Khan, Sara;Khan, Naveed Ali;Rehman, Ata Ur;Khan, Iqra;Samo, Khursheed A;Memon, Amjad Siraj
Asian Pacific Journal of Cancer Prevention
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v.17
no.3
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pp.1337-1340
/
2016
Background: There is a noticeable change in the approach with which women nowadays seek help for diseases like breast cancer, primarily due to awareness campaigns, but what happens after surgical procedures is of great significance too. This study focused on the several psychological connotations attached to mastectomy and how the patients cope. Objective: To understand the pattern of anxiety and level of depression among Pakistani patients undergoing mastectomy. Materials and Methods: The sample size consisted of 88 patients who had undergone mastectomy at the different surgical units of the Civil Hospital, Karachi, from January 2012-December 2014; The questionnaire was administered before they were discharged i.e. within 3 days of surgical procedures. The patients were asked if they were willing to participate in this study, those who agreed signed the consent form and then we preceded by asking questions with a standardized tool. A self made questionnaire was constructed keeping in mind the nature and specification of the disease, which consisted of 20 questions related to anxiety and depression, focusing on a mixture of psychological and physiological symptoms. Results: There were a total of 88 patients out of which 36 (41%) were aged 51 to 60 years, 24 (27.2%) of the patients were in the age category of 41 to 50 years, 17 aged 61 and above (19.3%) and only 11 (12.5%) 30-40 years of age, the youngest of all the age categories. The pattern of depression and anxiety was found to be similar among all age categories, severe depression and anxiety predominating over moderate level of such symptoms, with only relatively few patients sufering mild or no depression symptoms. Conclusions: It was concluded that going through mastectomy leads to moderate to severe levels of depression and anxiety, primarily because the females feel incomplete and insecure after losing a part of themselves.
Even in the hands of the expert endoscopists, an occasional instrumental perforation of the esophagus occurs. But instrumental perforation of the esophagus should not be difficult to diagnose if the possibility is borne in mind. Occasionally patient with esophageal perforations show little reaction at first, but usually they develop systemic manifestation if surgical management is delayed. Early surgical drainage of esophageal perforation is very important & effective therapeutic method. The delayed surgical treatment of esophageal perforation would have increased the morbidity & mortality by allowing mediastinitis & empyema thoracis. We have experienced 6 cases of delayed surgical management of instrumental perforation of esophagus from May 1974 to April 1986 in the department of thoracic and cardiovascular surgery, Yonsei University, college of the medicine. The ages ranged from 4 years to 57 years. The underlying esophageal diseases consisted of esophageal stricture in 3 cases, foreign bodies in the esophagus in 2 cases and esophageal ca. in one case. Most clinical manifestations on admission were high fever, chest discomfort, chest pain, dysphagia and subcutaneous emphysema. Most complications due to esophageal rupture were acute mediastinitis with or without empyema thoracis. Failure to diagnose promptly and failure to promptly institute adequate treatment undoubtedly were largely responsible for this patients death. All 6 patients had been taken delayed surgical drainage more than 24 hours following esophageal perforation. One patient had been in the open drainage state for long time and the another patient has been in the tracheostomy with postintubation vocal cord ulceration. The third patient died due to respiratory failure and sepsis due to fulminant mediastinitis & empyema thoracis. Even if the patients with esophageal perforation have been taken delayed surgical management, the patients should be survived with aggressive & effective surgical drainage with intensive post-operative care.
The obstructive diseases involving the left main coronary artery(LMCA) are serious. Surgical treatment is generally regarded as much more effective than medical therapy in terms of long-term survival and relief of symptoms. This study represents an attempt to present an analysis of early surgical results in 21 cases conducted at Chonnam University Hospital between October 1992 And August 1995. The subject. 12 males and 9 female, ranged in age from 25 to 67 years with a mean age of 49.3${\pm}$12.5 years. As for indications for operation, unstable angina was reported on 66.7% of the subjects, while stable angina and acute myocardial infarction in 4 and 3 cases, respectively. There were also 2 cases of Takayasu's aortitis and 1 case of failed percutaneous translumlnal coronary angioplasty(PTCA). Eleven subjects had isolated LMCA diseases compared to 10 subjects with associated LMCA diseases. Of the patients with ass;3ciated LMCA diseases, 4 subjects had single coronary artery disease, 3 had double coronary artery disease, remaining 3 suffered from triple coronary artery disease. As for the group with isolated LMCA disease, ostidl angioplasty llsing autopericardium was conducted with 5 subjects. The remaining subjects with the isolated diseases and all of the patients with associated LMCA disease underwent aortocoronary bypass grafts. The left internal mammary artery was used in all patients and the average number of anastomoses was 3.13 ${\pm}$0.93. One subject died of low cardiac output syndrome at the second postoperative day. There were 5 instances of postoperative complication including reoperation for bleeding in two patients, wound infection in two, and arrhythmia in one. Follow-up coronary angiogram were conducted with eights patients, including five patients who underwent ostial angioplasty. In these cases, the patients showed surf. ficient enlargement of the left coronary ostium and the grafted vessels kept their patency. In our experience, surgical treatment of the LMCA diseases has not shown a higher rAte of operative mortAlity or morbidity than other obstructive coronary artery diseases. To patients with ostial stenosis, which is frequently observed among young female, angioplasly utilizing autopericardium seems to be a desirable choice considering the cosmetic effect, chances of reoperation and hemodynamic characteristics.
