Quality of life among lung cancer patients undergoing treatment at a tertiary cancer institute in North India

2016-10-21T00-09-15Z
Source: International Journal of Research in Medical Sciences
Vijay Kumar Barwal, Salig Ram Mazta, Anita Thakur, Rajeev Kumar Seam, Manish Gupta.
Background: Lung cancer patients mostly present with advanced disease. Its treatment has shown limited progress in recent decades, so we studied their quality of life (QOL) and how it is affected during treatment. Methods: Patients ≥18 years of age, diagnosed/registered at our institute from 1st September 2012 through August 2013 were included in the study. QOL was assessed by means of the EORTC QLQ-C30 and QLQ-LC13. Data was analyzed using descriptive and inferential statistics Results: Out of 91 patients included in the study, 73 (80.2%) were males and 18 (19.8%) were females. Mean age of the study population was 59.24±10.53 years and median age was 60 years. A better QOL for nausea and vomiting (P=0.011), sleep disturbance (p=0.021), and coughing (p=0.016) was observed in female patients. There was significant worsening in symptom scales of fatigue (p=0.000), nausea and vomiting (p=0.000), sleep (0.006), appetite (p=0.000) and constipation (p=0.000). Though the mean scores of pain, dyspnoea and financial difficulties decreased, but they were not significant. According to the LC13 module, significant improvement was seen in the symptom scales of cough (p=0.000), haemoptysis (p=0.000) and pain chest (p=0.040). Conclusions: Lung cancer patients undergoing treatment suffer many limitations due to an array of symptoms and disruptions in various areas of QOL, arising from both the disease process and its treatment. It should be studied at every visit for each individual patient.


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Clinical spectrum and complications of scrub typhus: a single-centre, pilot observation from central India

2016-10-21T00-09-15Z
Source: International Journal of Research in Medical Sciences
Jay Deshmukh, Sandhya Saoji, Arjun Deshmukh, Vijay M. Katekhaye.
Background: Scrub typhus is known from various parts of India. However, reports from central India are lacking. We performed pilot observation of confirmed scrub typhus cases from a single, tertiary care centre from central India. Methods: A retrospective analysis of 16 IgM ELISA confirmed scrub typhus cases was done. Clinical features, signs, laboratory parameters and complications were identified. Age (40 years) and gender (male versuss female) specific comparisons were performed. Data were analysed descriptively with appropriate statistical tests. Results: Diagnosed cases of scrub typhus were frequent in patients aged below 40 years (68.8) and in females (81.2%). Fever (100%), nausea±vomiting (68.8%) and headache (56.2%) were common symptoms. Rash was reported in a single case whereas characteristic eschar of scrub typhus was not observed in any patient. Mean hospital stay duration did not vary either by gender or by age-groups. Laboratory abnormalities did not show any significant deviation by gender or age analysis except mean haemoglobin being lower in females than males (10.1±1.4 Vs 12.3±1.1, p


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Identification of patients at high risk for hypocalcemia after total thyroidectomy with serial calcium estimation and intact parathyroid hormone levels-a comparative study

2016-10-21T00-09-15Z
Source: International Journal of Research in Medical Sciences
Pauly T. J., Santhosh P. V., Santhosh T. V., Vinodh M..
Background: In recent years, multiple retrospective and prospective studies have emerged, which support the use of postoperative serum intact parathyroid hormone (iPTH) levels can also predict hypocalcaemia in postoperative thyroidectomy patients. Therefore, the present study was designed to determine the incidence of hypocalcaemia after total thyroidectomy. Methods: 146 patients who underwent total thyroidectomy were recruited. The incidence of hypocalcaemia was analyzed with serial calcium estimation results with 6 hours, 24 hours, 48 hours and 2 weeks post-operative calcium level estimations. The incidence of hypocalcaemia with regards to the number of parathyroid glands was determined and the results between the three groups were compared. Results: The incidence of transient hypocalcaemia at 24hr postoperative period and intact parathyroid hormone (iPTH) level showed a significant difference (p


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Giant adrenal myelolipoma - clinical spectrum and management: a single centre experience

2016-10-21T00-09-15Z
Source: International Journal of Research in Medical Sciences
Santosh Kumar, Ankur Mittal, Aditya Prakash Sharma, Abhinandan Mukhopadhyay.
Background: Adrenal myelolipomas are rare benign tumor composed of mature adipocytes and normal haematopoetic cells. Giant adrenal myelolipomas are rare clinical entities. Most of them are symptomatic. We present 15 such cases, their clinical spectrum and management. Methods: Retrospective analysis of giant adrenal myelolipomas from a tertiary level institute. Initial diagnosis was made by computed tomography. Results: Mean age of patient was 45.6±11 years with slightly higher female preponderance. All patients were overweight with predominantly left sided adrenal myelolipoma. Majority of them (93%) were symptomatic and presented with abdominal pain, anemia or fever. Mean size of the mass on imaging was 14 cm±6 cm, with largest lesion measuring 26 cm. Conclusions: The article highlights the varying clinical presentations including rare emergency presentations of giant adrenal myelolipomas. A brief literature review is also presented.


