scholarly journals Clinical Outcomes of Surgical Management of Primary Brachial Plexus Tumors

2021 ◽  
Vol 54 (02) ◽  
pp. 124-129
Author(s):  
Sunil Gaba ◽  
Subair Mohsina ◽  
Jerry R. John ◽  
Satyaswarup Tripathy ◽  
Ramesh Kumar Sharma
Keyword(s):  
Brachial Plexus ◽  
Clinical Outcomes ◽  
Surgical Resection ◽  
Total Resection ◽  
Dumbbell Tumor ◽  
Female Ratio ◽  
Grade 5 ◽  
Benign Pathology ◽  
A Prospective Study ◽  
Intraoperative Electrical Stimulation

Abstract Introduction This study evaluates the clinical presentation, tumor characteristics, and clinical outcomes of surgically treated benign and malignant brachial plexus tumors (BPTs). Methods A prospective study of patients with BPTs from June 2015 to August 2020 was conducted. All patients underwent surgical resection with microneurolysis and intraoperative electrical stimulation to preserve the functioning nerve fascicles. Results Fourteen patients with 15 BPTs underwent surgical resection. Mean age was 37.8 ± 12.3 years; with male to female ratio 4:10. The clinical presentations were swelling (100%), pain (84.6%), and paresthesia (76.9%). The lesions involved roots (5/15), trunk (5/15), division (1/15), and cords (4/15). Thirteen patients had benign pathology (8 schwannomas, 3 neurofibromas, 2 lipomas) and two had malignant neurofibrosarcoma. Gross total resection was achieved in all cases except a dumbbell tumor. The mean follow-up period was 24 ± 5 months. Postoperatively, all patients reported improvement in pain and paresthesia with no new sensory deficit. All patients had developed initial motor weakness (Grades 2–4); however, full power (Grade 5) was recovered by 3 to 5 months. Conclusion Total resection can be achieved by appropriate microneural dissection and electrophysiologic monitoring and is potentially curative with preserving function.

scholarly journals A prospective study of clinico-radiological assesment and management of obstructive jaundice in Mmimsr, Mullana

2021 ◽  
Author(s):  
Karaninder Singh Wilku ◽  
Himank Gandhi
Keyword(s):  
Early Diagnosis ◽  
Obstructive Jaundice ◽  
Prospective Study ◽  
Abdominal Ultrasound ◽  
Vital Role ◽  
Diagnosis And Treatment ◽  
Female Ratio ◽  
Cbd Stones ◽  
Benign Pathology ◽  
A Prospective Study

Background: Obstructive jaundice poses diagnostic and therapeutic challenges. This study was undertaken to highlight the clinical and radiological assessment of obstructive jaundice in our setting and to approach for early diagnosis and treatment before irreversible tissue insult sets in.Methods: Present study was prospective study conducted at Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala. Data were collected on prescribed proforma and analyzed stastically.Results: A total of 50 patients were studied. It is more common in productive adult with the mean age of 51.04±12.40 years. The male to female ratio was 1:1.08. Majority of the patients were having benign pathology (62%) and choledocholithiasis was the commonest benign cause. Abdominal ultrasound was the diagnostic imaging done in all patients and revealed dilated CBD (>1 cm) in 78% cases, dilated IHBR in 96%of cases and multiple CBD stones in 78.3% of cases. CT was reserved for suspected malignant and MRCP was planned in stone or benign causes. 70% patients were selected for ERCP and 62% of patients underwent definitive open procedure viz choledocholithotomy (40%), hepaticojejunostomy (12%).Conclusions: Obstructive jaundice in our study was more prevalent in females and the cause is mostly CBD stones. The result suggests that early diagnosis and treatment plays vital role in the prognosis of patients with obstructive jaundice.  

scholarly journals Clinical Outcomes of Metastatic Colorectal Cancer Following Surgical Resection of the Primary tumor at Hiwa Cancer Hospital, Sulaimani, Iraq

2021 ◽  
Vol 10 (1) ◽  
pp. 7-12
Author(s):  
Kadhim Faruq Namiq ◽  
Kosar Mohammad Ali ◽  
Mohammed Ibrahim Mohialdeen Gubari
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Clinical Outcomes ◽  
Surgical Resection ◽  
Primary Tumor ◽  
Smoking Habit ◽  
Primary Tumors ◽  
Female Ratio ◽  
Cancer Hospital ◽  
One Year

