SRMS Journal of Medical Science最新文献

{"title":"COMPUTED TOMOGRAPHY CORRELATION OF THORACIC LESIONS WITH TRANSTHORACIC FINE NEEDLE ASPIRATION CYTOLOGY AND BIOPSY","authors":"R. Madhok, Ashish Gupta, L. Singh, T. Agarwal","doi":"10.21761/jms.v2i02.2","DOIUrl":"https://doi.org/10.21761/jms.v2i02.2","url":null,"abstract":"INTRODUCTION: The study is an attempt to evaluate the sensitivity, specificity, positive predictive value, negative predictive value, p Value and complications of CT guided thoracic interventions fine needle aspiration\u0000 cytology and core biopsy which are used for diagnosing benign and malignant thoracic lesions. MATERIAL AND METHODS: Study included 102 Patients (87 males and 15 females) with age group ranged from 15 to 87 years.A total of 143 CT guided interventions\u0000 (84 FNAC’s and 59 core biopsies) were performed in 102 patients. The tissue obtained was sent to the laboratory for histopathological and cytological analysis for a final diagnosis which would contribute to patient management. RESULTS: All( 59) core\u0000 biopsies were successful in procuring adequate tissue for histopathological analysis and the yield of core biopsies was 100% .However out of 84 FNAC’s only 4 were unsuccessful in procuring adequate tissue with a failure rate of 4.8%. Post procedural\u0000 biopsy complications were only three (2.1%) which were small pneumothorax. There were 75 malignant lesions and 23 benign lesions based on cytology and histopathology (4 were excluded due to inadequate sample). There was good agreement between benign\u0000 and malignant lesions diagnosed on CT and that diagnosed by pathology. The most common benign and malignant lesions were granulomatous lesion and squamous cell carcinoma. CONCLUSION: Percutaneous CT guided interventions like core biopsy and fine\u0000 needle aspirations cytology are simple minimal invasive procedures with good patient acceptance and low morbidity and almost negligible mortality. CT guided interventions should be performed early for diagnosis of thoracic lesions.","PeriodicalId":133201,"journal":{"name":"SRMS Journal of Medical Science","volume":"189 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115725719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NUTRITION ASSESSMENT IN HEAD AND NECK CANCER PATIENTS PRE and POST CHEMORADIOTHERAPY.","authors":"Piyush Kumar, Bhavya P Pateneedi, D. Singh, A. Chauhan","doi":"10.21761/JMS.V2I02.5","DOIUrl":"https://doi.org/10.21761/JMS.V2I02.5","url":null,"abstract":"INTRODUCTION: Head and neck cancer patients are frequently malnourished at the time of diagnosis and prior to the beginning of treatment. Deterioration of the nutritional status results in an increase in chemo radiotherapy\u0000 related toxicity and this may increase the prolonged treatment time, which has been associated with poor clinical outcome. The present study aims to do nutritional assessment before and after chemo radiotherapy in head and neck cancer patients.\u0000 MATERIAL AND METHODS: The present study was undertaken at the Department of Radiation Oncology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly. In this study, 50 patients of Head and neck tumours were enrolled and their nutrition was\u0000 assessed before and after chemoradiotherapy. Nutrition assessment was done using different laboratory parameters like haemoglobin, total leukocyte count, blood urea, serum creatinine and serum bilirubin. Anthropometric parameters used are Body mass\u0000 index, Skin fold thickness, and Mid-arm circumference. Nutritional risk indicator and PG-SGA score is measured before and after chemoradiotherapy. All the parameters were assessed and analysed using different statistical tests- Chi-square test,\u0000 Fisher Exact test and paired t test.RESULTS: Haemoglobin decrease was statistically significant during treatment (p less than 0.001) and the decrease in total leukocyte count during treatment was showing trend towards significance (p value-0.056).