Common Age Group Of Presentation Research Articles

Wilms tumour in a two day old neonate: A rare and challenging case

Wilms tumor or nephroblastoma is the second most common renal tumor occurring in the neonatal age group next to congenital mesoblastic nephroma. The most common age group of presentation of Wilms tumor is between 3 and 4 years of age. Here, we report a case of right-sided Wilms tumor in a 2-day-old neonate. A term-born female baby presented on day 2 of birth with abdominal distension and physical examination revealed a large palpable mass in the right lumbar region crossing the midline. Imaging features were suggestive of a retroperitoneal mass of probable right renal origin. The patient was taken up for right radical nephroureterectomy and Per-operatively, there was anticipated tumor spillage. Post-operative histopathological examination was suggestive of a triphasic Wilms tumor with no anaplasia and favorable histology. The patient was diagnosed with Wilms tumor of the right kidney, COG stage III, SIOP (“International Society of Pediatric Oncology”) intermediate risk loss of heterozygosity testing for 1p and 16q was negative. She was started on chemotherapy with a DDA4 regimen. She completed whole abdominal radiotherapy and tolerated treatment well. The child is disease free and is under regular follow-up. This case of neonatal Wilms tumor was indeed a challenge to the pediatric surgeons and the oncologists but the final results were worth the challenge that was faced.

CLINICO PATHOLOGICAL ANALYSIS ON PAPILLARY CARCINOMA BREAST

Background : Papillary carcinoma of breast is rare and account for approximately 1-2% of newly diagnosed cases of breast cancers. The common age group of presentation is 6-7th decade. These tumours usually present with a painless retroareolar swelling associated with bloody nipple discharge in 50% cases. Case 1) 57 year old most Cases : menopausal woman presented with huge ulcerative lump in right breast over a period of 1 year. After confirming diagnosis with incisional biopsy, patient was proceeded with Neoadjuvant Chemotherapy (NACT) followed by Right MRM with SSG. Case 2) 66 year old male patient came with complaints of bloody discharge from nipple for past 1 year. A small subcentimetric lump present in retroareolar region on left breast was present, on which USG guided CNB revealed Invasive Ductal Carcinoma. Patient was proceeded with Left MRM. Case 3) 65 year old male patient presented with painless lump in left breast for 3 months. Clinical examination revealed a 1*2 cm lump in left breast with a single mobile ipsilateral axillary node. Image guided CNB revealed Invasive Papillary carcinoma. Patient was taken up for upfront Left MRM. All 3 patients are on regular follow-up for more than a year, and no recurrence is noted on followup

A HISTOMORPHOLOGICAL STUDY OF SEBACEOUS CARCINOMA OF EYELIDS: A 3-YEAR RETROSPECTIVE STUDY

Background: Sebaceous Carcinoma (SC) is a rare and aggressive malignancy that develops from the sebaceous glands. SC is most common in the periocular region, head and neck, but can occur anywhere in the body. To study and analyse de Purpose: mographic characteristics and outcomes of cases of Sebaceous carcinoma. Retrospective Study of 24 patients with Sebac Materials and Method: eous Carcinoma conducted at Department of pathology, Sarojini Devi Eye Hospital, Hyderabad, Telangana, India, for a period of 3 years. The data collected was subjected to statistical tabulations and analysis was done. A total of 24 biopsies of histopathologically Results: diagnosed Sebaceous Carcinoma (SC) cases were reviewed during the 3year retrospective study period. All the patients were above 25 years old being in the age group of 25-90 years of age. Mean age of presentation of SC is 56 years. Most common age group of presentation is 50-60 years (n=7, 29.16%). The distribution of SC in males=6 (25%) and females=18 (75%) with a ratio of male to female 0.33:1. The incidence of SC is found to be more in periocular region (n=24, 100%). The earliest age of presentation of SC is 25 years while 90 years being the late age of presentation. The current results support that the Conclusions: Sebaceous carcinoma is most commonly located in periocular region compared to extraocular region with right eye and upper lid more frequently involved. Incidence of SC is more in females compared to males with high female preponderance

HISTOMORPHOLOGICAL SPECTRUM OF OCULAR SURFACE SQUAMOUS NEOPLASIA: A 5 YEAR STUDY.

