Pub Date : 2021-07-27DOI: 10.9734/bpi/nfmmr/v2/10889d
J. Umeobika, E. Ojiyi
Background: Gynecological malignancies are significant contributors to morbidity and mortality in women and are key components of reproductive health. They are found all across the world, though their distribution varies by region. Objectives: To assess the frequency and pattern of Gynaecological malignancies at a University Teaching Hospital in South Eastern Nigeria. Methodology: From January 1, 2004 to December 31, 2013, all patients with histologically proven genital tract cancers in the Department of Obstetrics and Gynecology of a University Teaching Hospital in South Eastern Nigeria were analysed retrospectively. Results: Cervical cancer accounted for 60.1 percent (131/218) of the 218 cases, ovarian cancer 20.6 percent (45/218), corpus uteri cancer 10.6 percent (23/218), vulval cancer 8.2 percent (18/218), and vaginal cancer 0.5 percent (1/218). Overall, the age distribution was primarily between the ages of 30-69, with a high in the 40-49 age group. Cervical and ovarian cancers were most common in people aged 40 to 49, accounting for 39.7% and 24.5 percent of all cancers, respectively. The Gynaecological malignancies appear to occur less at the extremes of age (<20 years and (ge)70 years). Conclusion: The most common type of gynaecological cancer in this study was cervical cancer. Despite the fact that it is the most preventable of all gynaecological cancers and a leading source of morbidity and mortality in Nigeria, it continues to be a major cause of morbidity and mortality. Health education, awareness creation and good government policies are key to curbing this ugly trend.
背景:妇科恶性肿瘤是造成妇女发病率和死亡率的重要因素，也是生殖健康的关键组成部分。它们在世界各地都有发现，尽管它们的分布因地区而异。目的:了解尼日利亚东南部某大学教学医院妇科恶性肿瘤的发生频率和类型。方法:回顾性分析2004年1月1日至2013年12月31日尼日利亚东南部一所大学教学医院妇产科所有经组织学证实的生殖道癌患者。结果:218例患者中，宫颈癌占60.1％(131/218)，卵巢癌占20.6％(45/218)，子宫癌占10.6％(23/218)，外阴癌占8.2％(18/218)，阴道癌占0.5％(1/218)。总体而言，年龄分布主要在30-69岁之间，在40-49岁年龄组中比例较高。宫颈癌和卵巢癌在40至49岁的人群中最常见，占39.7％% and 24.5 percent of all cancers, respectively. The Gynaecological malignancies appear to occur less at the extremes of age (<20 years and (ge)70 years).Conclusion: The most common type of gynaecological cancer in this study was cervical cancer. Despite the fact that it is the most preventable of all gynaecological cancers and a leading source of morbidity and mortality in Nigeria, it continues to be a major cause of morbidity and mortality. Health education, awareness creation and good government policies are key to curbing this ugly trend.
{"title":"Study on Gynaecological Malignant Tumours at a University Teaching Hospital in Imo State South-Eastern Nigeria","authors":"J. Umeobika, E. Ojiyi","doi":"10.9734/bpi/nfmmr/v2/10889d","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v2/10889d","url":null,"abstract":"Background: Gynecological malignancies are significant contributors to morbidity and mortality in women and are key components of reproductive health. They are found all across the world, though their distribution varies by region.\u0000Objectives: To assess the frequency and pattern of Gynaecological malignancies at a University Teaching Hospital in South Eastern Nigeria.\u0000Methodology: From January 1, 2004 to December 31, 2013, all patients with histologically proven genital tract cancers in the Department of Obstetrics and Gynecology of a University Teaching Hospital in South Eastern Nigeria were analysed retrospectively.\u0000Results: Cervical cancer accounted for 60.1 percent (131/218) of the 218 cases, ovarian cancer 20.6 percent (45/218), corpus uteri cancer 10.6 percent (23/218), vulval cancer 8.2 percent (18/218), and vaginal cancer 0.5 percent (1/218). Overall, the age distribution was primarily between the ages of 30-69, with a high in the 40-49 age group. Cervical and ovarian cancers were most common in people aged 40 to 49, accounting for 39.7% and 24.5 percent of all cancers, respectively. The Gynaecological malignancies appear to occur less at the extremes of age (<20 years and (ge)70 years).\u0000Conclusion: The most common type of gynaecological cancer in this study was cervical cancer. Despite the fact that it is the most preventable of all gynaecological cancers and a leading source of morbidity and mortality in Nigeria, it continues to be a major cause of morbidity and mortality. Health education, awareness creation and good government policies are key to curbing this ugly trend.","PeriodicalId":19158,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 2","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84332057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-27DOI: 10.9734/bpi/nfmmr/v2/1803c
