Number Of Female Patients Research Articles

Association between postoperative cough and thyroidectomy: a prospective study

BackgroundThis study sought to determine whether thyroidectomy is associated with self-reported cough through a prospective analysis.MethodsPatients undergoing unilateral thyroidectomy were prospectively enrolled. The control group was selected to avoid the effect of general anaesthesia. The experimental group consisted of 300 patients (202 females and 98 males) who underwent thyroidectomy, with a mean age of 48.6 years, and the control group consisted of 103 patients (53 females and 50 males) who underwent other head and neck operations, with a mean age of 50.3 years. All patients were required to complete the Leicester Cough Questionnaire (LCQ) preoperatively and 2 weeks postoperatively.ResultsThe postoperative mean total LCQ scores in the experimental and control groups were 17.9 ± 5.0 and 19.8 ± 4.2, respectively; the difference was significant (p = 0.014). Adverse event analysis showed that patients in the experimental group scored significantly worse on items for chest or stomach pains, phlegm, feeling in control of coughing, sleep disturbances, coughing bouts, frustration, and feeling fed up with coughing. In the analysis of the three LCQ domains, a significant difference was noted in the physical domain between the two groups (p < 0.001). In the one-way analysis of variance, the factors of sex and anaesthesia time were associated with the postoperative LCQ score; in further multifactor analysis of variance, only the factor of sex was significantly related to the postoperative LCQ score.ConclusionThyroidectomy may be associated with postoperative cough, and a higher number of female patients complained of cough and related symptoms.

MON-070 NON-INFECTIOUS COMPLICATIONS OF CONTINUOUS AMBULATORY PERITONEAL DIALYSIS IN BANGLADESH: A SINGLE CENTRE EXPERIENCE

Continuous Ambulatory Peritoneal dialysis (CAPD) is increasingly getting popularity as a form of renal replacement therapy in end stage kidney disease (ESKD) patients of Bangladesh. Although CAPD may offer some advantages over Haemodialysis (HD) and is generally better tolerated, it is not without complications. Peritonitis is a well known complication of CAPD. However, non-infectious complications, though less common, are increasingly being recognized and can impact survival of this technique. The aim of this study was to evaluate the non-infectious complications of CAPD along with the outcome of patients performing CAPD in Bangladesh. This retrospective study was performed in a specialized kidney hospital in Dhaka, Bangladesh. Patients with end stage kidney disease who underwent percutaneous peritoneal dialysis catheter (double cuffed coiled Tenckhoff catheter) insertion by Seldinger technique over a period of one year from August 2017 to July 2018 were included. Patient’s files were reviewed and patients were interviewed by telephone calls. The nature and frequency of non-infectious complications and its impact on patients were analyzed. During the study period a total of 68 patients underwent CAPD catheter insertion and in one patient operation was abandoned due to bowel perforation. Average age of the patients was 56.7 ± 11.6 (24 to 90 years). Number of female patients was higher than male patients (48.5% vs 51.5%). Diabetic nephropathy was the most common (67.7%) cause of ESKD. The mean duration of follow up was 7.7 ± 3.4 months (1–15 months). CAPD was started on an average of 11.4 ± 3.0 (5 to 29) days after catheter insertion. Overall non-infectious complications were noted in 30.9% cases (21 out of 68). Pain was most commonly reported (19.7%) followed by haemoperitoneum (9.1%), leakage of fluids (7.6%) and malposition of catheter (1.5%). None of the patients suffered from hydrothorax, hernia or ultrafiltration failure during the study period. All the haemoperitoneum cases were secondary to anticoagulant use and resolved after omitting the anticoagulant for few days and daily flushes. Patients who had exit site leakage required temporary withdrawal of CAPD with or without temporary haemodialysis and/or secondary stitches but their CAPD was resumed after an interval. The patient with catheter malposition required catheter repositioning and CAPD could be performed after that. At the end of one year, 51 (75%) patients were continuing CAPD, five patients were shifted to haemodialysis due to either peritonitis (n=2) or financial problem (n=2) or non-compliance (n=1); one patient underwent renal transplantation and in one patient catheter was removed as renal function recovered. A total of 10 patients died during the study period, giving an overall mortality rate of 14.7%. Our study demonstrated that non-infectious complications affected about one third of the patients performing CAPD, though majority of those were managed conservatively. None of these complications affected catheter survival during the study period. Better understanding of the non-infectious complications of PD will help prevent, early recognize and manage them appropriately, making PD more acceptable and long lasting form of renal replacement therapy.

