A Clinicopathological Study on Cyclical Mastalgia with Special Reference to Serum Oestrogen Level and Breast Volume.

Cyclic mastalgia is defined as a breast pain that has a relationship to the menstrual cycle. As far as research studies are concerned the main etiological factors for cyclical mastalgia include dietary factors and hormonal imbalance. In this study, the clinicopathological aspect of cyclical mastalgia is studied with special reference to serum oestrogen and breast volume. This study provides valuable data on cyclical mastalgia with special reference to serum oestrogen level and breast volume.METHODSA total of 101 patients meeting inclusion criteria were selected for this prospective comparative observational study. Sample was selected from OPD patients from Surgery Department, Medical College Kolkata. A detailed history of the patients who was taken with special reference to the dietary habits and lifestyle. A thorough physical examination including breast size and volume were taken (by visual assessment method, size of the undergarments the patient wear and then breast circumference measurement) and the findings were noted. Patients underwent Tru-Cut biopsy for histopathological study and Oestrogen Receptor Status. All data was captured in a predesigned Case Data Sheet and analysis of all the data was done from the CDS using master chart or grand chart.RESULTS58.3% patients with cyclical mastalgia have h/o fatty diet. Patients with increased breast volumes had increased levels of serum oestradiol which signifies that mastalgia with medium and large size breast would respond to antioestrogens better than those patients with small sized breast volume. Majority of the patients with cyclical mastalgia in our study had medium breast volumes as per Bra-size, where the range of 32-36 has the highest frequency (42.8%). The mean measurement of bra size is 33.7 and the standard deviation is 3.737. In our study, we find positive correlation with breast volume and serum oestrogen level (Pearson correlation of breast volume as 1 and serum oestrogen level as 0.381 respectively) and negative correlation with breast volume and serum progesterone level (Pearson correlation of breast volume as 1 and serum progesterone level as -0.134 respectively).CONCLUSIONSThis study shows a significant positive correlation between breast volume, fatty diet and oestrogen level with cyclical mastalgia.

The Urgency of Redifining Minimum Monitoring Standards in Anesthesia.

Anesthesiology is an intense discipline, which entails unexpected, often life threatening complications, requiring immediate recognition and prompt intervention. It is essential to have uniform standards of monitoring irrespective of location, duration and type of anesthesia. The Indian Society of Anesthesiologists (ISA) in 1998 started preparing guidelines suited for indian conditions and presented these in 1999. The 1999 ISA guidelines have outlived and there is an urgent need to update the currently applicable guidelines. These guidelines of ISA are under revision since April 2007. Keeping in view of developments in the field, medically complex patients, training methods of present day trainees and CPA needs, updated guidelines should include additional monitoring techniques and precautions.