ABSTRACT
Objective:To determine the incidence of non-traumatic perforated gastro-duodenal ulcers in thesurgical population at GPHC.To identify/ discuss mortality associated with perforated hallow viscus at GPHC and itsrelated outcomes.Study Design and Methods:This study involves a retrospective analysis of all inpatients in the female and male adult surgical wards at GPHC.All charts coded for ‘acute abdomen’, ‘perforated hollow viscus’ and pneumoperitoneum were collected from 2016 to 2018 Data from this selective population were collected using the data collection tool. All data was coded for and entered into spreadsheet of which double data entry was done. Data was then analyzed using SPS.Results:Initially a total of 109 charts were collected but was reduced to sample size of 31 patients after review of charts. Majority of patients were males with an average age of presentation of 45.8years. Although many comorbidities are associated with perforations only 1 patient in this studyhad chronic hypertension. Time of presentation from onset of symptoms greatly influences theoutcomes for affected patients. However, 80% of patients presented after 24 hrs, none in a state of shock and no early mortality was found. Smoking affects the mucosal barrier of stomach and increases risk of peptic ulcer disease. In this study 67.7% of patients admitted to being frequent marijuana smokers and 74.2% cigarette smokers and although a small population size, a high association betweensmoking and resultant disease was shown with a P value of 0.0028. Graham’s patch was done by residents on all patients with an average operative time of 68.4 minutes. Intraoperatively the most common site of perforation was the antrum (60%) compared to the duodenum (6.7%), pylorus (6%) and body of stomach (3.3%). Post-op there was a 40% morbidity rate.Conclusions:Primary repair is a safe surgical approach with a low mortality.Conference Abstract
ABSTRACT
Objectives:To review the outcomes of oestrogen receptor(ER), progesterone receptor (PR) and Human epidermal growth factor receptor 2 (HER2) in breast cancer patients at GPHC over a 2 year period from December 2016-December 2018.Hypothesis:There is a higher incidence triple negative(ER (-), PR (-), HER2 (-)) breast cancer among patients in Guyana when compared to the Caribbean.Secondary Objectives:To identify the patients who had hormone receptor testing done at the Georgetown Public Hospital Corporation (GPHC).To specify the current trends of ER, PR and HER2 in patients at GPHC from December 2016-December 2018.To enumerate the percentage of BC diagnosed in the patients under 40 years.Design and Methods:Retrospective cohort study of 90 BC patients with known receptor status from December 2016-Dcember 2018.Results:In this study of 90 patients 46% of the patients are triple negative BC, while 38% are hormone receptor positive. Of least frequency are the triple positive BC representing 3%.The persons 40years and under represent 16% of the population. Conclusion: There in a high percentage of breast cancer in patients under 40 years representing 16% of the study population.There is a higher percentage of triple negative or non-hormonal receptive breast cancerat GPHC of approximately 46% which supersedes 20% when compared to the Caribbean population.Recommendations: Further study is needed, with screening and development of protocols. Breast receptor testing in all patients need to routinely done and a formal cancer registry and Digital database established.