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1.
J Family Med Prim Care ; 13(7): 2663-2668, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39071034

RESUMO

Aims and Objective: To evaluate the patients at risk of venous thromboembolism (VTE) based on Caprini VTE risk assessment scale and the effect of implementation of this scale on the use of thromboprophylaxis. Materials and Methods: A prospective study was conducted, including patients who underwent major elective surgical procedures. Demographic details were noted, and VTE prophylaxis offered if needed. According to the VTE risk assessment scale, patients were categorised into very low-, low-, moderate-, and high-risk categories. The data were analysed statistically. Results: A total of 500 patients (women = 259; men = 241) were enrolled in this study. Of them, eight women and nine men developed VTE (P = 0.691). The maximum number of patients who developed VTE belonged to 61-70 years group (n = 7). According to VTE risk assessment, 61 patients were categorised as low-risk, 217 patients as moderate-risk, and 222 patients were categorised as high-risk. A significant (P < 0.0005) correlation was found between body mass index (BMI) and VTE development. In obese patients with BMI >25, 14 patients developed VTE. Out of total, 329 patients received prophylaxis for deep vein thrombosis. Of 284 patients who received pharmacologic prophylaxis, only three developed VTE (P = 0.002). Of 145 patients who received mechanical prophylaxis, 75 had high risk and none of them developed VTE. Four patients had mortality, and a significant (P = 0.022) correlation was found between mortality and VTE development. Conclusion: According to Caprini risk assessment scale, the prophylaxis for VTE was effective in patients undergoing major elective general surgery, resulting in significant lowering of morbidity and mortality.

2.
Asian J Transfus Sci ; 14(1): 67-69, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33162711

RESUMO

Intravenous (IV) drug abuse has been well established to be the source of transfer of infections, such as HIV, hepatitis C virus, and hepatitis B virus. However, often overlooked fact is that IV drug abusers have a potential for developing alloimmunization due to universal practice of flushing/washing out the syringe by own blood to rinse out the drug in the syringe. We present here a case of a 28-year-old man who presented with a rather unique predicament of having developed four different alloantibodies after exposure to allogenic blood through IV drug abuse. This case was detected promptly due to routine usage of type and screen policy for all the patients receiving transfusion. Such screening for atypical antibodies must be instituted to preemptively identify these antibodies and arrange compatible blood, which could have been difficult otherwise, at short notice during routine crossmatch. This is the first of its kind case ever reported from India and has no precedence.

3.
Asian Pac J Cancer Prev ; 21(2): 349-354, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32102510

RESUMO

Treatment for cervical cancer consists of hysterectomy, radiotherapy, chemotherapy and targeted therapy in different combination based on stage at presentation. However, late consequences of such radical treatments are known but not many Indian studies have reported it. Quality of life and impact on sexual health has become an important issue in view of long survival of cervical cancer patients. LENTSOMA scale is one such scale validated for scoring radiotherapy related morbidity. However, there is need for a comprehensive scale covering all aspects of physical and psychological disruptions to provide complete recovery and rehabilitation. The study was prospective and patients who were treated for cervical cancer on follow up were included in this study. A total of 85 patients, who were treated with surgery, radiotherapy, chemotherapy alone or in combination, comprising of stage I to stage IV disease, participated in this study. Findings of this study showed that pain during intercourse and altered sexual life were reported by 32.9% and 25.9% patients respectively whereas 24.7% found it problematic and in 22.3% patients, alteration in interest in sex were reported. Vaginal stenosis was seen in 75.29% of patients after treatment with decreased frequency of intercourse after treatment was seen in 16.4 % of patients. Combination of surgery and radiotherapy in cervical cancer patients caused more sexual dysfunction and dissatisfaction, especially in lower age group. Treatment morbidity in term of sexual function was more with advanced stage disease and with the patients on longer follow up. Sexual function is an important aspect of quality of life but there is no single self-report measure in routine clinical follow up use which is brief, easy to complete and incorporates all (physical, psychological, emotional) aspects of sexual health for people affected by cancer.
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Assuntos
Qualidade de Vida , Autorrelato , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Psicogênicas/epidemiologia , Neoplasias do Colo do Útero/terapia , Adulto , Terapia Combinada , Feminino , Seguimentos , Humanos , Incidência , Índia/epidemiologia , Masculino , Prognóstico , Estudos Prospectivos , Inquéritos e Questionários , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/psicologia
4.
Asian Pac J Cancer Prev ; 20(2): 383-389, 2019 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-30803196

RESUMO

Background: Carcinoma cervix is the second most common type of cancer in the world. With the increasing proportion of women surviving carcinoma of the cervix, quality of life has been an important clinical issue. Since there are very few studies from India, this study is to assess urinary dysfunction issues in patients of carcinoma cervix treated with multimodality therapy using the LENT SOMA scores. Methods: The study was prospective and patients treated between 1995 - 2007 on follow up were included in this study after ethical clearance. A total of 85 patients were accrued comprising 6 stage IB, 6 stage II A, 25 stage II B, 2 stage IIIA, 45 stage III B and 1 stage IV A disease. Sixty-six patients were treated with radiotherapy in which 46 patients received chemoradiotherapy and 19 had surgery prior to post-operative radiotherapy. The mean age was 47.81 years with a range of 25-68 years. Completion of LENT SOMA scale and Statistical analysis was done. Results: Mean score for BU (Bladder/Urethra) was highest (0.0758) in fifth year of treatment whereas UK (Ureter/Kidney score was highest (0.0408) after 4 years. Bladder score was more in 60-69 years of age and in stage IIIB patients of cervical cancers. Bladder morbidity was more in patients who received chemoradiotherapy and in patients who received radiotherapy with boost where Bladder and Urethra morbidity was more in patients who were treated with Extended Field radiation. Conclusions: The LENT SOMA system was acceptable and feasible to use and gave us an insight into the morbidity in our patients and to develop effective management plans to reduce the post treatment symptoms and improve quality of life.


