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Background: Breast cancer is a major public health issue and it is the leading cause of cancer related death in females worldwide. New insights in the cancer treatment led to considerable improvement in the survival of cancer patients. But metastasis remain an area were all sorts of conventional treatments fails and it is the cause of death of most carcinoma breast patients. In this study we aim to establish a possible link to local recurrence and distant metastasis with different biological subtypes of breast cancer.Methods: One hundred and eighty patients of carcinoma breast patients of carcinoma breast who presented with local recurrence or distant metastasis in the period of January 2018 to March 2019 in Government Medical College, Thiruvananthapuram were included in this study. These data were collected from the hospital records.Results: Local recurrence was most seen in triple negative (50%) subtype followed by HER2 (32.1%) enriched. Local recurrence was least among luminal A (13.8%) with a p value of 0.001. Bone metastasis was the most common type of metastasis and was most seen in luminal A (p=0.001). Triple negative had the maximum CNS metastasis with a p value of 0.003. Liver metastasis was seen mostly in luminal B (26.2%) and A (20.7%) and lung metastasis in triple negative (13.5%) and HER2/neu (10.7%). However, there was no significant association for lung or liver metastasis to any subtype.Conclusions: Biological subtypes of breast cancer classified by immunohistochemical expression of ER, PR, HER2, Ki 67 show different clinicopathological features, recurrence pattern, and survival outcomes.
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Background: worldwide road traffic accidents accounts as the leading cause of death of young people. For a very long time most of the intra-abdominal injuries following blunt abdominal trauma were managed operatively. Conservative management is becoming more acceptable and effective management option for blunt abdominal trauma during the last few decades.Methods: This study was conducted in Government Medical College, Kottayam during September 2007 to December 2008. All conservatively managed blunt abdominal trauma patients during the study period were included in the study.Results: Out of 22 patients, 4 patients failed conservative management. Success rate was 81%. Most commonly injured solid organ in the study group was liver (77%). Maximum cases were of age group 10 to 20 (31.81%) years. 81% of patients were males. Motor vehicle accident was the most common cause of trauma (77%). Mean stay in intensive care unit was 4.2 days and mean hospital stay was 15.7 days. Mean systolic blood pressure was 110 mmHg ranging from 70 to 130 mmHg. 50% of patients had moderate hemoperitoneum and non-had massive hemoperitoneum.Conclusions: Non operative management is safe and effective approach in blunt spleen and liver injuries. Non operative management should be treatment of choice for all hemodynamically stable patients with blunt liver and splenic trauma.