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Background: Breast cancer is the leading cause of mortality and morbidity among women worldwide. It is one of the prime health issues in developed and developing countries because of the high prevalence of known risk factors. In the present study, we assess the knowledge of breast cancer and breast self-examination (BSE) screening practices among women in the capital city, Lucknow, Uttar Pradesh, North India. Methods: This cross-sectional study was conducted in urban and rural areas of Lucknow. The period of study was one year, starting from December 2020 to November 2021. Data were obtained from 400 adult women (212 rural and 193 urban) using a pretested, self-administered questionnaire. Participants aged >20 years were randomly selected from two rural and two urban community health centres (CHCs). The questionnaire assessed respondents’ socio-demographic characteristics, risk factors, signs and symptoms, early detection methods, and knowledge and practices related to self-breast examination among women in Lucknow. Results: Out of 400 respondents, only 33.5% (rural) and 55.96% (urban) women had heard of breast cancer. 17.55% (rural) and 13.47% (urban) women had heard about BSE. 4.72% (rural) and 8.81% (urban) women practice BSE occasionally. Knowledge about breast cancer, its symptoms, risk factors, and screening methods was similarly poor in women of Lucknow. Conclusions: This finding correlated significantly with older age, higher levels of education, and occupation. There is a low level of awareness of breast cancer in Lucknow's urban and rural areas. BSE is hardly practiced, though the willingness to learn it is high.
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Background: Endometrial cancer significantly contributes to gynecological cancers. The aim of the study was to assess the concordance between the preoperative endometrial biopsy and histology of hysterectomy specimens in patients surgically treated for endometrial hyperplasia and endometrial cancer. Concurrent malignancy was also assessed in cases of endometrial hyperplasia with atypia.Methods: This study is a retrospective analysis of patients surgically treated for atypical hyperplasia (47 patients) and cancer (210 patients) at HHFT from January 2014 to March 2020. The preoperative histology was compared to the histological findings of hysterectomy. In cases of endometrial cancer, its histological type and grade were also assessed.Results: In the endometrial cancer group, the majority were endometrioid adenocarcinoma (204 patients) and only 6 had a non-endometrioid type. In the endometrioid and non-endometrioid group, preoperative diagnosis was confirmed in 88.7% and 100% patients respectively in postoperative specimens. Tumor grade was reported in 193 patients. The present study shows the highest accuracy in grade 3 patients (88%) followed by grade 1 (82.8%) and grade 2 (62.5%). Out of these 47 patients who underwent surgical management for atypical hyperplasia, preoperative diagnosis was confirmed in 46.8% (22 patients). Importantly, concurrent endometrial cancer in hysterectomy specimens was found in 34% patients in atypical hyperplasia group.Conclusions: High level of concordance was noticed in histology and grade in endometrial cancer patients. Only half of the patients in atypical hyperplasia group showed concordance as one-third of patients were found to have concurrent malignancy.
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Ovarian pregnancy is a rare form of ectopic pregnancy. Its incidence is 0.5-1% of all ectopic gestations or 1 in 7000 to 40000 live births. The diagnosis is intricate and based on surgical and histopathological observations. In our institute in last 10 years, we have seen a single confirmed case out of 189 ectopic pregnancies. It was a spontaneous pregnancy with no history of contraception failure and diagnosed as tubal ectopic by ultrasound imaging. Laparotomy findings and histopathology confirmed it to be an Ovarian Pregnancy.
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The objectives of the programme were to promoting nutritional awareness, education and behavioural change in rural area involving farm women and school children, harnessing traditional knowledge through local recipe to overcome malnutrition and implementing nutrition sensitive agriculture through homestead agriculture and nutri-garden. For this study, All India Coordinated Research Project on Women in Agriculture, MPUAT, Udaipur adopted five villages of Badgaon Panchayat Samiti to make Nutri Smart Villages i.e. Madar, Thoor, Brahmano ki hunder, Feniyon ka guda and Loyra. Regarding nutritional, health and hygiene practices, 57.07 per cent of the respondents followed poor practices. Majority of the rural women were vegetarian. Regarding BMI of respondents, 40.53 per cent women were pre-obese and18.12 per cent were obese. Awareness generation is required regarding importance of good nutrition.