Wahinuddin Sulaiman, Aris Chandran Abdullah, J. Chuen, S. Baba, Norain Karim
It is often a challenge and a dilemma for clinicians encountering patients with pyrexia of unknown origin. Numerous tests performed to determine the underlying cause often give inconclusive results. We present a 52-year-old man with undulating fever for more than ten months consistent with diagnosis of pyrexia of unknown origin (PUO). It was associated with persistent hyperferritinaemia, elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), leukocytosis, thrombocytopaenia, hepatosplenomegaly, hypertrigyceridaemia, raised fibrinogen index and arthritis of the ankle joints. Serological markers, repeated septic workout, cerebrospinal fluid and bone marrow and trephine biopsy (BMT) studies were all negative otherwise. The imaging studies (computed tomography scan of whole body) apart from findings of mild hepatosplenomegaly, was otherwise normal. The positron-emission tomography (PET) scan shows evidence of polyarthritis. Based on these findings, diagnosis of refractory adult-onset Still’s disease complicated by haemophagocytic lymphohistiocytosis was made although the BMT findings was inconclusive. Despite corticosteroids, disease modifying anti-rheumatic agents (DMARD) and immune-modulator therapy, he succumbed to the illness. This case history illustrates the diagnostic complexity of adult-onset Still’s disease with protean manifestation.
{"title":"Refractory Adult-Onset Still’s Disease: A Case Report","authors":"Wahinuddin Sulaiman, Aris Chandran Abdullah, J. Chuen, S. Baba, Norain Karim","doi":"10.9734/bpi/nfmmr/v2/1803c","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v2/1803c","url":null,"abstract":"It is often a challenge and a dilemma for clinicians encountering patients with pyrexia of unknown origin. Numerous tests performed to determine the underlying cause often give inconclusive results. We present a 52-year-old man with undulating fever for more than ten months consistent with diagnosis of pyrexia of unknown origin (PUO). It was associated with persistent hyperferritinaemia, elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), leukocytosis, thrombocytopaenia, hepatosplenomegaly, hypertrigyceridaemia, raised fibrinogen index and arthritis of the ankle joints. Serological markers, repeated septic workout, cerebrospinal fluid and bone marrow and trephine biopsy (BMT) studies were all negative otherwise. The imaging studies (computed tomography scan of whole body) apart from findings of mild hepatosplenomegaly, was otherwise normal. The positron-emission tomography (PET) scan shows evidence of polyarthritis. Based on these findings, diagnosis of refractory adult-onset Still’s disease complicated by haemophagocytic lymphohistiocytosis was made although the BMT findings was inconclusive. Despite corticosteroids, disease modifying anti-rheumatic agents (DMARD) and immune-modulator therapy, he succumbed to the illness. This case history illustrates the diagnostic complexity of adult-onset Still’s disease with protean manifestation.","PeriodicalId":19158,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 2","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88771339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-27DOI: 10.9734/bpi/nfmmr/v2/2344f
J. Bakshi, A. Goyal
Langerhans cell histiocytosis (LCH) is a rare condition with unknown causes and is characterized by the infiltration of significant numbers of Langerhans cells in the affected tissues leading to formation of granulomas. In this chapter, we have discussed the case of a 31-year-old man with a swollen, diffusely firm, non-tender, non-mobile thyroid swelling presented with Langerhans cell histiocytosis associated with papillary thyroid carcinoma (PTC). The thyroid was shown to be involved by langerhans cell histiocytosis, confirmed with fine needle aspiration cytology. The patient was examined, and no signs of structural intervention were discovered. After ten cycles of vinblastine and etoposide chemotherapy, there was no reduction in the extent of the swelling observed.
