BACKGROUND HCC is the fifth most common cancer in the world. Overall, it has a poor prognosis making it the second leading cancer in terms of cancer-related mortality. A comprehensive analysis of patients with this disease is not available in India. MATERIALS AND METHODS A retrospective study was conducted to study the clinical features, biochemical and radiological features of patients presenting with HCC in the Department of Gastroenterology, Government Medical College, Kottayam, Kerala, during January 1, 2015-December 31, 2016. After applying inclusion and exclusion criteria's, patients with HCC were included in the study. RESULTS 84 patients were diagnosed to have HCC during the study period with male predominance. 51 males and 33 females. Mean age of presentation was 54.6 years. HCC developed in the background of cirrhosis in 97.7% cases. Most common presentation was decompensation of the underlying chronic liver disease. Alcohol was the leading aetiology. Multicentric nature was seen in 78.6% cases. AFP was elevated only in 28.5% cases. Portal vein thrombosis was present in 31.95% cases. 84.2% cases presented in advanced state according to BCLC classification. CONCLUSION Alcohol is the leading cause of cirrhotic patients who develop HCC followed by NAFLD. Most of the HCC patients presented with advanced diseases when curative therapeutic options are out. Study calls for creating public awareness about the causes of cirrhosis and its consequences. It also highlights the need for meticulous periodic USG screening in cirrhotics to detect early lesions.
Aim: This study retrospectively analyses the impact of the 1st year of the COVID-19 pandemic on route of presentation and staging in lung cancer compared to the 2 years before and after implementation of the Leicester Optimal Lung Cancer Pathway (LOLCP) in Leicester, United Kingdom. Method: Electronic databases and hospital records were used to identify all patients diagnosed with lung cancer in 2018 (pre-LOLCP), 2019 (post-LOLCP), and March 2020–2021 (post-COVID-19 lockdown). Information regarding patient characteristics, performance status, stage, and route of diagnosis was documented and analysed. Emergency presentation was defined as diagnosis of new lung cancer being made after unscheduled attendance to urgent or emergency care facility. Results: Following implementation of the LOLCP pathway, there was a significant decrease in emergency presentations from 26.8 to 19.6% ( p = 0.002) with a stage shift from 33.9% early stage disease to 40.3%. These improved outcomes were annulled during the COVID-19 pandemic, with emergency presentations increasing to 38.9% ( p < 0.001) and a reduction in early-stage lung cancer diagnoses to 31.5%. There was a 61% decline in 2 week wait referrals but no significant decline in the LOLCP direct-to-CT referrals. Conclusion: We have demonstrated a significant increase in late-stage lung cancer diagnoses and emergency presentations during the first year of the COVID-19 pandemic. The causes for these changes are likely to be multifactorial. The long-term effect on lung cancer mortality remains to be seen and is an important focus of future study.
BACKGROUNDIrritable Bowel Syndrome (IBS) is a common functional disorder and the pathophysiology of IBS is poorly understood.The aim of the study is to assess the prevalence of SIBO in patients with IBS using Lactulose Hydrogen Breath Test (LHBT). Diagnosis of IBS was made according to the Rome III Criteria and Lactulose Hydrogen Breath Test (LHBT) was done.
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