\u0000 There was deterioration in other parameters like blood urea, serum creatinine and serum bilirubin but was not statistically significant. Anthropometric parameters- Body mass index, mid-arm circumference and skin fold thickness and percent body fat\u0000 showed a significant change (p less than 0.00001). Nutritional risk indicator and PG-SGA class has decreased for majority of patients during treatment, the change is statistically significant (p less than 0.00001 and p=0.0251)\u0000 respectively.CONCLUSION: The nutrition has important role to play in the management of head and neck cancers by chemo radiotherapy. It helps to reduce the complications and improve the tolerance of chemo radiotherapy, thus avoiding treatment breaks\u0000 which may lead to failure of treatment.","PeriodicalId":133201,"journal":{"name":"SRMS Journal of Medical Science","volume":"1 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114037122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Ultrasound Imaging in Hepatic Lesions and its Correlation with Fine Needle Aspiration Cytology","authors":"Navreet Singh Pabla, S. Rastogi, R. Madhok, Hema Pant","doi":"10.21761/jms.v3i01.2","DOIUrl":"https://doi.org/10.21761/jms.v3i01.2","url":null,"abstract":"Introduction: Ultrasound is cheaper, effective, quick, painless,\u0000non-invasive with no radiation hazard. Guided FNAC of the\u0000liver is a safe, simple, cost-effective and accurate method\u0000for cytological diagnosis of hepatic lesions. To study the role\u0000of sonography findings including color doppler in Hepatic\u0000Lesions and its correlation with Fine Needle Aspiration\u0000Cytology.\u0000Materials and Methods: Patients referred to the department\u0000of Radiodiagnosis for Sonological evaluation were screened for\u0000hepatic SOLs. Patients with liver SOL were included in the study .\u0000Protocols included History, Routine laboratory and conventional\u0000radiological investigations, Ultrasonographic and Colour Doppler\u0000examination for size, margins, and color flow, intrahepatic bile\u0000duct status and lymph nodes followed byUSG guided FNA of\u0000the lesions and cytological co-relation\u0000Results: Out of 54 patients (28 male and 26 females), 37\u0000patients had malignant (metastatic/primary) lesions and 12\u0000had benign lesions. In 5 patients samples were inadequate for\u0000analysis. Maximum no of malignant cases were 15, in the age\u0000group of 41-60 years and benign cases were 5 each, in age less\u0000than 40 years and in age group 41-60 yrs.On ultrasound, 28\u0000patients had single lesions while 26 had multiple lesions. Most\u0000of the patients (30/54) had lesions in right lobe while only 10\u0000patients had lesions in left lobe. In 14 patients, lesions were\u0000present in both lobes.\u0000Conclusion: The sensitivity and specificity of ultrasound\u0000findings with Fine needle aspiration cytology was 78.4% and\u000091.7% respectively for diagnosis of malignant lesions.","PeriodicalId":133201,"journal":{"name":"SRMS Journal of Medical Science","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131525855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of HER2/neu in Ovarian Cancer: A Systematic Analysis of Observational Study in a Tertiary Care Centre in Northern India","authors":"Neha Agnihotri, H. Pant, S. Singh, J. K. Goel","doi":"10.21761/jms.v3i01.3","DOIUrl":"https://doi.org/10.21761/jms.v3i01.3","url":null,"abstract":"Introduction: Ovarian cancer accounts for 6% of all cancers\u0000in the female and is the fifth most common form of cancer in\u0000women which is caused by amplification of HER2/neu gene\u0000and it is widely studied most of the cancer but in gynecologic\u0000neoplasms it not well established biomarkerhence the study\u0000is carried out to analyse incidence of ovarian carcinoma in the\u0000local population and analysed relationship of HER2/neu positive\u0000cases with the histological type of ovarian tumour.\u0000Materials and Methods:The present study was an observational\u0000study. A total of 30 cases were studied and systematically\u0000evaluated the HER2/neu reactions by histopathological and\u0000immunohistochemical study done in Shri Ram Murti Smarak\u0000Institute of Medical Sciences, Bareilly, Uttar Pradesh.\u0000Result: Majority of the cases of ovarian carcinomas fell in\u0000the age group of 30-50 years with premenopausal age group\u0000followed by menopausal age group. Surface epithelial tumours\u0000were the most frequently encountered carcinomas in the\u0000present study in 50% of the cases followed by granulosa cell\u0000tumour in 20% of the cases.\u0000Conclusion: Present study emphasized the HER2/neu\u0000reactivity in ovarian carcinomas. 