{"title":"Langerhans Cell Histiocytosis Co-existing with Papillary Carcinoma of Thyroid","authors":"J. Bakshi, A. Goyal","doi":"10.9734/bpi/nfmmr/v2/2344f","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v2/2344f","url":null,"abstract":"Langerhans cell histiocytosis (LCH) is a rare condition with unknown causes and is characterized by the infiltration of significant numbers of Langerhans cells in the affected tissues leading to formation of granulomas. In this chapter, we have discussed the case of a 31-year-old man with a swollen, diffusely firm, non-tender, non-mobile thyroid swelling presented with Langerhans cell histiocytosis associated with papillary thyroid carcinoma (PTC). The thyroid was shown to be involved by langerhans cell histiocytosis, confirmed with fine needle aspiration cytology. The patient was examined, and no signs of structural intervention were discovered. After ten cycles of vinblastine and etoposide chemotherapy, there was no reduction in the extent of the swelling observed.","PeriodicalId":19158,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 2","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77517593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-27DOI: 10.9734/bpi/nfmmr/v2/2993f
B. Kanani, N. Garala
Background: Eclampsia is a life-threatening illness that is one of the most leading causes of maternal death around the world. Acute renal failure, DIC, postpartum haemorrhage, and other problems, as well as adverse foetal outcomes, are all linked to it. Aims: This study aimed to highlights fetomaternal outcomes in cases of Eclampsia. Methods: From January 1, 2016, to June 30, 2017, a total of 75 cases of eclampsia were assessed at RZ Hospital, a government tertiary referral centre. The complications of pregnancy, the efficiency of magnesium sulphate treatment, the foetal outcome, and the route of delivery were all investigated. Results: Eclampsia had a 0.55 percent incidence rate, with 62.66 percent of all cases being primigravida, 76 percent of cases being between the ages of 21 and 26, 84 percent of cases being from lower socioeconomic position, and maternal mortality occurring in two of every 75 cases. 66.67 percent of patients were pregnant to term (37 to 42 weeks).71 percent (53) of patients delivered vaginally, with 9 spontaneous deliveries and 44 induced vaginal deliveries. 22 patients required caesarean section. Conclusions: Early detection and prevention of pregnancy-induced hypertension and pre-eclampsia, as well as other eclampsia risk factors, may assist to lower the occurrence of the condition. Magnesium toxicity, acute renal failure (ARF), disseminated intravascular coagulation (DIC), and postpartum haemorrhage (PPH) were the maternal unfavourable events in this trial, with 92 percent of women having no problems.
{"title":"Study on Cases of Eclampsia: A Clinical Approach","authors":"B. Kanani, N. Garala","doi":"10.9734/bpi/nfmmr/v2/2993f","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v2/2993f","url":null,"abstract":"Background: Eclampsia is a life-threatening illness that is one of the most leading causes of maternal death around the world. Acute renal failure, DIC, postpartum haemorrhage, and other problems, as well as adverse foetal outcomes, are all linked to it. \u0000Aims: This study aimed to highlights fetomaternal outcomes in cases of Eclampsia. \u0000Methods: From January 1, 2016, to June 30, 2017, a total of 75 cases of eclampsia were assessed at RZ Hospital, a government tertiary referral centre. The complications of pregnancy, the efficiency of magnesium sulphate treatment, the foetal outcome, and the route of delivery were all investigated. \u0000Results: Eclampsia had a 0.55 percent incidence rate, with 62.66 percent of all cases being primigravida, 76 percent of cases being between the ages of 21 and 26, 84 percent of cases being from lower socioeconomic position, and maternal mortality occurring in two of every 75 cases. 66.67 percent of patients were pregnant to term (37 to 42 weeks).71 percent (53) of patients delivered vaginally, with 9 spontaneous deliveries and 44 induced vaginal deliveries. 22 patients required caesarean section. \u0000Conclusions: Early detection and prevention of pregnancy-induced hypertension and pre-eclampsia, as well as other eclampsia risk factors, may assist to lower the occurrence of the condition. Magnesium toxicity, acute renal failure (ARF), disseminated intravascular coagulation (DIC), and postpartum haemorrhage (PPH) were the maternal unfavourable events in this trial, with 92 percent of women having no problems.","PeriodicalId":19158,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 2","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86014680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-27DOI: 10.9734/bpi/nfmmr/v2/3346f
S. Albogami, Abdelfattah Touman
Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by the accumulation of amorphous lipoproteinaceous material in the distal air spaces due to defective surfactant clearance by alveolar macrophages. This leads to impaired gas exchange and arterial hypoxemia of varying degrees. Although autoimmune type of PAP is thought to be idiopathic, this focused report highlights the possible relationship between viral pneumonia and autoimmune PAP (APAP) in terms of causation, superinfection and effect of treatments. We report a newly diagnosed case of APAP with a possible viral causation “trigger” for the confirmed serum anti-granulocyte macrophage-colony stimulating factor (GM-CSF) antibody. To the best of our knowledge, this is the first report that describe and discuss this issue. The patient is a 38-year- old, ex-smoker woman who had had a progressively worsening dyspnea and a persistent, productive cough for more than 4 months. It was thought to be a community acquired pneumonia (CAP) case and was treated with multiple antibiotics which yielded no improvement in her condition. Physical examination revealed mild hypoxemia and minimal bilateral fine crepitations despite marked alveolar filling on chest X-ray (CXR). She underwent a bronchoscopic procedure that revealed PAP. The case also describes an acute flare up of the condition during the course of the disease caused by a confirmed H1N1 influenza infection. APAP should be considered in the differential diagnosis of recurrent pneumonia not responding to treatment. In this case report we suggest the possible role of viral causation “trigger” or cross-reactivity of GM-CSF antibodies that lead to APAP. We also describe the provided management, the response to the antiviral therapy and the diagnostic and management challenges that was encountered during the follow up.
