Background: Trends for incidence of breast cancer are on the rise in India. However, regional specific epidemiological data for North Coastal Andhra Pradesh are inadequate. The study aims to stress upon the trends of the incidence and burden of locally advanced breast cancer in the region.Methods: In a retrospective quantitative study, 310 in-patients of Department of General Surgery, King George Hospital diagnosed with breast cancer whose information is in the medical records covering the calendar period from May 2014 to May 2019 were studied.Results: The number of females being admitted as in-patients for treatment of breast cancer has increased from 11.2% to 13.6% in these five years. The overall result showed that the age of breast cancer patients ranged from 28-74 years, with a mean age of 49.12±10.942. The average duration of time lag to contact with health personnel was 3.6 months for all the cases included in our study. Stage III was the most common presentation constituting 55.01% patients of the series. Most common cause for late presentation was lack of awareness (64.5%) followed by emotional reasons and cultural barriers (31.9%).Conclusions: There is an urgent need for implementation of measures to ensure early presentation as prevention of LABC is much better than cure.
Background: Diabetic foot ulcers (DFU) are debilitating to the patients and significantly impair their quality of life. DFU associated with infection have the worst outcomes and may lead to amputations if timely intervention is not done. In the present study, aim was to identify the association between the type of organism isolated and the rates of amputations in diabetic foot ulcers.Methods: We retrospectively studied 50 diabetic foot ulcers from January 2017 to June 2017, who were in-patients in a single unit of surgery department in King George Hospital, Visakhapatnam. Baseline clinical examination was done. Parameters such as age, sex, duration, diabetic status and its treatment, organisms isolated, various treatment options for ulcers and the outcomes were studies.Results: Males were the predominant study subjects (M: F=32:18). The age of presentation was 18-65 years with an average of 46 years. Gram negative organisms were the frequent microbial isolates, all being mono-microbial infections. It was dominated by E. coli (17), Pseudomonas (12) and Klebsiella (11). Above-knee amputation was done in one patient and below-knee amputations in three patients. Total mortality in our study was 5. After applying the chi-square test, it was found that there is no significant association between the type of organism and the rate of amputations in our study.Conclusions: Diabetes is a significant risk factor for ulceration in the extremities, which possesses considerable mortality and morbidity. Early intervention, control of diabetes and compliance of the patient treatment are all necessary to reduce the rates of amputations and mortality in patients with diabetic foot ulcers.
Background: Aim of the study was to find accuracy of pre-operative fine needle aspiration cytology (FNAC) and thyroid imaging reporting and data system (TIRADS) in predicting the nature of nodular goitre and confirming it with post-operative biopsy. Objective of the study was to assess the sensitivity and specificity of FNAC compared with post-operative biopsy and to assess the sensitivity and specificity of TIRADS compared with post-operative biopsy.Methods: This retrospective study was carried out at tertiary hospital, King George Hospital, Visakhapatnam over a period of 1 year from march 2018 to march 2019. Sensitivity and specificity are calculated based on formulae.Results: Sample size calculated with 90% confidence interval for population of vizag is 96, a sample of 100 patients were taken in this study. Of the 100 cases, 16 had thyroid carcinoma. 15 of them were papillary carcinoma and 1 follicular carcinoma. 8 cases matched with cytology report after post op biopsy and 8 we mismatched with cytology report after post op biopsy. The incidence of malignancy in clinically and cytologically benign goitre is 8.69. In our study sensitivity of FNAC is 50%, specificity is 100% and accuracy of test is 92% and TIRADS has a sensitivity of 100% and specificity of 72.62% and an accuracy of 77%.Conclusions: The current study has showed the disparity we see in thyroid neoplasms in FNAC test and TIRADS, which were proved to be different diagnosis in clinical and histopathology, so even if cytology is benign, we can’t rule out malignancy. FNAC and TIRADS combined have more sensitivity and specificity than individual tests.
Background: Surgical site infections are one of the most common complications in the postoperative period leading to increased morbidity, prolonged hospital stay and reduced quality of life. The present study aims to identify the incidence of surgical site infection (SSI), risk factors, causative organisms, and their sensitivity patterns in patients who have undergone elective abdominal surgeries.Methods: A prospective study containing 200 patients who have undergone elective abdominal surgeries from May 2018 to January 2020 were evaluated. A thorough history was taken in all the patients. A detailed clinical examination and routine investigations were done. Parameters such as body mass index (BMI), diabetic status, type of surgery, wound grading, culture, and sensitivity patterns were considered. The patients underwent treatment based on their investigatory reports.Results: In the present study, 54 patients developed surgical site infection, and among them, 22 are diabetics. Only ten patients with normal BMI developed SSI, whereas the other 44 patients who developed SSI had abnormal BMI. The incidence of SSI was higher in clean-contaminated surgeries comprising up to 89% of cases. Staphylococcus aureus was the most commonly isolated organism, and cefoperazone plus sulbactam was the most sensitive on antibiogram.Conclusions: The surgical site infections are on rising trend due to the emergence of antibiotic-resistant microorganisms. Treatment of the underlying risk factors, regular wound dressings, and antibiotics, according to sensitivity patterns, are the mainstay.
Background: Ulcers of lower extremities are debilitating to the patient directly and also have a great impact on the economy. The present study aims to examine the outcomes of lower limb ulcers, mainly in terms of amputations and mortality in the diabetic and non-diabetic population. Research Design and Methods: A retrospective database containing 100 cases of lower limb ulcers from 2016 to 2017 were evaluated. History obtained and baseline clinical examination was done in all patients. Treatment options like debridement, fasciotomy, split-skin grafting, minor and major amputations were considered and outcomes studied. Results: Majority of the patients were from rural areas with a mean age of 52 years. Males were the predominant study subjects. The ratio of diabetics to non-diabetics is 52:48. Debridement was done in 63% of the cases, skin grafting in 13%, fasciotomy in 6%, minor amputations in 8% and major amputation in 10% of the study group. Above-knee amputation was done in 6 cases, of which only one was diabetic. 4 patients underwent below-knee amputation, of which 3 patients were diabetic. There were a total of 5 deaths, all of them being male, diabetic cases. Conclusion:Diabetes has an increased risk of mortality and morbidity in patients with lower limb ulcers and also leads to significant impairment of quality of life. An aggressive multidisciplinary approach is required to manage foot problems in such patients and also to reduce the risk of death from other comorbid conditions to save both limb and life.
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