76.7% of the cases were\u0000negative for HER2/neu. Positivity was noted in 23.3% cases.","PeriodicalId":133201,"journal":{"name":"SRMS Journal of Medical Science","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129726799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimum Treatment of Carcinoma Esophagus in Geriatric Age with Multiple Comorbidities- A Case Report with Review of Literature","authors":"Prachi Upadhyay, A. Chauhan, Piyush Kumar","doi":"10.21761/jms.v3i01.5","DOIUrl":"https://doi.org/10.21761/jms.v3i01.5","url":null,"abstract":"Introduction: Standard management of concurrent chemo\u0000radiotherapy (CCRT) in upper and middle 1/3rd of cancer\u0000esophagus may be challenging to practice in the geriatric\u0000age group with multiple comorbid conditions. The treatment\u0000may lead to life threatening side effects while compromised\u0000treatment may lead to failure of the case. The present case\u0000reports the treatment of cancer esophagus patient in geriatric\u0000age group with multiple comorbidities treated with standard\u0000regimen of concurrent chemoradiation.\u0000Case History: Sixty years old male with several comorbid\u0000conditions presented to our OPD with complaints of difficulty\u0000in swallowing in the past 6 months. Upper gastrointestinal\u0000endoscopy revealed ulcerated mass whose biopsy was\u0000suggestive of moderately differentiated squamous cell\u0000carcinoma. Positron emission tomography- computed\u0000tomography whole body scan revealed localized well-defined\u0000lesion in upper one third of the esophagus.\u0000Echocardiography (2D Echo) showed cardiac comorbidity\u0000for which medications were prescribed and close monitoring\u0000was done by cardiologist. Diabetes was monitored by general\u0000physician and proper diet by nutritionist.\u0000Patient was treated with standard CCRT protocol. There\u0000were no significant toxicities related to radiotherapy and\u0000chemotherapy. After 1 month of treatment upper gastrointestinal\u0000endoscopy revealed normal benign esopheagal mucosa. Follow\u0000up PET CT was done after 3 months which showed significant\u0000decrease with no new lesion. After one year follow up patient\u0000has no complaints of dysphagia.\u0000Conclusion: Geriatric patients of upper or middle 1/3rd\u0000esophagus can be treated with standard chemo radiotherapy\u0000regimes by radiation oncologist in association with team of other\u0000physicians with regular monitoring of the comorbid conditions.","PeriodicalId":133201,"journal":{"name":"SRMS Journal of Medical Science","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129503274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison and Assessment of Head and Neck Squamous Carcinoma in Younger and Older Patients Treated with Chemo Radiotherapy","authors":"S. Bisht, Piyush Kumar, A. Chauhan","doi":"10.21761/jms.v3i01.4","DOIUrl":"https://doi.org/10.21761/jms.v3i01.4","url":null,"abstract":"Introduction: Head and neck cancer (HNC) is the 6th most\u0000common cancer globally. Unfortunately, even though more than\u000025% of cancers are diagnosed in people over 60 years, they\u0000are often less extensively investigated and undertreated than\u0000younger patient and seldom included in clinical trials. The study\u0000aimed to compare the profile of younger and elderly patients in\u0000terms of compliance, toxicities, and clinical outcomes in head\u0000and neck cancers treated with chemo-radiotherapy.\u0000Materials and Methods: Fifty patients were included in the\u0000study and patients were distributed in two groups, age ≤ 60\u0000years of age and >60 years of age, and were planned to deliver\u0000standard radiotherapy at a dose of 70 Gy in 35 fractions over\u00007 weeks with concurrent chemotherapy dose Cisplatin 35 mg/\u0000m2\u0000 weekly followed by compliance assessment from 3 months\u0000of follow up to at least up to 6 months.\u0000Result: In the present study, it was observed that radiotherapy\u0000compliance was similar in the elderly group as in younger group.\u0000Our study also observed that though chemotherapy compliance\u0000in terms of number of the cycle was lower in elderly patients\u0000than younger patients due to increase hematological toxicities,\u0000they were of grade I/II toxicity. No significant difference in\u0000severe Grade III/IV toxicity was observed in elderly group in\u0000comparison to the younger group.