{"title":"A Challenging Case of Influenza H1N1 Pneumonia and Pulmonary Alveolar Protienosis, Comprehensive Discussion of Disease-Disease Relationship in Terms of Causality, Cross-Reactivity, Outcome and Effect of Treatment","authors":"S. Albogami, Abdelfattah Touman","doi":"10.9734/bpi/nfmmr/v2/3346f","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v2/3346f","url":null,"abstract":"Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by the accumulation of amorphous lipoproteinaceous material in the distal air spaces due to defective surfactant clearance by alveolar macrophages. This leads to impaired gas exchange and arterial hypoxemia of varying degrees. Although autoimmune type of PAP is thought to be idiopathic, this focused report highlights the possible relationship between viral pneumonia and autoimmune PAP (APAP) in terms of causation, superinfection and effect of treatments. We report a newly diagnosed case of APAP with a possible viral causation “trigger” for the confirmed serum anti-granulocyte macrophage-colony stimulating factor (GM-CSF) antibody. To the best of our knowledge, this is the first report that describe and discuss this issue. The patient is a 38-year- old, ex-smoker woman who had had a progressively worsening dyspnea and a persistent, productive cough for more than 4 months. It was thought to be a community acquired pneumonia (CAP) case and was treated with multiple antibiotics which yielded no improvement in her condition. Physical examination revealed mild hypoxemia and minimal bilateral fine crepitations despite marked alveolar filling on chest X-ray (CXR). She underwent a bronchoscopic procedure that revealed PAP. The case also describes an acute flare up of the condition during the course of the disease caused by a confirmed H1N1 influenza infection. APAP should be considered in the differential diagnosis of recurrent pneumonia not responding to treatment. In this case report we suggest the possible role of viral causation “trigger” or cross-reactivity of GM-CSF antibodies that lead to APAP. We also describe the provided management, the response to the antiviral therapy and the diagnostic and management challenges that was encountered during the follow up.","PeriodicalId":19158,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 2","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88281497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-27DOI: 10.9734/bpi/nfmmr/v2/2963f
Divya Jain Pokarna, K. Kshitija, S. Saritha
Aims and Objectives: The development of Kidney is a complex process having two parts the collecting & excretory part. Due to recent advances in the medical field it is now possible for premature babies to survive successfully. The original conception of human fetal Kidney morphology and developmental anatomy is very important for prenatal diagnosis of normal and congenital disorders such as Wilm’s tumor, Hydronephrosis, Multicystic dysplastic kidney, Autosomal recessive polycystic kidney disease, Megacystis, Renal dysplasia etc. Histogenesis of Kidney according to its gestational age gives overview of these congenital anomalies that are important for a developmental Anatomist , in diagnosing the Genetics aspects, Radiological and Histopathological diagnosis & finally improvising antenatal screening and forecasting the route of treatment. Methods: The study used 40 kidneys obtained from 20 spontaneously aborted foetuses [11 males and 9 females] ranging in gestation from 14 weeks to 36 weeks. After confirming their age with CRL, they were grouped and then processed to form slides stained with hematoxylin and eosin. The stained slides were seen under light microscope. Results: At an early gestational age, all kidneys were lobulated and fused by 36 weeks. By 18 weeks, the corticomedullary junction and preformed collecting tubules were plainly visible. By 19 to 23 weeks, well-differentiated PCT and DCT had formed. Well formed pyramids by 28 weeks and medullary rays by 29 weeks were clearly distinguished. Loop of Henle developed and distinguished by 28 weeks. Increased vascularity was seen by 32 weeks to 36 weeks. Nephrogenic zone and undifferentiated mesenchyme decreased and matured glomeruli increased by 36 weeks. Conclusion: This present study may help us in understanding various renal disorders. This study can also emphasizes on the development of each component in medulla and cortex of Kidney, regarding histological maturity & functional status according to gestational age & gives us an overall panoramic view.
