Challenges with Adjuvant Radiation for Intracranial Chondrosarcoma in Pregnancy

Background: Managing a brain tumor during pregnancy is a highly confusing and challenging situation, complicated by several technical, medical, ethical, and sociocultural concerns. The interests of the mother and child are often pitted against each other, for which legal opinion may occasionally be needed. Case Report?We present the report of a young lady with intracranial well-differentiated chondrosarcoma who was determined to be pregnant in the immediate postoperative period. We discuss the management of challenges and dilemmas in devising optimum therapy, and the modifications and care required at each step to help safeguard maternal and fetal health. Risks with therapeutic radiation and measures to assess and pre-empt fetal doses that may assist decision-making are also discussed. Conclusion?Radiation therapy during pregnancy is challenging and requires multidisciplinary involvement and psychosocial support for the patient and family.

Head-and-neck cancer patients beyond 2 years of disease control: Preliminary analysis of intensity-modulated radiotherapy late-effect assessment scale

Over a decade of intensity-modulated radiotherapy (IMRT) improved the toxicity profile among head-and-neck cancer patients and also improved the quality of life (QOL). Several parameters' few subjective and few objectives have documented various aspects related to QOL. Patients surviving beyond a certain period will have few unattended concern. A single questionnaire-based evaluation might answer few untouched issues. This brief communication formulated such an indigenous single-institution scale named IMRT late-effect assessment scale (ILEA). The preliminary analysis identified concerns related to dryness of mouth, swallowing habit change, and fear of disease recurrence. Future large-scale prospective evaluation is needed

Attitude and awareness of general population towards radiation hazards and safety: An institutional study

Context: Radiological investigations play a pivotal role in the diagnosis and treatment of a wide range of procedures. Aim: To assess the knowledge regarding adverse consequences of radiological examination and encourage awareness regarding radiation protection amongst general public. Settings and Design: A questionnaire-based cross-sectional study conducted amongst patients visiting the dental outpatient department. Materials and Methods: 1,000 adult male and female patients within the age of 20–70 years who visited the outpatient department during May–July 2017 were included in the study. Statistical Analysis: Comparison of frequencies of responses to each item with age and gender was done using chi square test. For all statistical tests, P < 0.05 was considered to be statistically significant, keeping α error at 5% and β error at 20%. Results: 85.3% participants had visited a hospital earlier and 69.3% had undergone the procedure of an X-ray earlier. Out of those patients, only 24.7% of the participants had any knowledge about the equipment or the procedure while taking a radiograph. 5.2% of the participants were given any safety measures during the radiological procedure. 14.4% had knowledge of the risks and hazards associated with radiation. Conclusions: This short study showed that there is a need for educating the general population about the hazards and risks associated with radiation exposure.

Distribution of ABO and Rh types in Voluntary Blood Donors in a Tertiary Care Center in a Southern District of Rajasthan

Background: Despite the long list of several other blood groups discovered, the knowledge and distribution of ABO and Rh-D blood group are essential for blood transfusion purposes, population genetic study and healthcare planning. Aims: This study is aimed to determine the distribution pattern of the ABO and Rh blood groups among blood donors in Southern Rajasthan and compare it with other data from similar studies within and outside India. The importance of the study lies in maintaining the blood bank inventory so that no patient dies due to the deficient supply of blood. Methods: It is a retrospective study carried out at blood bank, Ananta Institute of Medical Sciences and Research centre, Rajsamand, Rajasthan over a period of 2 years from January 1, 2016, to December 31, 2017. Blood group of the blood donors was determined by commercially available standard monoclonal antisera by test tube agglutination technique accompanied by reverse grouping. Results: Out of 1142 subjects, 1117 (97.81%) were male and 25 (2.19%) were female subjects. 279 (24.43%) donors were voluntary and 863 (75.56%) donors were replacement donors. On studying the ABO blood group system, the most frequent group was B (33.97%) followed by O (31.96%), A (22.06%), and AB (6.91%) in blood donors while in Rh system, 1084 (94.92%) donors were Rh positive and 58 (5.07%) were Rh negative. Conclusions: The knowledge of distribution of blood group is very important for blood banks and transfusion services which play an important role in the patient's health care. The study has a significant implication regarding the inventory management of blood bank and transfusion services and will also throw light on the reasons of deficiency of a particular group in a particular area so that deficient group donors may be encouraged to donate more frequently.

