Bronchoscopic findings of flexible bronchoscopy: a one-year retrospective study in a tertiary care hospital

Background: Since the introduction of the first flexible fiberoptic bronchoscope by Shigeto Ikeda in 1966, fiberoptic bronchoscopy (FOB) has been a valuable tool in the diagnosis of pulmonary diseases. Therefore, the aim of this study is to report our one-year experience with the yield of flexible fiberoptic bronchoscopy at MGM Medical College and Hospital, a tertiary hospital in Maharashtra.Methods: A retrospective study of fiberoptic bronchoscopy (FOB) was performed at MGM Medical College and Hospital, Aurangabad, Maharashtra during the period 2015-2016. Bronchoscopy was performed and collection of bronchial washing, bronchial brushing, bronchial biopsy and transbronchial needle aspiration was done.Results: Out of 192 patients, 140 were males and 52 were females. Majority of them were in age group 50-59 years. Main indication was pulmonary tuberculosis. Bronchial washings were done in 168 cases and brushing in 56 cases and common location for both was right upper lobe; bronchial biopsy was done in 90 cases with commonest location left main bronchus. Transbronchial needle aspiration was done in 4 cases, active bleed was seen in 6 cases and purulent discharge was seen in 24 cases. Bronchoscopic finding in majority of patients was normal tracheobronchial tree.Conclusions: The optimal use of conventional bronchoscopy and its techniques in the hands of experienced respiratory interventionists, with the adherence of the international guidelines for performing these techniques will improve the diagnostic outcomes of those patients with the least morbidity and mortality, employing better therapeutic strategies, and thus improving the overall management of those patients

How informed are bronchial asthma patients: a questionnaire based study in a tertiary care hospital

Background: Asthma has been considered as one of the most common chronic diseases worldwide. Asthma due to its effects on bronchial passage compromises the respiration and intern impairs the quality of life. Aim was to evaluate the knowledge of asthma among patients attending our tertiary care hospital.Methods: The patients were subjected to chest X-ray and spirometry followed by the knowledge on asthma questionnaire which consisted of 28 questions.Results: Out of 75 patients, aged between 18-80 years, majority were males. Out of 75 patients, 60 (80%) patients had obtained a total score below 10 out of the total of 28 score. The causative factors for asthma, 60 (80%) patients believed that asthma was due to allergy. Only 2-3 patients (3-4%) had knowledge of the underlying pathologic process during an asthma attack. Fifty nine (79%) patients were aware of the symptoms of asthma. However, only 10 (13%) patients knew about the early signs of worsening of asthma and only 14 (19%) patients could judge the severity of asthma. Only 5 (7%) patients knew which drug was for regular use and which was to be used if breathlessness occurred. Merely around 4-10 (5 to 13%) patients knew that asthma could be prevented by avoiding trigger factors and by taking medication regularly.Conclusions: A good level of knowledge about asthma and better practices are rigorously important to prevent asthma exacerbations. More comprehensive, regular and patient centred counselling programs will be beneficial in improving awareness of asthma

Correlation of fine needle aspiration cytology with histopathological diagnosis in assessing breast lumps at a tertiary care hospital

Background: Breast cancer is one of the most common malignancies in women worldwide (22%) and India ranks the second after cervical cancer. The diagnostic accuracy of FNAC increases to 99% when it is combined with clinical and radiological examination. In this study, authors plan to correlate the cytological findings with histopathological examinations for breast lesions and determine the accuracy of fine needle aspiration cytology in the diagnosis of breast lesions.Methods: It is a retrospective study carried out in the Department of Pathology at a Tertiary Care Hospital. All the FNAC results of breast lesions during the one year period were collected. Gauge needle maximum of 3 passes were made and the slides were fixed in 70-80% alcohol and stained with routine haematoxylin and eosin stain.Results: Among 200 patients, 197 were females and 3 were males. Benign breast lesions were found in 158 cases; among which fibroadenoma was the commonest lesion. Malignancy was observed in 25 cases. Two cases of phyllodes tumour were incorrectly reported as fibroadenoma on cytology. Of 12 cases which were diagnosed to have atypical lesions, 4 cases were papillary neoplasm, and 8 cases were atypical ductal hyperplasia.Conclusions: This study concludes that breast FNAC is a reliable, easy, cheap and effective procedure for the diagnosis. It reduces the need of core needle biopsies and very well correlated with histopathological examination. FNAC differentiates non neoplastic from the neoplastic by which it reduces the patient’s anxiety and helps the surgeons in planning the mode of treatment