{"title":"Determination of Histogenesis of Human Kidney in Spontaneously Aborted Human Fetuses from 14 Weeks to 36 Weeks","authors":"Divya Jain Pokarna, K. Kshitija, S. Saritha","doi":"10.9734/bpi/nfmmr/v2/2963f","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v2/2963f","url":null,"abstract":"Aims and Objectives: The development of Kidney is a complex process having two parts the collecting & excretory part. Due to recent advances in the medical field it is now possible for premature babies to survive successfully. The original conception of human fetal Kidney morphology and developmental anatomy is very important for prenatal diagnosis of normal and congenital disorders such as Wilm’s tumor, Hydronephrosis, Multicystic dysplastic kidney, Autosomal recessive polycystic kidney disease, Megacystis, Renal dysplasia etc. \u0000Histogenesis of Kidney according to its gestational age gives overview of these congenital anomalies that are important for a developmental Anatomist , in diagnosing the Genetics aspects, Radiological and Histopathological diagnosis & finally improvising antenatal screening and forecasting the route of treatment. \u0000Methods: The study used 40 kidneys obtained from 20 spontaneously aborted foetuses [11 males and 9 females] ranging in gestation from 14 weeks to 36 weeks. After confirming their age with CRL, they were grouped and then processed to form slides stained with hematoxylin and eosin. The stained slides were seen under light microscope. \u0000Results: At an early gestational age, all kidneys were lobulated and fused by 36 weeks. By 18 weeks, the corticomedullary junction and preformed collecting tubules were plainly visible. By 19 to 23 weeks, well-differentiated PCT and DCT had formed. Well formed pyramids by 28 weeks and medullary rays by 29 weeks were clearly distinguished. Loop of Henle developed and distinguished by 28 weeks. Increased vascularity was seen by 32 weeks to 36 weeks. Nephrogenic zone and undifferentiated mesenchyme decreased and matured glomeruli increased by 36 weeks. \u0000Conclusion: This present study may help us in understanding various renal disorders. This study can also emphasizes on the development of each component in medulla and cortex of Kidney, regarding histological maturity & functional status according to gestational age & gives us an overall panoramic view.","PeriodicalId":19158,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 2","volume":"91 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73005441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-27DOI: 10.9734/bpi/nfmmr/v2/3327f
Anju Dogra, V. Kumar
Hysterectomy is one of the gynecological operations performed due to benign indications such as uterine leiomyoma, dysfunctional uterine bleeding, endometrial hyperplasia, dysmenorrhea, dyspareunia, and severe endometriosis refractory to medical or conservative surgical management and malignant conditions like cervical, endometrial and ovarian cancer. Hysterectomy can be performed by abdominal, vaginal and laparoscopic method. Abdominal hysterectomy has been the most popular method but it is more invasive and is associated with more blood loss, delayed recovery and longer hospital stay. Since Reich's introduction of laparoscopic hysterectomy in 1989, it has become a widely accepted technique around the world. Laparoscopic hysterectomy was reported to have lower post operative morbidity, improved quality of life, shorter hospital stay and less blood loss when compared to laparotomy. The aim and objectives of the study was to compare the surgical results and intra- operative and post-operative complications between Total Laparoscopic Hysterectomy (TLH) and Total Abdominal Hysterectomy (TAH). A retrospective study was conducted at SMGS hospital, GMC Jammu between October 2016 and September 2018 and a total of 252 patients were recruited in the study. Patients were divided into two groups of 126 patients each- Group A consists of patients who underwent TLH and Group B comprises of patients who underwent TAH. We observed that there was no significant difference between the two groups in respect to patient’s age (45.16±4.58 versus 45.23±6.44), parity (4.32±2.08 versus 4.77±3.08) and indication of surgery. Duration of surgery was found to be longer in TLH (116.02±16.38) than TAH (83.18±21.40). The length of hospital stay was significantly less in TLH than TAH ( p value <0.0001). Hb drop was more in TAH group as compared to TLH (1.46±0.64 versus 1.83±0.68). 25(19.8%) patients of TAH were given post op blood transfusion but only 9(7.14%) patients of TLH were given post op blood transfusion and this difference was again statistically significant (p value<0.0001). The time to ambulation in patients of TLH was much shorter than TAH (9.94±4.29 versus 23.03±1.28). Wound infection was more prevalent in TAH than in TLH; 5 patients had wound infection, and 4 patients had wound dehiscence that required resuturing. Laparoscopy was converted to laparotomy in 8 patients due to adhesions, vascular injury, and bowel injury in one case. This study found that TLH can be performed safely as an alternative to abdominal hysterectomy by an experienced surgeon.It has various advantages over TAH, including a smaller incision, earlier ambulation, a shorter hospital stay, and a faster recovery time, as well as the absence of more serious complications.
