Archive : Volume - 5, Issue - 6, Month - June
1 CLINICAL PROFILE AND TREATMENT OUTCOME OF CARCINOMA BREAST PATIENTS--- EXPEREINCE FROM A TERTIARY CARE HOSPITAL OF WESTERN UP
- Surabhi Gupta* ,
- Laxman Pandey
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- Journal DOI : 10.46624/bjmhr.2018.v5.i06.001
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Abstract : Background and Aims: The epidemiological data, management strategies and treatment outcomes for carcinoma breast patients were analyzed in patients admitted to a tertiary care hospital of western up. Materials and Methods: Hospital records of 399 patients admitted for over a period of five years (January 2011 to December 2015) were used for data analysis. Results: The maximum no. of pts presented was of 40-49 yrs age group (41.35%).66.6% pts were postmenopausal. The most common complaint was painless lump. Most of the patients (48.62%) presented to clinician after 1 yr of developing symptoms and only 5.51% pts within 3 mths of onset of symptoms. 68.41% pts presented as post op cases including residual and recurrent disease while 29.32% pts presented as locally advanced breast cancer. Familial breast cancer was very uncommon. Left sided breast cancer was slightly preponderant. The most common histology was infiltrating duct carcinoma.38.23% pts received adjuvant radiotherapy after receiving adjuvant chemotherapy.16.99% pts lost to follow up after completion of treatment. The 2yr DFS in the 3 arms (25#,20#,17#) was 44.68%,51.61% and 50% respectively, while 2 yrs overall survival was 61.7%,51.61% and 75% respectively. Loco-regional failures were seen in 0%, 3.22% and 12.5% cases and distal recurrence in 27.65%, 9.67% and 12.5 consecutively. While 5yrs overall survival in 25# vs. 20# arm was 9.7% vs. 4%. Conclusion: Mean age of presentation was found to be lower compared to the western world, with an average one decade before as mentioned in literature. Most of the patients were not having any risk factors except being female. Most of the patients got defaulted in view of long waiting list for radiotherapy so we are trying to switchover conventional protocol to hypo-fractionated Radiotherapy protocol so more no. of pts can be benefitted particularly in a government setup.
Keyword : Breast cancer, risk factors, clinical profile, hypo fractionation Radiotherapy
2 Induced Delusional Disorder: A Case Report
- Anatolii Tsarkov* ,
- Patrick Msoni ,
- Petro Petlovanyi
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- Journal DOI : 10.46624/bjmhr.2018.v5.i06.002
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Abstract : Induced Delusional Disorder or Shared Psychosis is a rare psychotic syndrome which involves transference of a delusional belief and or abnormal behavior from one individual to another or others who has/ have been in close association with the primary affected person. This is a case study of a married couple with five children who had been living on a ten hector plot on a settlement scheme in a district of the Northern Province of Zambia. The wife strongly believed herself to be a prophetess and prophesied that the world would soon come to an end. Over several months she influenced her husband into this belief and together including children started praying and fasting on the isolated farming plot to an extent that children were not allowed to attend school and either couple was not seen at a local market or at the grinding mill. The last born son of about one and half years apparently had developed a fever during this period of isolation. The child was not taken to the health center in the belief that the “Spirit” they had would heal him. The child died five days after the onset of the fever. The death was not reported to authorities in the belief that the body would be resurrected. Relatives and neighbors found the body in a decomposed state two weeks later after forcing their way into the house in which the couple had barricaded itself with the children. Both husband and wife were charged with Murder in a High Court contrary to Section 200 of the Penal Code Chapter 87 the Laws of Zambia. Both husband and wife were admitted at a Forensic Facility for Medical Examinations in terms of Section 17 of the Criminal Procedure Code Chapter 88 of the Laws of Zambia. To the best of our knowledge this is the first documented case of Induced Delusional Disorder from Zambia.
Keyword : Induced Delusional Disorder, Schizophrenia, Forensic Psychiatry, Induced Psychosis
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