Sociodemographic and Clinical Profile of Cervical Cancer Patients Visiting in a Tertiary Care Hospital in India.

Background and Aim:Cervical cancer is a major health problem among the female population worldwide. Its incidence among the elderly group of patients seems to be increasing. Sociodemographic along with clinical profile of patients is the first step in planning preventive and curative measures; we thus conducted a retrospective analysis of demographic and clinical profile of elderly patients suffering from cervical cancer visiting at our institute.Patients and Methods:Records of 88 elderly patients (age> =65 years) suffering from cervical cancer from the year 2011 to 2014 were analyzed for a sociodemographic profile, symptoms, histology, and staging. Fisher's exact test was applied using R software (version 3.5.2) for statistical analysis.Results:The median age of the cohort was 74 years. The majority of patients were from a rural background and were nonsmokers. All patients were multiparous. The most common presenting symptoms were discharge, bleeding from vagina and pain in the abdomen; present in 45 (51.13%), 25 (28.40%) and 18 (20.45%) patients, respectively. 78 (88.63%) patients' had advanced stage (II, III, IV) at the time of presentation while the number of cases diagnosed at early stage were only 10 (11.36%). 69% had associated comorbidities. Prolonged duration of symptoms was also found to be associated with higher stage (P < 0.05).Conclusion:The study brings forth the background profile of the elderly patients suffering from cervical cancer. Since the majority of patients present in an advanced stage of disease appropriate preventive steps and also the possibility of initiating screening measures should be sought among an elderly group of cervical cancer patients.

Objective: This study aimed to describe the sociodemographic and clinical profile of pediatric patients who consulted at the Out-Patient Department of a psychiatric facility in Davao City, ie. Southern Philippines Medical Center Institute of Psychiatry and Behavioral Medicine and provide baseline data for future research and program development. Methodology: This is a descriptive chart review that used a purposive sampling method to determine the sociodemographic and clinical profile of patients below nineteen (19) years old, seen at the Out-Patient Department of a psychiatric facility from January 2015 to December 2019. Results: A total of 427 charts were reviewed in this study. Majority (30.2%) of the study population had their first consult in 2019, female (56%), belonged to the 12-18 age group (64%), and had high school education (43%). Most came from Davao Region (89%) with class D social classification (64%). The clinical profile showed that majority consulted due to forensic reasons (54%), with referrals coming from WCPU, courts, or police stations (54%). Sexual abuse (43.9%) was the most common cause for forensic consult. The most common diagnosis was clustered under Adverse Childhood Experiences (30%). Most were advised referral to the psychology unit (59%) and were discharged as Out-patient (97%). Conclusion: The number of child and adolescent consults in the Out-Patient Department of a psychiatric facility steadily increased within the span of five years. Majority of the patients came in for forensic reasons, with sexual abuse as the highest. A third of the consults were diagnosed to have Adverse Childhood Experience.

Objective: This study aimed to describe the sociodemographic and clinical profile of pediatric patients who consulted at the Out-Patient Department of a psychiatric facility in Davao City, ie. Southern Philippines Medical Center Institute of Psychiatry and Behavioral Medicine and provide baseline data for future research and program development. Methodology: This is a descriptive chart review that used a purposive sampling method to determine the sociodemographic and clinical profile of patients below nineteen (19) years old, seen at the Out-Patient Department of a psychiatric facility from January 2015 to December 2019. Results: A total of 427 charts were reviewed in this study. Majority (30.2%) of the study population had their first consult in 2019, female (56%), belonged to the 12-18 age group (64%), and had high school education (43%). Most came from Davao Region (89%) with class D social classification (64%). The clinical profile showed that majority consulted due to forensic reasons (54%), with referrals coming from WCPU, courts, or police stations (54%). Sexual abuse (43.9%) was the most common cause for forensic consult. The most common diagnosis was clustered under Adverse Childhood Experiences (30%). Most were advised referral to the psychology unit (59%) and were discharged as Out-patient (97%). Conclusion: The number of child and adolescent consults in the Out-Patient Department of a psychiatric facility steadily increased within the span of five years. Majority of the patients came in for forensic reasons, with sexual abuse as the highest. A third of the consults were diagnosed to have Adverse Childhood Experience

Neurocognitive and clinical profile of male patients with substance use disorder in early remission phase with and without comorbid depression

