), retromolar region (12 patients), maxillary alveolus (8 patients), tongue (2 patients), floor of mouth (4 patients) & lip (3 patients). Right side was most common, 48 patients as compare to left side, 12 patients while lip cancers was in upper lip in all patients including commissure. Results: Total 60 patients were included in the study with the male to female ratio of 1.4:1. No significant association was seen between age and gender of the patient (p-value 0.933). Majority of patients were male involving buccal mucosa (51.67%) as the most frequently involved site followed by retromolar area (20%) and tongue (13.3%). Mean age of patients included in the study was 50.87 ± 5.53. Conclusion: Most of the cases of OSCC were seen in older patients with increased number of cases involving buccal mucosa as their primary site. Majority of the tumors were classified as stage III followed by Stage IV, Stage II and stage 1 respectively.

scholarly journals Pediatric Germ Cell Tumors: An Experience of 7 Years in a Tertiary Hospital of Bangladesh

2020 ◽  
Vol 35 (2) ◽  
pp. 119-122
Author(s):  
SM Rashed Zahangir Kabir ◽  
Md Waheed Akhtar ◽  
Farida Yasmin
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Tertiary Care ◽  
Germ Cell Tumors ◽  
Yolk Sac ◽  
Cell Tumor ◽  
Yolk Sac Tumor ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Childhood Malignancies

Introduction: Germ cell tumors are a group of tumors with different clinical presentation and histological and biological characteristics. Malignant germ cell tumors occur at all ages with a trend of bimodal distribution in infancy and adolescence. Objective: To evaluate the demographic characteristics, distribution of different types of germ cell tumor, treatment modalities and outcome of germ cell tumor in children in a tertiary care hospital of Bangladesh. Methods: In this retrospective study, data regarding age and sex distribution, location, types of tumors, management of germ cell tumor in children were retrieved from the medical records of pediatric oncology department in NICRH, Dhaka from 2008 to 2014. Results: Out of total 87 patients female were 50 and male 37. Most of the patients were up to 5 years of age. The gonadal germ cell tumors (80%) were more than extragonadal tumor (20%) in both male and female patients. The most common germ cell tumor was dysgerminoma (32%) followed by yolk sac tumor (29.8%) and teratoma (19.5%). Yolk Sac Tumor (51.4%) was the most common in male and dysgerminoma (56%) the commonest in female. Out of 87, seventy two (82.7%) received chemotherapy following surgery. Among those 72 patients who received chemotherapy 49 (68 %) patients completed their treatment. Until the last follow up 71.4% patients remained alive and tumor free. Conclusion: Germ cell tumors are the most variable tumor of all childhood malignancies that has difference in age, sex, location and histological subtypes. Gonadal tumors have better prognosis than extragonadal tumors in both the sex. DS (Child) H J 2019; 35(2) : 119-122

scholarly journals A prospective clinical study of fistula in ano: comparing different treatment modalities in a tertiary care hospital

2019 ◽  
Vol 6 (7) ◽  
pp. 2411
Author(s):  
Hareesh G. S. R. ◽  
Siva Prasad Naik Nenavath
Keyword(s):  
Tertiary Care ◽  
Treatment Modalities ◽  
Prospective Clinical Study ◽  
Care Hospital ◽  
College Hospital ◽  
Common Procedure ◽  
Fistula In Ano ◽  
Low Level ◽  
Complex Fistula ◽  
A Prospective Study

Background: Fistula in ano is one of the common anorectal condition, which is easy to diagnose but difficult to manage because of post-operative complications like incontinence and recurrence. Also numerous procedures have been described for its treatment so as to individualize treatment options.The aim of the study was to assess the efficacy of different treatment modalities in fistula in ano.Methods: This is a prospective study carried out in a tertiary medical college hospital where 75 patients with fistula in ano are analysed for clinical features and surgical modalities compared.Results: Total 75 patients are studied. 82.70% patients presented with discharge in perianal region. Posterior fistulas are seen in 93.30% and anterior in 6.70% patients. 94.70% patients have low level fistula, 84% patients had simple fistula & 16% had complex fistula. 49.30% patients were treated with fistulectomy. 36.0% have undergone fistulotomy. 8.0% had LIFT and 6.7% had SETON. Recurrence is seen in 6.70% of patients.70.70% patients have stayed 4-6 days.Conclusions: Most of the fistulas are simple, posterior and low level fistulas. Fistulectomy is the most common procedure performed. Newer procedures like LIFT and Seton application show promising results with less complications. 

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