Interleukin 10 (IL10) is a poor prognostic marker in several cancers. Its role in breast cancer is not well elucidated. The present study is designed to see the expression of IL10 in breast cancer tissue and to evaluate its correlation with the established markers of prognosis. Sixty female patients who underwent surgery for breast cancer were enrolled for the study. Immediately after surgery, 2-5 g of tumour tissue and similar volume of peritumoural normal breast tissue were collected for IL10 assay. IL10 expression was assayed by immunohistochemistry. IL10 expressing tumours and IL10 non expressing tumours were compared. Chi square/Fisher exact test and student's t test were used to compare the data. p-valueless than 0.05 was considered as statistically significant. Thirty six patients (60 %) of carcinoma breast showed IL 10 expression in tumour tissue as compared to no IL 10 expression in any peritumouralnormal breast tissue (p < 0.01). IL10 expression had statistically significant correlation with locally advanced disease, tumour grade, HER2 + ve tumours and ER-ve, PR-ve, HER2 + ve breast cancer subtypes (p = 0.001, 0.001, 0.001 and 0.01 respectively). No correlation could be found with patient's age, tumour size, tumour histology and ER and PR status. Correlation of IL10 expressing tumours with several established poor prognostic markers of breast cancer may indicate the possible association of IL10 expression with poor prognosis. Large studies with long term follow up are needed to substantiate the association of IL10 with poor prognosis.
Background Small bowel volvulus is a rare entity and it is even rarer for the ileum to undergo torsion without any known predisposing factors. It presents as acute abdomen with features of intestinal obstruction. As it is a life-threatening condition, it should be kept as a differential for small bowel obstruction despite its rarity. Therefore, we report this case. Case report A 60-year-old gentleman presented to our emergency department with a 2-day history of worsening abdominal pain, vomiting, abdominal distension and obstipation. Exploratory laparotomy was done which revealed ileal volvulus with no predisposing factors. Derotation of the segment was done. The postoperative period was uneventful and on follow up after a month, he had a satisfying recovery. Conclusion Though primary ileal volvulus is a rare diagnosis, it should be kept in mind in any patient with small bowel obstruction with pain out of proportion and resistant to opioid management. Early diagnosis and urgent surgical intervention is the key to prevent bowel necrosis and associated morbidity and mortality.
Gastric volvulus leading to acute gastric dilatation is a surgical emergency that should be considered as a differential in patients who present to the emergency department with severe epigastric pain and evidence of gastric outlet obstruction. This condition requires a high index of suspicion that enables early diagnosis and treatment.
Introduction: Communication is an important aspect of the medical profession. Doctor-patient communication plays a significant role in health care delivery. This study aims to find outpatient department patient satisfaction in doctor-patient communication in a tertiary care hospital in Kathmandu, Nepal. Methods: A descriptive cross-sectional study was conducted in the outpatient department of a tertiary care hospital in Kathmandu, Nepal in the month of August 2019. Validated questionnaire of Patient Satisfaction Questionnaire, consisting of 80 items, originally developed by Willis H. Ware and his colleagues were used and distributed to the patient in the outpatient department of the hospital. Their satisfaction level for doctor-patient communication was assessed on a five-point scale. The questionnaire was distributed randomly to the patient attending the hospital outpatient department during one month period. Results: Out of the total participants, 420 (96%) at 95% CI (95.07–96.93) respondents reported that they were satisfied regarding communication with their doctors. Among the patients, 109 (24.0%) visited the department of medicine followed by obstetrics and gynaecology 85 (19.4%). Conclusions: The majority of participants were found to be satisfied with the doctor-patient communication. While this study has shown that the communication in the doctor-patient relationship was seen to be satisfactory, this might not show the generalized picture of the country. We should also think of ways to further improve the communication in our hospitals.
Introduction: Breast cancers in less than 40 years of age group usually present with aggressive biology and has poor prognosis. The aim of this study was to see clinic-pathological and hormone receptors of breast cancers in young women and compare with less than 40 year age group.