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Comparative study between histological changes in placenta from pre-eclampsia cases and normal pregnancy with special reference to cytotrophoblastic cell hyperplasia, villous stromal fibrosis and fibrinoid necrosis

2016-10-21T00-09-15Z
Source: International Journal of Research in Medical Sciences
Bhawana Sahay, Leena Talukdar, Pallavi Sahay, Debashish Datta, Rangnath Chaubey.
Background: Placenta is a vital organ and the most accurate record of the infants prenatal experience. Pregnancy complications like hypertension significantly affect the placenta. Thus there is a need for thorough examination of it. Therefore the present study is dedicated to see the histological changes in placenta of pre-eclampsia with special reference to cytotrophoblastic cell hyperplasia, villous stromal fibrosis and fibrinoid necrosis and compared it with that of normal placenta. Methods: Total 60 placentas were collected (30 from pre-eclampsia and 30 from normal pregnancy). Results were expressed in percentage after counting 100 villi. Data analysis has been done using Graphpad InStat 3 version and data is significant when p value is


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Role of multiparametric MRI in detection of prostatic lesions; of evaluation contrast enhanced MRI, diffusion weighted imaging and MR spectroscopy in malignant and benign prostatic lesions

2016-10-21T00-09-15Z
Source: International Journal of Research in Medical Sciences
Pratiksha Yadav, Rajul Bhargava.
Background: Prostate cancer is the most commonly diagnosed cancer in males and one of the leading causes of cancer-related death in men. Pretreatment assessment of prostate cancer is divided into detection, localization, and staging; accurate assessment is a prerequisite for optimal clinical management and therapy selection. The purpose of the study is to determine the diagnostic accuracy of multiparametric MRI for prostatic cancer detection using T2 weighted MR imaging, diffusion weighted imaging (DWI) and contrast enhanced MRI. To determine the use of MR spectroscopy in prostatic lesions. Methods: It is a prospective single institutional study done on 29 patients with prostate lesions and elevated PSA level. Axial, coronal and sagittal images were obtained using T1WI, T2WI and STIR sequences. Advanced sequences like Diffusion weighted images, Spectroscopy and post gadolinium T1WI were taken after the basic MRI images. Results: Study was done in 29 patients, age was ranging between 51years to 90 years, mean age is 70.7 years. On multiparametric MRI findings 45% were detected malignant lesions and 55% patients detected benign lesions. On biopsy correlation 42% of these cases turned out to be malignant and 58% as benign lesions. Detection of malignancy by T2WI imaging alone given sensitivity of 80.1% and specificity of 85.4%.By DWI alone sensitivity was 85.7% and specificity was 89.4%,on MRS sensitivity is 90.6% and specificity was 91.1%. Combined (MRI+DWI+MRS) gave sensitivity of 92.3% and specificity of 94.4% for detection of malignant prostatic lesion. Positive predictive value is 90% and negative predictive value was 88%. Conclusions: The best characterization of prostatic cancer in individual patients will most likely result from a multiparametric exam. Recent advances include additional functional and physiologic MR imaging techniques (diffusion weighted imaging, MR spectroscopy, and perfusion imaging), which allow extension of the obtainable information beyond anatomic assessment. Multiparametric MR imaging provides the highest accuracy in diagnosis and staging of prostate cancer.


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Clinico-radiological correlation of osteoarthritis knee using Western Ontario and McMaster Universities score and Kellegren and Lawrance grading

2016-10-21T00-09-15Z
Source: International Journal of Research in Medical Sciences
Manish Singh Rajpoot, Digember Peepra, Krishna Kumar Pandey, H. S. Varma.
Background: Diagnosis OA is basically based upon clinical and radiological features. In our study we have used a clinical scoring system of OA called as WOMAC (Western Ontario and McMaster Universities) score and a radiological staging system KL staging (Kellegren and Lawrance) OA radiological staging system and correlation between them. Methods: There were total 66 patients with 102 knees. X ray of bilateral knee was taken in weight bearing position (standing) and WOMAC score was calculated. X-rays were assessed with KL grading. WOMAC score a clinical scoring was correlated with a radiological KL grading for the OA of knee. Results: Range of WOMAC score was 11.5-67.7. Mean WOMAC score were 18.75, 31.31, 52.57 and 67.2 in patients of KL grade 1, 2, 3 and 4 respectively. Correlation between KL grading and WOMAC scoring were found to be significant; there were rise in the WOMAC scoring when KL grading increases. Conclusions: Both the KL grading and WOMAC score are directly proportional to each other, and hence, WOMAC scoring can be used to diagnose, assess the progression of the disease and the response to treatment of osteoarthritis.


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