Purpose: The earlobe is one of the areas which are most vulnerable to trauma. Various auricular diseases need compression treatment. We report a new compression method using magnetic disks. Methods: Seventeen patients with auricular diseases were treated from October 2002 to September 2006. The mean age was 29.1 years. The diseases details were osteochondroma in 2 patients; cauliflower's ears in 2 patients; acute otohematoma in 1 patient; and hypertrophic scars in 11 patients. The most common cause of their disease was ear piercing. The mean follow-up period was 8.9 months. All surgical procedures were performed under local anesthesia. To compress immediately, a pair of magnetic disks was applied to the anterior and posterior surface of the earlobe. Results: The results were generally good. Major complications, such as recurrence, necrosis, dehiscence, or infection, did not occur. Conclusion: A pair of magnetic disks are useful compression tool in various auricular diseases.
The author analyzed 99patients with VSD weighting less than 10kg of body weight who underwent surgical correction from 1981 to 1992 at cardiovascular department of Hanyang University hospital. Patients occupied 29.3% of total cases who were underwent surgical corrections for congenital heart diseases during that time. Of the 99 patients, 51 patients were male [52%] and 48 patients[48%] were female. Age ranged from 28 days to 36 months with mean age of 13.6 months. Mean body weight was 7.53kg. According to Kirklin`s anatomical classification, type II defect was most common [61.6%]. Associated anomaly was found in 48 patients [48.5%]. Patent foramen ovale was most commonly associated cardiac anomaly [14.1%] and followed by atrial septal defect [12.1%], patent ductus arteriosus [10.1%]. Cardiac catheterization data were analyzed. The most common range of Qp/Qs, Rp/Rs, Pp/Ps were above 3.0, 0.1 - 0.25, and above 0.75 respectively. Among the indications of surgical correction, there were pulmonary hypertention in 69 patients, congestive heart failure in 44 patients, frequent respiratory infection in 47 patients, growth retardation in 33 patients. The most common surgical approach and method for VSD closure were right atriotomy[48.3%] and dacron patch closure[93.3%]. Complication rate was 13.1% [13 cases], and overall mortality was 17.1% [17 cases]. The cause of death consisted of low cardiac output syndrome[11 cases], acute renal failure[3 cases], sepsis[2 cases] and pulmonary insufficiency[1 case] in order of frequency.
Idiopathic pleuroparenchymal fibroelastosis (PPFE) is a rare, recently classified entity that consists of pleural and subjacent parenchymal fibrosis predominantly in the upper lungs. In an official American Thoracic Society/European Respiratory Society statement in 2013, this disease is introduced as a group of rare idiopathic interstitial pneumonias. We describe a case of a 76-year-old woman with cough and recurrent pneumothorax. She was admitted to our hospital with severe cough at first. High resolution computed tomography (HRCT) disclosed multifocal subpleural consolidations with reticular opacities in both lungs, primarily in the upper lobes, suggesting interstitial pneumonia. Rheumatoid lung was diagnosed initially through an elevated rheumatoid factor, HRCT and surgical biopsy at the right lower lobe. However, one month later, pneumothorax recurred. Surgical biopsy was performed at the right upper lobe at this time. The specimens revealed typical subpleural fibroelastosis. We report this as a first case of idiopathic PPFE in Korea after reviewing the symptoms, imaging and pathologic findings.