Prevalensi Hipertensi pada Pasien Diabetes Melitus di Kelurahan Mojosongo Kota Surakarta

Diabetes Melitus merupakan suatu kelompok penyakit metabolik dengan karakteristik hiperglikemi .Penyakit Diabetes Melitus merupakan penyakit yang tidak dapat disembuhkan tetapi dapat dikendalikan. Tetapi jika penyakit ini tidak ditangani dengan baik akan timbul komplikasi, salah satu komplikasi makroangiopati pada DM adalah hipertensi, sehingga tujuan penelitian ini adalah untuk mengetahui prevalensi hipertensi pada pasien DM di wilayah Mojosongo Surakarta. Penelitian dilakukan di Puskesmas Sibela Surakarta, dengan subyek penelitian pasien DM sebanyak 50 orang. Desain penelitian pendekatancross sectional dengan tehnik purposive sampling . Instrumen penelitian yang digunakan adalah kuesioner dan alat spygnomanometer.Untuk mengetahui prevalensi digunakan pendekatan deskriptif. Pada hasil penelitian didapatkan adanya pasien DM yang juga terdiagnosa hipertensi. Prevalensi Hipertensi pada pasien DM sebanyak 14 orang ( 28 % ) dari 50 sampel, dimana jenis kelamin perempuan lebih banyak dibandingkan laki laki, yaitu sebanyak 11 orang ( 78,6 %). Sedangkan prevalensi berdasarkan umur didapatkan hasil bahwa sebagian besar berumur ≥ 61 tahun, yaitu sebanyak 8 orang ( 57,2 %). Untuk prevalensi berdasarkan lamanya menderita penyakit, didapatkan hasil bahwa sebanyak 9 orang ( 64,3%) telah menderita DM lebih dari 10 tahun. Adanya pasien DM yang disertai dengan hipertensi, dengan prevalensi sebesar 14 orang ( 28 %).

Study on etiological profile of respiratory distress in new borns in a teaching hospital

Background: The aim is to study the various risk factors associated with development of severe respiratory distress in the new born.Methods: This was a prospective study of 200 new-borns with respiratory distress. Clinical details, etiology for the respiratory distress, system-wise factors responsible for the distress, severity and duration of respiratory distress, oxygen therapy, type of treatment, mortality, maternal and antenatal risk factors, radiological findings were noted in all the cases and were analysed.Results: Of the 200 cases with respiratory distress, 118 (59%) had severe respiratory distress. 154 cases with distress were of respiratory system in origin out of which 45% (70 out of 154) were due to Meconium aspiration syndrome, 42% (64 out of 154) were due to Respiratory distress syndrome, 12% (18 out of 154) were due to transient tachypnea of new-born and 2% were due to congenital pneumonia. More number of female patients had severe respiratory distress. Mortality was 2.5%.Conclusions: Meconium aspiration syndrome is the most common cause of respiratory distress in new born. Almost 60% of new borns with respiratory distress developed severe respiratory distress who required intensive monitoring. Risk factors like meconium stained liquor, vaginal delivered new borns, preterm gestation age, and female gender of new born were associated with severe respiratory distress in new borns.

Hidden from history? A brief modern history of the psychiatric “treatment” of lesbian and bisexual women in England

It is well documented that homosexuality was classified as a mental illness in the DSM until 1973, when it was replaced with the diagnosis of “sexual orientation disturbance”. While it is widely known that homosexual men were criminalised and risked a spell in prison or aversion therapy in a psychiatric hospital (Dickenson, 2013), the class dimension is probably less well known. According to the Queer historian, Chris Waters (2017), it was the more privileged middle class men who were offered aversion therapy, as a “softer” option than jail (Alan Turing being the most prominent example). In contrast, the majority of mostly working class men who were discovered engaging in same-sex relations were more likely to end up in prison, without the offer of “treatment” as an alternative. However, there are aspects of this history we know even less about. Because it is well documented, gay men’s experiences of psychiatric treatment for same-sex attraction have become a dominant historical discourse. But what happened to same-sex attracted women in England (1950–70s) who were not subject to direct court referral routes into psychiatric treatment like their male counterparts? Although female homosexuality was not criminalised in England, it was still, like male homosexuality, officially classified as a mental disorder (“sexual deviation”). As part of a cohort of studies around the theme of sexualities and health funded by the Wellcome Trust, we conducted a bottom-up archival study of women’s and lesbian, gay, bisexual, and transgender (LGB&T) archives in England to investigate this question. Documentation proved to be sparse and fragmented, and what little material we found presented us with numerous challenges to interpretation. A small number of psychiatrists and psychologists had various, often competing, theories about homosexuality and published papers promoting examples of experimental or purportedly successful “treatments”, which they often used to test out their theories. However, it is not clear how much these theories actually influenced practice (Oram and Turnbull, 2001).

