ABSTRACT
Background: Lung cancer is most frequently diagnosed major cancer in the world and the most common cause of cancer mortality worldwide. It comprises about 17% of the total new cancer cases in males and 23% of the total cancer deaths. The objectives of this study were to compare bronchial biopsy, BAL and TBNA in diagnosing lung malignancies and IHC wherever required.Methods: The study was conducted at Sher-i-Kashmir Institute of Medical Sciences Srinagar, India in the department of Pathology. It was a prospective study over a period of 1½ years from June 2015 to December 2016. All patients clinically/ radiologically suspected of lung malignancies who presented between June 2015 to December 2016 and underwent bronchial biopsy, BAL (washings) and TBNA were included in the study. The study included only those cases where BAL, TBNA and bronchial biopsy were done simultaneously.Results: Out of a total 117 clinically suspected cases of lung cancer, tumor was found in 103 cases (103/117) by biopsy, 51 cases by BAL (51/117) and 64 cases by TBNA (64/117). The total number of false positive cases and false negative cases by BAL were 6 and 58. Sensitivity of BAL was found to be 43.69% and specificity 57.14%. The total number of false positive cases and false negative cases by TBNA were 7 and 46. Sensitivity and specificity of TBNA was found to be 55.34% and 50.0%.Conclusions: Thus, in the present study yield of diagnosis was highest with the bronchoscopic biopsies and in maximum number of cases with a sensitivity of 88.034%, and specific histologic diagnosis was made by biopsies and IHC only. Though BAL and TBNA were inferior to bronchial biopsy in diagnosing lung malignancies but these were effective for peripheral lung malignancies and when the patient was at risk of haemorrhage.
ABSTRACT
Background: Although the mortality and morbidity rates for Very Low Birth Weight (VLBW) and Extremely Low Birth Weight (ELBW) neonates have improved over last few decades, they still remain highly vulnerable groups. This study determines the neonatal morbidity and mortality within first four weeks of life in VLBW and ELBW neonates.Methods: It was a hospital based prospective study conducted in the department of paediatrics at GB Pant hospital, an associated hospital of Government Medical College Srinagar. All included neonates were evaluated in neonatology section and were followed up to 4 weeks of life. Standard protocols were used for management of these neonates.Results: A total of 116 neonates were included in the study. Among the 116 neonates 82 (70.69%) were VLBW and 34 (29.31%) were ELBW. 28 (34.14%) VLBW and 18 (52.94%) ELBW neonates died. Among the morbidities Respiratory Distress Syndrome was found in 35.37% of VLBW and 70.59% of ELBW neonates, out of which 12.20% VLBW and 20.58% ELBW neonates developed Bronchopulmonary dysplasia. Perinatal asphyxia was found in 20.73% of VLBW and 29.41% of ELBW neonates and Pathological apnea occurred in 28.04% VLBW and 85.29% ELBW neonates. 40.24% VLBW and 73.53% ELBW neonates developed clinically significant jaundice requiring treatment. Clinical sepsis was found in 43.90% VLBW and 67.65% ELBW neonates while as culture proven sepsis was found in 26.83% VLBW and 41.18% ELBW neonates. Intra ventricular haemorrhage was found in 15.85% VLBW and 52.94% ELBW neonates. Necrotizing enterocolitis developed in 18.29% VLBW and 35.29% ELBW neonates. Retinopathy of prematurity was found in 21.95% VLBW and 26.47% ELBW neonates. Patent ductus arteriosus was found in 14.63% VLBW and 32.35% ELBW neonates.Conclusions: Present study has shown Respiratory distress syndrome, perinatal asphyxia and sepsis as the predominant causes of neonatal morbidity and mortality and these are preventable with a proper health care system and policy directed to the primary prevention.