Pub Date : 2022-11-30DOI: 10.15587/2519-4798.2022.269967
A. Rani, B. N. Jacintha, Khuteja Khatoon, M. Harechandana, M. Mamatha
GDM is associated with an adverse fetal and neonatal outcome that often presents with macrosomia, birth trauma, neonatal hypoglycemia, and respiratory distress syndrome. The inclusion of GDM into 'the great obstetrical syndromes' emphasizes the role of the placenta in interactions between the maternal and fetal unit. The aim: To study pathological changes in the placentas of gestational diabetes mellitus and its association with fetal outcome. Materials and methods: The Prospective study was conducted among pregnant women above the age of 18 years diagnosed with gestational diabetes attending the hospital. All patients are subjected to complete physical examination along with obstetric examination. All the routine investigations, including the complete blood counts, blood picture, RBS, RFT, LFT, OGTT, CUE and, ultrasonography with doppler, histopathological examination of the placenta after delivery. Results: The weight of the babies born to GDM mothers and normal mothers were compared, and the GDM mother's baby weighed higher, meaning diabetes has an effect on the baby's weight which was statistically significant. Comparison of the placenta was made for cases and controls; the result suggested all the morphological parameters placenta - weight (p<0.001), diameter (p<0.001), area (p<0.002) and thickness (p<0.001) were statistically significant. The complications reported were respiratory complications, hypoglycemia, hyperbilirubinemia, meconium staining, polycythemia, sepsis and hypocalcemia. Babies of gestational diabetic mothers have a higher risk of developing neonatal complications than non-diabetic mothers. Villous oedema, villous fibrosis, syncytial knots, and fibrinoid necrosis is seen on histopathological examination was <0.05, and hence there was a significant difference between these findings in both the groups. Conclusions: GDM is associated with the adverse fetal and neonatal outcome that often presents with respiratory complications, hypoglycemia, hyperbilirubinemia, meconium staining, polycythemia, sepsis and hypocalcemia. Including GDM into 'the great obstetrical syndromes' emphasizes the role of the placenta in interactions between the maternal and fetal unit
{"title":"Study of pathological changes in placentas of gestational diabetes mellitus and its association with fetal outcome","authors":"A. Rani, B. N. Jacintha, Khuteja Khatoon, M. Harechandana, M. Mamatha","doi":"10.15587/2519-4798.2022.269967","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.269967","url":null,"abstract":"GDM is associated with an adverse fetal and neonatal outcome that often presents with macrosomia, birth trauma, neonatal hypoglycemia, and respiratory distress syndrome. The inclusion of GDM into 'the great obstetrical syndromes' emphasizes the role of the placenta in interactions between the maternal and fetal unit. \u0000The aim: To study pathological changes in the placentas of gestational diabetes mellitus and its association with fetal outcome. \u0000Materials and methods: The Prospective study was conducted among pregnant women above the age of 18 years diagnosed with gestational diabetes attending the hospital. All patients are subjected to complete physical examination along with obstetric examination. All the routine investigations, including the complete blood counts, blood picture, RBS, RFT, LFT, OGTT, CUE and, ultrasonography with doppler, histopathological examination of the placenta after delivery. \u0000Results: The weight of the babies born to GDM mothers and normal mothers were compared, and the GDM mother's baby weighed higher, meaning diabetes has an effect on the baby's weight which was statistically significant. Comparison of the placenta was made for cases and controls; the result suggested all the morphological parameters placenta - weight (p<0.001), diameter (p<0.001), area (p<0.002) and thickness (p<0.001) were statistically significant. The complications reported were respiratory complications, hypoglycemia, hyperbilirubinemia, meconium staining, polycythemia, sepsis and hypocalcemia. Babies of gestational diabetic mothers have a higher risk of developing neonatal complications than non-diabetic mothers. Villous oedema, villous fibrosis, syncytial knots, and fibrinoid necrosis is seen on histopathological examination was <0.05, and hence there was a significant difference between these findings in both the groups. \u0000Conclusions: GDM is associated with the adverse fetal and neonatal outcome that often presents with respiratory complications, hypoglycemia, hyperbilirubinemia, meconium staining, polycythemia, sepsis and hypocalcemia. Including GDM into 'the great obstetrical syndromes' emphasizes the role of the placenta in interactions between the maternal and fetal unit","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88427971","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 : 2022-09-30DOI: 10.15587/2519-4798.2022.265388
T. Yaroshevska, K. Skriabina