Journal of agricultural medicine and community health
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v.21
no.2
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pp.243-251
/
1996
Authors surveyed the inhabitants in Ulnung Island to assess the patterns of medical utilization. One hundred eighty six population(65 male and 121 female) were surveyed with formed questionnaire from Aug. 16 to Aug. 19 in 1994. Results are as follows. 1. The prevalence rate of acute diseases was 19.3%. 2. The prevalence rate of chronic diseases was 35.0%. In classification of chronic disease, the disease of musculoscletal system was the highest(33.9%) and that of digestive system in next order. 3. The first-visit medical facility when disease developed was community health center mainly. The admission care was taken in 37.6%. The 80.0% among location of medical facility for admission care was out of island. The surgical operative care were taken in 19.9%. The 86.5% among location of medical facility for surgical operative care was out of island. 4. Among the contents of dissatisfaction for medical service within island, 'Insufficient equipment' was the highest(35.8%), and 'Insufficient traffic networks' in next order. The results of this study suggest that public health facilities and medical personnel be strengthened and emergency transfer system be secured in Ulnung Island.
Bronchial carcinoid tumor accounts for less than 5% of all primary lung tumors in adults. Although surgical resection is the treatment of choice, here we report a case of bronchial carcinoid tumor treated with flexible bronchoscopic resection. A 19-year-old-man presented with a history of wheezing with dyspnea for six months. A simple chest x-ray showed no abnormal findings, but a pulmonary function test showed a moderate obstructive lung disease pattern without a bronchodilator response. A computed tomogram of the thorax revealed an enhanced $15{\times}12$ mm nodule in the left main bronchus. Bronchoscopic examination showed a polypoid mass with a stalk in the left main bronchus, which almost completely occluded the left main bronchus. Histopathology of the resected specimen revealed a bronchial carcinoid tumor. We treated the carcinoid tumor with a flexible bronchoscopic resection. During the follow up period of 6 months, the previous tumor didn't relapse. Initial bronchoscopic resection should be considered when bronchial carcinoid tumor can be approached by bronchoscopy.
Gulcelik, Mehmet Ali;Kuru, Bekir;Dincer, Halil;Camlibel, Mithat;Yuksel, Ulvi Murat;Yenidogan, Erdinc;Reis, Erhan
Asian Pacific Journal of Cancer Prevention
/
v.13
no.10
/
pp.5225-5228
/
2012
Introduction : The objective of this study was to analyze the complication rates after completion thyroidectomy and compare them with primary total benign and malign thyroidectomy causes in total of 647 patients. Patients and Methods: Among 647 patients, there were 159 receiving completion thyroidectomy for differentiated thyroiud cancer (DTC) (Group 1); 217 patients receiving total thyroidectomy for DTC (Group 2) and 271 given total thyroidectomy for benign diseases (Group 3). Results: When groups were compared for complications, there were no significant difference except temporary hypocalcemia between completion thyroidectomy and total thyroidectomy for DTC. When the total thyroidectomies were compared (Group 2 and 3), there were no significant difference observed except unilateral temporary RLN palsy. Conclusion: With improvements in surgical technique and experience, complication rates of thyroidectomy performed for benign or malign diseases are reduced. In spite of the improvement in surgical experience, temporary RLN palsy and hypoparathyroidism are the main complications in completion thyroidectomies which need special attention. To evaluate the patients more carefully in preoperative period and performing adequate thyroidectomy appears more logical.
This study conducted an analysis of the correlations among menopausal symptoms of middle-aged women, their exercise performance and subjective health conditions on those 417 middle-aged women aged 40-59 years, residing in Seoul and the Kyongki Province area, from December 6, 2000 through Jun. 20, 2001, using the SPSS 10.00 program. Resultant findings were revealed, as follows: 1. A difference was represented in general characteristics between menopausal symptoms of middled-aged women and variables such as satisfaction with life, sexual life, diseases, the presence or absence of surgical operations; a difference between exercise performance and variables such as age, the presence or absence of vocations, weight control, satisfaction with life, and sleep; and also a difference between subjective health conditions and variables such as weight control, satisfaction with life, diseases, and the presence or absence of surgical operations. 2. Furthermore, a difference was revealed between the levels of menopausal symptoms by exercise performance and variables such as mental and physical symptoms and psychological symptoms. 3. The group of good exercise performance showed higher subjective health conditions as to subjective health conditions by the levels of exercise performance. 4. The better their subjective health conditions, the lower their menopausal symptoms as to menopausal symptoms by subjective health conditions. 5. A negative relationship was disclosed between menopausal symptoms and exercise performance; a positive relationship between exercise performance and subjective health conditions; and a negative relationship between subjective health conditions and menopausal symptoms.
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