Antithrombotic Therapy in Patients with Malignant Lymphoproliferative Disorders Treated with Ibrutinib

Background. Antithrombotic therapy in chronic lymphocytic leukemia (CLL) patients is challenging, as this category of patients is initially characterized by high risk of hemorrhagic complications. The use of ibrutinib influencing the platelet function constitutes an additional bleeding risk. A crucial task consists in risk minimization of both hemorrhagic complications and thrombosis while sticking to ibru-tinib treatment. Aim. To assess the feasibility of antithrombotic therapy in CLL patients receiving ibrutinib and having indications for this therapy, as well as the use of dual antiplatelet and dual antithrombotic therapies. Materials &amp; Methods. The trial included patients with CLL (n = 190), mantle cell lymphoma (n = 5), and Waldenstrom macroglobulinemia (п = 2) aged 32 to 91 years (median 66 years). The number of female patients was 70, aged 39 to 83 years (median 64 years) and the number of male patients was 127, aged 32 to 91 years (median 66 years). The patients were at different stages of ibrutinib treatment within 5 to 56 months. In this work methods of nonparametric statistics were used. All data are shown in the form of median and interquartile range or absolute numbers and percentages. Results. Antithrombotic therapy during ibrutinib administration was used in 29 (14,7 %) patients. The new oral anticoagulants (NOAC) had to be prescribed to 26 patients with atrial fibrillation (AF). Dual antiplatelet therapy was used in 3 patients who underwent percutaneous coronary intervention with subsequent revascularization. In 2 patients with AF who underwent coronary stenting the dual antithrombotic therapy instead of the triple one was administered according to the management algorithm for patients with high risk of hemorrhagic complications. In 6 patients out of those who had AF and received NOAC the drug was withdrawn because of thrombocytopenia. Hemorrhagic manifestations which were the reason of NOAC withdrawal were observed in 1 female patient in the form of gross hematuria recurring when anticoagulant treatment was switched to the minimal effective doses and also when the administered anticoagulant was replaced with another one used in the minimal dose effective for stroke prevention in patients with AF. Hemorrhagic manifestations which were the reason of anticoagulant dose reduction emerged in 4 patients, and 3 patients required another anticoagulant for the same reason. In 5 patients there was no need to change the anticoagulant treatment. In 10 NOAC recipients no hemorrhagic syndrome was observed. None of 5 patients receiving dual antithrombotic therapy showed hemorrhagic complications within 3 to 14 months. The incidence of them in women is more than twice as high as in men. Conclusion. Hemorrhagic manifestations in patients receiving ibrutinib and antithrombotic therapy were not life threatening and, in most cases, did not require drug withdrawal. Thrombocytopenia was the main reason for NOAC withdrawal. A thorough follow-up of patients receiving ibrutinib and antithrombotic therapy allows for timely correction of it if necessary. It involves dose reduction, anticoagulant replacement, and in rare cases the withdrawal of antithrombotic therapy with subsequent consideration of the feasibility of its resumption. As a rule, the need for different variants of antithrombotic therapy is not an obstacle to either assignment or continuation of antineoplastic treatment with ibrutinib.

Epidemiology of lung cancer in a tertiary health-care center: A retrospective study

Background: Lung cancer is the most common cancer diagnosed worldwide. Tobacco smoking is the most important environmental factor associated with the development of lung cancer. However, a large number of patients with lung cancer have no history of smoking frequently among female patients. There are no enough data in Eastern India regarding epidemiological study of lung cancer. Objectives: The aim of our study was to evaluate the prevalence and pattern of lung cancer in our institution (NRS Medical College and Hospital). Materials and Methods: Our study was a retrospective analysis of prospectively collected data for newly diagnosed adult patients. All patients were registered only after lung cancer diagnosis was confirmed by histopathological and/or cytological examination. The following information was collected from the database such as age, sex, smoking status and histological type, disease location, and stage. Results: A number of male patients were 786 (82%) and a number of female patients were 172 (18%). 692 (72.2%) patients had a history of smoking and 266 (27.8%) patients had no history of smoking in their life. Among the non-smoker patients, female patients were 147 (55.3%) and male patients were 119 (44.7%). 80% of patients came from rural areas and 20% of patients came from urban areas. In our study; histologically, the adenocarcinoma was 398 (41.6%) found most prevalent which is followed by squamous cell carcinoma 365 (38.1%). Conclusion: Adenocarcinoma lung with the right upper lobe involvement was prevalent in our study and non-smoker female patients were predominant. The major etiological factor was smoking. Awareness in the society is needed about cancerous effect of tobacco smoking for reducing the incidence of lung cancer.