{"title":"A Comparative Overview of Total Laparoscopic Hysterectomy and Total Abdominal Hysterectomy","authors":"Anju Dogra, V. Kumar","doi":"10.9734/bpi/nfmmr/v2/3327f","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v2/3327f","url":null,"abstract":"Hysterectomy is one of the gynecological operations performed due to benign indications such as uterine leiomyoma, dysfunctional uterine bleeding, endometrial hyperplasia, dysmenorrhea, dyspareunia, and severe endometriosis refractory to medical or conservative surgical management and malignant conditions like cervical, endometrial and ovarian cancer. Hysterectomy can be performed by abdominal, vaginal and laparoscopic method. Abdominal hysterectomy has been the most popular method but it is more invasive and is associated with more blood loss, delayed recovery and longer hospital stay. Since Reich's introduction of laparoscopic hysterectomy in 1989, it has become a widely accepted technique around the world. Laparoscopic hysterectomy was reported to have lower post operative morbidity, improved quality of life, shorter hospital stay and less blood loss when compared to laparotomy. The aim and objectives of the study was to compare the surgical results and intra- operative and post-operative complications between Total Laparoscopic Hysterectomy (TLH) and Total Abdominal Hysterectomy (TAH). A retrospective study was conducted at SMGS hospital, GMC Jammu between October 2016 and September 2018 and a total of 252 patients were recruited in the study. Patients were divided into two groups of 126 patients each- Group A consists of patients who underwent TLH and Group B comprises of patients who underwent TAH. We observed that there was no significant difference between the two groups in respect to patient’s age (45.16±4.58 versus 45.23±6.44), parity (4.32±2.08 versus 4.77±3.08) and indication of surgery. Duration of surgery was found to be longer in TLH (116.02±16.38) than TAH (83.18±21.40). The length of hospital stay was significantly less in TLH than TAH ( p value <0.0001). Hb drop was more in TAH group as compared to TLH (1.46±0.64 versus 1.83±0.68). 25(19.8%) patients of TAH were given post op blood transfusion but only 9(7.14%) patients of TLH were given post op blood transfusion and this difference was again statistically significant (p value<0.0001). The time to ambulation in patients of TLH was much shorter than TAH (9.94±4.29 versus 23.03±1.28). Wound infection was more prevalent in TAH than in TLH; 5 patients had wound infection, and 4 patients had wound dehiscence that required resuturing. Laparoscopy was converted to laparotomy in 8 patients due to adhesions, vascular injury, and bowel injury in one case. This study found that TLH can be performed safely as an alternative to abdominal hysterectomy by an experienced surgeon.It has various advantages over TAH, including a smaller incision, earlier ambulation, a shorter hospital stay, and a faster recovery time, as well as the absence of more serious complications.","PeriodicalId":19158,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 2","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90525294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-27DOI: 10.9734/bpi/nfmmr/v2/10804d
S. Jadhav, C. Khanwelkar, Abhay Jadhav
Acute respiratory tract infections (ARTI) are very common in all age groups. Childhood respiratory tract infections are responsible for considerable morbidity and mortality. It is significant health problem in India also. The World Health Organization (WHO) estimates that 2 million children under five years of age die due to pneumonia. Majority of ARTIs have viral etiology. Rhinoviruses, respiratory syncytial viruses, parainfluenza and influenza viruses, human metapneumovirus, and adenoviruses are main causative agents. Among bacteria, group A streptococci, Corynebacterium diphtheriae, N. meningitides, H. influenzae, pneumococcus and Staphylococcus aureus are responsible for ARTIs. Drug utilization studies help to understand the pattern of prescription in that particular area for specific conditions. Our aim was to study the prescribing pattern of drugs and to evaluate the rationality of this pattern in acute respiratory tract infection in children aged 1 to 5 years. We evaluated 298 prescriptions given to these children. Analysis of these prescriptions was done as well as they are compared with WHO prescription indicators. Cough (96%), fever (93%) and rhinitis (82.5%) were common symptoms observed, but sore throat, earache and breathlessness were also present in these children. Average number of drugs prescribed was 4.1/patient. Following drugs were prescribed, Antipyretics 98.3%, antimicrobials 91.3%, antihistaminics and cough syrups in 75.2%, Leukotriene antagonist in 25.1% patients, Vitamin B complex 11% and glucocorticoids 4.6%. All drugs were prescribed by brand names and not by generic name. 97.3% prescribed drugs were from national list of essential medicine. We found overuse of antimicrobials in our study. Educational programs are needed in order to bring rational use of antimicrobials. At the same time awareness in parents also should be done regarding antimicrobial use.