Ocular surface squamous neoplasia encompasses the entire spectrum of epithelial dysplasias and neoplasia including squamous cell carcinoma. It may arise from ocular surface of conjunctiva, cornea and limbus. Purpose: The aim of this study is to demonstrate varying degrees of histomorphological spectrum in Squamous neoplasias of ocular surface. This is a Retrospective study conducted at Department Materials and Methods: of Pathology for a period of 5 years in Sarojini devi eye Hospital, Hyderabad, Telangana, India. The data collected was subjected to statistical tabulations and analysis was done. Results: The mean age of presentation was 46.39 years (6 to 82 years) with male preponderance (64.9%). The most common age group of presentation was 31-40 years (n =31, 22.62%) .The most common type of OSSN was invasive Squamous cell carcinoma seen in 37.22% (n =51) followed by Carcinoma in situ 20.43% (n =28). Out of 51 patients diagnosed with Squamous cell carcinoma, male patients were 34 (66.6%) and female patients were 17 (33.3%), among females diagnosed with SCC 13 cases(76.7%) were well differentiated type and remaining 4 cases(23.52) were moderately differentiated type. Only 1 male patient had Poorly differentiated type of Squamous cell carcinoma, 3 patients (5.8%) had inltrating tumor into surrounding tissues. 7 Patients (5.10%) diagnosed with OSSN were HIV positive. OSSN occurred in a relatively young Conclusion: age group with male preponderance possibly due to outdoor exposure . Based on Histopathology, Squamous cell carcinoma is the most common form of OSSN in the Asian Indian population.

ROLE OF MDCT IN THE PREOPERATIVE EVALUATION OF ADULT INTUSSUSCEPTION

Introduction: Intussusception is a condition which occurs when one segment of the intestine "telescopes" inside of another segment . It may or may not be associated with features of intestinal obstruction .The telescoping proximal segment is called intussusceptum and the distal receiving bowel segment is called intussuscipien.Intussusception can occur due to congenital cause like Meckel diverticulum, benign cause like intestinal polyps, intestinal lipomas, hypertrophied lymphnodes, malignant conditions like colorectal carcinoma , lymphomas , metastatic depostis. Depending on the presence or absence of lead point on MDCT,further treatment planning can be done like surgical or non surgical options like water soluble contrast enema/ air enema can be administered . The prese Material and Methods: nt study was conducted in the department of radiodiagnosis, NRI general hospital,chinakakani, Guntur district from 2020 to 2022. A total of 40 patients attending the general surgery department in the age group between 20 to 70 years abdominal symptoms like pain,vomittings,bleeding per rectum, intestinal obstruction were studied. All patients underwent MDCT and the ndings of CT scan are noted. Out Results: of the total 40 patients the most common age group of presentation was 41-50 years(30%). 72% were males and 28% were females.out of 40 patients location of intussusception is ileocaecal in 50%,enteric in 35% ( ileoileal in 20%,jejunojejunal in 13% duodenoduodenal in 2%),colocolic in 15%. Intusussception can be detected by USG in 72% ,not detected by USG in 28% of individuals. Out of 40 patients no evidence of lead point on MDCT detected in 20%,In rest 80% lead point is neoplastic etiology out of which 55% are benign( Lipomas being most common 22%, polyps 20%,carcinoids 8%,GIST 5% ), Malignant being 25% (carcinoma 15%, lymphoma 10 %). In case of adults neoplastic being most common cause sugery is the denitive management in 90% patients , reduction is done in rest 10% patients. Preoperative evaluation of i Conclusion: ntussusception patients with MDCT is very essential to diagnose the presence or absence of lead point and determine appropriate treatment and reduce the rate of unnecessary surgical intervention.