Relationships between Age, Sex, Laboratory Parameter, and Length of Stay in Patients with Dengue Hemorrhagic Fever

Background : Dengue Hemorrhagic Fever (DHF) is an infectious disease caused by dengue virus. Until now, Dengue virus infection remains a health problem in Indonesia. The things which cause problems in DHF case are high mortality rates, diseases spread which are easily spread, especially affect children. Handling of DHF patients needs long of a length of stay which has large costs. Subjects and Method: This was an analytic observational study with a cross-sectional design. This study was conducted at Dr. Moewardi Hospital, Surakarta, based on medical records. 32 samples were selected using purposive sampling. The independent variables were age, sex, platelet count, hematocrit value, and a number of leukocytes. The dependent variable was the length of stay. The data were obtained from medical records using a Chi-square test. Bivariate analysis was used to determine the factors which affected DHF on length of stay using Chi-square, Kolmogorov Smirnov, continuing with multiple linear regression analysis. Results: The age of DHF patients was from 1 year of age to 53 years of age with an average age of 20.07 + 13.45 years. The number of female patients was 15 patients. Platelets level (x 1,000) was 25 for minimum and 308 for maximum. Mean ± SD platelet was 94.86 + 67.97. Hematocrit level was 28 for minimum and 54 for maximum. Mean ± SD hematocrit was 40.69 + 6.59. Leukocytes level (x 1,000) was 1.6 for minimum and 10.8 for maximum. Mean ± SD leukocytes was 5.50 + 2.95. The shortest length of stay was 3 days and the longest was 11 days. Mean ± SD length of stay was 5.21 ± 1.90 days. The result of multiple linear regression analysis showed a statistically non-significant relationship (p> 0.05) between age, sex, platelets, hematocrit, leukocytes, and length of stay. Conclusion: There is a non-significant relationship between age, sex, platelet count, hematocrit value, leukocyte count, and length of stay. Keywords: DHF, length of stay, platelet count, hematocrit value, leukocyte count Correspondence : Maria Devi Arianti. Masters Program in Family Medicine, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: ariantidevi­88@yahoo.co.id Mobile: 08124612699 Journal of Epidemiology and Public Health (2019), 4(4): 307-313 https://doi.org/10.26911/jepublichealth.2019.04.04.05

Cold Urticaria: Clinical Features and Natural Course in a Tropical Country.

PurposeTo review the clinical features and natural courses of cold urticaria (ColdU) in a tropical country.MethodsA retrospective chart review was performed of patients who visited Siriraj Urticaria Clinic, Siriraj Hospital, Bangkok, Thailand, and were diagnosed with ColdU between 2007 and 2018. Data on provocation and threshold tests, clinical courses, and laboratory work-up were analyzed and compared with data reported by studies in temperate countries.ResultsOf 1,063 chronic urticaria patients, 27 (2.5%) were diagnosed with ColdU, with a mean age of symptom onset of 34.8 years. Half of the patients had a history of atopy, and 1 (3.7%) had a history of anaphylaxis. All patients were positive to 1 of 3 provocation tests: an ice cube test; TempTest 4.0; or a tray filled with ice, salt and water. Thirteen patients underwent the ice cube test, and all had positive results. TempTest was performed on 15 patients, 8 of whom had positive results, with a mean critical temperature threshold (CTT) of 21.0°C. All of the 7 patients who had a negative TempTest result later produced positive results to the immersion of their hand and forearm in a tray filled with ice, salt, and water. All patients were treated with H1-antihistamines, the vast majority (96.3%) being non-sedating H1-antihistamines. Some (14.8%) needed to be administered oral corticosteroids, ciclosporin, or omalizumab. Six patients (22.2%) were in remission. A Kaplan-Meier survival curve demonstrated 5-year and 10-year remission rates of 13.8% and 42.6%, respectively.ConclusionsThe rate of anaphylaxis in patients with ColdU in a tropical country was lower than those reported by other studies conducted intemperate climates. On the other hand, the number of female patients, mean age at symptom onset, atopy rate, rate of concomitant chronic spontaneous urticaria and mean CTT were higher.

