Locally advanced breast cancer: an observational study for the delay in presentation of patients

Background: Breast cancer is the most common cause of cancer in women and cancer related mortality all over the world. There is strong evidence that delayed diagnosis of breast cancer is associated with poor survival. At our center most of the patients with breast cancer presented as locally advanced breast cancer (LABC) which drew our attention to find out the reasons of delay and its association with different socio-demographic variables.Methods: We enrolled 50 histologically proven cases of LABC in this study. With help of semi structured interview, questions were asked from each patient which could reflect their understanding about the disease to find likely reasons for their delayed presentation, including socioeconomic status.Results: In present study most of our patients were more than 45 years, married. 88% presented late due to unawareness and ignorance about nature and severity of breast cancer disease, 86% had financial issues, 64% had shyness as reason, 20% wasted time by taking alternative treatment, 52% presented late due to painless lump; 30% had fear of losing breast, 18% didn’t get support from family, 4% presented late due to other reasons.Conclusions: Awareness and knowledge of breast cancer was found to be poor amongst sufferers prior to their diagnosis, making it important reason for delayed presentation. Other significant factors being socioeconomic status and education. The need for increased awareness and use of screening practices was identified to be essential for early diagnosis of the disease and for improved outcomes.

A study of incidence and factors determining the occurrence of surgical site infection in abdominal surgeries

Background: Surgical site infection (SSI) can be defined as infections which develops within 30 days after surgery involving the skin and subcutaneous tissue of the incision and/or the deep soft tissue and/or any part other than the incision handled during surgery. This study has been taken up to determine the incidence of SSI in abdominal surgery and to determine factors responsible for its occurrence.Methods: The study was conducted in Dr. D.Y. Patil Medical College, Hospital and Research Centre located in Pimpri, Pune between July 2017 to September 2019.It is a prospective longitudinal descriptive study. Information collected from the patients included patient’s age, gender, diabetes mellitus status, smoking status and haemoglobin and albumin levels.Results: Total 150 cases with abdominal operations were included in this study. Among them 29 patients developed SSI. Incidence of SSI among them was 19.3%. There was no significant difference among gender between both the groups. (p=0.172). Among 29 SSI cases, 10 (34.5%) had diabetes while 19 (65.5%) did not have diabetes. There was significant difference in diabetes status between both the groups (p=0.021). Patients having diabetes has more risk of getting SSI post operatively. Among 29 SSI cases, 8 (27.6%) were smokers while 21 (72.4%) were non-smokers.Conclusions: The incidence of SSI among cases underwent abdominal surgery was 19.3%. In our institute where most patients come from low economic state, poor hygiene and nutrition status, with current preoperative protocol for SSI prevention SSI rate is comparable to that of most developing countries.

A study on Developmental delay among children less than 2 year attending Well Baby Clinic - Prevalence and antecedents factors.

Background: Early detection of neurodevelopmental abnormalities is important because of possibility of instituting early intervention program for that child. Trivandrum developmental screening test (TDSC) has sensitivity of 66.7% and specificity of 78.8%. This makes it a reasonably good test to screen children. Aims & Objective: To study the prevalence of developmental delay among children less than 2 years attending well baby clinic using TDSC and antecedents factors of developmental delay. Material and Methods: This cross sectional study was conducted on 200 patients visiting well baby clinic starting from age of 1 month till 2 years. Study was conducted for a period of 3 months from February 2013 to May 2013. Details pertaining to exact age, term or preterm status, maternal and paternal h/o was taken. Developmental screening was done using TDSC chart. Bell, pen, keys were used for assessment along with chart. Results were analyzed using SPSS 16.0. Results: Total of 200 patients was screened.181 children were found to be normal with 85.6%- 94.2 % CI. In 19 children, delay was found with 5.8%-14.4 % CI. Preterm, IUGR, respiratory distress, sepsis, seizures in neonatal period showed significant p value for developmental delay. Microcephaly patients when screened for TDSC showed developmental delay with p value less than 0.05.All growth parameters (head, weight and length) when less than third centile showed significant association to developmental delay. The study also showed linear regression curve significant for awareness of developmental as maternal education improves. Conclusion: Developmental screening with TDSC showed developmental delay prevalence 9.5%. All children should be screened in well baby clinic for developmental delay. In India, sources have found prevalence of 1.5-2.5% of developmental delay in children less than 2 years of age. High incidence of our study can be due to study done at tertiary care centre. Preterm and IUGR were found to have developmental delay with significant p value. Various antecedents’ factors responsible for early brain injury showed significant p value. Hence every child attending well baby clinic should be screened for developmental delay with effective screening method such as TDSC.

Knowledge about HIV-AIDS among first-time and regular voluntary non-remunerated blood donors.

Acquired Immune Deficiency Syndrome (AIDS) is one of the serious public health problems in India. AIDS education has been considered as one of the main intervention for control. Sexual route is the major route of transmission of Human Immunodeficiency Virus (HIV); however, approximately 2.5% is transmitted through blood and blood products. The present study was carried out to know the level of awareness about HIV infection and blood donation among first time (190) and repeat (310) voluntary donors of all age groups. One pre-structured questionnaire was circulated among altruistic blood donors. About 96.6% donors want to become repeat donors. Majority of the donors had good knowledge about routes of HIV transmission. According to 97.4% donors, it is transmitted by sexual route, according to 87.4% of donors by sharing needle, according to 85% of donors by blood transfusion and 82.4% of donors believe through vertical transmission. However, 32.4% of the donors, still believe that HIV infection could be transmitted through blood donation. Intense motivational program among donors is needed to remove this myth. Regular donors were convinced the importance of regular and repeat blood donation. They came forward to donate blood for the cause of humanity (80.6%) and the sense of pride (27.79%). First time donors were less motivated by the cause of humanity (56.21%) and volunteered because of peer pressure (26.03%) and motivated by relative or friend. Donors were very alert about precaution to be taken for protecting themselves from danger of HIV infection and priority wise use of safe sexual practice (90%), disposable needles (61.43%) and receive tested blood (45.71%) whenever required. When in need of blood for relatives the donors will give priority to the quality (64.65%) and properly tested blood from voluntary blood donors (86.7%).

Estimation of supernatant hemoglobin in red cell units with and without temperature interruptions.

Red cell units issued to patient and returned back unused, are visually inspected for hemolysis before releasing them for reissue. A study was conducted to find out effect of temperature interruptions in the red cell units, during transport. The aims were to find out hemolysis in units with temperature interruptions and its relationship to the duration and also to compare actual hemolysis with visible hemolysis, if any. Thirty samples with different duration of temperature interruptions were evaluated for actual hemolysis. Fifteen samples of similar shelf-age but without temperature interruptions were included in the study as controls. Low hemoglobin photometer was used to measure supernatant hemoglobin. Despite temperature interruptions, almost all red cell units had acceptable level of hemolysis and this was similar to the red cell units without temperature interruption. The difference between the units with or without temperature interruption was not statistically significant (p > 0.05). Red cell units with smaller duration of temperature interruptions had lesser hemolysis than in those with longer temperature interruptions (p < 0.05). Red cell units younger than 7 days had lesser hemolysis than the units older than 8 days in both categories of units with and without temperature interruptions (p < 0.05). The units without visible hemolysis had lower hemolysis than units with visible hemolysis (p < 0.05). It can be concluded that temperature interruptions have a very minor role in hemolysis, younger units have lesser hemolysis than older units and visual assessment is subjective and tend to overestimate hemolysis.