Diagnosing inflammatory bowel diseases in children and differentiating them from functional disorders is complicated based on clinical assessment, laboratory data, and radiological, endoscopic, and histological signs. Therefore, in paediatrics, substantial attention has been given to standard invasive evaluation methods. Recently, research efforts have been directed towards using faecal calprotectin as a sensitive non-invasive stool test. The aim of the research was to study the diagnostic value of faecal calprotectin in pediatric chronic inflammatory bowel diseases. The paper discusses faecal calprotectin's diagnostic and monitoring role in 35 children aged 3 to 17 years with ulcerative colitis, non-specific non-ulcerative colitis, and irritable bowel syndrome. The concentration of the faecal calprotectin level was examined by ELISA using monoclonal antibodies. Results. The study shows that in patients with non-specific ulcerative and non-ulcerative colitis, the faecal calprotectin level exceeds the normal ranges 2-5 times, corresponding to clinical and morphological manifestations of the diseases and the level of inflammatory markers. However, this biological marker does not exceed the average values in children with irritable bowel syndrome. Conclusions. The faecal calprotectin test allows us to differentiate organic and functional intestinal diseases, monitor chronic inflammatory bowel disease activity dynamics, and estimate treatment effectiveness. Applying the faecal calprotectin test within the framework of primary medical care can decrease the number of referrals for invasive endoscopic, laboratory, and radiologic examinations in pediatric patients with inflammatory bowel diseases
{"title":"Diagnostic approach to chronic bowel diseases in children","authors":"T. Yaroshevska, K. Skriabina","doi":"10.15587/2519-4798.2022.265388","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.265388","url":null,"abstract":"Diagnosing inflammatory bowel diseases in children and differentiating them from functional disorders is complicated based on clinical assessment, laboratory data, and radiological, endoscopic, and histological signs. Therefore, in paediatrics, substantial attention has been given to standard invasive evaluation methods. Recently, research efforts have been directed towards using faecal calprotectin as a sensitive non-invasive stool test. \u0000The aim of the research was to study the diagnostic value of faecal calprotectin in pediatric chronic inflammatory bowel diseases. The paper discusses faecal calprotectin's diagnostic and monitoring role in 35 children aged 3 to 17 years with ulcerative colitis, non-specific non-ulcerative colitis, and irritable bowel syndrome. The concentration of the faecal calprotectin level was examined by ELISA using monoclonal antibodies. \u0000Results. The study shows that in patients with non-specific ulcerative and non-ulcerative colitis, the faecal calprotectin level exceeds the normal ranges 2-5 times, corresponding to clinical and morphological manifestations of the diseases and the level of inflammatory markers. However, this biological marker does not exceed the average values in children with irritable bowel syndrome. \u0000Conclusions. The faecal calprotectin test allows us to differentiate organic and functional intestinal diseases, monitor chronic inflammatory bowel disease activity dynamics, and estimate treatment effectiveness. Applying the faecal calprotectin test within the framework of primary medical care can decrease the number of referrals for invasive endoscopic, laboratory, and radiologic examinations in pediatric patients with inflammatory bowel diseases","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76272562","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 : 2022-09-30DOI: 10.15587/2519-4798.2022.265104
P. Jyothi, D. Vanisree, D. S. Murty, Kolli Prasanthi
Chronic liver diseases (CLD) cause significant morbidity and mortality worldwide, accounting for approximately 2 million deaths annually. The majority of CLDs include alcoholic liver disease, chronic viral hepatitis, including hepatitis B and C, non-alcoholic fatty liver disease (NAFLD), and hemochromatosis. Of these, hepatitis B virus (HBV) and hepatitis C virus (HCV) infections account for a substantial proportion of liver diseases which is responsible for liver damage ranging from minor disorders to liver cirrhosis and hepatocellular carcinoma (HCC). Fibroscan is a novel non-invasive method for assessing hepatic fibrosis by measuring liver stiffness. The aim. The present study was conducted to know the prevalence of blood-born viral pathogens (HBV, HCV) among patients with chronic liver diseases (CLD) and also to assess the role of Fibroscan and liver function tests (LFT) in evaluating the extent of chronic liver disease. Material and methods: The present study comprised 100 chronic liver disease patients attending the gastroenterology department. All the chronic liver disease cases were tested for Hepatitis B and Hepatitis C viral infections using a rapid Immunochromatography assay. Simultaneously they were subjected to liver function tests and fibroscan to assess the extent of fibrosis by staging from F0 to F4. Results: When screened for bloodborne viral pathogens, 46 % were HBV positive, 10 % were HCV, and none were HIV positive. No co-infection was detected. HBV was identified as the most typical cause of CLD in about 46 %, followed by non-viral/non-infectious (alcoholic, metabolic, autoimmune) cause in 44 % and 10 %, the cause for CLD was HCV. As per fibroscan results, 80 % of HCV and 39 % of HBV patients were in the stage of cirrhosis/advanced fibrosis. Conclusion: HBV was the predominant cause of CLD. Liver stiffness has recently been shown to be a good predictor of clinical outcomes. A fibroscan will help in the decision-making process in staging the disease and choice of treatment in viral hepatitis cases