Real life management of chronic urticaria: Multicenter and cross sectional study on patients and dermatologists in Iran.

Recently, advances in understanding the etiology of urticaria and updates of diagnostic and therapeutic management guidelines have drawn attention to chronic urticaria (CU) morbidity. The present study aimed to evaluate Iranian dermatologists' practice and real life management of CU patients. A total of 35 dermatologists and 443 patients were included in the study. Number of female patients was 321 (72.5%). Mean (standard deviation) age of the study patients was 38 (13) years and the median (inter quartile range) of disease duration was 12 (6-48) months. Severity of patients' symptoms was mild for 32.1%, moderate for 38.7%, severe for 18.8%, and 10.4% of them had no evident signs or symptoms. The most common diagnostic methods were physical examination (96.6%), differential blood count (83.5%), erythrocyte sedimentation rate (77.4%), and C-reactive protein (62.8%). The number of dermatologists prescribed nonsedating antihistamines (nsAH) in regular dose and high dose mono therapy were 26 (74%) and 6 (17%), respectively. About 66% of dermatologists were familiar with British Association of Dermatologists (BAD) guideline. The most common first-line treatment for CU by Iranian dermatologists was nonsedating antihistamines in regular or high doses. The real-life management of patients with CU in Iran was in accordance with the available practice guidelines.

Clinical study of 100 cases of hoarseness of voice: a hospital based study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Hoarseness is defined as roughness of voice resulting from variations of periodicity or intensity of consecutive sound waves. Hoarseness is a symptom not a disease.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The present study was carried out in the Department of ENT and Head and Neck Surgery, SMGS Hospital, Jammu over a period of 2 years from March 2016 to February 2018. During this period the patients who presented with hoarseness of voice were evaluated. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Total 100 cases were studied. Average age group was found to be between 15-85 years. The number of female patients were 36 (36%) and male 64 (64%). In the present series the most common lesion was vocal nodule (30%) followed by vocal polyp (23%), squamous cell carcinoma (16%), papilloma (10%), Reinkes oedema (9%), keratosis (7%), vocal cord paralysis (4%) and laryngeal tuberculosis (1%).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Hoarseness is a common symptom of laryngeal dysfunction. The micro laryngeal surgery is a minimally invasive procedure used to correct voice disorder or other problems affecting the larynx.&lt;/p&gt;

Gastric calcifying fibrous tumor: A clinicopathological study of nine cases.

The aim of the present study was to analyze the clinicopathological characteristics presented in 9 cases of gastric calcifying fibrous tumor (CFT), and investigate the expressions and clinical implications of G protein-coupled estrogen receptor (GPER), estrogen receptor (ER) and vimentin in gastric CFTs. The clinical and pathological information of 9 patients with CFTs was investigated retrospectively. Subsequently, the expression of GPER, ER and vimentin were examined using immunohistochemistry, and a literature search for gastric CFT was conducted. The 9 patients were 40–71 years old with a mean age of 52.22 years, including 6 female and 3 male patients. Pathological features included dense hyalinized collagen fibers with a psammomatous body or dystrophic calcification, and the infiltration of scattered lymphocytes and plasma cells. Immunohistochemically, all cases expressed vimentin and GPER, whereas ER expression was negative. Using a database research, 25 studies regarding gastric CFT were identified, including 48 cases with a sex ratio (female:male) of 1.4:1. In addition, the number of female patients was twice the number of male patients in patients <50 years old, whereas the number was almost equal between women and men ≥50 years of age. Gastric CFT is a benign lesion with a good prognosis and a predilection for female patients, particularly premenopausal women. Estrogen may serve a role in this female predominance, and this may be mediated by GPER rather than ER.

Imaging Aspects of the Mandibular Incisive Canal: A PROSPERO-Registered Systematic Review and Meta-Analysis of Cone Beam Computed Tomography Studies