Study of side effect profile of bedaquiline containing regimen among patients with extensively drug-resistant tuberculosis at a nodal drug-resistant center

Background: Extensively drug-resistant tuberculosis (XDR TB) is a type of tuberculosis (TB) characterized by resistance to isoniazid and rifampicin, along with resistance to one of the fluoroquinolones and at least one of the second line injectable drugs. Bedaquiline is a diarylquinoline antimycobacterial agent approved for the treatment of adults with pulmonary multidrug-resistant TB (MDR-TB) and XDR-TB by the food and drug administration. Aim and Objective: The aim of this study was to study the side effect profile of bedaquiline containing regimen among XDR TB patients. Materials and Methods: This study was conducted at outpatient and wards of nodal drug-resistant TB Center, Department of Pulmonary Medicine, SVRRGGH, Tirupati, for a period of 1 year. Forty patients of more than 18 years age and diagnosed with XDR TB were included in the study. Bedaquiline was started and daily monitoring was done with ECG and all organ function tests were repeated every 15 days. Results: All 40 cases were retreatment cases; no new XDR TB case was reported in study period. Most common age group of presentation in our study was 46 to 55 years (32.5%). Gastrointestinal adverse drug reactions were found to be more common (37.5%), cardiovascular QTc changes were observed in 10% of patients, 5% of patients had neurological reactions (Headache), 2.5% of patients had peripheral neuropathy, and 2.5% of patients had arthralgia. Conclusions: Bedaquiline containing regimen is very effective for the treatment of XDR TB cases. The study shows that compliance with this regimen is very good. Bedaquiline has minimal adverse reactions and even these are easily manageable. Bedaquiline has good safety profile and patients have improved quality of life.

A clinical study on groin hernias presenting as acute emergencies in a tertiary care hospital

Background: Inguinal hernias are the most common hernias encountered in the surgical practice. A small section of cases present to the emergency with certain complications at time of presentation. Complications like irreducibility, obstruction and strangulation occur which require immediate management. Aim of this study is to study groin hernias presenting as emergencies and their surgical management. Materials and Methods: This study was a prospective observational study, conducted in the Department of General Surgery, Rangaraya Medical College and Hospital, during May 2021 to May 2022(1 Years). The study population is 50 patients.Results: The incidence of hernia is more common in the age group consisting 60-70 years (34%). The incidence at the age group 51-60 years is 22%.The frequency of hernia in males is greater than females. Incidence in males is 98% and 2% in females. The duration of hernia before the acute episode is more common in the first year. Complications were more common on the right side than the left side. The common site of constriction is at the internal ring. The duration of hernia before the acute episode is more common in the first year. Complications were more common on the right side than the left side. The common site of constriction is at the internal ring. Pain is universal in all patients. Pain and irreducibility were present in the frequency of 50 patients. Constipation was found in 36 patients and fever was present in 16 cases respectively. Complications like obstruction which were present in 64% of cases. Pain and irreducibility were present in 22% of cases. Strangulation was seen in 14% of the cases. Optimum procedure done was herniorrhaphy in 84% of cases. Resection and anastomosis was done in 6% of the cases. Omentectomy was done in 3% of the cases.Conclusion: The most common age group of presentation is 51 to 60 years. It is more common in male sex group. Pain and irreducibility were universal. The incidence of complications were common in the first year of presentation. The most common site of constriction is the deep ring followed by superficial and femoral canal. Pain and irreducibility were universal. Herniorrhaphy was done universally for all cases with resection and anastomosis of gangrenous bowel and omentectomy as adjunctive procedures.