{"title":"Role of fibroscan in assessing the extent of liver involvement among chronic hepatitis B and C cases","authors":"P. Jyothi, D. Vanisree, D. S. Murty, Kolli Prasanthi","doi":"10.15587/2519-4798.2022.265104","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.265104","url":null,"abstract":"Chronic liver diseases (CLD) cause significant morbidity and mortality worldwide, accounting for approximately 2 million deaths annually. The majority of CLDs include alcoholic liver disease, chronic viral hepatitis, including hepatitis B and C, non-alcoholic fatty liver disease (NAFLD), and hemochromatosis. Of these, hepatitis B virus (HBV) and hepatitis C virus (HCV) infections account for a substantial proportion of liver diseases which is responsible for liver damage ranging from minor disorders to liver cirrhosis and hepatocellular carcinoma (HCC). Fibroscan is a novel non-invasive method for assessing hepatic fibrosis by measuring liver stiffness. \u0000The aim. The present study was conducted to know the prevalence of blood-born viral pathogens (HBV, HCV) among patients with chronic liver diseases (CLD) and also to assess the role of Fibroscan and liver function tests (LFT) in evaluating the extent of chronic liver disease. \u0000Material and methods: The present study comprised 100 chronic liver disease patients attending the gastroenterology department. All the chronic liver disease cases were tested for Hepatitis B and Hepatitis C viral infections using a rapid Immunochromatography assay. Simultaneously they were subjected to liver function tests and fibroscan to assess the extent of fibrosis by staging from F0 to F4. \u0000Results: When screened for bloodborne viral pathogens, 46 % were HBV positive, 10 % were HCV, and none were HIV positive. No co-infection was detected. HBV was identified as the most typical cause of CLD in about 46 %, followed by non-viral/non-infectious (alcoholic, metabolic, autoimmune) cause in 44 % and 10 %, the cause for CLD was HCV. As per fibroscan results, 80 % of HCV and 39 % of HBV patients were in the stage of cirrhosis/advanced fibrosis. \u0000Conclusion: HBV was the predominant cause of CLD. Liver stiffness has recently been shown to be a good predictor of clinical outcomes. A fibroscan will help in the decision-making process in staging the disease and choice of treatment in viral hepatitis cases","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"36 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77927144","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 : 2022-09-30DOI: 10.15587/2519-4798.2022.265395
G. Sanjeevani, Paniharam Ramakanth, Adhi Chaitanya
Caregivers of cancer patients were prone to deterioration of their QOL due to the caregiving burden. A high caregiving burden and low QOL were common among CG. In India, only a few studies were done on the caregivers of cancer patients. Hence this study was undertaken. The aim: To study psychopathology, quality of life and burden in caregivers of cancer patients Materials and methods: The study was done on 100 caregivers of cancer patients attending after fulfilling the inclusion criteria. A semi-structured Proforma was administrated to collect the socio-demographic details. Following by Mini International Neuropsychiatric Interview (MINI), WHO-QOL and Burden assessment scale was administered to the caregivers. Data were analysed using SPSS. Descriptive statistics, Pearson and Spearman Correlations and ANOVA were used. Results: 31 % of caregivers suffer from generalised anxiety disorders (15 %) and depression (16 %). The environmental domain of QOL (mean-18.2, SD-15.4) was the most affected. 83 % of caregivers experienced a moderate burden, and 17 % had a severe burden. These variables are significantly associated with caregiver relation with patient and socio-economic status (<0.05). A significant correlation was found between Psychiatric morbidity, QOL and Burden in caregivers. Conclusion: psychiatric morbidity, quality of life and burden in CGs influence one another. The least attention was paid to caregivers' mental health, many of them left unidentified and untreated. These results highlight the need to educate them about mental health and counsel and treat them for their psychiatric problems
{"title":"A cross-sectional study of psychopathology, quality of life and caregiver burden in caregivers of cancer patients","authors":"G. Sanjeevani, Paniharam Ramakanth, Adhi Chaitanya","doi":"10.15587/2519-4798.2022.265395","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.265395","url":null,"abstract":"Caregivers of cancer patients were prone to deterioration of their QOL due to the caregiving burden. A high caregiving burden and low QOL were common among CG. In India, only a few studies were done on the caregivers of cancer patients. Hence this study was undertaken. \u0000The aim: To study psychopathology, quality of life and burden in caregivers of cancer patients \u0000Materials and methods: The study was done on 100 caregivers of cancer patients attending after fulfilling the inclusion criteria. A semi-structured Proforma was administrated to collect the socio-demographic details. Following by Mini International Neuropsychiatric Interview (MINI), WHO-QOL and Burden assessment scale was administered to the caregivers. Data were analysed using SPSS. Descriptive statistics, Pearson and Spearman Correlations and ANOVA were used. \u0000Results: 31 % of caregivers suffer from generalised anxiety disorders (15 %) and depression (16 %). The environmental domain of QOL (mean-18.2, SD-15.4) was the most affected. 83 % of caregivers experienced a moderate burden, and 17 % had a severe burden. These variables are significantly associated with caregiver relation with patient and socio-economic status (<0.05). A significant correlation was found between Psychiatric morbidity, QOL and Burden in caregivers. \u0000Conclusion: psychiatric morbidity, quality of life and burden in CGs influence one another. The least attention was paid to caregivers' mental health, many of them left unidentified and untreated. These results highlight the need to educate them about mental health and counsel and treat them for their psychiatric problems","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83179080","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}