{"title":"Determination of Prescribing Pattern of Drugs in Acute Respiratory Tract Infection in Children at Tertiary Care Teaching Hospital, India","authors":"S. Jadhav, C. Khanwelkar, Abhay Jadhav","doi":"10.9734/bpi/nfmmr/v2/10804d","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v2/10804d","url":null,"abstract":"Acute respiratory tract infections (ARTI) are very common in all age groups. Childhood respiratory tract infections are responsible for considerable morbidity and mortality. It is significant health problem in India also. The World Health Organization (WHO) estimates that 2 million children under five years of age die due to pneumonia. Majority of ARTIs have viral etiology. Rhinoviruses, respiratory syncytial viruses, parainfluenza and influenza viruses, human metapneumovirus, and adenoviruses are main causative agents. Among bacteria, group A streptococci, Corynebacterium diphtheriae, N. meningitides, H. influenzae, pneumococcus and Staphylococcus aureus are responsible for ARTIs. Drug utilization studies help to understand the pattern of prescription in that particular area for specific conditions. Our aim was to study the prescribing pattern of drugs and to evaluate the rationality of this pattern in acute respiratory tract infection in children aged 1 to 5 years. \u0000We evaluated 298 prescriptions given to these children. Analysis of these prescriptions was done as well as they are compared with WHO prescription indicators. Cough (96%), fever (93%) and rhinitis (82.5%) were common symptoms observed, but sore throat, earache and breathlessness were also present in these children. Average number of drugs prescribed was 4.1/patient. Following drugs were prescribed, Antipyretics 98.3%, antimicrobials 91.3%, antihistaminics and cough syrups in 75.2%, Leukotriene antagonist in 25.1% patients, Vitamin B complex 11% and glucocorticoids 4.6%. All drugs were prescribed by brand names and not by generic name. 97.3% prescribed drugs were from national list of essential medicine. We found overuse of antimicrobials in our study. Educational programs are needed in order to bring rational use of antimicrobials. At the same time awareness in parents also should be done regarding antimicrobial use.","PeriodicalId":19158,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 2","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79182328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-27DOI: 10.9734/bpi/nfmmr/v2/11001d
P. Ramulu, P. Rao, K. Swaroop, K. Marx, C. Devi
Background: Suicides have been increasing at an alarming rate around the world in recent decades, claiming the most productive age group in society. India, like other developing countries, is not immune to this unnecessarily rising toll. Methods: Between November 2011 and October 2013, 31 patients were enrolled at Osmania General Hospital for this prospective observational study. After the exclusion criteria were ruled out, patients admitted to MICU for claimed hair dye consumption were enrolled in the study. Every patient or the patient's relatives gave their informed consent. From the time of hospital admission until discharge or death, all routine laboratory investigations were performed according to normal clinical procedures and protocols, and patient-related clinical information was documented on the produced proforma. RIFLE criteria were used to define and rate the existence of AKI. Results: The current study looks at 31 cases of suicidal hair dye consumption, with males accounting for 6 (19.35 percent) and females accounting for 25 (80.64 percent). Males (30%) and females (30%) were found to have a higher probability to commit suicide in the age range 21-30 years (70 percent). Acute Kidney Injury necessitating hemodialysis developed in 19% of all patients who ingested more than 50 mL of dye. Following treatment, approximately 58 percent of patients were discharged from the hospital in good general health. Four patients died as a result of respiratory complications such as pneumonia, ARDS, sepsis, and ARF. Conclusions: Hence, in the current situation of emerging hair dye poisoning, it is critical for a timely intervention by reducing the time of admission in hospital and also early management by clinicians is the need of an hour.