Study of Women Presenting with Leiomyoma in Terms of Symptoms, Age of Presentation and Location

Abstract Aim and objective: To Categories women presenting with leiomyoma with respect to: • Age • Most common symptom • Location of leiomyoma Settings and Design: This was an observational study carried out in a tertiary health center for a period of 1 year from September 2019 to September 2020. Materials and Methods: A retrospective observational study was conducted in 35 women having pain in abdomen, abnormal uterine bleeding, who were presented to the department of obstetric and gynecology, Bharati Vidyapeeth deemed university, Pune between sept 2019 and sept 2020. All the patient presented with above mentioned symptoms were studied after obtaining consent from participant. Ultrasound was done and location of leiomyoma was studied. Fibroid were studied in terms of its, location and most common presenting symptoms and age of occurrence of symptoms. Results: In our study, themost common age group of presentation was 36-40 years (reproductive age group.) Most common type of fibroid was intramural (62.8 %) Most common symptoms was menorrhagia (57.1%). Most commonly associated with nulligravida (49.5%). Keywords: Ultrasound; Clinical symptoms; Abnormal uterine bleeding.

Histopathological spectrum of ocular surface squamous neoplasia: A retrospective study of 776 lesions.

Ocular surface squamous neoplasia (OSSN) comprises neoplasm arising from the ocular surface, which includes conjunctiva, cornea, and limbus and ranges from mild dysplasia to invasive squamous cell carcinoma. The aim of this work was to study the spectrum of OSSN based on histopathological analysis. Materials and. This was a retrospective cross-sectional study comprising 776 histopathologically diagnosed cases of OSSN from January 2004 to December 2014. The mean age of presentation of OSSN was 45 years (median, 45 years; 2 to 87 years) with male preponderance (74%). The most common age group of presentation was 41-60 years (n = 299; 39%). The most common type of OSSN was invasive squamous cell carcinoma seen in 50% (n = 383) eyes followed by severe dysplasia/carcinoma in situ in 31% (n = 250) eyes. Tumor infiltration at base was seen in 16% (n = 124), positive margins in 32% (n = 248), scleral infiltration in 14% (n = 109), intraocular extension in 3% (n = 23), and orbital extension in 4% (n = 26) eyes. OSSN was associated with actinic keratosis in 21% (n = 165) cases. Based on histopathology, invasive squamous cell carcinoma is the most common form of OSSN in the Asian Indian population.

X-linked agammaglobulinemia rare disease with a rarer presentation

X-linked agammaglobulinemia (XLA) is a rare disorder, characterized by absence of mature B cells leading to severe antibodies deficiency. This translates to recurrent sinopulmonary infections in affected children. The most common age group of presentation is 6 months to 2 years. Being an X-linked recessive disorder males are affected, females are carriers. Intravenous immunoglobulins and antibiotics remains the corner stone of treatment. Here in, we report a case of 11-year-old male having recurrent episodes of fever with one episode of hospitalization 3 years back. Child was treated at healthcare facility elsewhere for recurrent fever. He presented to our institute with signs and symptoms suggestive of meningitis, investigated, had culture proven Staphylococcus aureus meningitis with a low Absolute Lymphocyte Count (ALC). On further work up found to have low serum immunoglobulins (IgG, IgM, IgA) and Flowcytometry showing absence of B cells (CD19/CD20). Child was diagnosed to have XLA. This case highlights the importance of having strong clinical suspicion of XLA, despite not having recurrent sinopulmonary infections.