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Background: The present study aims at comparing efficacy and safety of two different regimens of induction of labour (IOL) in pregnancies with fetal demise.Settings and Design: A randomised controlled trial was conducted on 100 eligible pregnant women diagnosed with intrauterine fetal demise who were admitted in the labour ward of a tertiary care hospital.Methods: All participants were randomly divided into two groups in group A and group B. In Group A, IOL was done with transcervical foley’s catheter and vaginal misoprostol while in group B, mifepristone with vaginal misoprostol were used for IOL. During intrapartum period the mode of delivery, induction-delivery interval, total dose of induction agent used and amount of total blood loss were noted. Any side effect if present was also noted.Results: Comparing both the groups, Induction delivery interval was less in group A as compared to group B.Conclusions: Use of mifepristone with misoprostol as well as Foley’s with misoprostol were found to be equally safe and effective methods.
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Background: Achromobacter spp. is a rare nosocomial pathogen known to cause many serious infections like bloodstream infection, osteomyelitis, meningitis, urinary tract infections, corneal ulceration, peritonitis, and endocarditis. Materials and Methods: In this study, we retrospectively analyzed all the bacteriological sample records from the bacteriology database from January 2021 to December 2021 to determine the prevalence of Achromobacter spp. Result: Nine patients with Achromobacter xylosoxidans causing bacterial infection were identified, from whom five blood samples, two pus, one respiratory sample, one central venous pressure (CVP), and one cerebrospinal fluid were found positive for Achromobacter spp., among whom one was a 6-year-old patient having the same organism from two different body sites—CVP line and cerebrospinal fluid. Five patients had coinfection with another organism, whereas acute kidney injury was the most common comorbidity. Conclusion: In our single-center experience, approximately 50% of the cases with Achromobacter denitrificans bacteremia suffered from chronic kidney disease and had a history of antibiotic therapy, hospitalization, and the presence of devices. Active research on rising trends of Achromobacter spp. needs to be promoted.
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@#A 31-year-old Indian female with a history of near-total thyroidectomy 2.5-years prior presented with recurrent neck swelling. Magnetic resonance imaging (MRI) of the neck revealed an infiltrating mass involving the thyroid bed. Biopsy from the mass and review of slides from the previous thyroidectomy revealed a spindle cell tumour with interspersed areas of fibrosis and infiltrative edges entrapping thyroid follicles. Beta-catenin immunopositivity and CTNNB1 mutation confirmed the diagnosis of fibromatosis. The case is being reported for its rarity and the discussion of its differential diagnoses.
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Glándula Tiroides , Fibroma , Inmunohistoquímica , Nódulo TiroideoRESUMEN
Objectives:The uses of devices of electromagnetic waves(EMWs)are increasing day by day.Similarly,the gen-eration of the waves is increasing.The frequency spectrum of the generation of waves is also increased.In this manuscript,an analysis of the high frequency EMWs has been made by the electric fields generated due to the exposure of 5th generation(5 G)of mobile phones. Methods:Due to the emission of waves from the towers,the electric field is generated around the transmission tower of mobile phones.The electric fields are computed by the power of the transmission tower.The electric fields across the biological tissues/cells are also computed when the EMWs penetrate inside the body.The electric fields are made across the organs of different depths inside the body. Results:The induced electric fields inside the organs of the human beings are responsible for the absorption of energy from high frequency EMWs.The absorbed amount of energy from high frequency waves may become the cause of harmful effects on the life of organs of human beings. Conclusion:In this manuscript,after analysis of the computed electric fields inside the organs of human beings,it is concluded that the EMWs of 5 G spectrum of mobile phone towers may more harmful for the life of organs as 4th generation(4 G)spectrum of mobile phone waves.The energy absorption by the 4 G spectrum is lower than 5 G spectrum due to the range of frequency of waves.The effects on the pancreas,retina,skin,intestine,spleen,stomach and uterus are more than low water content organs like nails,bone,teeth etc.
