Prevalence of type and etiology of lung cancer among the patients presented to a tertiary care hospital at central Kerala: a descriptive study

Background: Lung cancer remains the most common cause of premature mortality in men in developing countries. This study was aimed to evaluate the type and etiological factors of lung cancer in patients presented to a tertiary care hospital of central Kerala.Methods: A retrospective descriptive study was conducted in patients who were diagnosed as lung cancer. The medical records of such patients were reviewed. The data such as age, gender, etiological risk factors and type of lung cancer were collected. Patients with incomplete reports or repeated tests, or histopathological findings were negative for lung cancers were excluded from the study.Results: Total 228 patients were included in the study with age of 64.71± 9.75. The male (198) and female (30) ratio was 6.6:1, indicated the male dominance. Among the histological types, the squamous cell carcinoma was 29% (68/228) found as the most prevalent type which is followed by adenocarcinoma 26 % (61/228). The right side (132/228) lobe was the major segment than the left side (91/228). Similarly, incidence in the central region (128/228) was more than the peripheral region (69/228). Among the right side, the upper lobe was dominant when compared to the lower or middle lobe. The lower left lobe incidence was found in 47/228 cases. Among the total, 188 cases were tobacco smokers while the remaining were nonsmokers.Conclusions: Squamous cell carcinoma with right side upper lobe of lung was prevalent among the lung cancer cases. Tobacco smoking was found to be the major etiological factor

Diagnostic yield of conventional transbronchial needle aspiration in suspected bronchogenic carcinoma without intraluminal growth on bronchoscopy

Background: Bronchogenic carcinoma with spread along the mucosal plane presents as an exophytic mass. Most of the submucosal and peribronchial patterns of this malignancy are harder to detect by standard diagnostic procedures such as bronchial washing, brushing and forceps biopsy. We sought to investigate the utility of transbronchial needle aspiration (TBNA) in the diagnosis of bronchogenic carcinoma without intraluminal mass, through prospective analysis of routine diagnostic bronchoscopies performed in a 24-month period, at a tertiary care hospital.Methods: Patients with suspected bronchogenic carcinoma (clinical and radiological) underwent standard computed tomography (CT) of thorax. Further the patients were subjected to conventional TBNA, singly, and in combination with bronchial washings and brushings. The results were analyzed statistically for the diagnostic yield of TBNA.Results: Among the 42 patients assessed, 29 had malignancy confirmed by forceps biopsy or CT guided Fine Needle aspiration cytology or biopsy and bronchoscopy. Among them, 17 cases were detected by a combination of the results of bronchial washing, brushing and TBNA. The individual sensitivities amounted to 3.4% (n=1), 51.72% (n=15) and 27.6% (n=8), respectively. There were no false positive results. Concerning different bronchoscopic sampling techniques, 9 cases were diagnosed solely by bronchial brushings and 2 cases by TBNA alone. No periprocedural complications were encountered.Conclusions: Value of bronchial brushing in the diagnosis of bronchogenic carcinoma without bronchoscopically visible intraluminal mass is above that of conventional TBNA. Addition of bronchial washings, to bronchial brushings and TBNA has an insignificant impact on the diagnosis

Comparison of diagnostic yield and complications of bronchoscopy, closed pleural biopsy and medical thoracoscopic pleural biopsies in undiagnosed pleural effusions

Background: Undiagnosed exudative pleural effusion is a commonly encountered clinical scenario, which requires further evaluation. This study was aimed to analyze the diagnostic yield and complications of three procedures- Bronchoscopy, closed (Abram’s) pleural biopsy and medical thoracoscopy. Further, this study assessed whether combining closed pleural biopsy with bronchoscopy can be a substitute for medical thoracoscopy.Methods: An observational study was conducted among people with undiagnosed exudative pleural effusion. Initially, closed pleural biopsies were performed with Abrams needle and multiple tissue fragments were taken through the incision and the samples were sent in formalin to the laboratory for histopathology examination. For thoracoscopy, a cannula of 10 mm diameter with blunt trocar was inserted into the pleural cavity and semi rigid thoracoscope was introduced through the trocar. Bronchoscopy was performed 48 hours after thoracoscopy. Sensitivity, specificity and positive and negative predictive values were calculated and compared.Results: Out of 25 people, 14 were diagnosed to have malignancy and 7 were diagnosed tuberculosis. The overall sensitivity of the three procedures were 28.5% for closed pleural biopsy, 14.2% for bronchoscopy, 95.2% for medical thoracoscopy, 42.8% for the combined pleural biopsy and bronchoscopy. The complication rate was lowest for bronchoscopy (4%), followed by medical thoracoscopy (8%) and closed pleural biopsy (16%).Conclusions: Medical thoracoscopy is a comparatively safe procedure which has got the highest sensitivity for the diagnosis of undiagnosed exudative pleural effusions. Bronchoscopy combined with closed pleural biopsy, the diagnostic yield was increased (than that of individual yield), but cannot be a substitute for medical thoracoscopy