CLINICO-EPIDEMIOLOGICAL STUDY OF LEPROSY IN TERTIARY CARE INSTITUTE IN CHHATTISGARH

INTRODUCTION – Leprosy is a chronic bacterial infection. India has achieved an elimination target of less than one case per ten thousand population in December 2005. Even after elimination leprosy is remaining a major health issue in a few states like Chhattisgarh and union territories like Dadra and Nagar haveli. AIMS AND OBJECTIVE –To study the clinico-epidemiological pattern of leprosy in a tertiary care institute at Chhattisgarh. MATERIAL AND METHOD- A retrospective descriptive study was performed at LSLAM medical college, Raigarh, Chhattisgarh. All the cases of leprosy attending skin OPD from January 2020 to December 2020 were recruited for the study. Data was collected in MS excel sheet and analyzed using SPSS software version 20. RESULT – A total of 92 patients were diagnosed as leprosy. 4 (4.35%) patients were children less than 14 years of age. 67 patients were male and 25 were female with male to female ratio was 2.68:1. Commonest age group of presentation was 21 to 40 years. The most common type of leprosy was Borderline Tuberculoid Hansen Disease (BTHD) (43.48%). 64 patients (69.57%) were diagnosed as multibacillary (MB) leprosy. The most common nerve found thickened was ulnar nerve. 30 patients (32.60%) presented with lepra reaction at the time of diagnosis. Out of 30 Lepra reaction cases, 21 (70%) were diagnosed as type1 lepra reaction and the rest 9 (30%) cases were diagnosed as type 2 lepra reaction cases. 59 patients (64.13%) presented with peripheral nerve involvement at the time of diagnosis. 23 (25%) patients were having grade 2 disability at the time of diagnosis. CONCLUSION – Even after achieving the target of elimination leprosy remains a major health problem especially in endemic states of India like Chhattisgarh.

English

BACKGROUND Cancer is the second most common cause of deaths after cardiovascular disorders in the world. In India lakhs of people die due to cancer every year. Many of them do not have access to health care system and those who have access to health care system often reach for help in advanced stage. Incidence of cancer varies from country to country and within the country from region to region. It depends on the environment, lifestyle, and diet. The present research was undertaken to study the incidence of histopathological spectrum of malignant lesions in the local region of northern part of Andhra Pradesh. METHODS The present study is a retrospective study of 42 malignant cases from 159 neoplastic biopsies received over a period of 12 months from January 2019 to December 2019. RESULTS Among 42 malignant cases, 27 were females and 15 were males with a male to female ratio of 1:1.8. the most common age group of presentation with malignancies was 61 - 70 years. Youngest patient was 22 years. Cancer of the cervix was the commonest cancer in females in this region of Andhra Pradesh. Among men it was lung cancer. CONCLUSIONS In the present study, it was observed that the most common malignancy was lung cancer followed by cervical cancer. Squamous cell carcinoma was the most common histopathological type among them. As cancer incidence is more after 50 years this group should be targeted for health education and screening so that early diagnosis and timely treatment can be given. This reduces cancer mortality. KEY WORDS Spectrum of Malignancies, Squamous Cell Carcinoma

Observational study on clinical profile and outcome of Rickettsial infections in children

Background: Rickettsial diseases are one of the most re-emerging infections of the present time. They are generally incapacitating and difficult to diagnose. Untreated cases can have fatality rates as high as 30-35% but when diagnosed properly, they are often easily treatable. Rickettsial infections are one of the important causes of pyrexia of unknown origin (PUO) and this needs to be differentiated from other febrile illnesses. Rickettsial infections are grossly under- diagnosed in India. Objectives of The Study: To study the clinical profile and outcome of rickettsial infections in children aged less than 12 years Methods: It is a time bound prospective hospital based observational study conducted from 2019 to 2020. All children aged less than 12 years admitted in paediatric ward with fever without an identifiable source of infection and one or more of the following clinical features: rash, oedema, hepatosplenomegaly, Lymphadenopathy, an Eschar and a tick bite or tick exposure were suspected to have rickettsial infection. The purpose of the study was explained to the parents or guardians of the child and an informed consent was taken from them enrolling the child in study group. All suspected cases were subjected to rickettsial IgM/IgG ELISA test and tests to exclude other diseases.All rickettsial IgM/IgG positive cases were followed up through hospital stay and outcomes were noted. Results: The most common age group of presentation was between 1 and 5 yrs. The common symptoms in these children included fever (100%), rash (83.3%), edema of limbs (26.6%), puffiness of face (30%), generalised edema (23.3%), cough (23.3%), pain abdomen (16.6%), vomiting (13.3%), convulsions (10%), headache (3.33%) and arthralgia (3.33%). Signs like Hepatomegaly, facial puffiness, pedal edema, splenomegaly, ecchymosis present in 53.3%, 46.6%, 43.3%, 10% and 6.6% of the cases respectively, mimicking common illnesses. Thus warrants high index of suspicion. SCRUB Typhus and Indian Tick Typus Elisa Positive (mixed infection) noted in 14% of cases. Complications like meningoencephalitis (3.33%), shock (3.33%), DIC (3.33%) was observed in the study. There was good clinical response on initiation of doxycycline within 48hrs of initiation of treatment. Case fatality rate of rickettsial disease in this study was 6.66% (n=2). Conclusion: Indian tick typhus is the most common rickettsial fever noted in this part of Telangana. Rickettsial diseases are difficult to diagnose, unless suspected but treatment is easy, affordable and often successful with dramatic response to antimicrobials.