Background and Objectives: Iron Deficiency is the commonest nutritional deficiency worldwide, affecting more than one-third of the population, its association with Heart Failure with or without anemia is of growing interest. As iron supplementation improves prognosis in patients with Heart Failure, Iron Deficiency is an attractive therapeutic target – a hypothesis that has recently been tested in clinical studies. This study is designed to estimate the prevalence and pattern of iron deficiency (ID) in heart failure (HF) with reduced ejection fraction patients with or without anemia. Material and methods: It was a single center hospital based cross sectional observational study. A total of 60 male and female patients with diagnosis of heart failure based on the Framingham Criteria, who gave consent for the study were included. They underwent laboratory evaluation including hemoglobin concentration, serum iron, transferrin saturation percentage, serum ferritin, total iron binding capacity. Serum ferritin <100 μg/l was used to diagnose absolute ID. Functional ID was defined as a serum ferritin level of 100–300 μg/l and a transferrin saturation of <20 %. Anemia was defined as hemoglobin (Hb) <13 g/dl for males and <12 g/dl for females, based on World Health Organization definition. Results: Using the above definitions iron deficiency was found in 28 (46.67%) patients. 36.67% patients had absolute iron deficiency and 10% patients had functional iron deficiency. Females had a higher non statistically significant iron deficiency than males 63.16% vs 39.02%. 15 patients (48.38%) with iron deficiency did not have anemia, and 11 (35.5%) of those patients had absolute iron deficiency. Conclusion: Iron deficiency is prevalent in patients with heart failure and reduced ejection fraction irrespective of anemia and hemoglobin levels. Many of those patients can have functional iron deficiency. Measurement of iron status should be a routine during workup of heart failure patients and further studies are needed to determine the prognostic value of iron status measurement and the influences of treatment of iron deficiency in heart failure patients. Many such trials are now underway.
Summer monsoon onset is considered as the beginning of the rainy season in South Asia. In Nepal, summer monsoon onsets from eastern part and ~80% of the annual rainfall occurs during summer monsoon season (i.e., June to September). The monsoon onset is one of the crucial elements for the socio-economic development as the majority of the population depends primarily on rain fed agriculture systems for their livelihood. For identification of the monsoon onset date over eastern Nepal, daily mean satellite-derived Outgoing Long-wave Radiation (OLR) data (10 × 10 spatial resolution) obtained from National Environmental Satellite Data and Information Service (NESDIS), NOAA is used. Long term OLR data from 1979 to 2019 for March to June is analyzed to study monsoon progression towards eastern Nepal. The rainfall amount obtained from rain gauge stations is compared with the OLR data, which depicts a higher correlation in the southern part of Eastern and Central Nepal than in the northern regions. A convective episode signifies the drop in OLR by about 45 Wm-2 from 10 May to 10 June. Further, the relation between the date of characteristic fall of OLR below 250Wm-2 and monsoon onset date announced by MFD (Meteorological Forecasting Division) for the study period is evaluated to predict new onset dates over the region. The predicted onset date is found as 13th of June on average and its correlation with the MFD onset date is 0.6 (p<0.01). The study highlights the potential application of the satellite-derived OLR based method for the early prediction of onset of summer monsoon over eastern Nepal.
Introduction: There is great concern and risk of transmission of COVID-19 infection from the aerosolized smoke during laparoscopic surgery although there is a lack of enough literature to prove this. To minimize these risks and get the benefi t of laparoscopic surgery, we used a low-cost fi ltration system connected to an underwater seal bag fi lled with a 5% sodium hypochlorite solution.Materials and Methods: This is a retrospective study of prospectively maintained data of cases of laparoscopic surgeries using a low-cost fi ltration device system connected with an underwater seal bag fi lled with 5% sodium hypochlorite solution. Use of personal protective equipment, minimal staff in operative theatre, preoperatively testing of patients before admission for surgery was done. During surgery, minimal use of electrocautery in low power setting maintaining low pneumoperitoneum and cautious desuffl ation of smoke during and end of the procedure from one of the trocars fi tted to heat and moisture exchanger Filter, connected through a tube to 5 % sodium hypochlorite solution in underwater seal bag was performed.Results: During the lockdown from May 2020 to October 2020, 41 elective laparoscopic surgeries were done. All patients were tested negative before the procedure. No staff in operation theatre developed symptoms of COVID-19 or tested positive for COVID-19 infection for up to 2 weeks period.Conclusions: In this Pandemic situation, we have to co-habit with this SARS-Cov-2 virus. Minimally invasive surgeries can be continued with safety measures with modifications like the use of low-cost filtration devices for smoke filtration and evacuation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.