{"title":"Clinical Profile and Incidence of Acute Kidney Injury Due to Hair Dye Poisoning: A Prospective Study","authors":"P. Ramulu, P. Rao, K. Swaroop, K. Marx, C. Devi","doi":"10.9734/bpi/nfmmr/v2/11001d","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v2/11001d","url":null,"abstract":"Background: Suicides have been increasing at an alarming rate around the world in recent decades, claiming the most productive age group in society. India, like other developing countries, is not immune to this unnecessarily rising toll. \u0000Methods: Between November 2011 and October 2013, 31 patients were enrolled at Osmania General Hospital for this prospective observational study. After the exclusion criteria were ruled out, patients admitted to MICU for claimed hair dye consumption were enrolled in the study. Every patient or the patient's relatives gave their informed consent. From the time of hospital admission until discharge or death, all routine laboratory investigations were performed according to normal clinical procedures and protocols, and patient-related clinical information was documented on the produced proforma. RIFLE criteria were used to define and rate the existence of AKI. \u0000Results: The current study looks at 31 cases of suicidal hair dye consumption, with males accounting for 6 (19.35 percent) and females accounting for 25 (80.64 percent). Males (30%) and females (30%) were found to have a higher probability to commit suicide in the age range 21-30 years (70 percent). Acute Kidney Injury necessitating hemodialysis developed in 19% of all patients who ingested more than 50 mL of dye. Following treatment, approximately 58 percent of patients were discharged from the hospital in good general health. Four patients died as a result of respiratory complications such as pneumonia, ARDS, sepsis, and ARF. \u0000Conclusions: Hence, in the current situation of emerging hair dye poisoning, it is critical for a timely intervention by reducing the time of admission in hospital and also early management by clinicians is the need of an hour.","PeriodicalId":19158,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 2","volume":"118 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77402240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-27DOI: 10.9734/bpi/nfmmr/v2/2818f
Abdulwahid S. AlQahtani, Ramzi M. Dagriri, Radeif E. Shamakhi, Ahmad M. Alrasheed, Ahmed A. Etwadi, K. Alqahtani
Background: One of the most common causes of nasal obstruction in adults is a deviated nasal septum (DNS). Anterior rhinoscopy (AR), which is generally the first diagnostic procedure in the evaluation of obstructive nasal pathologies, is frequently insufficient in the assessment of the posterior nasal cavity, and paranasal sinus computed tomography(PNS CT) is the gold standard method for the evaluation of paranasal anatomy and inflammatory paranasal sinus pathologies .The goal was to prove that a pre-operative computed tomography scan was helpful in reducing post-septoplasty complications. Methods: All patients with clinically confirmed DNS who had surgical intervention at Khamis Mushayet General Hospital were included in a retrospective record-based analysis. Patients' demographic information, as well as post-operative problems and the history of a preoperative CT scan for evaluating and grading DNS, were all collected. Results: For DNS, a total of 60 patients underwent septoplasty. The average age of the patients who had a preoperative CT scan was 30.The remaining 30 patients did not get a pre-operative CT scan to rule out DNS. Nasal obstruction was the most common problem (28.3%), followed by external nose deformity (20 percent). A total of 47% of patients with postoperative nasal obstruction did not have a pre-operative CT scan. About 42% of patients with postoperative nasal deformity did not have a CT scan, whereas 33% of patients with postoperative bleeding and septal perforation did not have a CT scan. Conclusions: In conclusion, the study found that preoperative CT had insignificant efficacy in relieving nasal obstruction or minimising postoperative complications.
{"title":"Determining the Impact of Pre-Operative Computed Tomography Scan in Patients Underwent Septoplasty on the Postoperative Complications","authors":"Abdulwahid S. AlQahtani, Ramzi M. Dagriri, Radeif E. Shamakhi, Ahmad M. Alrasheed, Ahmed A. Etwadi, K. Alqahtani","doi":"10.9734/bpi/nfmmr/v2/2818f","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v2/2818f","url":null,"abstract":"Background: One of the most common causes of nasal obstruction in adults is a deviated nasal septum (DNS). Anterior rhinoscopy (AR), which is generally the first diagnostic procedure in the evaluation of obstructive nasal pathologies, is frequently insufficient in the assessment of the posterior nasal cavity, and paranasal sinus computed tomography(PNS CT) is the gold standard method for the evaluation of paranasal anatomy and inflammatory paranasal sinus pathologies .The goal was to prove that a pre-operative computed tomography scan was helpful in reducing post-septoplasty complications. \u0000Methods: All patients with clinically confirmed DNS who had surgical intervention at Khamis Mushayet General Hospital were included in a retrospective record-based analysis. Patients' demographic information, as well as post-operative problems and the history of a preoperative CT scan for evaluating and grading DNS, were all collected. \u0000Results: For DNS, a total of 60 patients underwent septoplasty. The average age of the patients who had a preoperative CT scan was 30.The remaining 30 patients did not get a pre-operative CT scan to rule out DNS. Nasal obstruction was the most common problem (28.3%), followed by external nose deformity (20 percent). \u0000A total of 47% of patients with postoperative nasal obstruction did not have a pre-operative CT scan. \u0000About 42% of patients with postoperative nasal deformity did not have a CT scan, whereas 33% of patients with postoperative bleeding and septal perforation did not have a CT scan. \u0000Conclusions: In conclusion, the study found that preoperative CT had insignificant efficacy in relieving nasal obstruction or minimising postoperative complications.","PeriodicalId":19158,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 2","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81006288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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