ABSTRACTBackground:Increased serum uric acid (SUA) level is considered a risk factor for kidney diseases in type 2 diabetes mellitus (T2DM) patients. Deranged lipid profile in T2DM is an overall risk factor for cardiovascular complications.Aim:This study aimed to find the correlation between SUA and serum lipid profile in T2DM patients who had serum creatinine levels within normal limits.Materials and Methods:This cross-sectional observational study was conducted in a tertiary care hospital in eastern India. Serum creatinine level was measured first. Then, patients with serum creatinine levels within normal limits were recruited as the final sample. Anthropometric measurements were conducted by an experienced clinician. A 12-h fasting venous blood sample was used to measure serum urea, lipids, sugar, and glycated hemoglobin.Results:A total of 176 (male = 104 [59.1%], female = 72 [40.9%]) T2DM patients with a median age of 46 (Q1–Q3 = 40–55) years participated in the study. There was no gender difference in fasting blood sugar (FBS) (P = 0.57), SUA (P = 0.42), and high-density lipoprotein-cholesterol (HDL-C) (P = 0.17). Females showed higher total cholesterol (TC) (P < 0.0001), triglyceride (TG) (P = 0.002), low-density lipoprotein-cholesterol (LDL-C) (P = 0.0002), and very-low-density lipoprotein-cholesterol (VLDL-C) (P = 0.01). SUA showed significant positive correlation with TG (rs = 0.65, P < 0.0001) and VLDL-C (rs = 0.63, P < 0.0001) and significant negative correlation with HDL-C (rs = −0.35, P < 0.0001) and FBS (rs = −0.45, P < 0.0001).Conclusions:A higher level of SUA, an indicator for kidney disease in T2DM patients, may be associated with a higher TG and VLDL-C and lower FBS and HDL-C. Thus, SUA should be monitored along with lipid profile for early detection of the risk of kidney diseases.

BACKGROUND: Diabetic foot infection (DFI) is a major challenge in podiatric surgery. Initiation of an appropriate antimicrobial drug is the determining factor in the prognosis in DFI.AIM: This study was undertaken to analyse the changing trends in the clinical profile of patients and the bacterial profile causing DFI for over a decade.MATERIALS AND METHODS: This was a retrospective observational study conducted at the department of microbiology and surgery of the tertiary teaching hospital. The clinical and bacterial profile of patients with DFI in 2009 and 2019 was collected and analysed for the changing trend.RESULTS: Amongst the 203 patients (95 in 2009 and 108 in 2019) included in the study, 113 (56%) were male patients. There was a shift in the age group of patients from 51–60 to 61–70 years over a decade. There was a change of most common pathogens from Pseudomonas aeruginosa to Klebsiella species. The resistance rates to third-generation cephalosporins decreased amongst the Gram-negative isolates such as P. aeruginosa and Escherichia coli, but an increase in resistance to carbapenems was observed during the study period. There was reduced incidence of infection with methicillin-resistant Staphylococcus aureus during the study period.CONCLUSION: There was a change in the demographic and bacteriological flora in the DFI patients over a decade. The antimicrobial resistance rate varied for various antimicrobial agents over a decade for a particular pathogen. Regular surveillance of the change in resistance pattern amongst the pathogens is essential for the initiation of appropriate empirical therapy to reduce the morbidity in DFI.

Background: Cervical cancer remains a major public health challenge in low and middle-income countries including India. However, if detected early, it is preventable and curable. Objective: The present study aimed to ascertain the sociodemographic and clinical profile of cervical cancer patients visiting a tertiary cancer center. Methodology: A retrospective study was carried out at the Delhi State Cancer Institute, New Delhi. The study population included 136 women who were diagnosed with cervical cancer. A pretested data extraction sheet was used as the study tool for collecting information from the inpatient records. Descriptive analysis and chi-square test were performed and the level of significance was set at p&lt;0.05. Results: A total of 136 cervical cancer patients with mean age of 46 ± 9.85 and mean BMI of 23.78 ± 5.03, were studied retrospectively. About 36.8% of patients were aged between 40-49 years and 57.4% were illiterate. While 40.4% of the patients belonged to FIGO stage II, 27.2% had FIGO stage III cancer. Majority (63.2%) of patients were diagnosed with squamous cell carcinoma (SCC), while the rest were adenocarcinoma (25%) and adenosquamous (11.8%). Clinical stage of cancer was found to be significantly associated with educational status (p=0.03) and dietary practices (p=.007). Conclusion: Our study found higher percentage of women with stage II and III cervical lesions and reaffirms the importance of education and healthy diet in early detection and prevention of cervical cancer. Therefore, it is suggested that accelerated population awareness and screening, incorporating digital innovations including vaccination programs are mandatory.

