Epidemiology and receptor status distribution in a cohort of carcinoma breast patients presenting in our institution

Background: Carcinoma Breast is the most common cancer among females after cervical cancer. An estimated 1 million cases of breast carcinoma have been diagnosed worldwide and it is the leading cause of cancer death among women of age 20-59 years. Aim: The aim of the study is to understand the epidemiological factors and prevalence of different receptor status in cases of Ca breast from the South Indian Population to Govt. Stanley Medical College. Materials and methods: The materials for our retrospective study were collected from the medical records department of Govt. Stanley Medical College (GSMC). All cases of Ca breasts who attended GSMC for admission, treatment, investigations of breast cancer from July 2015 to August 2016 were included in the study. All patients were triple assessed and ER, PR, Her2Neu status were assessed by IHC staining. The study population was grouped based on parameters such as age groups, parity, family history of breast cancer, menopausal status, TNM staging, grade and histological type. Results: In our Study most common age group affected by Ca breast is 41-60 years (57%). 39% of Ca breast cases are premenopausal women. Most common Grade was grade II (41.8%). Most common Histological type was Intra ductal carcinoma about 94.5%. Stage III is common (50.3%). Metastasis was more common in age group > 60years (23%). On comparing stage and grade of tumor 62.8% cases of Stage III were Grade II. Triple Negative cancer is the most common receptor status (25.5%). 57% of triple positive and 57.5% of triple negative cases were in the premenopausal age group. Stage II is the most common presentation in triple positive disease (76.9%). Stage IV is more common in Triple negative patients. K. Muthu Raj MS, S. Mathan Sankar. Epidemiology and receptor status distribution in a cohort of carcinoma breast patients presenting in our institution. IAIM, 2016; 3(12): 75-83. Page 76 Conclusion: In conclusion, our study shows there is an increasing trend of Ca breast in South Indian population among younger and middle age group with Triple Negative Receptors is being most common associated with poor prognostic factors. Hormone receptor status and grading evaluation is needed for targeted therapy

Acute superior mesentric vessel thrombosis with bowel ischemia Case series

Background: Acute mesenteric ischemia consists of the sudden, partial or complete, interruption of the blood flow in superior or inferior mesenteric vessels that result in intestinal ischemia. The incidence was exponentially increasing with age and no difference has been observed between sexes. Aim: The Aim of this case series was to highlight clinical presentation, the difficulty in diagnosis and importance of early intervention and the prognosis of superior mesentric vessel thrombosis with bowel ischemia. This article presented a case series of intestinal infarction through obstruction of superior mesenteric vessels – three cases of acute mesenteric artery thrombosis, two case of acute mesenteric vein thrombosis. Materials and methods: The materials for this case series was collected from patients diagnosed and admitted as acute superior mesentric vessel thrombosis in various surgical units in Department of General Surgery, Govt. Stanley Medical College, Chennai. All 5 cases have been analyzed for this study during period of 6 months from January 2016 to June 2016. All Cases with superior mesentric vessels thrombosis were included. No exclusion criteria. Results: This case series consisted of 5 cases, three cases of acute mesenteric artery thrombosis and two case of acute mesenteric vein thrombosis. In this case series, superior mesentric artery thrombosis was more common with male preponderance. 4 out of 5 cases were male in which Superior mesenteric artery was more common when compared to vein thrombosis. Out of 5 cases, 2 cases were asymptomatic with mild abdominal discomfort. Most common complaints of 5 cases were sudden onset of abdominal pain with or without vomiting. Abdominal distension/ Constipation were not seen in all cases. Out of 5 cases, 4 patients were on favorable follow up in which 2 cases had been diagnosed very early who had less post-operative stay and no complications after surgery. 2 cases developed post op complications. 1 case had deceased because of late presentation. This case series S. Krishnabharath, S. Mathan Sankar. Acute superior mesentric vessel thrombosis with bowel ischemia – Case series. IAIM, 2016; 3(8): 258-265. Page 259 presentation draws to attention that timely diagnosis and appropriate surgery with resection and immediate postoperative heparinization and proper follow up with anti coagulant the morbidity and mortality is averted. Conclusion: The diagnosis of AMI is difficult and mostly delayed resulting in irreversible bowel ischemia which requires emergency intervention. Mortality and morbidity for AMI remains high, and in patients requiring extensive bowel resection the survival rate was low. As AMI mostly affects the elderly population physicians have to be aware of the possibility of this condition when facing the elderly patient even with mild sudden onset of abdominal pain complaints. An interdisciplinary collaboration is must, since patients are not initially evaluated by surgeons.