Efficacy of drainage of pleural effusion using small bore pleural catheter and conventional thoracostomy using large bore chest tube: a comparative study

Background: Pleural effusions commonly occur in patients with advanced cancer and tuberculosis. Pleural aspiration by the conventional tube thoracostomy using large bore chest tube-intercostal drain (ICD) - can often cause discomfort to patients. The aim of this study is to compare the efficacy of drainage of pleural effusions using flexible small bore Pleural Catheter (PC) and ICD.  Methods: In this prospective study, 101 patients (age 16-65 years) with pleural effusions were divided into PC (n=60) and ICD (n=41) groups. Responses were evaluated and analyzed statistically.Results: The PC group was equally efficacious as ICD with regard to complete re-expansion of lung. The most common complication in the PC group was block (9/60 i.e. 15%). Difference in the mean number of days on drain in the PC (4.9 days) and ICD group (5.8 days) as well as the mean number of times analgesics administered in the PC (2.85 days) and the ICD group (7.53 days) were statistically significant (p <0.05). Similarly, the complications such as surgical emphysema, haemorrhage, desaturation and hypotension were high in the conventional group when compared to that of PC group (p <0.05).Conclusions: Flexible small bore intercostal catheter is a valid and safe option for drainage of pleural effusion when compared to the conventional tube thoracostomy.

Cardiovascular risk factors and diabetic foot syndrome in south indian diabetic population

The diabetic foot syndrome is one of the most frequent reasons for hospitalization among the diabetic population and also one of the most common cause for lower-limb amputation. Apart from the obvious associated morbidity, patients with diabetic foot have an increased risk of death from cardiovascular diseases. Correction of glycaemia, serum lipids and blood pressure lead to a regress in progression of diabetes complications. In this article, the influence of cardiovascular risk factors on occurrence and progression of the diabetic foot syndrome in the Indian diabetic population during a 1-year follow up was analyzed

Determinación de hongos patógenos en cultivos ornamentales y su control con soluciones de propóleos

La producción de plantas ornamentales es una actividad económica cada vez más importante en la economía de la provincia de Corrientes, siendo frecuente la detección de enfermedades producidas por hongos. Para conocer esta problemática se hicieron recolecciones de muestras en cultivos e invernaderos de estas especies, su cultivo en medio agarizado y estudios microscópicos. Se seleccionaron dos cepas de Alternaria alternata y Colletotrichum gloeosporioides en la búsqueda de productos que controlen las mismas, con mínimo de impacto ambiental. Se evaluó in-vitro el efecto de soluciones de propóleos sobre estos patógenos, los que fueron aislados de los tejidos enfermos. Con propóleos procedentes de Misiones (Argentina) y Mina Gerais (Brasil), se prepararon diluciones alcohólicas al 30 % pv, que se utilizaron para probar su acción fungicida a las dosis de 1,2 y 1,5 ml de solución, sobre dichas cepas. Los ensayos se realizaron en placas de Petri con agar papa glucosado al 2%. Se observó que los testigos tuvieron crecimiento normal, en tanto que en los tratamientos con solución de propóleos sobre ambas cepas patogénicas, no tuvieron crecimiento

Association between socioeconomic factors and origin of hospital referrals among patients with oral cancer

The Brazilian Unified Health System (SUS) is responsible for offering free assistance to more than 100 million Brazilians, including treatment of oral cancer lesions. Considering that the Brazilian public system aids the most vulnerable population, this study analyzed whether the origin of hospital referrals of patients with oral cancer is associated with socioeconomic factors. A cross-sectional study was carried out from cancer hospital records of the National Cancer Institute (RHC-INCA), considering the primary locations (C00 to C06) diagnosed between 2016 and 2019. Data on gender, skin color (white and non-white), education (no schooling, incomplete or complete elementary education; high school; incomplete and complete higher education) and origin of referral (SUS and non-SUS) were analyzed by multiple logistic regression (p<0.05). Higher referral rates by the SUS were observed in 2017 (OR=1.27; 95% CI=1.098-1.480) and 2018 (OR=1.28; 95% CI=1.101-1.490); no differences were found between the years 2016 and 2019. Regarding gender, men were 40% more likely to have the SUS as the source of referral (OR=1.40; 95% CI=1.233-1.600). Non-white individuals were 34% more likely to have the SUS as the source of the referral (OR=1.34; 95% CI=1.190-1.512). Illiterate individuals or individuals who only attended elementary school were 6.38 times more likely to be referred by the SUS than individuals with higher education (OR=6.38; 95% CI=5.228-7.796). It is concluded that the origin of hospital referrals via SUS of patients with oral cancer is associated with socioeconomic factors