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Direct involvement of females in high-intensity exercise causes hormonal changes and also affects the menstrual cycle. The duration of the normal reproductive cycle in females is about 26-35 days and divided into different phases. In the absence of pregnancy, menstruation or vaginal bleeding occurs, about 8 days after ovulation which is followed by low estrogen and progesterone levels as well as endometrium deterioration. The purpose was to study the menstrual profile of college girls and compare them between the athletes and non-athletes. The subjects were 30 female college athletes with regular conditioning and 30 sedentary female college girls from West Bengal. The variables were Height, Weight, BMI, Menarche Age, Menstrual Age, Menstruation duration, and Flow rate history of the subjects which were measured by the self-made questionnaire validated by Professors and Doctors. The mean day of the menstrual cycle was 27.5 for athletes and 25.9 for non-athletes. The days of menstrual duration also show normal characteristics in the case of athletes and less than the nonathletes. In the case of flow rate also the athletes show less than their counterparts. The menarche ages are lying in the same age range of 12 to 15 years. More non-athletes (23) have crossed over the normal cycle of 25-28 days than the athletes (17). Athletes (27) have a more normal menstrual duration (3-5 days) than non-athletes (21). Non-athletes (8) suffer a long period of menstrual duration than athletes (1). The flow rate of the non-athletes is more than the athletes. A significant effect of exercise occurred on the menstrual profile of college girls. Significance differences were found in the case of menstrual duration and flow rate between athletes and non-athletes. No significant difference occurred in the case of menarche age between athletes and non-athletes.
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Purpose@#To assess the feasibility of accelerated hypofractionated radiotherapy with simultaneous integrated boost (SIB) in patients with breast cancer. @*Materials and Methods@#A total of 27 patients after breast-conserving surgery were included in this study. Patients were planned on a four-dimensional computerized tomogram, and contouring was done using RTOG guidelines. The dose was 34 Gy/10#/2 week to the breast and 40 Gy/10#/2 week to the tumor bed as SIB with volumetric modulated arc technique. The primary endpoint was grade 2 acute skin toxicity. Doses to the organs-at-risk were calculated. Toxicities and cosmesis were assessed using RTOG/LENT/SOMA and HARVARD/NSABP/RTOG grading scales, respectively. Disease-free survival (DFS) and overall survival (OS) were calculated with Kaplan-Meier curves. @*Results@#The mean age of the patients was 42 years. Left and right breast cancers were seen in 17 (63%) and 10 (37%) patients, respectively. The mean values of ipsilateral lung V16 and contralateral lung V5 were 16.01% and 3.74%, respectively. The mean heart doses from the left and right breast were 7.25 Gy and 4.37 Gy, respectively. The mean doses to the contralateral breast, oesophagus, and Dmax to brachial plexus were 2.64 Gy, 3.69 Gy, and 26.95 Gy, respectively. The mean value of thyroid V25 was 19.69%. Grade 1 and 2 acute skin toxicities were observed in 9 (33%) and 5 (18.5%) patients, respectively. Grade 2 hyperpigmentation, edema, and induration were observed in 1 (3.7%), 2 (7.4%), and 4 (14.8%) patients, respectively. Mild breast pain and arm/shoulder discomfort were reported by 1 (3.4%) patient. The median follow-up was 51 months (range, 12 to 61 months). At four years, breast induration, edema, and fibrosis were observed in 1 (3.7%) patient. Cosmesis was excellent and good in 21 (78%) and 6 (22%) patients, respectively. Local recurrence and distant metastases occurred in 1 (3.7%) and 2 (7.4%) patients, respectively. DFS and OS at four years were 88% and 92%, respectively. @*Conclusion@#With this radiotherapy schedule, acute and late toxicity rates were acceptable with no adverse cosmesis. Local control, DFS, and OS were good.