Study of socio-demographic, behavioural and clinical risk factors of diabetic foot in a tertiary care centre

Background: Diabetic foot is the most devastating complication of diabetes. Diabetic foot infection is a potential limb threatening condition. Several socio-demographic, behavioural and clinical factors are responsible for higher risk of diabetic foot. Hence this study was planned with the objective to assess association between socio-demographic, behavioural and clinical risk factors and diabetic foot and response of patients to various treatment modalities.Methods: 50 patients of diabetic foot were studied over a six-month period. The diabetic foot ulcers were classified according to Wagner’s classification. Data about various socio-demographic, behavioural and clinical factors was collected. Radiological investigations, neurological examination and culture and sensitivity of ulcer discharge was done. The patients were managed by conservative or surgical management. Results: Common age group of presentation was 51-60 years. Males were more commonly affected. All participants were of low socio-economic status and majority were unskilled labourers. Tobacco (40%) and alcohol (32%) use and lack of physical activity (92%) were seen. All had diabetes of >10 years and elevated BMI. Grade 4 ulcer were the most frequent and toes were commonly involved. S. aureus was the commonest organism. Wound debridement was done in 76% patients and 34% required amputation.Conclusions: Factors like advancing age, low socio-economic status, lack of family support, occupations involving risk of trauma to foot, tobacco use, sedentary life style, and clinical factors like longer duration of diabetes, higher BMI, uncontrolled diabetes are risk factors for diabetic foot. Hence it is essential to educate the diabetic patients about these risk factors.

A COMPARATIVE STUDY OF TYMPANOPLASTY WITH OR WITHOUT MASTOIDECTOMY IN TUBOTYMPANIC TYPE OF CHRONIC SUPPURATIVE OTITIS MEDIA

Background: CSOM is one of the most common ear diseases in developing countries. Lack of an aerating mastoidectomy at the time of the initial tympanoplasty may be a signicant source of failure in patients with chronic non-cholesteatomatous otitis media so cortical mastoidectomy along with tympanoplasty has for long been considered the surgical procedure of choice. The purpose of our study is to ascertain the effectiveness of tympanoplasty with or without cortical mastoidectomy. Methods: Our study was carried out in the Department of Otorhinolaryngology, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar. It included 50 patients of CSOM tubotympanic type of age between 15 years to 45 years and of either sex who were diagnosed and treated in E.N.T Department during the study period February 2019 to January 2020. Out of 50 patients who underwent surgery in 25 cases tympanoplasty with mastoidectomy was done and tympanoplasty without mastoidectomy was performed in 25 cases. Results: Commonest age group was 15-19 years. Male to female ratio was 1.6:1. In x-ray bilateral mastoids Schuller's view, 24 patients (48%) had sclerotic mastoids and 26 patients (52%) showed pneumatic mastoids. Clinical improvement, graft uptake and postoperative hearing improvement was similar in both the groups. Conclusions: Most common age group of presentation with CSOM tubotympanic type is 15-25 years. CSOM tubotympanic type appears to be more common in males. Hearing improvement following tympanoplasty alone and tympanoplasty with mastoidectomy were comparable in both the groups. Mastoidectomy with tympanoplasty does not give additional benet in terms of hearing improvement.

