Purpose:To compare the cancer detection rate in patients with raised serum prostate-specific antigen (PSA) or abnormal digital rectal examination (DRE) results between the 10-core and the 16-core biopsy techniques in an Indian population.Methods:Between November 2010 and November 2012, 95 men aged >50 years who presented to the Urology Department with lower urinary tract symptoms, elevated serum PSA, and/or abnormal DRE findings underwent transrectal ultrasonography (TRUS)-guided prostate biopsy. A total of 53 patients underwent 10-core biopsy and 42 patients underwent 16-core biopsy.Results:Of the 53 men in the 10-core group, 8 had cancer, whereas in the 16-core biopsy group, 23 of 42 men had cancer. Detection of prostate cancer was significantly higher in patients who underwent 16-core biopsy than in those who underwent 10-core biopsy (P<0.001). Among the 95 men, 44 men had abnormal DRE findings (46.3%), of whom 23 showed cancer (52.27%). Of 51 men with normal DRE findings and elevated PSA, 8 men had malignancy with a cancer detection rate of 15.68%. Among 20 men with PSA between 4.1 and 10 ng/mL, 2 (10%) had cancer. In 31 men with PSA between 10.1 and 20 ng/mL, 3 cancers (9.67%) were detected, and in 44 men with PSA >20 ng/mL, 26 cancers were detected (59.09%).Conclusions:The cancer detection rate with 16-core TRUS-guided biopsy is significantly higher than that with 10-core biopsy (54.76% vs. 15.09%, P<0.001). In patients with both normal and abnormal DRE findings, 16-core biopsy has a better detection rate than the 10-core biopsy protocol. With increasing PSA, there is a high rate of detection of prostate cancer in both 10-core and 16-core biopsy patients.
Background: Surgical site infections (SSI) are the second most common Nosocomial infections after urinary tract infections accounting to 20-25% of Nosocomial infections worldwide. Based on the depth of the infections, SSI is classified by CDC as superficial incisional, deep incisional and organ/space. The development of SSI is dependent upon multiple factors like class of wound, immune status, type of surgery, type of anesthesia; surgical techniques etc and are interplay of multiple factors. Objective of the present study was conducted in identifying the predictors, risk factors and incidence rates of SSI at a tertiary care hospital. The study also identifies the causative bacterial pathogens and their antibiotic susceptibility patternMethods: A prospective cross-sectional study was conducted for a period of two years by department of general surgery involving all patients who underwent surgery, and pre-operative, intra operative and risk factors of the cases were collected using standardized data collection form. Specimens from the infected wounds were collected and processed for isolation of pathogens. Antibiotic susceptibility of pathogens was done using standard guidelines.Results: The incidence of SSI in present study was 25.34% with 81.58% superficial SSI and 18.42% deep SSI. Laparotomy was the common procedure and 63.2% of cases were females and 41-60 years was the most common age group. Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli were the common pathogens and were sensitive to carbapenems, vancomycin and linezolid. Significant association was observed with presence of pre-morbid analysis, presence of drain, use of povidone iodine alone and development of SSI.Conclusions: In present study the incidence of SSI was significantly high in this hospital and associated with premorbid illness, duration of surgery, presence of drain and use of drain at site of surgery. Staphylococcus aureus was the common pathogen and incidence of MRSA is higher than many other reports. A continuous monitoring and surveillance of patients with a predefined protocol will help in early identification of cases with risk of development of SSI. A feedback of appropriate data to surgeons is highly recommended to reduce the SSI rate in developing countries.
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