\u0000Conclusion: The present study suggests that elderly patients\u0000should get a complete radical course of concurrent chemo\u0000radiotherapy as in younger patients with good supportive care\u0000to overcome treatment-related toxicities.","PeriodicalId":133201,"journal":{"name":"SRMS Journal of Medical Science","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126381577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of Treatment and Causes of Failure in Cancer Cervix Treated with Concurrent Chemoradiation","authors":"Amit Kumar, Piyush Kumar","doi":"10.21761/jms.v3i01.1","DOIUrl":"https://doi.org/10.21761/jms.v3i01.1","url":null,"abstract":"Introduction: Cervix uteri cancer is most known disease\u0000found among women worldwide after breast, colorectal and\u0000lung cancers. The present study aimed to evaluate prognostic\u0000factors (patient, tumor and treatment) in carcinoma of cervix\u0000treated with concurrent chemoradiation.\u0000Materials and Methods: 40patients included in the study\u0000and were planned to deliver by 3- Dimensional Conformal\u0000radiotherapy using four field box technique.Radiotherapy\u0000dose delivered to pelvic area was 50 Gy in 25 fractions at\u0000200cGy/dayfollowed by intracavitary brachytherapy either 4\u0000applications of 6Gy/fraction or 3 applications of 7Gy/fraction\u0000each as per departmental protocol. Chemotherapy dose\u0000delivered to patients received cisplatin 35mg/m2 weekly i.v.\u0000for a total of 5 cycles or 75mg/m2 triweekly i.v. for a total of 2\u0000cycles. All patients were followed up at least 6 months from\u0000day of completion of treatment.\u0000Result:Collected data was analyzed using Chi Square test\u0000to calculate level of significance it was found that significant\u0000prognostic factors are blood haemoglobin level (p = 0.006),\u0000stage (p = 0.016), histological grade (p = 0.039), lymph node\u0000involvement (p = 0.031), parametrial extension (p = 0.038),\u0000hydronephrosis (p = 0.015), tumor size (p = 0.038) and\u0000duration of treatment (p = 0.031) whereas age, histological\u0000type and subtype, total radiation dose and concurrent use of\u0000chemotherapy are found to be insignificant.\u0000Conclusion: The outcomes of cancer cervix patent depends\u0000upon patient, tumor and treatment related factors. Presence of\u0000poor prognostic factors related to tumor may need intensification\u0000of the treatment by concurrent use of chemotherapy drugs,\u0000counteracting hypoxia by maintaining hemoglobin during\u0000treatment.","PeriodicalId":133201,"journal":{"name":"SRMS Journal of Medical Science","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130424054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RECTAL LYMPHOMA: A RARE CASE REPORT WITH REVIEW OF LITERATURE","authors":"Sunigdha, M. Kang, P. Garg, R. Banipal, N. Gupta","doi":"10.21761/JMS.V2I01.11207","DOIUrl":"https://doi.org/10.21761/JMS.V2I01.11207","url":null,"abstract":"Introduction: Colorectal lymphoma is an extremely rare disease. The disease is usually \u0000diagnosed in the advanced stages because of its primary nonspecific symptoms. Treatment \u0000modality of primary lymphoma of the rectum remains uncertain. \u0000Case History: A 45-year-old male presented with rectal bleeding, pain in perianal region and \u0000alteration in bowel habits along with fungating and circumferential mass in the rectum. The \u0000histopathology and immunohistochemistry confirmed the diagnosis of Plasmablastic \u0000Lymphoma. He was planned six cycles of CHOP regime. On follow up the residual disease was \u0000managed with second line of chemotherapy (DHAP regimen). The patient was started on \u0000Metronomic chemotherapy (Chlorambucil & Etoposide) in view of persistent residual disease. \u0000Conclusion: Optimal treatment for rectal lymphoma needs to be established.","PeriodicalId":133201,"journal":{"name":"SRMS Journal of Medical Science","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125407303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PREVALENCE OF RISK FACTORS AND COMORBID CONDITIONS IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS","authors":"Abhishek Jain, L. Singh, A. Agrawal, Rajeev Tandon, Nipun Agrawal","doi":"10.21761/JMS.V2I01.11206","DOIUrl":"https://doi.org/10.21761/JMS.V2I01.11206","url":null,"abstract":"Introduction: