Clinicopathological correlation of serum prostate specific antigen levels in patients of prostatomegaly in a tertiary care hospital

2016-12-02T09-16-04Z
Source: International Journal of Medical Science and Public Health
Vitesh Popli, Amit Rajan, Sonali Bose, Amit Kamewad.
Background: In clinical practice, biopsies are generally performed only when the results of a prostate specific antigen (PSA) test or digital rectal examination (DRE) are abnormal. This leads to misdiagnosis of most small prostatic cancers present in many older men. Patients with lower urinary tract symptoms (LUTS) who have serum PSA levels higher than 4 ng/ml are primarily advised to undergo prostate biopsy to rule out cancer. However, PSA is organ specific but not cancer specific, so the presence of other prostate diseases such as benign prostatic hyperplasia (BPH), and prostatitis may influence its effectiveness for cancer detection. Hence, the PSA-based prostate cancer detection is fraught with high false-positive rate. Objectives: The use of Serum PSA levels for the early detection of prostate cancer and evaluate its role with other modalities for diagnosis of prostate cancer and to diagnose different diseases of prostate, i.e., prostatitis, BPH in prostatomegaly, and its correlation with serum PSA levels. Materials and Methods: This prospective descriptive study was conducted in Command Hospital (EC), Kolkata, West Bengal, India, in the period of June 2011 to June 2013. The patients were selected from the outdoor of Department of Urology and General Surgery. Institutional Ethical Committee Clearance and informed consent of all patients were obtained. 101 men at or >50 years of age presenting with LUTS specifically attributed to prostate problems were included in the study. Men with calcified or fibrotic prostate, with skeletal or distant metastasis or LUTS caused by any urological malignancy and who had previous prostatic surgery or pelvic radiotherapy or complications of urinary obstruction, were excluded from the study. Results: A total of 101 male patients presenting with LUTS were included. Their mean age was 68.66 years. The majority, i.e., 49 (48.5%) of the study group were in the age group of 61-70 years. 52 (51.5%) of patients had serum PSA


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Study of clinico-epidemiological profile, drug utilization pattern, and outcome of swine flu cases: A recent epidemic in Latur

2016-12-02T09-16-04Z
Source: International Journal of Medical Science and Public Health
Aruna Gurung, Jugalkishor Bhavarlal Jaju, Shrikant Chandrakant Dharmadhikari, Ganesh Ramkrishna Pawar, Rajvardhan Rameshrao Solunke.
Background: Swine flu, an acute respiratory tract disease, is caused by swine flu virus. The World Health Organization (WHO) declared the H1N1 pandemic in June 2009 after more than 70 countries reported cases of H1N1 infection. Since 2009-2014, 59,677 cases and 4141 deaths have been reported in India. Objective: To study the clinico-epidemiological profile, drug utilization pattern, and outcome of H1N1 positive cases admitted to swine flu ward from January 2015 to September 2015 at a tertiary care hospital in Latur. Materials and Methods: The study was conducted from January 2015 to September 2015 at Government Medical College (GMC), Latur. Clinicoepidemiological profile, treatment details, and outcome of the patients were recorded. Prescription pattern was analyzed using the WHO International Network for Rational Use of Drug use indicators. Results: A total of 52 swine flu positive cases were admitted to GMC, Latur, out of which 38 (73.07%) were female patients and 14 (26.92%) were male patients. Total numbers of drugs prescribed were 267. The most common antimicrobial prescribed was oseltamivir. Total drugs prescribed from the National List of Essential Medicine 2015 were 98 (36.70%). Conclusion: This study is an attempt to know the clinico-epidemiological profile, drug utilization pattern, and outcome in swine flu positive patients. A good adherence to the WHO guideline for clinical management of swine flu cases, the Joint Indian Chest Society and the National College of Chest Physician guidelines, and the WHO Essential Drug List was seen in our study. However, prescription with the brand name, polypharmacy, and excessive use of fixed dose combinations are a matter of concern.


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Cutaneous metastasis: An unusual presenting feature of silent renal cell carcinoma

2016-12-02T09-16-04Z
Source: International Journal of Medical Science and Public Health
Pradosh Kumar Sarangi, Pragnyamaya Debadatta Mangaraj, Pratisruti Hui, Sasmita Parida, Jayashree Mohanty.
Renal cell carcinoma (RCC) is a potentially lethal cancer with aggressive behavior and propensity for metastatic spread. However, it is very rare for RCC to present as metastasis to skin and it is virtually a sign of poor prognosis. Skin metastases have been reported to occur in around 3% of RCC. The most common site for cutaneous metastasis from RCC is the scalp and face, followed by the chest and the abdomen. Herein, we are reporting a case of RCC in a 60-year-old man who presented to us with multiple skin nodules in thorax and abdomen as the sole complaint. Fine needle aspiration cytology from these nodules revealed metastatic deposits of RCC though the patient had no urologic symptoms. Computed tomography and ultrasonography of abdomen revealed right RCC with multiple secondaries in liver, spleen, lungs, chest wall, abdominal wall with retroperitoneal lymphadenopathy, and inferior vena cava thrombus. This case highlights the ubiquity of RCC metastasis and emphasizes the importance of keeping RCC as differential in patients who present with cutaneous metastases.