Aim: To know the prevalence of overt and subclinical thyroid disorders in Indian pregnant women and to know the effect of overt and subclinical thyroid dysfunction on maternal and fetal outcome. Materials and methods: This study was conducted at the Government Maternity Hospital, sultan bazaar, Osmania medical college, Hyderabad over a period of 15 months from august 2016 to October 2017. 1000 pregnant women who attended the antenatal clinic were screened for the thyroid dysfunction. Serum TSH level estimated. fT3, fT4 and anti TPO Ab levels were estimated if the TSH level was abnormal. Patients were managed accordingly and followed till the delivery. Maternal and fetal outcome recorded. Results: It was a prospective study done on 1000 antenatal women. Prevalence of thyroid disorder in this study was 11.3%. Prevalence of subclinical, overt hypothyroidism, subclinical and overt hyperthyroidism was 9.4%, 1.4%, 0.4% and 0.1% respectively. Subclinical hypothyroidism was associated with complications like preeclampsia (13.8%), Anaemia (15.95%), preterm delivery (6.38%), Intrauterine growth restriction (4.25%), low birth weight (12.76%) and Intrauterine fetal death)(2.12%). Overt hypothyroidism was associated with complications like Preeclampsia (14.28%), anaemia (21.4%), Preterm delivery (14.28%), intrauterine growth restriction (14.28%), low birth weight (21.4%) and Intrauterine fetal death (7.14%). Incidence of CD was 18.05% in women with hypothyroidism. Subclinical hyperthyroidism was associated with complications like Preeclampsia, Preterm delivery, Intrauterine growth restriction, Intrauterine fetal death. Conclusion: Thyroid disorders in pregnancy are significantly associated with both maternal and fetal complications and adversely affect the outcome of pregnancy. Hence, early identification of thyroid disorders and timely initiation of treatment is essential
{"title":"Prevalence of overt and subclinical thyroid dysfunction in pregnant women and outcome in a tertiary care centre","authors":"Lakshmi Aravelli, Amritha Aurora Meduri, Swathi Rallabhandi, Kundena Srilakshmi","doi":"10.15587/2519-4798.2022.265721","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.265721","url":null,"abstract":"Aim: To know the prevalence of overt and subclinical thyroid disorders in Indian pregnant women and to know the effect of overt and subclinical thyroid dysfunction on maternal and fetal outcome. \u0000Materials and methods: This study was conducted at the Government Maternity Hospital, sultan bazaar, Osmania medical college, Hyderabad over a period of 15 months from august 2016 to October 2017. 1000 pregnant women who attended the antenatal clinic were screened for the thyroid dysfunction. Serum TSH level estimated. fT3, fT4 and anti TPO Ab levels were estimated if the TSH level was abnormal. Patients were managed accordingly and followed till the delivery. Maternal and fetal outcome recorded. \u0000Results: It was a prospective study done on 1000 antenatal women. Prevalence of thyroid disorder in this study was 11.3%. Prevalence of subclinical, overt hypothyroidism, subclinical and overt hyperthyroidism was 9.4%, 1.4%, 0.4% and 0.1% respectively. Subclinical hypothyroidism was associated with complications like preeclampsia (13.8%), Anaemia (15.95%), preterm delivery (6.38%), Intrauterine growth restriction (4.25%), low birth weight (12.76%) and Intrauterine fetal death)(2.12%). Overt hypothyroidism was associated with complications like Preeclampsia (14.28%), anaemia (21.4%), Preterm delivery (14.28%), intrauterine growth restriction (14.28%), low birth weight (21.4%) and Intrauterine fetal death (7.14%). Incidence of CD was 18.05% in women with hypothyroidism. Subclinical hyperthyroidism was associated with complications like Preeclampsia, Preterm delivery, Intrauterine growth restriction, Intrauterine fetal death. \u0000Conclusion: Thyroid disorders in pregnancy are significantly associated with both maternal and fetal complications and adversely affect the outcome of pregnancy. Hence, early identification of thyroid disorders and timely initiation of treatment is essential","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79272625","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 : 2022-09-30DOI: 10.15587/2519-4798.2022.265543
Nindra Armugam, Zohaib Saleem, Chandipriya Veluru, E. Ramanjaneyulu
The aims: to dosimetrically evaluate the dose to the heart and left anterior descending artery in left-sided early breast cases using different techniques. Materials and methods: Prospective observational/analytical study done in cases of left-sided BCS referred for adjuvant RT in 54 patients. Patients who underwent left-sided BCS (breast conservative surgery), patients aged between 18- and 75 years performance status ECOG 0-2, histological confirmed DCIS, Invasive Breast Cancer-Stage 1, 2, 3, patients without any evidence of metastatic disease Irrespective of hormonal receptor and HER-2 neu status are included in the study. Results: All the 3 parameters for LAD showed the highest doses with 3DCRT and lowest with VMAT. Thus our study favoured VMAT (p<0.01) as the planning technique to achieve the least doses of LAD. However, for the heart, there was no statistically significant difference between 3DCRT and IMRT (p=0.349) for the average mean dose (Gy). On the other hand, there was a statistically significant difference