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@#A 35-year-old female presented with abdominal pain, fever, projectile vomiting, and a diffuse tender epigastric mass. She was diagnosed to have acute persistent pancreatitis with a pancreatic pseudocyst. Elevated serum calcium levels provided an etiologic link between hypercalcemia and pancreatitis. On examination, a nodule was found in the left side of her neck which was later diagnosed as a giant left inferior parathyroid adenoma. This report highlights the critical analysis of history, examination, and investigations to reach an ultimate diagnosis. Pseudocyst drainage and parathyroidectomy resolved her symptoms.
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Pancreatitis , Obstrucción de la Salida Gástrica , Hiperparatiroidismo PrimarioRESUMEN
Background@#Organochlorine pesticides (OCPs) exposure may induce an endocrine disruption which may lead to the risk of developing diabetes through alteration and disturbance of glucose metabolism, insulin resistance, and destruction of β-cells. The present study determines the recent trend of OCPs residue in blood samples and their association with the known risk factors responsible for developing the risk of diabetes among the North Indian population. @*Methods@#Blood sample of 300 patients (100 each of normal glucose tolerance [NGT], prediabetes and newly detected diabetes mellitus [DM]) between the age group of 30 to 70 years were collected. OCPs residue in whole blood samples was analyzed by using gas chromatography equipped with a 63Ni selective electron capture detector. @*Results@#Significantly higher levels of β-hexachlorocyclohexane (HCH), dieldrin, and p,p’-dichloro-diphenyl-dichloroethylene (DDE) were found in the prediabetes and newly detected DM groups as compared to NGT group. Insulin resistance showed to be significantly positive correlation with β-HCH and dieldrin. Also, fasting and postprandial glucose levels were significantly positively correlated with levels of β-HCH, dieldrin, and p,p’-DDE. Further, when OCPs level was adjusted for age and body mass index (BMI), it was found that β-HCH, dieldrin, and p,p’-DDE levels in blood increases the risk of diabetes by 2.70, 2.83, and 2.55 times respectively. Moreover, when we adjust OCPs level based on BMI categories (BMI 25 kg/m2); β-HCH and p,p’-DDE showed a significant risk of developing newly detected DM with BMI >25 and ≥23 and ≤25 kg/m2. @*Conclusion@#The OCPs level present in the environment may be responsible for biological, metabolic, and endocrine disruptions within the human body which may increase the risk of developing newly detected DM. Hence, OCPs exposure can play a crucial role in the etiology of diabetes.
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Background@#Organochlorine pesticides (OCPs) exposure may induce an endocrine disruption which may lead to the risk of developing diabetes through alteration and disturbance of glucose metabolism, insulin resistance, and destruction of β-cells. The present study determines the recent trend of OCPs residue in blood samples and their association with the known risk factors responsible for developing the risk of diabetes among the North Indian population. @*Methods@#Blood sample of 300 patients (100 each of normal glucose tolerance [NGT], prediabetes and newly detected diabetes mellitus [DM]) between the age group of 30 to 70 years were collected. OCPs residue in whole blood samples was analyzed by using gas chromatography equipped with a 63Ni selective electron capture detector. @*Results@#Significantly higher levels of β-hexachlorocyclohexane (HCH), dieldrin, and p,p’-dichloro-diphenyl-dichloroethylene (DDE) were found in the prediabetes and newly detected DM groups as compared to NGT group. Insulin resistance showed to be significantly positive correlation with β-HCH and dieldrin. Also, fasting and postprandial glucose levels were significantly positively correlated with levels of β-HCH, dieldrin, and p,p’-DDE. Further, when OCPs level was adjusted for age and body mass index (BMI), it was found that β-HCH, dieldrin, and p,p’-DDE levels in blood increases the risk of diabetes by 2.70, 2.83, and 2.55 times respectively. Moreover, when we adjust OCPs level based on BMI categories (BMI 25 kg/m2); β-HCH and p,p’-DDE showed a significant risk of developing newly detected DM with BMI >25 and ≥23 and ≤25 kg/m2. @*Conclusion@#The OCPs level present in the environment may be responsible for biological, metabolic, and endocrine disruptions within the human body which may increase the risk of developing newly detected DM. Hence, OCPs exposure can play a crucial role in the etiology of diabetes.