Background: Colorectal cancer (CRC) is one of the main causes of cancer-related mortality. The surgical resection of primary CRC tumors is a critical line of treatment. The present study investigated the clinical outcomes of the surgical resection of the primary tumor in metastatic CRC patients. Materials and Methods: In this prospective and retrospective study, 81 metastatic CRC patients were recruited at Hiwa Cancer Hospital in Sulaimani, Iraq from January 2016 to December 2019. Forty-one patients underwent surgical resection of their primary tumor while the remaining 40 patients did not undergo resection. Data regarding patients’ clinical outcomes were obtained from the clinical portal system of the hospital and were analyzed using SPSS (version 23.0). Results: The patients’ mean (± SD) age was 53.5 (± 17.02) years and the male-to-female ratio was 1.3:1. Patients undergoing the surgical resection of their primary tumors had a significantly better one-year survival compared to those who did not undergo resection (P = 0.04). Based on the results, patients in the surgical resection group continued to have a better overall survival although it was not statistically significant (P = 0.1). Significantly more patients with colon cancer underwent surgical resection compared to rectal cancer (P = 0.03), and smoking habit negatively affected the chance to undergo surgical resection (P = 0.009). Conclusion: In general, the surgical resection of the primary tumor has a significant favorable impact on one-year survival, but possibly not on overall survival. The primary site of the tumor and smoking habits significantly influence the chance to undergo surgical resection whereas the grade of the tumor or the type of systemic therapy has no significant impact in this regard.

scholarly journals Myxopapillary ependymomas; proximity to the conus and its effect on presentation and outcomes

2021 ◽  
Vol 12 ◽  
pp. 429
Author(s):  
Ahmed Helal ◽  
Anthony L. Mikula ◽  
Nadia N. Laack ◽  
William E. Krauss ◽  
Michelle J. Clarke
Keyword(s):  
Clinical Outcomes ◽  
Surgical Resection ◽  
Extent Of Resection ◽  
Conus Medullaris ◽  
Spinal Tumors ◽  
Myxopapillary Ependymoma ◽  
Female Ratio ◽  
Presenting Symptoms ◽  
Direct Invasion ◽  
Pain Symptoms

Background: Myxopapillary ependymomas (MPE) are intradural spinal tumors with a predilection to the filum terminale. Damage to conus medullaris during surgery can result in sphincteric and sexual dysfunction. The purpose of this study is to determine how myxopapillary ependymoma proximity to the conus impacts patient presentation, extent of resection, and clinical outcomes. Methods: Fifty-one patients who underwent surgical resection of pathologically confirmed myxopapillary ependymoma with at least 1 year of follow-up were included in the study. We collected initial presenting symptoms, distance of the tumor from the conus, extent of resection, and postoperative clinical outcomes including bladder dysfunction. Results: Average age was 38 years (range 7–75 years) with a male to female ratio of 1.43:1. Patients most commonly presented with pain symptoms (88%), and 12 patients (23.5%) had urologic symptoms on presentation. The mean tumor distance from the tip of the conus was 1.60 cm (10 cm above to 21 cm below the tip of the conus). Patients with tumors in contact with the conus had a significantly higher rate of preoperative urinary symptoms and were more likely (32% vs. 14%) to suffer postoperative urinary sphincteric disturbances. Tumors with direct invasion of the conus medullaris were more likely to require intralesional resection and fail to achieve a gross total resection (GTR). Conclusion: Patients with MPE in close proximity to the conus were more likely to suffer from long-term morbidity related to urologic issues following surgical resection. Adjuvant radiotherapy may be a viable option for patients who fail to achieve GTR.

Sociodemographic, Clinical Profile and Outcome of Tuberculosis in Baramulla District of North Kashmir of India

JMS SKIMS ◽  
2018 ◽  
Vol 21 (1) ◽  
pp. 11-16
Author(s):  
Abdul Ahad Wani ◽  
Javeed Iqbal Bhat ◽  
Muzafar Naik ◽  
Nisar Ahmed Dar ◽  
Syed Masood Ahmed
Keyword(s):  
Elementary Education ◽  
Pulmonary Tuberculosis ◽  
Rural Areas ◽  
Extrapulmonary Tuberculosis ◽  
Steady Increase ◽  
Female Ratio ◽  
Directly Observed Treatment ◽  
Night Sweats ◽  
Immunodeficiency Syndrome ◽  
A Prospective Study