Cyto-Histopathological Correlation of Breast Lump as a Part of Internal Quality Control

Background: Breast malignancy is the most widely recognized tumor in females around the world. With the advent of fine needle aspiration cytology (FNAC), the approach to diagnosis and management of breast lesions has been revolutionized. Its accuracy in many situations can approach that of histopathology in providing an unequivocal diagnosis. Hence a review was undertaken with the following objectives. To correlate cytological and histopathological diagnosis of breast lesions as a part of internal quality control. To know the incidence of false positive and false negative cases. To find out the sensitivity and specificity of FNAC of breast lesions. Methods: This study was conducted for a period of 2 year and 102 aspirations of breast lumps studied. Out of which 82 cases were followed- up by histopathological correlation. Results: Cytological diagnosis in general was divided into four categories, benign (76.29%), malignant (18.29%), suspicious (2.44%), and unsatisfactory (00). Age of the patient was range from 16 - 62 years with mean age of 32 years. There were 76 female patients and 06 male patients. Fibroadenoma (54.87%) was most common benign neoplasm. The two cases which were categorized as “Epithelial Hyperplasia, Suspicious” by cytology turned out to be malignant lesions on histopathology. Sensitivity and specificity of FNAC in breast lesions were reported to be 88.24 % and 100% respectively, with 100% positive predictive value and 97.01% negative predictive value. Conclusion: Considering the high specificity and sensitivity of aspiration cytology in the cases of breast lesion, it can be established as an internal quality control at tertiary centre to minimize economical stress demanded for EQAS (External Quality Assessment Scheme).

Primary cutaneous actinomycosis of scrotal skin: A rare entity often misdiagnosed.

Lichen sclerosus (LS) is a rare disease affecting the skin and the mucous membrane, and it is chronic inflammatory in nature. It occurs in both males and females, but mainly affects females in the fifth or sixth decade of life. It mainly involves the genital and perianal areas but can affect any part of the body and the involvement of the oral mucosa is exceptionally rare, but sometimes it affects only the oral mucosa. It requires differentiating from other lesions of the oral cavity which looks similar to this lesion. In considering the rarity of the reported cases, the present article reports one more case of LS affecting the soft palate in an edentulous 66 year-old male patient.

Sarcomatoid carcinoma of the maxillary sinus: a rare head and neck tumor.

Sarcomatoid carcinomas are rare tumors. These tumors have been reported at other sites, but head and neck origin is extremely uncommon. We report here a rare case of sarcomatoid carcinoma involving the maxilla. Only four such cases with maxillary origin have been discussed in English literature earlier. As compared to squamous cell carcinoma of maxilla, this variant is associated with poor prognosis and advanced disease at presentation, as was also seen in our case. There are no standard recommendations for management owing to the rarity of this histology. Surgery and radiotherapy form the mainstays of treatment. Exploration of the role of chemotherapy and novel targeted therapy agents is warranted in order to improve treatment results.

Accessory breast tissue in axilla masquerading as breast cancer recurrence.

Ectopic or accessory breast tissue is most commonly located in the axilla, though it may be present anywhere along the milk line. Development is hormone dependent, similar to normal breast tissue. These lesions do not warrant any intervention unless they produce discomfort, thus their identification and distinction from other breast pathologies, both benign and malignant, is essential. We report a case with locally advanced breast cancer who presented with an ipsilateral axillary mass following surgery, radiotherapy, and chemotherapy. Subsequent evaluation with excision biopsy showed duct ectasia in axillary breast tissue and the patient was continued on hormone therapy with tamoxifen.