Psychological impact of cancer on patients in a tertiary care centre: a prospective study

Background: Diagnosis of cancer, although physical in nature, has far reaching emotional impact on the person. The study aimed to analyse the psychological impact of cancer on patients with a focus on levels of distress and psychiatric comorbidity.Methods: It was a prospective study conducted on 169 consenting individuals in the department of radiation oncology, SKIMS, Jammu and Kashmir, India, in collaboration with the department of psychiatry, SKIMS medical college, Jammu and Kashmir, India, from November 2013 to January 2015. The NCCN distress thermometer was used to observe the temporal variations in the levels of distress over a period of time.Results: Anxiety disorders (panic disorder, generalized anxiety disorder and post-traumatic stress disorder) were the most common psychiatric disorders diagnosed constituting 59%, followed by depression in 29%. About 12% patients were not diagnosed with any psychiatric ailment. One female patient with anxiety disorder developed acute psychosis. Counselling and psychotherapy provided improvement in 45% patients with cancer. In all, 86.4% required medication during the course of treatment and majority had improvement with it. A mean distress score of 7.73 was seen before, 8.29 during and 7.66 after treatment.Conclusions: Cancer bore a significant impact on the psychological bearing of patients, ranging from anxiety disorder, post-traumatic stress disorder, depression to psychosis. Hence there is a need for monitoring psychological symptoms in cancer patients and development of appropriate psycho-oncology services.

Results of emergency appendectomy for appendicular mass.

Emergency appendectomy was done on 1142 patients during the period of July 1990 to January 2003 to evaluate the results. Of which 656(57.44%) were male and 496(42.56%) were female. The mean age was 22.21+/-3.93 years (04-85 years). The duration of pain before admission was 3.05+/-0.94 days (01-17 days) and 708(62%) patients presented with palpable mass; ultrasonogram revealed additional lump in 114(9.98%) patients, rest of the lump (28.02%) was detected during operation. 342(30%) patients had appendix abscess and 228(19.96%) had loculated collection. Eight patients had tuberculosis and four had carcinoma in addition. All had appendicitis except two of which one patient had carcinoid tumor and one had enteric fever perforation. Operative time ranged from 15-85 minutes (29.38+/-3.19 minutes). The average hospital stay was 4.22+/-0.82 days (03-17 days). There was no failure, faecal fistula or death. The overall wound related complication was 22.86% of which 14.62% was very minor and overall intra abdominal complication was 4.12%. Persistent wound pain was in 43(3.87%) and hypertrophied scar was found in 05 (0.45%) patients. 05(0.45%) patients needed exploration for persistent sinus one of which was tuberculosis and remaining was due to suture material. Remote complications like RTI, UTI, and DVT was found in 04(0.35%) patients. There was no death, no faecal fistula and no failure. It seems that emergency appendectomy could safely be done in appendix mass without any increased risk of mortality and morbidity.

Prevalence of chronic suppurative otitis media among the children living in two selected slums of Dhaka City.

Chronic Suppurative Otitis Media (CSOM) is one of the important health problems in our country. Serious complications may arise from it. As such the study was aimed to find out the prevalence of CSOM among the children of two-selected slum dwellers in Dhaka City. This was a descriptive type of cross-sectional study. A total of 203 samples were interviewed and examined. Altogether 7.39% of children were observed to have CSOM. Among CSOM cases, 60% had hearing impairment. Ear discharge and perforation were observed in 26.7% in right ear, 46.7% in left ear and 26.7% in both ears. Central perforation was present in 93% cases. Cholesteatoma was present in 6.7% cases. Among CSOM cases, 53.3% children were in 2-5 years age group, 80% were dependent, 53.3% cleaned ear by cotton buds, 93.3% lived in Kutcha house, 73.3% had a monthly income of TK. 1001-2000 and 46.7% belonged to families having 6 members. Out of 15 CSOM, 11 cases were seen among children of 141 illiterate mothers. Four cases of CSOM were found among children of 62 literate mothers. Among the 203 mothers, 65.52% were found aware, and 34.48% were not aware about the disease and sequel of CSOM. Here 39.9% mothers had knowledge and 60.01% had no knowledge about the treatment of CSOM. Among the CSOM cases 46.67% cases did not receive any treatment. In treatment receiving group, only 3(20%) children received it from MBBS doctor or Hospital.

Mania in a Six-year Old Child

The case of first episode of mania in a six year old girl is presented. Stated as uncommon in prepubertal children in literature, the authors attempt to discuss the reasons for the reported uncommonness in the light of diagnostic criteria. The possible ramifications of the early age of onset is also discussed.

Transformation of sitosterol to androsta-1, 4-diene-3, 17-dione by immobilized Mycobacterium cells.

Transformation of sitosterol to androsta-1, 4-diene-3, 17-dione was studied with Mycobacterium cells entrapped in various polymeric matrices. Of the three supports viz. alginate, carageenan, agarose and polyacrylamide, studied, the polyacrylamide immobilized cells showed optimum catalytic stability and reusability.