ABSTRACT
Background: Breast lesions are most common among women, where majority of the breast lesions are benign. Even though most of the breast lesions are benign; malignant lesions are most concern, as because they are commonest malignant lesions especially among western population. Fine Needle Aspiration Cytology (FNAC) has proved to be a safe cost effective, good screening and quick procedure for early diagnosis of palpable breast lesions. Aim: The aim of this present study is to diagnosis different categories of various breast lesions and correlation of FNAC and Histopathological diagnosis. Methods: This study was done on 224 breast lesions with palpable breast swellings referred to Department of Pathology, Government Medical College, Kadapa, Andhra Pradesh over a period of 4 years from January 2015 to December 2018. Lesions were categorised as per cytomorphological features obtained on FNAC. Histopathological correlation was assessed in all breast lesions, inclusive of all malignant cases. Results: Out of 224 breast lesions, 178 (79.46%) cases were categorized as Benign and 39 (17.4%) cases as malignant, 7 cases (3.12%) are inflammatory. Most common benign lesions are fibroadenoma i.e., 54%. Most common malignant lesions are Infiltrating duct cell carcinoma, it was 16.96%. Uncommon malignant lesion is medullary carcinoma, it was 0.44%. Out of 224 palpable breast lesions, 203 (90.63%) diagnosed by histopathology were consistent with FNAC. Conclusion: FNAC is safe, cost effective, good screening, quick outpatient procedure with high sensitivity & sensitivity and histopathology is a confirmatory diagnosis and especially it can help to confirm suspicious malignant cases.
ABSTRACT
Emergency peripartum hysterectomy (EPH) is a major obstetric procedure, usually performed as a life-saving measure in cases of intractable obstetric hemorrhage. The aim of this study was to determine the incidence, indications and the risk factors and complications of emergency peripartum hysterectomy (EPH). The medical records of 13 patients who had undergone EPH, between January 2012 and December 2018, were reviewed retrospectively. All necessary data was obtained by record review. The mean age of pregnant women was 30 year. There were 13 EPHs out of 15768 deliveries, a rate of 0.82 per 1,000 deliveries. Out of 13 women who underwent EPHs, 8 hysterectomies were performed after cesarean delivery and 5 after vaginal delivery. The most common indication for hysterectomy was abnormal placentation (7/13), followed by atony (4/13), rupture of scared uterus (1/13) and rupture of unscared uterus (1/13). There were two cases of intra-operative bladder injury, we had 1/13 maternal death because of EPH. There were no cases of neonatal mortality. In our series, abnormal placentation was the most common of indication for EPH. The risk factors for EPH were previous CS for abnormal placentation and placental abruption for uterine atony and peripartum hemorrhage. Limiting the number of CS deliveries would bring a significant impact on decreasing the risk of EPH.
ABSTRACT
Background: The objectives of this study were to calculate the maternal mortality ratio, causes for maternal death in our institution and the duration of hospital admission to death interval.Methods: The study included collecting and analyzing the details of maternal death in women who were admitted to St. Johns Medical College Hospital, Bengaluru, from January 2007 to December 2016. Results: Total maternal deaths were 61 and live births were 26,001 during the study period. The maternal mortality ratio (MMR) was 234.6 per 100,000 live births. Majority of maternal deaths occurred in women aged 18 - 35 years 56 (91.80%) women, primipara 45 (73.77%) and referred cases to our institution from other hospitals 52 (85.24%). Most of the women died in the postnatal period 54 (88.52%). Direct obstetric causes accounted for 44 (72.13%) maternal deaths and indirect causes 17 (27.86%) deaths. Preeclampsia and eclampsia were the leading causes for death 13 (21.31%) followed by acute fatty liver of pregnancy 12 (19.67%), hemorrhage 7 (13.11%) and sepsis 6 (9.83%). Anemia was present in 77.04% of women at the time of admission to our hospital. Thirty six (59.01%) women died within a week of admission to the hospital, in which 13 (21.31%) women died in less than 24hours of admission. Twenty five (40.98%) women died after a week of admission to hospital.Conclusions: Apart from the triad of preeclampsia, obstetric haemorrhage and sepsis, acute fatty liver of pregnancy has emerged as an important cause of maternal death. Most of the maternal deaths are preventable. Early detection of complications and timely referral to tertiary care hospital in St. Johns Medical College Hospital, Bengaluru, Karnataka, India decreases maternal morbidity and mortality.