A comparative study of efficacy of tamsulosin monotherapy vs. combined (Solifenacin + tamsulosin) in treatment of ureteric stent related symptoms

Ureteric Double J stenting is the most common in endourological practice. The double-J stent, which is the most common form of ureteral stent, is used in obstructive pyelonephritis, intolerable acute renal colic, ureteral edema, ureter perforation following endoscopic procedures. Post stenting commonly reported symptoms include flank pain, haematuria, dysuria, frequency, and urgency. Tamsulosin acts as a selective inhibitor of α1A/1D and Solifenacin acts as a muscarinic receptor antagonist have been used in alleviating the symptoms and have been proved effective. Objective: To study the efficacy of tamsulosin monotherapy vs. combined (solifenacin + tamsulosin) in treatment of ureteric stent related symptoms.Methodology: The prospective control study conducted in R.L. Jalappa Hospital, Tamaka, Kolar. The study included 60 subjects divided on even and odd method with 30 in each group with a period of 3 months. The subjects in group A received oral Tamsulosin of 0.4mg once daily and group B received oral Tamsulosin+ solifenacin (0.4mg+6mg) once daily. The subjects were observed for post-operative complications like flank pain, dysuria and sexual dysfunction. The dysuria was calculated according to Boysarky score and UTI with grading. The data were collected and analysed statistically.Results: The most common age group of presentation of subjects were less than 40 years i.e 22(36.66%) with next common group was 51-60 years accounting 15(25%) with mean age being 45.5 years. The combined therapy group accounted most of the subjects in grade I 23(38.33%) showing significant reduction of post-operative dysuria compared to monotherapy. The combined therapy group had 6 patients with only one patient had grade III UTI. The monotherapy group had 7 subjects developing UTI with grade II being most common. The commonest organism on culture was E. Coli in 9 subjects. There was a significant difference between two groups in reducing UTI. Conclusion: The present study in treatment of DJ stent related symptoms shows combined therapy being more beneficial in terms of reducing post stenting flank pain, dysuria and UTI development in comparison to monotherapy.

To study the management of primary pterygium by surgical excision with conjunctival autograft with limbal stem cells in a tertiary care hospital in hilly area of North India

Aim: The aim is to study the management of primary pterygium by surgical excision with sutureless conjunctival autograft with limbal stem cells. Materials and Methods: Patients with advanced pterygium were recruited from eye outpatient department (OPD) of rural tertiary care hospital of central India from January 2016 to October 2016. Informed written consent was taken before enrollment. The total 54 eyes (of 42 patients) were operated for pterygium with conjunctival autograft with limbal stem cells. Graft margins were buried around 0.25mm below the host conjunctiva. Results: The mean age of the patients was 48.71 ± 12.87 years. The male patient were 30 (38 eyes, 71.43%) and females were 12 (16 eyes, 28.57%). The most common age group of presentation was 40 to 60 years (28 patients, 66.67%), followed by 61 to 80 years (10 patients, 23.81 %) and lastly age less than 40 years (4patients, all female, 9.52%). At the follow up of 6 months 1 eyes showed recurrence and at 1 year 1 eyes showed recurrence. The recurrence was 3.70 percentage at 1 year of follow up. The recurrent pterygium were reoperated with pterygium excision with mitomycin C (0.02). The patients with recurrence have completed 2 months follow up without any signs of recurrence. In 28 patients (51.85%) showed improvement in visual acuity (2 or more lines) on Snellen chart. Conclusion: Management of primary pterygium by surgical excision with sutureless conjunctival autograft with limbal stem cells is a effective surgical technique in preventing recurrence of pterygium and good cosmetic appearance of eyes after pterygium surgery. The author recommends use of Mitomycin C (MMC) or 5 Fluorouracil (FU) only in selected cases pterygium like extensively infiltrating pterygium or recurrent pterygium. Keywords: Conjunctival autograft, Pterygium surgery, Stem cells.

Clinical profile and management of vitreous hemorrhage in tertiary eye care centre in Nepal.