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SUMMARY Ultrasonic velocity, density and viscosity of Lacosamide were measured in various alcohols at 298.15 K. From these measured experimental data, various acoustical parameters such as Specific acoustical impedance (Z), Adiabatic compressibility (k s), Intermolecular free path length (L f ), Rao's molar sound function (R m), Molar compressibility (W), van der Waals constant (b), Solvation number (S n ), Thermal conductivity (K bm), Relaxation strength (r) have been calculated for understanding the molecular interactions occurring in the solution.
RESUMEN Se midieron la velocidad ultrasónica, la densidad y la viscosidad de soluciones de lacosamida en varios alcoholes a 298,15 K. A partir de estos datos experimentales, se calcularon varios parámetros acústicos para comprender las interacciones moleculares que ocurren en la solución, tales como la impedancia acústica específica (Z), la compresibilidad adiabática (k s), la longitud del camino libre intermolecular (L f), la función molar de sonido de Rao (R m), la compresibilidad molar ( W), la constante de van der Waals (b), el número de solvatación (Sn), la conductividad térmica (K bm), y la fuerza de relajación (r).
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Background: There is a growing demand for breast reconstruction and among the plethora of breast reconstruction techniques, the latissimus dorsi (LD) flap is a versatile, reliable means for soft tissue coverage, providing form and function with acceptable perioperative and long-term morbidities for a variety of breast defects. The aim of this study was to find out the advantages of immediate breast reconstruction in terms of postoperative morbidity and patient satisfaction with respect to her expectations.Methods: The study was conducted in the Department of General Surgery at Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah, Sri Amritsar. Thirty female patients who had undergone immediate breast reconstruction with latissimus dorsi flap after modified radical mastectomy attending surgery department from November 2017 to September 2019 were taken. The follow up was done to find out post-operative complications and a statistical scoring was done according to rating scale of quality of life.Results: Most common complication after breast reconstruction with LD flap was found to be seroma formation (50%) followed by wound infection and flap necrosis 25% each while flap necrosis >20% was not found in any case. For emotional feeling regarding health, social activities, overall health and quality of life; there was significant improvement after surgery.Conclusions: It can be concluded that immediate breast reconstruction with autologous latissimus dorsi flap is the treatment of choice following mastectomy in cases of breast carcinoma, whenever possible.
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Background: Clomiphene citrate, a non-steroidal triphenylethylene compound, is the first line medicine used for ovulation in anovulatory women Worldwide. Objective of this study was to study fertility rates of combination of enclomiphene citrate and melatonin and compare it with fertility rates of plain enclomiphene citrate in cases of dysovulatory infertility.Methods: A total of 107 cases participated in the study out of which 7 women were excluded from the study. So, the results of 100 women were analyzed. Out of 100 women 50 were of Group A i.e., clomiphene supplemented with melatonin group and 50 were in Group B which was clomiphene only group with no supplementation. Cases were followed for three cycles and pregnancy rates in both groups were evaluated.Results: Study demonstrated the potential benefit of melatonin supplementation in naturally conceived cycles where ovulation induction was given by enclomiphene citrate. The ovulation rates were comparable in both study versus control group (68% versus 66%) while there was increase in pregnancy rate in melatonin group (36% versus 24%). However, difference between pregnancy rates in both the groups failed to reach statistically significant levels (p value 0.4065).Conclusions: The adjuvant role of melatonin with enclomiphene citrate in cases of dysovulatory infertility in improving pregnancy rates, which is due to strong anti-oxidant effect of melatonin which in turn reduces oxidative stress thus resulting in good quality oocyte production.