COPD is associated with several risk factors and co morbid conditions. Dealing \u0000with co-morbidity needs a patient centered approach, rather than a disease oriented approach7. \u0000The present study was conducted to study risk factors and co morbid conditions of COPD \u0000patients. \u0000Material and Methods: The present study was conducted in department of Pulmonary \u0000Medicine at Shri Ram Murti Smarak Institute of Medical Sciences with respiratory complaints \u0000over a period of one and a half year. The data was collected in terms of demographic features, \u0000anthropometric measurements and various risk factors and co morbid conditions. Spirometry \u0000was performed thrice and the largest values of both FVC and FEV1 were noted from three \u0000technically satisfactory curves. COPD severity was classified based on Spirometric \u0000assessment according to the GOLD classification. Categorical variables were analyzed using \u0000proportions and percentages. \u0000Results: In a study of 201 cases that were diagnosed as a case of COPD the mean age was 62.6 \u0000years and male predominance. Majority of the patients had sedentary life style and were from \u0000poor class. The co morbid conditions anemia, cardiac, hypertension, diabetes mellitus, lipid \u0000disorders, thyroid disorders, osteoporosis, psychiatric illness, ophthalmic defects and \u0000obstructive sleep apnea was found in 43.8%, 52.2%, 65.2%, 52.2%, 51.7%, 64.7%, 72.1%, \u000066.7%, 28.9% and 54.2% respectively. \u0000Conclusion: Co morbidities should be taken into consideration while prescribing multiple \u0000drugs so that side effects and interactions of drug can be monitored and quality of life can be \u0000improved.","PeriodicalId":133201,"journal":{"name":"SRMS Journal of Medical Science","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114649328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial Palliative Care in ICU for a Metastatic Breast\u0000Cancer: A Case Report","authors":"Piyush Kumar, A. Garg","doi":"10.21761/jms.v2i02.6","DOIUrl":"https://doi.org/10.21761/jms.v2i02.6","url":null,"abstract":"Introduction: Palliative care does not always mean an active\u0000treatment but maybe in the form of counseling and psychosocial\u0000support. We present a case of metastatic breast cancer where\u0000the psychosocial principle of palliative care was applied.\u0000Case History: A 20-year-old breast cancer patient was\u0000treated with surgery, radiotherapy, and chemotherapy before\u0000it metastasized to lung and liver. The disease was slowly\u0000progressing, and she was deteriorating symptomatically in\u0000terms of breathlessness. The father of the patient informed\u0000about the marriage of her younger daughter after one week and\u0000was not able to take care of the elder daughter (patient). We\u0000assured him to help during admission while he may continue\u0000his preparations for the marriage. The patient had developed\u0000pleural effusion for which she was treated by pulmonologist by\u0000tapping the pleural fluid. One day before the marriage of her\u0000younger sister, the condition of the patient started deteriorating.\u0000On phone consultation and the consent, we shifted the patient\u0000in ICU. It was a very difficult decision for a father to take care of\u0000both her daughters at the same time. We counseled the father\u0000and brother not to worry and assured them all logistic help\u0000during the duration of stay in the hospital while he may continue\u0000his preparations for the marriage of his younger daughter. The\u0000patient expired on the day of marriage, and the father was\u0000humbly informed about the bad news. The patient was kept in\u0000mortuary. The father approached the hospital authorities after\u0000two days to collect the body of his daughter. The father and son\u0000were very grateful about the help that they received from the\u0000institute, our team of doctors and paramedical staff.\u0000Conclusion: In the terminal phase of cancer, we need to\u0000approach patients as a family physician rather than treating\u0000oncologist.","PeriodicalId":133201,"journal":{"name":"SRMS Journal of Medical Science","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130639456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}