Background: Cervical cancer is associated with HPV infection. In India, it is 2nd leading cause of female cancer taking a huge toll on human life. This study explores the socio-demographic and clinical profile of cervical cancer patients at a tertiary care hospital in Kolkata. Methods:A cross-sectional study was undertaken for 2 months with 41 cervical cancer patients using a questionnaire for socio-demographic details, gynecological history, and details of the cancer and its treatment. Results:The mean age of the respondents was 54.80 ± 2.17 years, with majority belonging to lower socio-economic status. 69.44% presented with post-menopausal per vaginal bleeding and 45.45% of the patients were in stage IIB. 51.85% had symptoms for 2-6 months before visiting a doctor. Conclusions: Delay in seeking medical help has significant association with per capita monthly family income (p=0.004). Cervical cancer is a major public health problem in India majority of patients belonging to lower socio-economic status.

A significant number of homeless mentally ill (HMI) patients without any personal, family or other identification details represent a unique problem in the psychiatric services of developing countries like India in the context of legal, humanitarian and treatment issues. These patients pose challenge to the mental health professional in diagnosis and management. To study the sociodemographic and clinical profiles of HMI patients admitted under psychiatry. We performed a retrospective chart review of 'HMI' patients from 1 January 2002 to 31 December 2015, who were admitted to the Department of Psychiatry at National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India. Sociodemographic and clinical profiles of the patients were analyzed by descriptive statistics. Mean age of the sample was 34.6 years (±12.21 years), 42 (53.8%) were females, 74 (94.9%) were registered as Medico Legal Case and 53 (80.8%) were admitted under reception order issued by a magistrate. HMI patients brought by police were 32 (41.0%), by the public were 32 (41.0%) and 14 (18.0%) by nongovernmental organization /ambulance/social worker. In total, 51 (65.4%) of them had schizophrenia and other psychotic disorders, 24 (30.8%) had mental retardation and 23 (29.5%) had a comorbid substance use disorder. The mean Clinical Global Impression severity at admission was 5.07 (±1.7), and the mean duration of inpatient care was 15 weeks. Anemia and malnutrition were found in 34 (43.6%) and 25 (32.1%) patients, respectively. This study shows that schizophrenia, comorbid mental retardation and substance use disorder are common causes of admission of HMI patients in psychiatry. It is an emerging problem, which needs urgent interventions, and there is a need for an efficient system, guidelines and collaboration with government and nongovernmental agencies.

INTRODUCTION The burden of type 2 diabetes is increasing in world and same is scenario in Nepal.The prevalence of T2DM in Nepal has increased from 2014 to 2020. T2DM is still a major cause of worldwide morbidity and mortality, due to its complications. A strong correlation between cardiovascular diseases and diabetes mellitus type 2 (DM) has been found. This study aimed to investigate echocardiographic features and clinical profile in patients with newly diagnosed T2DM. MATERIAL AND METHODS Our study included 100 patients with newly diagnosed type 2 diabetes, presented to Medicine Department of Universal College of Medical Sciences Teaching Hospital, Bhairahawa from 1st May, 2019 AD to 30th April 2020. We included type 2 diabetes diagnosed as per American diabetes association 2018 criteria. RESULTS Males (52%) were more compared to females (44%). 28% were in age group 61-70 years, 26% in age group 41-50 years and 25% in age group 51-60 years. Abnormal thirst 42%, polyuria 38% and weight loss 32% were most common presenting symptoms with 23% having all 3 symptoms. Fifty two percent were smokers, 22% consumed alcohol, 48% had HTN and 23% cases had CAD. Fourty two cases (42%) had Left ventricular diastolic dysfunction, 25 cases (25%) had Left ventricular hypertrophy (LVH), 16 cases (16%) had RWMA others had RA/RV dilated and dilated LV/LA. CONCLUSION LVDD was most common echocardiographic finding in newly diagnosed type 2 diabetes.