This study aimed to perform a systematic review and meta-analysis of the literature on the mandibular incisive canal (MIC) studies using cone beam computed tomography (CBCT). A PROSPERO-registered systematic review (#42017056619) was conducted following the PRISMA statements to summarize current knowledge on the CBCT aspects of the MIC. A search was performed in PubMed's Medline and Scopus databases, without date or language restrictions, using the algorithm {[(Interforaminal region) OR (mandibular incisive channel) OR (mandibular incisive nerve) OR (mental mandible) OR (anterior mandible) (cone beam computed tomography). Also, the references were crosschecked. The Meta-Analysis of Statistics Assessment and Review Instrument and meta-analysis was used to evaluate the selected studies. A total of 410 articles were found, and 25 studies were selected after a two-step selection process. The CBCT systems differed regarding field of view (FOV) (large, n = 3; medium, n = 2; small, n = 4; not informed, n = 16) and voxel size (0.15 to 0.4 mm). Geographically, the studies were distributed across four continents (South America, North America, Asia, and Europe), and there was a statistical significance of studies from the American and Asian continents (P < .0001). From 3,421 CBCT exams, the number of female patients was slightly higher than male, and the mean age ranged from 29.8 to 59.1 years. The overall mean prevalence of MIC was 89.6% ± 15.08%, and bilateral occurrence was statistically significant (P < .0001). The studies using a voxel size lower than 0.3 mm showed the highest mean prevalence (93.88%) in comparison with voxel size described as ≥ 0.3 mm (89.33%). Diameter (0.45 to 4.12 mm) and length (6.6 to 40.3 mm) showed great variability among the included studies. In summary, the results of this systematic review evidenced a high worldwide prevalence of MIC. There was no prevalence of MIC in relation to sex, and its presence was mainly related to adults between the fourth and sixth decades of life. In addition, great heterogeneity of methodologies was observed.

Medication Related Osteonecrosis of the Jaw: Basic Research and Clinical Practice for Prevention and Treatment by Ultrasound/Laser Pulsation

Objective: The latest survey by Japanese Society of Oral and Maxillofacial Surgeons suggested that the number of medication related osteonecrosis of the jaw (MRONJ) patients who received oral bisphosphonate, mostly for postmenopausal osteoporosis, may exceed that by intravenous bisphosphonate for cancer treatment. Consequently, the number of female patients with MRONJ can be 3 times that of male in Japan. The predominance of oral bisphosphonate related cases is more apparent in Korea. MRONJ treatment by laser including that by low level laser (LLLT) is uncommon in Japan partly because of insufficient referrals and collaboration between medical and dental professionals. Here, we evaluated the potential and prospective effectiveness of low-intensity pulsed ultrasound (LIPUS) treatment for MRONJ in terms of translational research. Materials and Methods: Primary pathophysiology of MRONJ described in the revised position paper (2016) by the allied task force committee of 6 Japanese societies was listed and used as outcome measures to compare the following therapeutic methods: LIPUS, LLLT, parathyroid hormone (PTH) and cellular transplantation in a review of laboratory and clinical (PTH and LLLT) studies. Results: Characteristics of periodontal lesions observed in early stages, including periosteal reaction, thickening of lamina dura and persisting alveolar sockets, were all prevented by LIPUS treatment in model rat experiments. Discussion: While half of patients diagnosed as stage 0 may have been overdiagnosed, not progressing to later stages, it remains important to diagnose and treat early stage patients to prevent deterioration of their condition. Non-invasive LIPUS treatment prevented all early symptoms of MRONJ and is promising as a preventive measure for MRONJ.

Analysis of the clinicopathological characteristics and their trends among patients with lung cancer undergoing surgery in a tertiary cancer hospital of north China during 2000-2013.

Lung cancer is the primary cause of death among all cancers in China. However, clinical and pathological features and trends among patients with lung cancer in mainland China are largely unknown. This study analyzed the clinicopathological characteristics and trends of patients newly diagnosed as lung cancer and underwent surgery in a tertiary cancer hospital of north China between 2000 and 2013. Data were collected retrospectively from medical records. Pathological diagnosis was confirmed by surgery or puncture, bronchoscopy, thoracoscopy, and sputum cytology. This study included 3,733 patients with lung cancer (2,252 male and 1,481 female; male-to-female 1.52:1). An increase in the incidence of lung cancer was observed among women. The most frequently observed pathology types were adenocarcinoma (ADC, 63.41%), squamous cell carcinoma (SQ, 24.48%), and small cell carcinoma (SCC, 3.08%). There was a decrease in the proportion of SQ cases and increase in ADC cases. The proportion of male patients with SQ and female patients with ADC increased. Differences between men and women in the distribution of lesions according to pathology were as follows: ADC and SQ were present in 49.73% and 35.92% of male patients, respectively, and in 84.20% and 7.09% of female patients, respectively. Comparing the time period 2000-2006 and 2007-2013, there were no changes in the distribution of pathology among men, while the proportion of ADC and SQ cases among women increased from 74.43% to 85.90% and decreased from 15.07% to 5.71%, respectively. The proportion of female patients with lung cancer who could undergo surgery increased significantly. The proportion of patients with SQ decreased while that of ADC increased, and the increase of ADC was mainly due to the increase in the number of female patients with ADC.