Background: India accounts for one-fourth of the global tuberculosis (TB) burden. Since the countrywide implementation of RNTCP, tuberculosis care has received renewed focus. Directly observed treatment short-term (DOTS) is a cornerstone of RNTCP program. Objective: To evaluate demographic profile, clinical presentation and outcome of TB in district Baramulla of North Kashmir. Methods:  A prospective study over a period of seven years in patients diagnosed with TB in district Baramulla of North Kashmir. Results: This study was conducted prospectively over seven years from March 2011 to February 2017. A total of 802 patients were enrolled in the study. Among them, there were a total of 638 adult patients and 164 paediatric patients with a male: female ratio of 1:0.99. Majority of patients belonged to rural areas of north Kashmir and had received no or elementary education. Pulmonary tuberculosis was diagnosed in 530 (66 %) patients and 272 (34%) patients were diagnosed as extrapulmonary tuberculosis. Sputum for AFB was important mode of diagnosis in our series and was positive in 525 (65%) our patients. Majority of patients presented with fever, weight loss, and night sweats. None of the patients had Acquired Immunodeficiency syndrome (AIDS). There was a consistent improvement in AFB isolation among TB patients over the study period. Majority of our patients were cured completely of disease Conclusion: Sputum positive pulmonary tuberculosis remains the most common presentation of tuberculosis in North Kashmir. There is a steady increase in the proportion of bacteriologically confirmed TB cases over the study period. Furthermore, DOTS treatment is successful in all forms of tuberculosis. JMS 2018;21(1):11-16

Predictive value of CA 19-9 in patients with pancreatic tumours

2020 ◽  
Vol 14 (1) ◽  
pp. 45-48
Author(s):  
Faiza Abrar ◽  
Adnan Riaz ◽  
Kaukab Sultana ◽  
Tariq Feroz Khawaja
Keyword(s):  
Surgical Resection ◽  
Predictive Value ◽  
Local Population ◽  
Pancreatic Disease ◽  
International Studies ◽  
Malignant Tumours ◽  
Pancreatic Tumours ◽  
Benign Pathology ◽  
Pancreatic Tumour ◽  
Age Range

Background: Pancreatic carcinoma is a disease with high modality and has a high incidence of recurrence after surgical resection. The prognosis depends on early diagnosis and treatment. Numerous international studies have reported use of CA 19-9 in diagnosis of pancreatic cancer. We planned this study to validate role of CA 19-9 in our local population. The objective of this study is to correlate raised serum CA 19-9 levels in patients with pancreatic tumours to distinguish between benign and malignant pancreatic disease. Subjects and methods: The present study is a validation study. Thirty-five patients with diagnosis of pancreatic tumor on radiological imaging were included after their informed consent. Data collection forms were filled, blood samples were taken and serum CA 19-9 was estimated by ELISA in Biochemistry department, SIMS. Histopathology samples were collected at time of surgical resection, sent to pathology departments of respective hospitals and histopathological reports collected. All data was collected and analysed by using descriptive method. The study was conducted in Biochemistry department of PGMI and SIMS, Lahore from May 2015 till June 2016. Results: Out of 35 patients, nineteen (54.3%) were female and sixteen (45.7%) were male. Thirty [85.7%] patients were between third to seventh decades of their life. The mean age range around 47.28. Thirty-four patients had malignant tumor and 1 benign on histopathology. CA 19-9 was raised (>37 U/ml) in 33 out of 34 patients with malignant pathology. The patient with benign pathology had CA 19-9 level <37U/ml (the cut off value). Head of pancreas was the commonest site in 32 patients (65%) for tumour occurrence. Total 28 (82%) patients had adenocarcinoma as the histological type of pancreatic tumour. Cholangiocarcinoma in Periampullary region of pancreas was second in frequency, 4 patients (12%). CA 19-9 shows sensitivity of 97% and specificity of 100% to diagnose carcinoma of pancreas in patients with pancreatic tumour. CA 19-9 has 100% positive predictive value to diagnose benign tumour and 50% negative predictive value to diagnose malignant tumours. Conclusion: Raised levels of CA 19-9 has an important role in diagnosis of patients with pancreatic tumour to differentiate between benign and malignant pathology.

scholarly journals Baseline and Kinetic Circulating Tumor Cell Counts Are Prognostic Factors in a Prospective Study of Metastatic Colorectal Cancer