Assuntos
Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/etiologia , Qualidade de Vida , Índice de Gravidade de Doença , Sobreviventes/estatística & dados numéricos , Neoplasias do Colo do Útero/complicações , Adulto , Idoso , Terapia Combinada , Feminino , Seguimentos , Humanos , Índia , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Inquéritos e Questionários , Neoplasias do Colo do Útero/terapia
5.
Perit Dial Int ; 37(2): 237-239, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28360371

RESUMO

Fungal infection is an extremely rare etiology of exit-site and tunnel infection in patients on continuous ambulatory peritoneal dialysis (CAPD). There are few data available regarding its management-especially choice of antifungals, duration of therapy, and removal of catheter. There are no guidelines pertaining to reinsertion of the CAPD catheter following fungal exit-site and tunnel infection. This case report highlights Candida albicans as a rare cause of exit-site and tunnel infection of the CAPD catheter. The catheter was removed and the patient received appropriate antifungal therapy followed by reinsertion of the CAPD catheter and re-initiation on CAPD.


Assuntos
Candidíase/tratamento farmacológico , Infecções Relacionadas a Cateter/microbiologia , Cateteres de Demora/efeitos adversos , Remoção de Dispositivo/métodos , Falência Renal Crônica/terapia , Diálise Peritoneal Ambulatorial Contínua/efeitos adversos , Antifúngicos/administração & dosagem , Candida albicans/isolamento & purificação , Candidíase/fisiopatologia , Infecções Relacionadas a Cateter/terapia , Feminino , Seguimentos , Humanos , Falência Renal Crônica/diagnóstico , Pessoa de Meia-Idade , Diálise Peritoneal Ambulatorial Contínua/métodos , Doenças Raras , Retratamento/métodos , Resultado do Tratamento
6.
Indian J Surg ; 77(Suppl 2): 603-7, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26730072

RESUMO

Peripheral arterial pseudoaneurysms are quite common in Northern India (Punjab Province) and thus a common presenting complaint of varied etiology. The objective of this study was to evaluate the clinical outcome of patients presenting with peripheral arterial pseudoaneurysms of varied etiology. Retrospective analysis of medical records of patients with diagnosis of peripheral arterial pseudoaneurysm from 1 May 2001 to 30 October 2009 was done. In the prospective period from 1 November 2009 to 30 April 2011, the patients were personally examined by the authors and followed up till discharge from the hospital and subsequently at 2 weeks, 1 month, 3 months, and 6 months postdischarge from the hospital. We studied 50 patients (13 in the prospective group and 37 in the retrospective study group). Intravenous drug abuse (26 cases) followed by trauma (nine cases) was the commonest etiology. Femoral artery was the commonest artery involved (37 cases). A pulsatile mass with localized tenderness was the commonest presentation. All patients underwent surgical treatment with 36 (72 %) patients undergoing ligation and excision of the pseudoaneurysm. Six (12 %) patients underwent revascularization with reverse saphenous vein graft. Five (10 %) patients underwent primary repair, and three (6 %) patients were managed by putting a synthetic ePTFE graft. Postoperative wound infection was seen in 18 (36 %) patients, and 33 (66 %) patients had an uneventful recovery. In pseudoaneurysms, surgical repair at the early instance carries a favorable prognosis. If feasible, reverse saphenous vein grafting is the best conduit for repair. Synthetic vascular graft (ePTFE) can be used in case autologous saphenous vein is not available. Excision and ligation is safe, and we recommend it as the treatment of choice for infected arterial pseudoaneurysms.

7.
Int J Appl Basic Med Res ; 4(Suppl 1): S23-6, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25298938

RESUMO

BACKGROUND: Infected pseudoaneurysm in intravenous (IV) drug abusers is a serious clinical problem, with difficult and controversial management. With existing controversies regarding their optimal management, we present the results of simple ligation and local debridement for treatment of infected pseudoaneurysms. PATIENTS AND METHODS: Records of 72 consecutive patients with pseudoaneurysms in IV drug abusers over the last 20 years were reviewed retrospectively. RESULTS: Ligation and excision of pseudoaneurysm was done in all patients with delayed revascularization in only two patients. Four patients had amputations because they had gangrenous limbs on presentation. All other patients had healthy limbs at the time of discharge. There were three deaths, two due to sepsis with multiorgan dysfunction and one with hemorrhagic shock. CONCLUSION: Infected pseudoaneurysm should be managed by simple ligation of involved artery with delayed revascularization, if required.

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