Utility of pediatric female fertility preservation discussions following pelvic radiation.

While many childhood cancers are curable with therapy, adverse consequences in fertility exist. We sought to assess the number of female patients with pelvic tumors receiving radiation therapy, and the proportion that undergo measures for fertility preservation (FP). A total of 53 female patients treated with pelvic tumors from 2000 to 2016 were retrospectively identified. 19 (34%) of these patients underwent pelvic radiation therapy (pXRT). Three of the patients received pXRT for palliative treatment. Of the 19 female patients receiving pXRT, six (31%) were prepubertal and 13 (68%) were postpubertal. Three patients (16%) had documentation of a discussion of FP measures prior to pXRT. One was prepubertal and the others were post-pubertal. Six patients (32%) were evaluated by endocrinology after radiation therapy, diagnosed with ovarian failure, and placed on hormone therapy. Current guidelines recommend discussion of FP in pre-and postpubertal patients with cancer. This 16-year retrospective review of female patients that underwent pXRT for pelvic tumors demonstrated < 17% of patients have documentation of a discussion of FP measures. Female pediatric patients who underwent chemotherapy and pXRT suffer a high rate of premature ovarian failure, high morbidity and mortality as well as low rates of documented FP discussions. Based on these findings we have established a multi-disciplinary fertility preservation team available for consultation and a protocol for discussing and documenting the impact of pXRT, along with other treatments, on fertility. III.

Laparoscopic management of appendicular mass

Background: Appendicitis is inflammation of the appendix. In managing the patients with appendicular mass, many controversies arouse between conservative method of treatment and surgery, antibiotic therapy duration, drain usage, skin closure. This study evaluates the safety and efficacy of laparoscopic appendectomy in patients with complicated appendicitis.Methods: This is a retrospective study conducted in in Kamineni Institute of Medical Sciences, Narketpally, Nalgonda, April 2017 to August 2017. It included a total of 100 patients who were treated for appendicitis.Results: The numbers of male patients were 15, number of female patients were 7. The male to female ratio was 2:1. The patients age ranged from 14 to 48 years. The duration of treatment before admission ranged from 5 days to 10 days. Most of the patients had leucocytosis (68%) of greater than 10,000/mm3. All patients had undergone laparoscopic appendectomies within 24 hours. The average duration of stay in hospital was 5 to 10 days. No intra-operative complications were observed.Conclusions: This study concludes that laparoscopic appendectomy is more feasible in patients with appendicular mass.

Characteristics of atrial fibrillation in women: About a study of 642 patients

In many studies, female gender was considered as a risk factor for onset of atrial fibrillation (AF) and its complication of thromboembolic events. The aim of our study was to compare according to gender, predictive factors, causes and complication of AF. We carried out in our department a study including 642 patients with AF. Patients were divided into two groups according to gender: a “Female” group and a “Male” group to demonstrate the and less ischemic heart disease (8% vs. 16.5%, P = 0.001) in the “Female” group. For the complications of AF, there were no significant differences between the two genders regarding thromboembolic events (8.3% vs. 6.1%, P = 0.28) and bleeding caused by oral anticoagulation (6.4% vs. 6.4%, P = 1). 52.5% 48.5% 51% 49%. Prevalence of diabetes rate of male and female difference in predictive factors, causes and complications of AF between the groups. A total of 642 patients were studied with the mean age was 63.2 ± 15.7 years. The number of female patients was 314 (48.9%). The prevalence of hypertension was 52.5% and that of diabetes mellitus was 27.1%. The prevalence of hypertensive heart disease, valvular heart disease and ischemic heart disease were 10.1%, 36.8% and 12.3% respectively. The comparison of the “Female” group and “Male” group showed that there was more hypertension (57.6% vs. 47.7%, P = 0.001), more renal failure (6.2% vs. 2.1%, P = 0 .01) and less smoking (1.4% vs. 22.6%, P < 0.001) in the “Female” group. Regarding AF etiologies, there were more hypertensive heart disease (5.4% vs. 1.8%, P = 0.018), more valvular disease (44.1% vs. 29.9%, P < 0.001). In our study, in female gender, hypertension and renal failure are the most frequent predictive factors of AF. Valvular and hypertensive heart diseases are the first etiologies of AF in women, whereas for men it is more ischemic heart disease. Thromboembolic and hemorrhagic complications are not influenced by gender.

