ABSTRACT
Background: Adolescence is a transient and dynamic period between childhood and adulthood, characterised by several changes in the body and the child’s mind. The World Health Organization defines adolescents as young people aged 10-19 years, but changes may begin before and continue after this age group. Adolescents constitute over 21.4% of population in India. Adolescence is a period of enormous physical and psychological change for young girls. Hormonal events play a key role in this transition. One of the major physiological changes that take place in adolescent girls is the onset of menarche, which is often associated with problems of irregular menstruation, excessive bleeding and dysmenorrhea. The aim of this study was to determine the proportion of various gynecological problems among adolescent girls seeking care at a tertiary care centre, Kolar, Karnataka, India.Methods: A cross sectional study was conducted during March 2016 to March 2018 among all adolescent girls (10-19 years) with gynecological problems attending inpatient and outpatient Department of Obstetrics and Gynecology. A pre-tested semi-structured questionnaire was used to collect information regarding their socio-demographic characteristics, gynecological history, family history, obstetric history, documentation of general physical examination and other investigations. Data entered using Microsoft Excel and analysed using SPSS v20.Results: A total of 720 adolescent girls sought care for gynecological problems in the study period with more than 80% of the cases belonging to the age group between 15 and 19 years. Of the 720, 362 (49.8%) had some type of menstrual disorders. Of these 362 cases about 41 of them were a case of puberty menorrhagia (11.32%) and 89 cases were of dysmenorrhea (22.37%). Among 720 cases, 290 (40.2%) of them were diagnosed of teenage pregnancy; among which 34 of them were unwanted pregnancy. Other presentations include vaginal discharge, urinary tract infection, mass per abdomen, trauma to genital tract and turners syndrome (two cases).Conclusions: The study shows around half of the adolescent girls are having menstrual disorders. One third were teenage pregnancies with most of them been ‘wanted’. This alarming finding calls for strengthening of adolescent programme with targeted health education and behavioural change. Setting up a separate adolescent clinics is necessary for efficient management of menstrual disorders in adolescents.
ABSTRACT
Background: Epidermal Growth Factor Receptor (EGFR) is one of the important molecules involved in lung cancer initiation and progression. Studies on over expression of EGFR and its survival in relation with Non-small cell lung cancer (NSCLC) patients have yielded controversial results. Prevalence of EGFR expression in NSCLC patients and 6-month survival in south Indian population is unknown.Methods: We carried out a prospective study in tertiary hospital. Diagnosed patients with NSCLC were included in the study and were interviewed with questionnaire containing demography and investigations like Chest X-ray, CT thorax, Bronchoscopy were recorded. EGFR expression analysis was done for all patients and were followed up monthly for 6 months and details of survival and treatment were collected. Cox regression analysis was used to assess their survival.Results: 50 patients with NSCLC were included. Forty-four (88%) were men, median age of study group was 65 years. Twenty-seven patients (54%) had Adenocarcinoma, 14 patients (28%) had Squamous cell carcinoma, 7 patients (14%) had poorly differentiated carcinoma and 2 patients (4%) had large cell carcinoma. Thirty-four (68%) samples were positive for EGFR expression. On multivariate analysis we found patients who took chemotherapy and with good performance status (Karnofsky score >65 and Eastern Cooperative Oncology Group >2.5) had better survival at 6 months.Conclusions: Patients with EGFR positivity had better survival with chemotherapy but worse with radiotherapy. Patients who took chemotherapy and had good performance status had better survival on multivariate analysis. We didn’t find any correlation between EGFR positivity and poor survival.
ABSTRACT
Background: Patients with Human Immunodeficiency Virus (HIV) infection are predisposed to numerous opportunistic infections due to decreased cell mediated immunity, Tuberculosis being most common. Low CD4 count is associated with low immunity and higher risk of tuberculosis.Methods: Author conducted a retrospective study in the department of Pulmonary medicine in a tertiary care teaching hospital during January to December 2017. Author collected data of all the patients with HIV diagnosed with Tuberculosis from the ART centre. Author collected demographic details including age, sex, symptoms at presentation, details of diagnosis of TB including type of tuberculosis, CBNAAT results, CD4 count at the diagnosis of TB, details of ART therapy and ATT therapy and outcomes of treatment.Results: Eighty one patients with HIV-TB co- infection were included in the study. Males (70.37%) were more affected than females. Mean age of the study group was 39.97� years. Sixty one patients (75.4%) were diagnosed with Pulmonary Tuberculosis and 20 (24.6%) patients were diagnosed with extra pulmonary TB. Mean CD4 counts of the cohort was 226�0/祃. Eighty percent of patients developed Tuberculosis with CD4 count <250/祃.Conclusions: Author found in this study higher proportions of tuberculosis (80.2%) in patients with HIV infection with CD4 count <200/祃. Author also found higher proportion of pulmonary Koch抯 in patients with low CD4 count (CD4 <200/祃).