Studies on microorganisms in a large cohort of patients with congenital heart disease (CHD) and infective endocarditis (IE) are rare. Using a nationwide survey, the relationship between causative microorganisms and clinical profiles in patients with CHD and IE was investigated. Data from 188 patients with CHD (pediatric patients (n=113), mean age, 6.2+/-4.9 years; adult patients (n=75), mean age 28.4+/-13.4 years) and IE from 60 institutions were analyzed. Causative microorganisms were Streptococcus species (94:50.0%), Staphylococcus species (68:36.2%), Haemophilus species (9:4.8%), Candida (5:2.7%), Pseudomonas species (4:2.1%) and other unclassified microorganisms (8:4.3%). Staphylococcal IE was observed significantly higher in perioperative IE (11/16), in cyanotic patients (32/73) and patients younger than 1 year old (11/16). Streptococcal IE was observed significantly higher in acyanotic patients (64/109) and patients aged 16 years or older (48/75). Total mortality was 20/188 (10.6%) and was high for candidial (2/5; 40%) and pseudomonal IE (2/4; 50%). Mortality was highly associated with younger age, especially infants (5/16), and methicillin-resistant staphylococcal IE (6/15). The causative microorganisms are significantly related to the clinical profile and outcome in patients with IE and CHD. These results form the basis for selecting appropriate antibiotics for prevention and management.

The inter-relationships of voxels can be captured by the radiomics texture features across multiple spatial scales. Prediction models of brain texture changes captured by the contrast texture feature in recent-onset psychosis (ROP) and recent-onset depression (ROD) have recently been proposed, although the validation of these models transdiagnostically at the individual level and the investigation of the variability in clinical profiles are lacking. Established prevention and treatment approaches focus on specific diagnoses and do not address the heterogeneity and manifold potential outcomes of patients. Here we aimed to investigate the cross-sectional utility of brain texture changes for (1) identification of the psychopathological state (ROP and ROD) and (2) the association of individualized brain texture maps with clinical symptom severity and outcome profiles. We developed transdiagnostic models based on structural magnetic resonance imaging data for 116 patients with ROD, 122 patients with ROP and 197 healthy control participants from the PRONIA (Personalized pROgNostic tools for early psychosIs mAnagement) study by applying a set of tools and frameworks to explain the classification decisions of the deep-learning algorithm (named explainable artificial intelligence) and clustering analysis. We investigated the contrast texture feature as the key feature for the identification of a general psychopathological state. The discrimination power of the trained prediction model was >72% and was validated in a second independent age- and sex-matched sample of 137 ROP, 94 ROD and 159 healthy control participants. Clustering analysis was implemented to map the changes in texture brain produced from an explainable artificial intelligence algorithm, in a group fashion. The explained individualized brain contrast map grouped into eight homogeneous clusters. In the clinical group, we investigated the association between the explained brain contrast texture map and clinical symptom severity as well as outcome profiles. Different patterns in the explained brain contrast texture map showed unique associations of brain alterations with clinical symptom severity and clinical outcomes, that is, age, positive, negative and depressive symptoms, and functionality. In some clusters, the mean explained brain contrast texture map values and/or brain contrast texture voxels that contributed significantly to the classification decision predicted accurately the PANSS (positive and negative symptom scale) scores, functionality and change in functionality over time. In conclusion, we created homogeneous clusters which predict the clinical severity and outcome profile in ROP and ROD patients.

ObjectiveTo compare the sociodemographic and clinical profiles of patients with advanced cancer admitted to a tertiary palliative care unit before and during the COVID-19 pandemic.MethodsThis is an analysis of data from patients receiving care before (10/21/2019 to 03/16/2020) and during (09/23/2020 to 08/26/2021) the COVID-19 pandemic. Sociodemographic and clinical data were evaluated. Logistic regression analyses were used, with the odds ratio (OR) and 95% confidence interval (CI) as measures of effect.Results673 patients were enrolled (204 in the pre-pandemic period and 469 in the pandemic period). The final logistic regression model demonstrated that patients admitted during the pandemic had a greater chance of having white skin (OR: 1.66 [95% CI: 1.15–2.39]), having a gastrointestinal tract cancer (OR: 2.95 [95% CI: 1.55–5.62]) and in skin, bones, and soft tissue (OR: 2.40 [95% CI: 1.13–5.08]), having received prior radiotherapy (OR: 1.83 [95% CI: 1.26–2.55]), and having a higher global PG-SGA SF score (OR: 1.06 [95% CI: 1.02–1.09]).ConclusionEthnicity, nutritional risk, previous radiotherapy, and type of tumor were associated with advanced cancer during the COVID-19 pandemic. It is unclear what impacts the COVID-19 pandemic had on palliative care. This study presented findings based on one tertiary palliative care facility for patients with cancer. Give the limited literature on the subject, our comparative analysis of data serves as a starting point for a debate on this subject. More studies of a similar nature are needed to enable future comparisons and assist planning for other pandemics.