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Socioeconomic impact on prevalence of chronic suppurative otitis media in school going children in a tribal district of India

2016-12-02T09-16-04Z
Source: International Journal of Medical Science and Public Health
Sachin Garud, Aniket Buche, Prashant Keche, Gaurav Chamania.
Background: Chronic suppurative otitis media (CSOM) is one of the most common ear diseases in the South East Asia having a prevalence of approximately 5.2% in the general population. The socioeconomic cost of CSOM can hamper the auditory development of the child, thus putting a burden on the society. Objective: To find the prevalence of CSOM in school going children and its relation with socioeconomic status. Materials and Methods: Descriptive cross-sectional study involving 990 schools going children in Nanded District of Maharashtra. Result: The prevalence of CSOM was found to be 6.4%, with tubotympanic type constituting majority 87.50% trailed by atticoantral type 12.50%. With respect to socioeconomic groups, upper and lower groups had 37.5%, and lower group had 34.37% prevalence. The most patients presented with moderate hearing impairment 43.75% and mild hearing impairment 31.25%. Conclusion: The socioeconomic cost of CSOM puts an immense burden on the growth of a child. Improvement of health care facilities and awareness among health-care providers would definitely be helpful in reducing the prevalence of ear diseases in the developing countries like ours.


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A cross-sectional study to assess the knowledge and practices about breastfeeding among women in Sembakkam village, Kancheepuram District

2016-12-02T09-16-04Z
Source: International Journal of Medical Science and Public Health
Sahaya Sona Thresa.
Background: Breastfeeding is one of the most effective ways to ensure child health and survival. A lack of exclusive breastfeeding (EBF) during the first 6 months of life contributes to over a million avoidable child deaths each year. Objectives: To estimate the prevalence of EBF and to assess the knowledge and practices about breastfeeding. Materials and Methods: This cross-sectional descriptive study was conducted for a period of 18-month in Sembakkam village. Universal sampling was employed based on the prevalence study, and the sample size was 334. All women with children between 6 and 24 months of age were included as study participants after obtaining written informed consent. Data entry was done in Microsoft Excel, and statistical analysis was performed using SPSS version 23. Chi-square test was used for testing the association at P = 0.05. Results: The prevalence of EBF among the mothers was observed to be 69.1% whereas 30.9% did not practice EBF for their children up to the recommended period. Further, parameters such as educational status, socioeconomic status, occupation, mode, and place of delivery had a significant impact on the prevalence of EBF, and they were statistically significant. Conclusion: The prevalence of EBF in this study was 69.1%. The study participants had good knowledge about breastfeeding though some gaps were observed with regard to their practices. The study clearly emphasized the importance of increasing awareness among pregnant women about breastfeeding and even gave impetus on the necessity of family supporting breastfeeding for the recommended duration.


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Prescription pattern of antihypertensive drugs in a tertiary care teaching hospital

2016-12-02T09-16-04Z
Source: International Journal of Medical Science and Public Health
Rajeev Mishra, Priyanka Kesarwani, Shyam Sunder Keshari.
Background: Hypertension is a major health problem all over the world. It is not a disease in itself, but it is an important risk factor for cardiovascular mortality and morbidity. Objective: To evaluate the prescribing pattern of antihypertensive drugs in a tertiary care teaching hospital in Lucknow region. Materials and Methods: A cross-sectional study was carried out at the Outpatient Department in a tertiary care teaching hospital in Lucknow to access the prescription pattern of antihypertensive drugs during October 2015 to July 2016. Results: In the present study, 65.2% patients received monotherapy while 34.8% received combination therapy. In monotherapy, calcium channel blockers (CCBs) were most commonly prescribed, while angiotensin receptor blockers (ARBs) + diuretics were the most commonly prescribed combination therapy. Conclusion: In the present study, it was found that CCBs were the most commonly prescribed antihypertensive drug, followed by ARBs in monotherapy. Combination therapy was given according to associated risk factors and comorbid conditions.


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A survey study in diabetic subjects on the general information about diabetes mellitus, it’s social aspects, complications and treatment

2016-12-02T04-57-08Z
Source: Medicine Science | International Medical Journal
Gokhan Colpan, Merve Colpan, Canan Ersoy.
Diabetes mellitus (DM) is a metabolic disorder affecting many people worldwide, and its complications have become a global public health burden. Most diabetic patients are not aware of their conditions and the importance of the disease until complications develop, despite education programmes. This study was conducted to evaluate the general information level of diabetic patients about DM, its social aspects, treatment and complications. Patients with type 1 and 2 diabetes were enrolled in the study. A face to face questionnaire was applied to obtain patients' general information and diabetes awareness. To evaluate the overall knowledge, 40 questions were asked. In the assessment of the total scale scores (TSS), each correct answer was scored as 1 and incorrect as 0 point. The mean age of 120 participants was 42.5±15.4 years, 60.8% were females, 75% were married. The information level about the complications were statistically significantly higher in female diabetics than males. Information level about treatment of diabetes was higher in single diabetics compared to married ones. Married group had significantly higher scores concerning complications compared to single group. The results for the general information level, social aspect of diabetes, treatment and TSS were found to be statistically significantly higher in high education level group compared to low. In conclusion, education level of a patient seems to be the most prominent contributor of level of knowledge of diabetes, its complications, treatment and social aspects.


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