ABSTRACT
Background: Voiding difficulty and urinary retention is a common phenomenon in immediate postpartum period. Absolute or relative failure to empty the bladder resulting from decreased bladder contractility (magnitude or duration) or increased bladder outlet resistance or both are defined as voiding dysfunction. It needs high index of suspicion or else can go undiagnosed and can lead to magnitude of problems. The study aims to calculate the incidence of dysfunction of bladder in postnatal women and to study risk factors associated with development of bladder dysfunction and management strategies in cases of bladder dysfunction.Methods: Authors did a prospective observational study in a tertiary care hospital. 200 postpartum women were screened for complaints of voiding dysfunction within 6 hours of removal of catheter in post caesarean patients and of normal vaginal delivery. Authors found that the voiding dysfunction was relatively common with an incidence of 20.20%. Following risk factors were analyzed: parity, mode of delivery, pain at suture site, baby weight, para-urethral tear.Results: Postpartum voiding dysfunction was found to be relatively common with statistically significant association found for pain at suture site and para urethral tear. Intra partum events contributed to voiding dysfunction. 93% of patients who with voiding dysfunction could be managed conservatively, and only 7% had to undergo intervention in the form of re catheterization.Conclusions: The early identification and treatment can reduce the pain and discomfort. Majority of the cases resolves with conservative management and nursing staff plays a key role in early detection of the symptoms.
ABSTRACT
Background: : Colorectal cancers being one of the leading causes of cancer related deaths in the world. Earlier it was thought that the colorectal cancers usually occur in older age groups. This thought has led to decrease in chances of malignancy in young patients. Therefore, we conducted this study of colorectal cancers in young patient to emphasise the importance of keeping in entity in mind while dealing with the patient presenting with complaints consistent with colorectal malignancy even if there age is less than forty year. Methods This study was a prospective cohort study of 30 cases of colorectal malignancy of age 40 years and below conducted in patients admitted in Department of Surgery at FH Medical College & Hospital, Tundla (UP), Firozabad, U.P. Results: In this study of colorectal cancers in young patient maximum number of patients were found in the age group of 31-40 years (70.4%) followed by in the age group of 21-30 years (27.57%)and 11-20 years (2.58%). Males were found to be affected more (59.76%) than females (41.23%). Most common site of involvement was found to be rectum (59.24%) followed by rectosigmoid (15.36%), caecum and descending colon (10.20%). Most common sign was found to be bleeding per rectum (71.24%) and most common symptom was found to be altered bowel habits (53%) followed by pain abdomen (62.58%). Mucinous adenocarcinoma (54.68%) was found to be most common histological type of colorectal malignancy followed by adenocarcinoma (46.35%). Conclusions: Our study was aimed at analysing colorectal malignancy in young patients. It should promote high index of suspicion on the part of treating surgeons about this entity even in young patients.
ABSTRACT
Background: Colorectal cancers are one of the leading causes of cancer related deaths worldwide. Its a common knowledge that the colorectal cancers usually occur in older age groups. This has led to low index of suspicion of having this malignancy in young patients who are less than 40 years of age. We conducted this study of colorectal cancers in young patient to emphasise the importance of keeping in entity in mind while dealing with the patient presenting with complaints consistent with colorectal malignancy even if there age is less than forty year. the stage at which the diagnosis is made is of crucial importance in colorectal malignancy and a delayed diagnosis can have serious consequences for the patient. Objectives: (1) To determine incidence of colorectal malignancy in young patient. (2) To study the symptom complex (3) To determine sex and site distribution (4) To determine operability and respectability of tumour in young patients (5) To study the histopathological types and grading in young patients. Methods: This study was a prospective cohort study of 42 cases of colorectal malignancy of age 40 years and below conducted in patients admitted in department of surgery at a tertiary care institute. The duration of study was 2 years. Results: In this study of colorectal cancers in young patient maximum number of patients were found in the age group of 31-40 years (69.4%) followed by in the age group of 21-30 years (28.57%)and 11-20 years (2.38 %). Males were found to be affected more (54.76%) than females (45.23%). Most common site of involvement was found to be rectum(57.14%) followed by rectosigmoid (16.66%) , caecum and descending colon (11.90%).Most common sign was found to be bleeding per rectum (69.04%) and most common symptom was found to be altered bowel habits (50%) followed by pain abdomen (59.52%). Mucinous adenocarcinoma (52.38% ) was found to be most common histological type of colorectal malignancy followed by adenocarcinoma (42.85%). Most patients were diagnosed in Stage C (47.61%) of duke staging followed by stage B (23.80), stage D (19.04%) and stage A (9.52%). Metastasis were seen in 6 patients. 38 patients were operated. Most common surgical procedure done was abdominoperineal resection (11 patients) followed by Palliative sigmoid colostomy (10 patients ), Right hemicolectomy (5 patients), anterior resection (5 patients), while left colectomy and palliative transverse colectomy was done in 3 patients each. Only 1 patient underwent total proctocolectomy with ileostomy. 4 patients were not operated as they had advanced stages of the disease.Adjuvant chemotherapypy and radiotherapy was given in all patients except in 2 patients who had favourable histological stage and was under follow up. Total 9 patients died during follow up period. 2 refused treatment and 31 patients are still under follow up. Conclusion: Our study was aimed at analysing colorectal malignancy in young patients. It should promote high index of suspicion on the part of treating surgeons about this entity even in young patients.