Objective: To study the clinical profile in patients with acute pulmonary embolism. Methods: Retrospective study of clinical profile and management of patients presenting with acute pulmonary embolism from January 2015 to January 2016. Results: 53 patients who were newly diagnosed to have acute pulmonary thromboembolism with a mean age of 47.2 years with 91% being males were included in the study. It was found that majority of the patients had atleast 1 risk factor for embolisation(58.5%) with smoking being the most important risk factor. Dyspnea (71.7%) and syncope (17.0%) were the predominant symptoms. 39.6% patients had tachycardia and 22.6% had hypotension. Echocardiography was done in all patients. 45 patients (84.9%) had pulmonary arterial hypertension, 31 patients (58.4%) had evidence of RA/RV dysfunction and 3 patients (5.7%) had evidence of thrombus in heart. CT pulmonary angiogram was done in all patients. 32(60.3%) patients underwent anticoagulataion with unfractionated heparin, 10(18.7%) patients were thrombolysed and 6(11.3%) patients underwent embolectomy. 5 patients underwent both thrombolysis and anticoagulation. However independent of the mode of treatment, most patients had good treatment outcomes with the mortality rate being only 7.5%. Conclusion: Pulmonary embolism can have multiple presentations in terms of clinical symptoms, signs and investigations. Early diagnosis and aggressive management is the key to successful outcome.

Cancer of the cervix is the most common genital tract malignancy in the female and is a major public health problem in developing countries. Study of the sociodemographic data, clinical profile and compliance of patients is the first step in planning preventive measures and treatment facilities.The aims of the study were to determine the sociodemographic data and clinical profile, prognostic factors, compliance to concurrent chemo radiation of cervical cancer patients and study their association with other tumor-related factors.Our study is a record-based retrospective study from a single institution. The data of sociodemographic and clinical factors of 175 cervical cancer patients visited and their compliance to treatment were analyzed over a 2-year period. Data were analyzed using descriptive statistics.The mean age at presentation in our study is 54.8 years. The patients presented with bleeding per vagina as the most common presenting complaint i.e. 42.28%.38.88% patients presented with both bleeding per vagina and white discharge per vagina and 18.85% patients presented with white discharge per vagina.21.14% presented with symptoms less than 1 month, 52 patients presented with symptoms 1to 3 months duration. 49.14% presented with symptoms &amp;#62;3months. In our study, 62.85% patients were married at age &amp;#60; 17&amp;#62; 17 years. squamous cell carcinoma is the most common histology in our study accounting for 85.71% followed by adenocarcinoma 11.42% other histoligies accounted for 2.85%.87.42% were grade 2 histologies. Stage IIB is the most common stage of presentation our study 47.4%. 86.28% patient are compliant with planned treatment (external beam radiotherapy +brachy therapy, 4.57% patients defaulted prior to the start of treatment, 3.42% patients defaulted during external beam radiotherapy, 15.71% defaulted for brachytherapy out of 151 patients who completed planned treatment, 80.79% patients received 5-6 cycles of concurrent ciplatin 40mg/m 2.11.92% were lost to follow up at the end of 1 year.Cervical cancer is a debilitating illness seen to affect mainly elderly women. Late presentation is still the norm, as majority of the patients presented with advanced disease at the time of diagnosis and were treated with radical radiotherapy, with or without chemotherapy. Compliance during treatment was good comparable to the other studies. The response and complication rates were comparable with other datasets. Further, the scope of studying socio-demographic factors is not limited to hospital services, and this information can also be utilized while making public health policies and implementation of cervical cancer control programs.