COLORECTAL CANCER AND ITS RISK FACTORS AMONG PATIENTS ATTENDING A TERTIARY CARE HOSPITAL IN SOUTHERN KARNATAKA, INDIA

Objective: To determine the association between certain socio-demographic and life style factors with colorectal cancer.Methods: This case-control study was conducted using a pre-designed questionnaire among 100 incident colorectal cancer patients and 200 unmatched controls attending a tertiary care hospital in southern Karnataka. Cases and the controls were interviewed and details regarding their socio-demographic factors were collected. Information on lifestyle factors such as dietary habits, physical activity levels and substance use were documented. They were also assessed for presence of existing co-morbidities and family history of colorectal and other cancers. Multivariable logistic regression was performed to determine the association between various risk factors and colorectal cancer.Results: In the present hospital based study, mean age of the participants was less than 55 years. Sixty three percent of the cases and 54.5% of the controls were males. On multivariable analysis age ≥50years (OR=1.87; 95%CI=1.02-3.45), low physical activity (OR=5.66; 95%CI=3.10-10.34) and low frequency of fruits consumption (OR=4.10; 95%CI=2.21-7.50) and hypertension (OR= 4.65; 95% CI=1.32-16.44) showed a positive association with colorectal cancer.Conclusion: Promoting healthy dietary practices and physical activity among the middle aged population appears to be significant in the context of colorectal cancer prevention in the Indian subcontinent.Keywords: Colorectal cancer, Case–control, Risk factors, Lifestyle, Comorbidities

Comparison of three doses of intrathecal fentanyl (15 mcg, 20 mcg and 25 mcg) for labour analgesia

Background and Objectives: Intrathecal fentanyl provides rapid profound analgesia in labouring parturients in the dose range of 10-50 mcg. Therefore, this study was taken up to compare the effects of three different doses of intrathecal fentanyl (15mcg, 20mcg and 25mcg) with regards to onset and duration of analgesia and to find the effective and safe dosage of the drug for labour analgesia. Materials and Methods: A comparative double blinded RCT was performed on 90 term multigravida parturients after obtaining approval from Institutional Ethical Committee. They were divided randomly into three groups (Groups A, B and C) with 30 parturients each. At cervical dilatation of 3-5cm, they received intrathecal fentanyl 15mcg, 20mcg or 25mcg respectively. In all groups, variables such as HR, SBP, DBP and MBP, SpO2, pain assessment by VAS and sedation score by RSS were recorded at different points during the course of labour and mode of delivery and APGAR score was noted after the delivery of the baby. Results: The demographic data was comparable between the groups. The mean duration of onset of analgesia was 13+/-1 min, 9+/-1min and 5+/-1 min in groups A, B and C respectively.&nbsp

Perfusion index as a predictor of hypotension following subarachnoid block in parturients with non-severe pre-eclampsia undergoing lower segment cesarean section

Background and Aims: Perfusion index, which assesses perfusion dynamics is used as a non‑invasive method in spinal anesthesia cases to detect the occurrence of hypotension. A Perfusion Index value after which hypotension is common can be assessed. Methods: In this prospective double-blind observational study, 100 parturients were included. Baseline Perfusion Index was recorded and spinal anesthesia was carried out with Injection bupivacaine 0.5% (hyperbaric), 10 mg at L3 - L4 / L2 - L3 intervertebral space. Fall in Systolic Blood Pressure < 20 % of baseline was defined as hypotension. Chi-Square test and independent sample t-test was used for the statistical analysis. Spearman’s rank correlation coefficient was applied to assess the correlation between baseline PI and hypotension. The receiver operating characteristic (ROC) curve was mapped for PI and the occurrence of hypotension. Results: The occurrence of hypotension in parturients with PI < 4.25 was 40.9% compared to 94.6% in parturients with PI > 4.25. There was a remarkable association between baseline PI > 4.25, the number of episodes of hypotension 53/100 (p-value < 0.0001) and the total dose of phenylephrine used 53/100 (p-value 0.02).

Perfusion Index as A Predictor of Hypotension Following Subarachnoid Block in Parturients with Non-severe Pre-eclampsia Undergoing Lower Segment Cesarean Section

Background and Aims: Perfusion index, which assesses perfusion dynamics is used as a non‑invasive method in spinal anesthesia cases to detect the occurrence of hypotension. A Perfusion Index value after which hypotension is common can be assessed. Methods: In this prospective double-blind observational study, 100 parturients were included. Baseline Perfusion Index was recorded and spinal anesthesia was carried out with Injection bupivacaine 0.5% (hyperbaric), 10 mg at L3 - L4 / L2 - L3 intervertebral space. Fall in Systolic Blood Pressure < 20 % of baseline was defined as hypotension. Chi-Square test and independent sample t-test was used for the statistical analysis. Spearman's rank correlation coefficient was applied to assess the correlation between baseline PI and hypotension. The receiver operating characteristic (ROC) curve was mapped for PI and the occurrence of hypotension. Results: The occurrence of hypotension in parturients with PI < 4.25 was 40.9% compared to 94.6% in parturients with PI > 4.25. There was a remarkable association between baseline PI > 4.25, the number of episodes of hypotension 53/100 (p-value < 0.0001) and the total dose of phenylephrine used 53/100 (p-value 0.02).