Although esophageal cancers have poor survival outcomes, evidence suggests that preoperative chemoradiation followed by surgery have improved survival outcomes. Minimally invasive surgery has equivalent oncological outcomes with less complication compared with open surgery, but there is insufficient data available in South Indian population. Our aim was to analyze the perioperative outcome and survival between minimally invasive and open transhiatal esophagectomy group. Data from patients operated for esophageal cancer in our department from the year 2015 to 2018 were collected retrospectively using medical records. Among 55 carcinoma esophagus patients, squamous histology (67%) and lower third location (57%) being predominant. Twenty-six patients underwent video-assisted thoracoscopic surgery (VATS)–assisted esophagectomy and 18 patients underwent open transhiatal esophagectomy. Eleven patients were inoperable. Sixteen patients in VATS arm and three patients in transhiatal arm received preoperative chemoradiation. VATS arm has lesser intraoperative blood loss, early pulmonary recovery with early intercostal drain removal, and lesser hospital stay but longer mean operating time of 171 min versus 140 min (P < 0.01). It has higher mean nodal harvest of 15 versus 7 nodes (P 0.01) and higher overall median survival of 36 months (95% CI, 29.3 to 42.7) as against 23 months (95% CI, 17.8 to 29.2) for transhiatal arm (P < 0.01). VATS-assisted esophagectomy is less morbid procedure with early postoperative recovery, better oncological outcomes, and improved survival compared with transhiatal arm which is equivalent to apex centers in India.

Advanced epithelial ovarian cancers have a dismal prognosis with a 5-year survival rate of 29.2%. A relapse rate in excess of 75% is noted in patients who achieve remission following neoadjuvant chemotherapy and cytoreductive surgery. Our study aims to find out the progression-free survival and overall survival of advanced epithelial ovarian cancers in South Indian population. Demographic data, neoadjuvant treatment and surgery details, recurrence, and survival status of patients operated for advanced ovarian cancer in our department from year 2015 till 2018 were retrospectively collected through medical records. Statistical analyses were performed using SPSS version 25. Our study included 111 patients with the majority staged as IIIC (82%). 107 patients received neoadjuvant chemotherapy. Six patients were lost to follow-up. The median pre- and post-chemotherapy CA 125 level was 694 IU/L and 33.5 IU/L, respectively. Optimal cytoreduction was achieved in 87.6% of patients. At a median follow-up of 24 months, median progression-free survival was 30 months (95% CI: 26.5–34.5) in the optimally cytoreduced versus 13 months (95% CI: 10.3–15.4) in the suboptimally cytoreduced patients (P0.005). The median overall survival was 36 months (95% CI: 32–39) in optimally cytoreduced versus 19 months (95% CI: 17.6–20.3) in suboptimally cytoreduced patients (P0.001). Patients achieving optimal cytoreduction after neoadjuvant chemotherapy have significantly lower recurrence rates, higher progression-free survival, and overall survival rates than those suboptimally cytoreduced. Results from our centre are equivalent to apex centres in India.

BACKGROUND: Cervical cancer is the second-most common cancer among women in the developing world and approximately 500,000 cases are diagnosed each year. In developed countries, cervical cancer (CCa) accounts for only 3.6% of newly diagnosed cancers. OBJECTIVE: The present study aims to identify the most effective barriers associated with CCa screening uptake in low and middle-income countries (L and MICs) and aid to adopt effective measures to overcome prevailing barriers to the attainment of CCa uptake in the community. MATERIALS AND METHODS: Health sciences electronic databases like MEDLINE, PubMed, Cochrane library, and Google Scholar were searched for studies published until August 2017. Keywords used for the search were ("cervical cancer screening"), ("barriers"), AND ("low income countries" OR "Middle income countries"). Articles were reviewed and data were extracted by using Mendeley Desktop Software (V-1.17.10). Income-level classification of countries was done as per the World Bank 2017 report. Statistical software like SPSS-V.23 and Medical-V.14 were used for the statistical application. RESULTS: A total of 31 studies met the inclusion criteria with a total of 25,650 participants. The sample size of the included studies ranged from 97 to 5929 participants. Articles majorly reported data on participants from African region (51.6%) and minimally in the Western Pacific region (3.2%). Sampling methods among studies varied from convenience sampling-12 (39.7%) to consecutive sampling-1 (3.2%). Besides, two studies (6.5%) did not discuss their sampling procedures. It was observed that "Lack of information about CCa and its treatment" (Barrier of lack of knowledge and Awareness); "Embracement or shy" (Psychological Barrier); "Lack of time" (structural Barrier); and "Lack of family support" (Sociocultural and religious barrier) were the most commonly reported among all 22 barriers. CONCLUSION: There is a need of policies advancement of CCa screening programs by focusing on aspects of accessibility, affordability, CCa education, and the necessity of screening to improve screening uptake to control the CCa morbidity and mortality rate in L and MIC's.

Background: These days the effective management of diabetes has boundless challenges. Patient involvement is paramount for the successful care of diabetes. The aim of the study was to control medication adherence by providing patient education to the diabetic patients and also evaluating their drug-use, comorbidities, lifestyles and knowledge about diabetes and its management.Methods: Total 240 diabetic patients of above 18 years of age with comorbidities were included in the study, in which 128 of study group and 112 of control group. Patient's comorbidities, drug-use and also knowledge level about diabetes was also assessed using a questionnaire. Results: Among the enrolled patients type-1 diabetes patients were 12 (5%) and 228 (95%) were type-2. Most of the patients about 25% were from age group of 40-50 years. The major number of patients has comorbidities of Systemic and coronary artery disease. Later the post counselling of test group, the mean score was 9.860±0.21 which is significant compared to pre-counselling 7.769±0.201 (p<0.001).Conclusions: The present study revealed that the patients were unaware of the basic concept related to diabetes mellitus. For better control of hyperglycaemia, there is a need for advancement of policies regard of disease education.

Inappropriate medication use (IMU) in the elderly population is an issue in disease management and healthcare provision. The aim of this observational 6-month study was to assess the prevalence and predictors of inappropriate prescribing and evaluate drug-related problems and morbidity in a geriatric inpatient population.