between 3DCRT Vs VMAT and IMRT Vs VMAT (95 % CI, p<0.01), again favouring VMAT as the choice of planning technique. The average heart max dose(Gy) and average heart V20(%) showed statistically significant benefits with VMAT (p<0.01). There was a statistically significant benefit (p<0.000) with VMAT for both LV parameters. At the same time, there was a statistically significant benefit in terms of ipsilateral lung dose with VMAT(p<0.000), the dose to the right lung, right breast and favoured 3DCRT (p<0.01). PTV95 % (Gy) by 3DCRT, IMRT, and VMAT in our study is 41.01, 41.96, and 41.76, respectively. Though the difference between the 3 techniques seems meagre, there was a statistically significant difference (p<0.012) favouring IMRT. Conclusion: We conclude that using the VMAT technique in radiotherapy for left-sided breast cancer can significantly reduce radiation doses to the heart and LAD, potentially reducing cardiac risk. For all patients, the cardiac doses are considerably decreased for all dose levels without compromising the dose coverage to PTV, which is an advantage over IMRT and 3DCRT
目的:对不同治疗方法对早期左乳患者心脏及左前降支的剂量进行剂量学评价。材料和方法:对54例左侧BCS患者进行辅助RT的前瞻性观察/分析研究。接受左侧BCS(乳房保守手术)的患者，年龄在18- 75岁之间的患者，ECOG 0-2，组织学证实的DCIS，浸润性乳腺癌- 1、2、3期，无任何转移性疾病证据的患者，无论激素受体和HER-2新状态如何，均纳入研究。结果:LAD 3项指标均显示3DCRT剂量最高，VMAT剂量最低。因此，我们的研究倾向于VMAT (p<0.01)作为实现最小LAD剂量的计划技术。然而，对于心脏，3DCRT和IMRT的平均剂量(Gy)无统计学差异(p=0.349)。另一方面，3DCRT Vs VMAT与IMRT Vs VMAT之间的差异有统计学意义(95% CI, p<0.01)，再次倾向于VMAT作为计划技术的选择。平均心脏最大剂量(Gy)和平均心脏V20(%)显示VMAT有统计学意义(p<0.01)。VMAT在两个LV参数上都有统计学上显著的获益(p<0.000)。同时，VMAT组的同侧肺剂量(p<0.000)、对右肺、右乳及3DCRT的剂量(p<0.01)均有统计学意义。本研究3DCRT、IMRT和VMAT的ptv95% (Gy)分别为41.01、41.96和41.76。虽然这三种技术之间的差异似乎微不足道，但有统计学意义上的显著差异(p<0.012)有利于IMRT。结论:VMAT技术用于左侧乳腺癌放疗可显著降低对心脏和LAD的辐射剂量，潜在降低心脏风险。对于所有患者，在所有剂量水平下，心脏剂量都大大降低，而不影响PTV的剂量覆盖，这比IMRT和3DCRT有优势
{"title":"Dosimetric evaluation of cardiac and left anterior descending artery dose in patients with left-sided breast cancer treated by different techniques of hypofractionated adjuvant radiotherapy after breast conservative surgery","authors":"Nindra Armugam, Zohaib Saleem, Chandipriya Veluru, E. Ramanjaneyulu","doi":"10.15587/2519-4798.2022.265543","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.265543","url":null,"abstract":"The aims: to dosimetrically evaluate the dose to the heart and left anterior descending artery in left-sided early breast cases using different techniques. \u0000Materials and methods: Prospective observational/analytical study done in cases of left-sided BCS referred for adjuvant RT in 54 patients. Patients who underwent left-sided BCS (breast conservative surgery), patients aged between 18- and 75 years performance status ECOG 0-2, histological confirmed DCIS, Invasive Breast Cancer-Stage 1, 2, 3, patients without any evidence of metastatic disease Irrespective of hormonal receptor and HER-2 neu status are included in the study. \u0000Results: All the 3 parameters for LAD showed the highest doses with 3DCRT and lowest with VMAT. Thus our study favoured VMAT (p<0.01) as the planning technique to achieve the least doses of LAD. However, for the heart, there was no statistically significant difference between 3DCRT and IMRT (p=0.349) for the average mean dose (Gy). On the other hand, there was a statistically significant difference between 3DCRT Vs VMAT and IMRT Vs VMAT (95 % CI, p<0.01), again favouring VMAT as the choice of planning technique. The average heart max dose(Gy) and average heart V20(%) showed statistically significant benefits with VMAT (p<0.01). There was a statistically significant benefit (p<0.000) with VMAT for both LV parameters. At the same time, there was a statistically significant benefit in terms of ipsilateral lung dose with VMAT(p<0.000), the dose to the right lung, right breast and favoured 3DCRT (p<0.01). PTV95 % (Gy) by 3DCRT, IMRT, and VMAT in our study is 41.01, 41.96, and 41.76, respectively. Though the difference between the 3 techniques seems meagre, there was a statistically significant difference (p<0.012) favouring IMRT. \u0000Conclusion: We conclude that using the VMAT technique in radiotherapy for left-sided breast cancer can significantly reduce radiation doses to the heart and LAD, potentially reducing cardiac risk. For all patients, the cardiac doses are considerably decreased for all dose levels without compromising the dose coverage to PTV, which is an advantage over IMRT and 3DCRT","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"56 5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77835406","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 : 2022-09-30DOI: 10.15587/2519-4798.2022.265313
Katakonda Sunitha, M. P. Akarsh, Geethavani. Panchakarla
Primary central nervous system (CNS) tumours are rare, but they are the second most common in childhood after the most common malignancy, leukaemia. They are considered the most notorious of all cancers. They represent characteristics of a unique, heterogeneous population of neoplasms with benign and malignant tumours and are reported to be less than 2 % of all malignant neoplasms. The aim of the study: To study various tumours of the central nervous system (CNS) Methods: A prospective study on CNS tumours was conducted in the department of Pathology, Guntur Medical College, Guntur, for two years, from June 2011 to May 2013. The data necessary for the study has been retrieved from the histopathology records at the department. 104 cases of CNS tumours were studied in detail, correlating the clinical, radiological and histopathological findings. The department of neurosurgery has provided the biopsy material. The applied nomenclature is that adopted by the 2007 WHO classification. Results: The tumours have been encountered in all age groups, from infants to 80yr elderly persons. The highest frequency is seen in the age group of 41 to 50 years (27 %), followed by 51 to 60 years age group (19 %). The most common tumour reported was astrocytomas constituting 21.1 % (22/104), followed by schwannomas constituting 19.2 % (20/104). least reported was plasmacytoma astrobalstoma 0.9 % (1/104). Conclusion: Adequate imaging by CT/MRI is an essential aid in the diagnosis. Although H&E staining is the mainstay for histopathological diagnosis, immunohistochemistry has played a significant role in diagnostic accuracy. In addition, the judicious use of a panel of selected antibodies is helpful in diagnostically challenging cases