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Background: Menopause is recognised to have occurred after 12 months of amenorrhoea for which there are no obvious pathological and physiological causes, it is retrospective diagnosis. Objective of this study was to compare the efficacy, safety and compliance of oral estradiol and vaginal estriol for urogenital problems in post-menopausal women.Methods: A total of 100 postmenopausal women having urogenital symptoms were selected for the prospective study. The selected patients were randomly allocated in 2 groups. Group A received 2 mg of estradiol OD for 4 weeks and then evaluated after 4 weeks. Group B received 0.5 mg of vaginal estriol cream continuously for 4 weeks at night and then evaluated after 4 weeks. Patients were followed after 1,3 and 6 months. Inclusion criteria were postmenopausal women, vaginal symptoms, urogenital symptoms. exclusion criteria were all patients having estrogen dependent neoplasia and comorbidities.Results: For urinary complaints, symptomatic relief was assessed by AUA Score in which after 6 months; in Group A the difference in mean from baseline was 19.64±1.63 and in Group B it was 21±2.52 and was statistically insignificant from each other. For genital complaints, symptomatic relief was graded as 1, 2, 3, 4 in which grade 4 means complete relief. After 6 months of therapy 88.2% got complete relief in Group A and 91.1% in Group B. In vaginal cytological smears; in both groups, parabasal cells were reduced and superficial cells were increased after 6 months of therapy and both groups were statistically insignificant from each other. After 6 months of therapy, increase in mean value of KPI from the baseline is 24.54±10.1 in Group A and 28.6±10.11 in Group B and both groups were statistically insignificant. Endometrial thickness remained unchanged in both the groups after 6 months of therapy.Conclusions: Both drugs were equally effective in alleviating the urogenital symptoms with no significant side effects.
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Benign Recurrent Intrahepatic Cholestasis (BRIC) is a rare autosomal recessive disorder characterized by intermittent episodes of jaundice and pruritus. It is also known as Summerskill-Walshe-Tygstrup syndrome. It is a benign disease with no progression to end stage liver disease.. The first episode of cholestatic jaundice occurs early in life and there are asymptomatic periods between attacks lasting weeks to years. This case report presents a young male who presented with severe pruritus and acute onset jaundice. He had his first episode of jaundice at the age of twelve and had several intermittent episodes since then. Diagnosis was made by the unique clinical presentation with exclusion of other causes of cholestatic jaundice. This case report highlights the importance of detecting such cases of rarity and preventing unnecessary invasive diagnostic procedures on such patients.
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Background: Families of children with disabilities otherwise experience higher stress; and relation between parenting styles and coping of children is well known. Parental factors and family functioning may play a role in shaping the child, especially having issues like SLD. The objective is to study was coping strategies of children with SLD, parenting styles of their parents, their family functioning and relation of these with each other.Methods: It is a cross-sectional study undertaken after Institutional Ethics Committee approval, parent's consent and child's assent. Participants were 100 consecutive children, diagnosed with SLD, 9-13 years of age. Tools used were: Semi-structured proforma, Parenting Practices Questionnaire, Family Assessment Device and Children's Coping Strategies Checklist Revision 1.Results: Authoritarian parenting style was significantly was associated with less use of 'active' and 'support seeking'; and increased use of 'distraction' and 'avoidance' strategies. High scores on Authoritative style was associated with 'active' and 'support seeking' strategies. Avoidance coping strategy was associated with poor (high scores) and active coping strategies with higher (low scores) on problem solving, communication, and general family functioning.Conclusions: Parenting practices and family functioning can be pivotal in determining child's attitude and coping. Assessment of this can be routinely included in child evaluation.