Author Archives: pisrt

Abstract:Background: Breast cancer is the most common malignancy among women worldwide. According to the GLOBOCAN 2020 estimates of cancer incidence and mortality, female breast cancer has surpassed lung cancer and is now the most commonly diagnosed cancer, with an estimated 2.3 million new cases. In India, breast cancer has moved from being the fourth most common cancer in the 1990s to the first. The prevalence of established hormonal and reproductive risk factors is higher in Western countries, but these risk factors are not commonly observed in the rural population of India. Therefore, it is important to study the probable risk factors in our population, including the potential role of obesity, especially in postmenopausal women, in the development of breast cancer.
Aim and Objectives: The aim of our study is to determine the demographic profile of breast cancer patients and identify any associated risk factors for breast cancer in this population.
Methods: This analytical cross-sectional study was conducted at Alluri Sita Rama Raju Academy of Medical Sciences (ASRAM) over a period of one year from March 2021 to February 2022. We included 72 patients with histologically proven breast carcinoma who attended the Oncology OPD and met the inclusion criteria.
Results: In our study, approximately 86% of breast cancer patients had a body mass index (BMI) greater than 23. Obesity is known to be associated with increased estrogen levels, which can be a risk factor for hormonal-dependent breast cancer. Among the study group, 52% were luminal positive, 25% were triple negative, and 22.2% were HER2 neu positive.
Conclusion: Our study found that approximately 86% of breast cancer patients were obese. The association between BMI and breast cancer needs to be further studied in randomized control trials. Furthermore, reproductive and hormonal risk factors were not significantly observed in our population group.

Abstract:Background and Aims: Ventilator associated pneumonia (VAP) develops after more than 48 hours of mechanical ventilation. VAP is the leading cause of death among hospital acquired infection and prolongs time spent on the ventilator, length of intensive care unit (ICU) stay and length of hospital stay after discharge from the ICU. The concept of ‘bundles’ which can be defined as groups of evidence based interventions when, performed together, improve outcome. Hence this study was undertaken to assess the incidence of VAP and effectiveness of Bundle to prevent VAP.
Methods: This study was conducted in two phases. Pre-interventional phase (Phase-1) is done for three months by observing the current practices in mechanically ventilated patents and assessing the incidence of VAP. Then in post-interventional phase is conducted for three months by applying the bundle care approach, educating the interns, staff nurses and contact care givers regarding the quality improvement project and then assessing the incidence of VAP.
Results: Total 40 patients were involved in the study with 20 patients in each trial. The incidence of VAP was more in pre-interventional trial and the VAP incidence was reduced in post-interventional trial after implementing bundle care.
Conclusions: VAP prevention can be achieved to a large extent with the use of Bundle care approach .However, a major limitation is the lack of adherence to the set protocols by the health care professional especially in developing countries like India where the still the Patient to Nurse ratio is poor and overworked doctors . But one of the way to improve is by educating them through targeted training and using checklist which will help to improve adherence and ultimately patient outcome.

Abstract:Objective: The objective of this study was to compare the effects of single intra-articular platelet-rich plasma (PRP) and corticosteroid (CS) injections in patients diagnosed with adhesive capsulitis of the shoulder.
Design: Patients between the ages of 30-70 years, of either sex, diagnosed with adhesive capsulitis of the shoulder with a duration of less than 6 months, were included. In the intra-articular corticosteroid (IA-CS, control) group, 30 patients received a single injection of IA-CS (2 ml), while in the IA-PRP (test) group, 30 patients received a single IA-PRP injection (2 ml) into the glenohumeral joint under ultrasound guidance. All patients were prospectively followed for 24 weeks.
Results: Thirty patients in the IA-PRP group and thirty in the IA-CS group completed the entire 24-week study period. At 24 weeks, a decrease in QUICK DASH score was observed in the IA-PRP group (16) compared to the IA-CS group (33). In terms of range of movement, the IA-PRP group showed significant improvement in abduction, internal rotation, and external rotation compared to the IA-CS group. No major complications were observed in any patients.
Conclusions: At the 24-week follow-up, a single dose of IA-PRP injection was found to be more effective than an IA-CS injection in improving pain, disability, and shoulder range of motion in patients with adhesive capsulitis of the shoulder.

Abstract:Overview: Cancer poses a significant global threat\({}^{1}\). Lymph nodal metastasis is a crucial prognostic factor, and its detection presents a challenge for pathologists.
Aims: The aims of this study are as follows: to determine the common sites affected by metastatic lymphadenopathy, to evaluate the effectiveness of the cell block technique in preserving cell morphology compared to conventional fine needle aspiration (FNA) samples, to assess the preservation of immunohistochemical properties using the cell block technique, and to determine the role of immunohistochemistry in cell block preparations of malignant breast neoplasms for making a final diagnosis.\\
Materials and Methods: Immunohistochemistry using AE1 and AE3 markers was performed on sections made from cell blocks obtained through the fine needle aspiration technique. Cell block preparation involved a mixture of 9 parts ethyl alcohol and 1 part 10% formalin, followed by hematoxylin and eosin staining. Two pathologists independently analyzed H&E-stained smears and immunocytochemistry results, and the findings were calculated.
Results: In the present study, pan CK positivity was observed in 31 out of 48 cases, of which 25 were squamous cell carcinomas, 2 were suspicious for malignancy, and 2 were other cases.
Conclusion: The use of Pan CK (AE1/AE3) markers demonstrated a significant percentage of positivity in identifying squamous differentiation. This panel of markers, along with others, can be employed for epithelial differentiation and can assist in neoadjuvant therapy and patient care.