Anup Kharde

Abstract

Background: Endometrial cancer (EC) is a commonly occurring cancer among post-menopausal women. Pre-treatment imaging of the extent of disease can influence the decisions in the management of EC. MRI with its diffusion weighted (DW) images can help in better depiction of the primary tumour, its local extension and extrauterine spread to the peritoneum and lymph nodes. This study was conducted to know the role of MRI for pre-operative staging of endometrial cancer and as a guide for pelvic lymph nodal dissection. Methodology: It was a descriptive cross-sectional study conducted at a tertiary care hospital patients diagnosed with primary endometrial adenocarcinoma on biopsy. Patients with advanced disease requiring chemotherapy prior to surgery were excluded. Fifty consecutive patients were subjected to MRI Pelvis with abdominal screening in the week preceding definitive surgery, Findings from imaging were compared with final histopathology for concurrence on tumour size, depth of myometrial invasion, presence of adnexal, nodal and cervical stromal involvement. Results: Majority of the patients in this study were post-menopausal women. Sensitivity of MRI for staging of Endometrial Carcinoma in this study was 91.84% and Accuracy was 90%. When compared to HPE for lymph node positivity, MRI had sensitivity of 100%, specificity of 97.87%, PPV of 75%, NPV of 100% and accuracy of 98%. Conclusion: Pre-operative MRI in the week prior to the planned surgery can help in accurately staging the endometrial carcinoma in terms of myometrial infiltration, cervical stromal infiltration as well as pelvic lymph nodal involvement.   Keywords: Endometrial cancer, MRI pelvis, Diagnostic accuracy, Staging.

View Article

Abstract

Background: The delivery of an alert and active baby into the arms of a conscious and pain free mother is one of the most exciting and rewarding experiences in medicineEpidural analgesia is considered one of the most effective methods for pain relief during labor, and the intrapartum use of epidural analgesia has substantially increased over the previous two decades. Objective: To study efficacy of epidural analgesia in labour and its feto-maternal outcome. Materials and Methods: Present descriptive observational study was conducted at a tertiary care hospital. The study was conducted over the period one year from 2019 to 2020. Pregnant women reporting for delivery at study setting were the study population. Healthy pregnant primigravidae or multigravida women who had gestational age of greater than 37 weeks without any risk factors, in true labour with vertex presentation of fetus were included after obtaining an informed consent. Results: Total number of patients were 50 with mean age 23.57 ± 2.73. Mode of delivery in 70% (35) parturient was spontaneous while 14% (07) and 6% (03) had forceps and vacuum delivery respectively. The remaining 10% (5) underwent lower section caesarian section (LSCS). The mean Apgar score of babies at one minute and at 5 minutes was 9.0±1.5and 9.6±1.4 respectively. Majority of the mothers were relieved from pain after epidural analgesia. Conclusion: Present study concludes that Epidural analgesia provides good pain relief in majority of the patients without any evidence of foeto-maternal compromise.   Keywords: Epidural analgesia, Efficacy, Apgar score, Mode of delivery, Labour.

View Article

Abstract

Introduction: The present study aims to assess the practice of prescription writing before and after a teaching intervention among interns. Materials and Methods: This longitudinal study was conducted in the Department of Pharmacology, Rural Medical College, Loni. Interns undergoing Internship training programme were included in the study. They were instructed to write a prescription for a common ailment i.e., a patient with throat infection, in a given prescription blank page. The prescriptions were collected before the session of “Prescription Writing” of the Internship training programme, including the above mentioned case as example. After the teaching session was over, the interns were instructed to write the same prescription in light of training received. Results: The number of interns prescribing the required medicine i.e, antitussives increased statistically. There was also statistically significant reduction in the number of interns who prescribed the unwanted medication i.e, the antimicrobial agents. There was significant increase in number of interns who wrote prescription with date, Generic name, Doctor details, patients details, Instruction to patient, rationality. There was statistically significant reduction in the number of interns prescribing antibiotic use, average number of drugs and over prescription. Conclusion: Interns tend to make errors during prescription writing indicating a poor retention of undergraduate teaching in Pharmacotherapeutics. An intervention in the form of internship training programme for training of prescription training is essential for reviving their knowledge and skills of prescription writing. Keywords: Training program, Prescription writing, Rational drug prescribing, Interns, Antimicrobial use.

View Article