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 502
Author(s):  
Virgílio Souza e Silva ◽  
Emne Ali Abdallah ◽  
Angelo Borsarelli Carvalho de Brito ◽  
Alexcia Camila Braun ◽  
Milena Shizue Tariki ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Drug Resistance ◽  
Prospective Study ◽  
Metastatic Colorectal Cancer ◽  
Clinical Outcomes ◽  
Predictive Biomarkers ◽  
Multi Drug Resistance ◽  
Cell Counts ◽  
Potential Clinical Benefit ◽  
A Prospective Study

The discovery of predictive biomarkers in metastatic colorectal cancer (mCRC) is essential to improve clinical outcomes. Recent data suggest a potential role of circulating tumor cells (CTCs) as prognostic indicators. We conducted a follow-on analysis from a prospective study of consecutive patients with mCRC. CTC analysis was conducted at two timepoints: baseline (CTC1; before starting chemotherapy), and two months after starting treatment (CTC2). CTC isolation/quantification were completed by ISET® (Rarecells, France). CTC expressions of drug resistance-associated proteins were evaluated. Progression-free survival (PFS) and overall survival (OS) were estimated by the Kaplan–Meier method. Seventy-five patients were enrolled from May 2012 to May 2014. A CTC1 cut-off of >1.5 CTCs/mL was associated with an inferior median OS compared to lower values. A difference of CTC2−CTC1 > 5.5 CTCs/mL was associated with a reduced median PFS. By multivariate analysis, CTC1 > 1.5 CTCs/mL was an independent prognostic factor for worse OS. Multi-drug resistance protein-1 (MRP-1) expression was associated with poor median OS. CTC baseline counts, kinetics, and MRP-1 expression were predictive of clinical outcomes. Larger studies are warranted to explore the potential clinical benefit of treating mCRC patients with targeted therapeutic regimens guided by CTC findings.

scholarly journals Tumor Tissue MIR92a and Plasma MIRs21 and 29a as Predictive Biomarkers Associated with Clinicopathological Features and Surgical Resection in a Prospective Study on Colorectal Cancer Patients

2020 ◽  
Vol 9 (8) ◽  
pp. 2509
Author(s):  
Masahiro Fukada ◽  
Nobuhisa Matsuhashi ◽  
Takao Takahashi ◽  
Nobuhiko Sugito ◽  
Kazuki Heishima ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prospective Study ◽  
Surgical Resection ◽  
Tumor Tissue ◽  
Lymphatic Invasion ◽  
Clinicopathological Features ◽  
Stage Iii ◽  
Sample Type ◽  
Significant Difference ◽  
A Prospective Study

Cancer-related microRNAs (miRNAs) are emerging as non-invasive biomarkers for colorectal cancer (CRC). This study aimed to analyze the correlation between the levels of tissue and plasma miRNAs and clinicopathological characteristics and surgical resection. This study was a prospective study of CRC patients who underwent surgery. Forty-four sample pairs of tissue and plasma were analyzed. The miRNA levels were evaluated by RT-qPCR. The level of tumor tissue MIR92a showed a significant difference in CRC with lymph node metastasis, stage ≥ III, and high lymphatic invasion. In preoperative plasma, there were significant differences in CRC with stage ≥ III (MIR29a) and perineural invasion (MIR21). In multivariate analysis of lymphatic invasion, the levels of both preoperative plasma MIR29a and tumor tissue MIR92a showed significant differences. Furthermore, in cases with higher plasma miRNA level, the levels of plasma MIRs21 and 29a were significantly decreased after the operation. In this study, there were significant differences in miRNAs levels with respect to the sample type, clinicopathological features, and surgical resection. The levels of tumor tissue MIR92a and preoperative plasma MIR29a may have the potential as a biomarker for prognosis. The plasma MIRs21 and 29a level has the potential to be a predictive biomarker for treatment efficacy.

Clinical outcomes from a prospective study evaluating the role of ambulation during medical termination of pregnancy

Contraception ◽  
2012 ◽  
Vol 85 (4) ◽  
pp. 398-401 ◽  
Author(s):  
Kamal Ojha ◽  
David J. Gillott ◽  
Patricia Wood ◽  
Elizabeth Valcarcel ◽  
Arti Matah ◽  
...  
Keyword(s):  
Prospective Study ◽  
Clinical Outcomes ◽  
Termination Of Pregnancy ◽  
Medical Termination Of Pregnancy ◽  
Medical Termination ◽  
A Prospective Study
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