Study of reactivity pattern of hormone receptors in patients with breast cancer at a tertiary care hospital, Aurangabad, India

Background: Breast cancer is one of the most common malignancies affecting the female population worldwide. Prognosis and management of breast cancer are influenced by variables such as stage, grade, and hormone receptor status. Tumours that express ER and/or PR have a better prognosis and most of them respond well to hormonal therapy. In addition to hormone receptors, HER2 has emerged in recent years as an important independent predictive marker.Methods: All surgically operated female cases of breast carcinoma which were submitted for immunohistochemistry test for estrogen, progesterone and human epidermal growth factor receptor-2 in the Department of Pathology, MGM Medical College, Aurangabad for the duration of December 2015 to October 2017 were included in this prospective study. A total of 50 patients were taken up for the study.Results: The maximum age of the patients were in the 4th -5th decade and were mostly premenopausal. The tumour was maximum involving the right breast, upper outer quadrant and were BI-RADS 4. Majority were grade 2 and were invasive ductal carcinoma. Hormone receptor status showed ER positivity 48%, PR positivity 46% and HER2 positivity 28%.Conclusions: So, to conclude, immunohistochemical analysis of ER, PR and HER2 receptors is widely available at a reasonable cost and provides valuable prognostic, predictive and therapeutic information. Although we could see different patterns of hormonal receptor status, irrespective of the histological grade, type and lymph node status in our study, HER2 testing along with ER/PR status should be performed routinely in all the patients diagnosed of breast cancer as this will help the clinicians to manage the patients further

Integer programming methods for large-scale practical classroom assignment problems

In this paper we present an integer programming method for solving the Classroom Assignment Problem in University Course Timetabling. We introduce a novel formulation of the problem which generalises existing models and maintains tractability even for large instances. The model is validated through computational results based on our experiences at the University of Auckland, and on instances from the 2007 International Timetabling Competition. We also expand upon existing results into the computational difficulty of room assignment problems

Sodomites in the pillory in eighteenth-century London

The arrival of the eighteenth century brought with it new legal attention to sodomitical behaviour. Nowhere was this more notorious and public than in the punishment of those offences in the pillory. This paper argues that the pillory was a productive space for the understanding of sodomy in this period, a place where the logic and practice of that particular punishment intersected with a new and emerging conceptualization of masculinity and erotic desire between men. The intersection between these discourses had a dynamic function: far from merely reflecting public attitudes prevalent elsewhere, the practices of the pillory helped to create the new attitudinal structure to sodomitical behaviour

Perfectionism in obsessive-compulsive disorder and related disorders: What should treating clinicians know?

© 2017 Elsevier LtdPerfectionism is known to be highly prevalent in obsessive-compulsive disorder (OCD). This review seeks to explore perfectionism in OCD and related disorders, particularly in relation to treatment, in order to inform treating clinicians. We also evaluate the potential role of perfectionism in the maintenance of OCD. Evidence supports perfectionism as a transdiagnostic process central to the psychopathology of OCD and other mental illnesses. Treatment outcomes in EX/RP for OCD are diminished in the presence of perfectionism, which is thought to be due to inherent treatment interfering features of perfectionism. Successful OCD treatment has been shown to decrease perfectionistic thinking, though data are mixed on whether reducing perfectionism mediates subsequent reductions in OCD symptoms. Short-term cognitive behavioral protocols for perfectionism are reviewed here and recommendations are made for the treatment of perfectionism in the context of OCD and related disorders