Vitreous hemorrhage is one of the most common diseases presenting to emergency department and leading cause of painless vision loss. To determine the profile of vitreous hemorrhage in patients presented to Outpatient Department (OPD) and emergency Department of Tilganga Institute of Ophthalmology (TIO). This is a hospital based observational non interventional descriptive study. Total 198 patients were enrolled who visited OPD and Emergency department of TIO from August 1st 2012 to July 30th 2013. Total 198 patients (201 eyes) were enrolled for the study, out of which 144 were male and 54 females. 195 were unilateral and 3 bilateral cases. Most common age group of presentation of vitreous hemorrhage was 51-60 years (24.75%). Most common presenting complaint was sudden onset of decreased vision (95%). Most common etiology of vitreous hemorrhage was branch retinal vein occlusion (22.38%). Among the total subjects, 57.7% of the patient were managed with medical therapy, 35.8% surgically and 6.47 % with combined medical and surgical treatment. Branch retinal vein occlusion (BRVO) is the most common cause of vitreous hemorrhage. Diabetes and hypertension are the most commonly associated systemic illnesses.

Study of Histopathological Patterns in Breast Lumps

Background: Breast lesions in females are heterogeneous diseases that consist of several distinct entities with remarkably different characteristic features. The present study was conducted to assess histopathological findings of excision biopsies of breast lesions.Subjects and Methods:The present study was conducted on 150 cases of lumpectomy breast specimens received in the department of histopathology. The histopathological diagnosis made after routine processing and hematoxlin and eosin staining.Results:The most common age group of presentation was 30 to 50 years having well defined breast mass lesion. The difference was significant (P< 0.05). Among 150 breast specimens, 145 found to be benign and 05 malignant. In benign, common lesions were fibroadenoma in 64, fibroadenosis in 30, Acute Suppurativeinflammatory lesion (Abscess) in 20, fibrocystic disease (FCD) in 22, duct papilloma in 05 and benign phyllodes in 04 cases. In malignant, 04 cases were infiltrative ductal cell carcinoma NOS (Not otherwise specified) and 01 carcinoma in situ. The difference was significant (P< 0.05).Conclusion: Authors found that most common benign breast lesions were fibroadenoma (44.1%) and fibroadenosis (20.6%) followed by acute suppurative inflammatory (Abscess) and FCD.

A clinicopathological study of morbidity and mortality of patients following radical cystectomy

Background: Assessing the prognostic significance of specific clinicopathological features plays an important role in surgical management after radical cystectomy. Aim& Objective of the study: The current study is done to analyse the perioperative, early and late complications of tumors and also find out the mortality rate during radical cystectomy Methodology: This is a retrospective observational study conducted at NIZAMS INSTITUTE OF MEDICAL SCIENCES in Department of urology from September 2017 to September 2019. Results: In the present study, mean age of presentation is 58 yrs and range is 20 to 80 yrs. Among in total study population (60), 83.33% were male patients and 16.66% were female patients. Male: Female ratio is 5:1. All the smokers noted in the study were males. Thirteen members are smokers and all of them are males. The most common age group of presentation is 60-69 years (35%). Followed by 50-59 years (25%) followed by 40-49 years (20%). The most common presentation was painless hematuria seen in 61.66%. Followed by both hematuria and dysuria in 30% followed by only dysuria in 8.33%. Urine leak is the most common early complication seen in 10%. Ureteric stricture (5%), Pelvic recurrence 5 (8.33%) and distant recurrence 4 (6.66%) are the late complications. Out of 60 cases, 54 cases (90%) had high grade tumors while 6 cases (10%) had low grade tumors. Pelvic lymphnode involvement was seen in 18 patients (30%). In remaining 42 patients pelvic lymph node involvement was not seen (70%). Patients with lymph node positivity showed a 52% rate of survival while patients with negative lymph node status showed 80% survival. No deaths were recorded during the perioperative period. Conclusion: Our results revealed that several clinicopathological characteristics can predict CSS risk after radical cystectomy. Prospective studies are needed to further confirm the predictive value of these variables for the prognosis of bladder cancer patients after radical cystectomy.