{"title":"Study of histopathology of tumors of the central nervous system in a teaching hospital","authors":"Katakonda Sunitha, M. P. Akarsh, Geethavani. Panchakarla","doi":"10.15587/2519-4798.2022.265313","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.265313","url":null,"abstract":"Primary central nervous system (CNS) tumours are rare, but they are the second most common in childhood after the most common malignancy, leukaemia. They are considered the most notorious of all cancers. They represent characteristics of a unique, heterogeneous population of neoplasms with benign and malignant tumours and are reported to be less than 2 % of all malignant neoplasms. \u0000The aim of the study: To study various tumours of the central nervous system (CNS) \u0000Methods: A prospective study on CNS tumours was conducted in the department of Pathology, Guntur Medical College, Guntur, for two years, from June 2011 to May 2013. The data necessary for the study has been retrieved from the histopathology records at the department. 104 cases of CNS tumours were studied in detail, correlating the clinical, radiological and histopathological findings. The department of neurosurgery has provided the biopsy material. The applied nomenclature is that adopted by the 2007 WHO classification. \u0000Results: The tumours have been encountered in all age groups, from infants to 80yr elderly persons. The highest frequency is seen in the age group of 41 to 50 years (27 %), followed by 51 to 60 years age group (19 %). The most common tumour reported was astrocytomas constituting 21.1 % (22/104), followed by schwannomas constituting 19.2 % (20/104). least reported was plasmacytoma astrobalstoma 0.9 % (1/104). \u0000Conclusion: Adequate imaging by CT/MRI is an essential aid in the diagnosis. Although H&E staining is the mainstay for histopathological diagnosis, immunohistochemistry has played a significant role in diagnostic accuracy. In addition, the judicious use of a panel of selected antibodies is helpful in diagnostically challenging cases","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"217 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85539829","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 : 2022-09-30DOI: 10.15587/2519-4798.2022.265222
E. Satvaldieva, Eldor Turgun ugli Kuralov
The aim of the study. To improve the quality of perioperative analgesia by combined multimodal use of paracetamol and ketorolac tromethamine in children after abdominal surgery. Materials and methods. 48 children (6-17 years old) with choledochal, pancreatic cysts, hepatic echinococcosis, and abdominal trauma. The study period was from January 2021 to January 2022. Group 1 (main group, n=28): baseline analgesia - 15 min before surgery, intravenous paracetamol administration at 25-30 mg/kg. In order to prevent postoperative pain syndrome 15 minutes before the end of the surgery, we administered ketorolac and tromethamine in a dose of 0.5 mg/kg. Pain relief was repeated 6-8 h later with ketorolac at a dose of 0.5 mg/kg. Group 2 (comparison, n=20), who received 0.2 – 0.3 mg/kg promedol (trimeperidin) in the postoperative period. Both groups received standard endotracheal anaesthesia (propofol + fentanyl + arduan against the background of Low-flow anaesthesia with sevoflurane MAK=1). Systemic haemodynamics, C-reactive protein, and glucose were investigated, and a visual analogue scale was applied at the main stages of the study. Results: Analysis of the parameters of central hemodynamics, parameters of the operational stress response and clinical data showed that in the postoperative period, sufficient analgesic effect was established only in children in group 1 with the preventive combined administration of paracetamol and ketorolac on the operating table, which allows recommending them in the practice of perioperative analgesia during abdominal surgical interventions. Conclusions. Optimised method of preventive (preoperative) use of paracetamol in children at a dose of 25-30 mg/kg during abdominal surgery followed by administration of ketorolac tromethamine (15 minutes before the end of the surgery) increases the degree of nociceptive protection. It ensures high efficiency of postoperative pain relief, which allows to recommend it in the practice of perioperative analgesia for the above abdominal surgical interventions in children
