To ascertain different etiologies for abdominal pain in dengue fever with their respective incidence and their management. Patients and Methods: Patients admitted with dengue fever (Confirmed by ELISA or NS1Ag) with pain abdomen in our hospital were included in the study. The cause of pain abdomen ascertained clinically and by following test: Pancreatitis -amylase, lipase, USG, CECT, Hepatitis -liver function test, Hollow viscous perforation Erect -X-ray abdomen, Cholecystitis -USG, Appendicitis -TLC, USG. Results: Out of total cases (n=214) included into the study features of acalculous cholecystitis were seen in 122 (58%) patients, pancreatitis in 24 (11.5%), appendicitis in 4 (1.9%), hepatitis: 27 (12.9%) non-specific in 33 (15.7%) patients. All of the patients were managed conservatively and regularly followed up till they became asymptomatic. None of the patients required any surgical intervention. All the patients responded well to conservative line of management and were discharged. Conclusions: Abdominal pain developing in dengue patients mimics many of surgical emergencies like cholecystitis, appendicitis, hepatitis, pancreatitis. Most of these patients respond well to conservative line of management with I.V fluids, antibiotics, analgesics without the need for any surgical intervention. Hastily taken decisions with operative management for such patients have led to serious consequences in the past. Our study supports conservative line of management in such scenarios and advocates avoidance of surgical option. Our study also throws light on the various modes of presentations, with their respective percentages.
To evaluate and quantify the response to single cycle neo-adjuvant chemotherapy in stage IIB & IIIA breast cancer. Methods: A total number of 25 cases of breast carcinoma were selected for the study. All the patients diagnosed as breast carcinoma with stage IIB and IIIA and admitted in surgical wards were selected for this prospective study at R.L. Jalappa. Hospital and Research Centre, Tamaka, Kolar Attached To Sri Devaraj Urs Medical College between December 2013 and June 2015. Clinical tumor size was estimated before the start of chemotherapy (FAC regimen) and after an interval of 10 days by sonomammography. Results: In our study we found that there is decrease in tumor size in 16% of patients (i.e 4 patients among 25) in those who received single cycle neo adjuvant chemotherapy in patients with stage IIB and IIIA patients. With 95% confidence interval ranging from 6.40-34.65. This decrease in tumor size has resulted in down staging among three cases (Down staged from stage IIB to stage IIA). Conclusion:In our study we found that single cycle NAC does not decrease the tumor size in significant number. The decrease in tumor size was noticed in patients who had no nodal involvement and in multiparous women. Single cycle Neoadjuvant chemotherapy is preferred in patients who cannot take up 3 cycles of NAC. These patients can be tried with single cycle NAC which helps to halt the disease in tumor progression.
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