Pattern of Heart Valve Involvement in Rheumatic Heart Disease

Rheumatic heart disease is the most important consequence of acute rheumatic fever. Both are common cardiovascular problems in Nepal. Echocardiographic detection of rheumatic heart disease is important to establish the diagnosis. The involvement of valves and their severity guides the therapeutic options. A total of 133 valvular heart disease cases attended in Dhulikhel Hospital between July 2008 to June 2009 were analyzed. Fifty-one patients, in whom the problems were rheumatic in origin were studied. Among them, 12% (6) had isolated aortic valve involvement, 35%(18) had isolated mitral valve and 53%(27) ahd mixed involvement. Severe mitral stenosis accounts for 24% of all mitral stenosis and severe aortic stenosis is 20% fo all aortic stenosis. The rates for severe mitral regurgitation and severe aortic regurgitaiton are 30% and 28% respectively. Although the study population has a high number of female patients, the differences in the rates of involvement of aortic or mitral valve in both genders are statistically insignificant. The study, although small, confirms that in this population, females are more commonly affected, that the mitral valve is the most commonly damaged valve and that disease affecting multiple valves is marginally more common than isolated valve disease. The detection of valvular involvement at different stages can guide the therapeutic options.

Patients with dementia and Alzheimer’s in Hungary

Introduction: In this study we would like to give an overview about the presence of patients with dementia in the Hungarian health care system, because besides the cardiovascular diseases these are also important syndromes among the elderly. Alzheimer’s disease is the most common form of dementia and according to the global burden of disease statistics (GBD compare statistics) this (with other dementias) caused 3,8 % of the total deaths and 1,81 % of total DALY’s in Hungary. In the case of the population over 70 years of age it means 5,47 % of the total deaths and 5 % of total DALY’s. Methods: This analysis shows the utilization of National Health Insurance Fund (NHIF) financed active, chronic and nursery care capacities during 2011-15 and the description of social care data from TeIR database during 2011-13. The patients have been selected from the NHIF database on the base of ICD classification (G3, F0-F3). The analysis is particularly focused on the characteristics of the patients over 65 years of age. Results: This study presents that during five years there was a significant growth in the proportion of the total hospital days of the population over 65. The number of patients with dementia diagnosis is stabile; every year 17 thousand people appear in the hospitals. The patient number with dementia is 0,5 % from the total number of patients over 65 years of age and 0,9% from the total hospital days. In view of the age distribution of patients, the 80-84 age group covers the highest percentage (25%), but the proportion of the over 85-89 years of ages is also high (21%). The number of the female patients (12 thousand) is twice as high as male patients (5 thousand). The number of patients with Alzheimer’s disease is continuously growing; it was a 25 percent increasing from 2011 to 2015. The tendency is the same as in dementia; the 80-84 age group covers the highest percentage (27%) and the number of female patients (470) is almost double of the male patients (280). In the public-funded residential/nursing homes there were 10 753 residents (24%) with registered dementia from the total number of residents (45 519) in 2013. Conclusions and discussions: According to the recent European Health Survey the lifestyles of the Hungarian people is not appropriate. The smoking, the heavy drinking or the insufficient degree of physical activity are the most important risk factors of dementia and many other diseases. The prevention and the early diagnosis of dementia are good for the patients and the care system, because the dementia usually means a loss of memory, reasoning, speech, and other cognitive functions, which put a significant burden on the informal carers and caregivers as well. This separated social and health care of people with dementia is not an optimal solution. The residential homes are suffering from the care burden of dementia despite of the increased normative fee of dementia. There are plenty of good practices around the world, which are worth to consider. The preservation of these patients’ dignity and the support in their everyday life should be the key elements of the dementia care, which requires strong cooperation between social and health care. Limitations: The knowledge of the activities of the residential homes is very limited. The TEIR database is not complete and it does not contain some very important information about the cared residents. There is no information about the status of the patients, the care needs, the organized care programs in the social institutes. The main limitation of the examination of dementia is that, there is no methodologically unified collection of the people with dementia. The patients appear in social and health care databases, but some of them do not appear in the statistics. There is no connection between social and health care data, the common information system is missing, because of it is hard to monitoring of the status and needs of the patients. Suggestions for future research: It would be very useful to know the real number of people with dementia, the real burden of dementia and to have information about the satisfaction of dementia care.