Trend of hospitalized cases of oral cancer in Brazil and its relationship with oral health coverage in public health system between 2009 and 2017

This study aimed to analyze the trend in the number of hospitalized cases of oral cancer in Brazil, according to the coverage of oral health services in public health system, and also investigate the influence of healthcare and clinical characteristics on the severity of oral cancer cases. This retrospective study considered the period between 2009 and 2017. Data from the Hospital Registry of Cancer from the National Cancer Institute were used, considering the primary locations C00 to C06. Detailed information including sex, age, alcohol and tobacco use, year of first consultation, and the clinical stage of the cases were also collected. The frequency of hospitalized cases was correlated with the coverage of Primary Care Oral Health Teams (ESB) and the number of Dental Specialty Centers (CEO). It was also estimated the chance of advanced oral cancer cases, according to healthcare and clinical characteristics. Data were analyzed using Tweedie's multiple regression and multiple binary logistic regression (?<0.05). There was an increasing trend in the number of hospitalized cases of oral cancer in Brazil between 2009 and 2017 (B=0.043, p<0.001, PR=1.044). The increase in ESB coverage was associated with small increase in the number of hospitalized cases of oral cancer (B=0.001, p=0.003, PR=1.001). The increase in the number of CEO was associated with decrease in the number of hospitalized cases of oral cancer (B=-0.085, p<0.001, PR =0.918). The increase of ESB (OR=0.998) and CEO (OR=0.974) contributed for reducing the number of stage IV cases, whilst the history of alcohol and tobacco use (OR=1.574) was associated with an increase in the number of stage IV cases. Although an increasing trend was detected, the expansion of the public health system reduced the number of hospitalized cases and the frequency of advanced oral cancer cases in Brazil

Analisis Logam Berat Seng (Zn) pada Akar dan Daun Mangrove Rhizophora Mucronata serta Sedimen di Kawasan Mangrove Wonorejo, Surabaya, Jawa Timur

Mangrove memiliki fungsi ekologis untuk menyerap, mengangkut dan menimbun zat yang bersifat toksik yang berasal dari lingkungan tempat tumbuhnya, salah satunya logam berat. Mangrove dapat menyerap zat hara yang terdapat pada sedimen maupun air melalui akarnya. Banyaknya kegiatan industri di daerah Surabaya menjadi penyebab pencemaran logam berat khususnya seng (Zn) yang berasal dari berbagai aktivitas perindustrian. Bentuk usaha yang efektif untuk mengurangi pencemaran logam berat salah satunya dengan melakukan fitoremidiasi menggunakan tanaman mangrove yang diketahui dapat mengakumulasi logam berat di lingkungan tumbuhnya. Penelitian ini bertujuan untuk menganalisis konsentrasi logam berat seng (Zn) pada akar dan daun jenis Rhizhopora mucronata serta sedimen di Kawasan Mangrove Wonorejo, Surabaya, Jawa Timur. Pelaksanaan penelitian dilakukan pada bulan Februari 2019 di Kawasan Mangrove Wonorejo, Surabaya, Jawa Timur dengan pengambilan sampel dilakukan di tiga stasiun yaitu kawasan pemukiman, kawasan ekowisata mangrove dan muara sungai. Analisis konsentrasi logam berat seng (Zn) dilakukan di Laboratorium Halal Center Universitas Islam Malang. Metode penelitian yang digunakan merupakan metode survey dan data yang digunakan adalah data primer dan data sekunder. Pengujian kadar seng (Zn) menggunakan metode AAS (Atomic Absorbtion Spectophotometer). Pengukuran kualitas air yang dilakukan meliputi pengukuran suhu, pH dan salinitas. Hasil penelitian yang di dapatkan pada nilai BCF dan TF mangrove Rhizophora mucronata di Kawasan Mangrove Wonorejo, Surabaya, Jawa Timur memiliki nilai <1 yang berarti bahwa mangrove tersebut bersifat exluder dan fitostabilisasi terhadap logam berat seng (Zn). Hasil pengukuran kualitas air yaitu suhu berkisar antara 28-290C, pH berkisar antara 7,73-8,18 sedangkan salinitas berkisar antara 1-3 ppt. Hasil pengukuran parameter kualitas air tersebut masih tergolong baik dan tidak melebihi ambang batas baku mutu. Perlu adanya penelitian lebih lanjut mengenai analisis konsentrasi logam berat seng (Zn) pada mangrove Rhizophora mucronata sebagai fitoakumulator logam berat serta membandingkan tingkat keefektifannya dengan spesies mangrove jenis lain