{"title":"Optimisation of acute pain treatment in children in abdominal surgery at the stages of the perioperative period","authors":"E. Satvaldieva, Eldor Turgun ugli Kuralov","doi":"10.15587/2519-4798.2022.265222","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.265222","url":null,"abstract":"The aim of the study. To improve the quality of perioperative analgesia by combined multimodal use of paracetamol and ketorolac tromethamine in children after abdominal surgery. \u0000Materials and methods. 48 children (6-17 years old) with choledochal, pancreatic cysts, hepatic echinococcosis, and abdominal trauma. The study period was from January 2021 to January 2022. Group 1 (main group, n=28): baseline analgesia - 15 min before surgery, intravenous paracetamol administration at 25-30 mg/kg. In order to prevent postoperative pain syndrome 15 minutes before the end of the surgery, we administered ketorolac and tromethamine in a dose of 0.5 mg/kg. Pain relief was repeated 6-8 h later with ketorolac at a dose of 0.5 mg/kg. Group 2 (comparison, n=20), who received 0.2 – 0.3 mg/kg promedol (trimeperidin) in the postoperative period. Both groups received standard endotracheal anaesthesia (propofol + fentanyl + arduan against the background of Low-flow anaesthesia with sevoflurane MAK=1). Systemic haemodynamics, C-reactive protein, and glucose were investigated, and a visual analogue scale was applied at the main stages of the study. \u0000Results: Analysis of the parameters of central hemodynamics, parameters of the operational stress response and clinical data showed that in the postoperative period, sufficient analgesic effect was established only in children in group 1 with the preventive combined administration of paracetamol and ketorolac on the operating table, which allows recommending them in the practice of perioperative analgesia during abdominal surgical interventions. \u0000Conclusions. Optimised method of preventive (preoperative) use of paracetamol in children at a dose of 25-30 mg/kg during abdominal surgery followed by administration of ketorolac tromethamine (15 minutes before the end of the surgery) increases the degree of nociceptive protection. It ensures high efficiency of postoperative pain relief, which allows to recommend it in the practice of perioperative analgesia for the above abdominal surgical interventions in children","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74808232","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 : 2022-09-30DOI: 10.15587/2519-4798.2022.265238
A. Suprun, Victor Lysenko
The aim. The paper evaluates the effectiveness of implemented combined anaesthesia (inhalation with paravertebral blockade) in comparison with inhalation anaesthesia (IA) and total intravenous anaesthesia (TVA) at the stages of surgery and the early postoperative period in the surgical treatment of cancer lungs. Methods. The study involved 60 patients with an average age of 55±5.6 years, physical status ASA II–III, who underwent open surgical interventions in the scope of frontal or pneumonectomy or resection of part of the lung. Patients were divided into 3 groups depending on the method of anaesthetic support at the stage of anaesthesia maintenance: I (n=20) – combined anaesthesia was used; II (n=20) – IA with sevoflurane; III (n=20) – TVA. In addition, the leading indicators of central hemodynamics were studied; oxygen saturation (SaO2), CO2 ET (concentration of CO2 in exhaled air), cortisol level, and indicators of acid-base status were determined. The effectiveness of analgesia in the early postoperative period was assessed using a visual analogue scale (VAS) at 10 control stages. Fasting intensity was recorded after waking up, after extubation, after 1 h. after surgery, on the first day after surgery every 3 h. and once a day from the 2nd day for 5-6 days. Results. The studied clinical and laboratory indicators indicated an adequate course of the applied type of anaesthesia. In the dynamics of pain syndrome (PS) in the postoperative period, a gradual subjective increase of pain syndrome was noted until the 3rd day, including a decrease in pain on the 4th - 6th day. It was established that when using combined anaesthesia, a less significant level of PS, according to VAS, was noted compared to inhalation anaesthesia and the use of TVA. Conclusions. Combined anaesthesia (inhalation with PVB) can more effectively prevent the development of post-thoracotomy pain syndrome (PTPS) compared to TVA and IA in the surgical treatment of lung cancer
{"title":"Evaluation of the efficacy of paravertebral blockade as a component of combined anesthesia in the surgical treatment of pulmonary cancer","authors":"A. Suprun, Victor Lysenko","doi":"10.15587/2519-4798.2022.265238","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.265238","url":null,"abstract":"The aim. The paper evaluates the effectiveness of implemented combined anaesthesia (inhalation with paravertebral blockade) in comparison with inhalation anaesthesia (IA) and total intravenous anaesthesia (TVA) at the stages of surgery and the early postoperative period in the surgical treatment of cancer lungs. \u0000Methods. The study involved 60 patients with an average age of 55±5.6 years, physical status ASA II–III, who underwent open surgical interventions in the scope of frontal or pneumonectomy or resection of part of the lung. Patients were divided into 3 groups depending on the method of anaesthetic support at the stage of anaesthesia maintenance: I (n=20) – combined anaesthesia was used; II (n=20) – IA with sevoflurane; III (n=20) – TVA. In addition, the leading indicators of central hemodynamics were studied; oxygen saturation (SaO2), CO2 ET (concentration of CO2 in exhaled air), cortisol level, and indicators of acid-base status were determined. The effectiveness of analgesia in the early postoperative period was assessed using a visual analogue scale (VAS) at 10 control stages. Fasting intensity was recorded after waking up, after extubation, after 1 h. after surgery, on the first day after surgery every 3 h. and once a day from the 2nd day for 5-6 days. \u0000Results. The studied clinical and laboratory indicators indicated an adequate course of the applied type of anaesthesia. In the dynamics of pain syndrome (PS) in the postoperative period, a gradual subjective increase of pain syndrome was noted until the 3rd day, including a decrease in pain on the 4th - 6th day. It was established that when using combined anaesthesia, a less significant level of PS, according to VAS, was noted compared to inhalation anaesthesia and the use of TVA. \u0000Conclusions. Combined anaesthesia (inhalation with PVB) can more effectively prevent the development of post-thoracotomy pain syndrome (PTPS) compared to TVA and IA in the surgical treatment of lung cancer","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78978415","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 : 2022-09-30DOI: 10.15587/2519-4798.2022.263490
V. Dunaevskaya, Evgenia Loginova, Pavlina Botsuin, Nataliia Bohonis
Timely diagnosis and effective treatment of precancerous diseases of the female genital organs prevent the development of oncogynecological diseases. Vulvar intraepithelial neoplasia is a precancerous disease characterized by lesions of the stratified squamous epithelium with impaired maturation and normal keratinization of cells, but without inclusion of the basement membrane in the pathological process. The main methods of diagnosis of vulvar intraepithelial neoplasia are vulvoscopy, cytological and histological examination. The aim of this study was to assess the clinical significance and effectiveness of different sampling methods for cytological examination in comparison with histological report. Materials and methods. The study involved 235 women aged 35-79 years, with a mean age of 57±11,3 years with complaints of pain, burning, discomfort and itching in the vulva. All patients underwent a simple vulvoscopy, where atrophy of the mucosa, partial or complete loss of the clitoris and / or labia minora, fissures, ecchymoses (haemorrhages), eroded surfaces, exophytic growths from 1 to 5 cm were detected. Material sampling was performed by various cytological methods. Results. According to the results of the study, no significant differences between the methods of cytological sampling were observed. The cytological report was compared to the result of histological examination of biopsies. According to the results of cytological examination, squamous cell carcinoma of the vulva was detected in 12 patients, atrophy was identified in 5 women and squamous epithelial scales cytologically detected in the remaining 218 women. Conclusions. The sensitivity and specificity of cytological examination methods were high in the presence of eroded surfaces and exophytic lesions. It was found that cytological research methods were not informative enough to detect vulvar cancer, which is in the stratum of hyperkeratosis, and was diagnosed in 5.1 % of patients. Therefore, for the reliability of the results and confirmation of the diagnosis it is necessary to conduct histological examination, with the help of which 14.9 % of patients were diagnosed with squamous cell carcinoma
{"title":"The results analysis of cytological examination of vulvar intraepithelial neoplasia compared to histology report","authors":"V. Dunaevskaya, Evgenia Loginova, Pavlina Botsuin, Nataliia Bohonis","doi":"10.15587/2519-4798.2022.263490","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.263490","url":null,"abstract":"Timely diagnosis and effective treatment of precancerous diseases of the female genital organs prevent the development of oncogynecological diseases. Vulvar intraepithelial neoplasia is a precancerous disease characterized by lesions of the stratified squamous epithelium with impaired maturation and normal keratinization of cells, but without inclusion of the basement membrane in the pathological process. The main methods of diagnosis of vulvar intraepithelial neoplasia are vulvoscopy, cytological and histological examination. \u0000The aim of this study was to assess the clinical significance and effectiveness of different sampling methods for cytological examination in comparison with histological report. \u0000Materials and methods. The study involved 235 women aged 35-79 years, with a mean age of 57±11,3 years with complaints of pain, burning, discomfort and itching in the vulva. All patients underwent a simple vulvoscopy, where atrophy of the mucosa, partial or complete loss of the clitoris and / or labia minora, fissures, ecchymoses (haemorrhages), eroded surfaces, exophytic growths from 1 to 5 cm were detected. Material sampling was performed by various cytological methods. \u0000Results. According to the results of the study, no significant differences between the methods of cytological sampling were observed. The cytological report was compared to the result of histological examination of biopsies. According to the results of cytological examination, squamous cell carcinoma of the vulva was detected in 12 patients, atrophy was identified in 5 women and squamous epithelial scales cytologically detected in the remaining 218 women. \u0000Conclusions. The sensitivity and specificity of cytological examination methods were high in the presence of eroded surfaces and exophytic lesions. It was found that cytological research methods were not informative enough to detect vulvar cancer, which is in the stratum of hyperkeratosis, and was diagnosed in 5.1 % of patients. Therefore, for the reliability of the results and confirmation of the diagnosis it is necessary to conduct histological examination, with the help of which 14.9 % of patients were diagnosed with squamous cell carcinoma","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90788950","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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