Subject(s)
Humans , Leadership , Personnel Management , Physician Executives/psychology , Physicians/psychologyABSTRACT
Results of 21 cases of squamous cell carcinoma of anal canal treated by continuous infusion of 5-fluorouracil 1000 mg/sqm for 4 days and mitomycin-C 15 mg/sqm on 1st day by i.v. route with concurrent external beam radiotherapy of 42 Gy from 1st day of chemotherapy were analysed. Out of 21 patients, 16(76.19%) achieved complete remission, 3 (14.28%) partial remission and 2 (9.52%) cases did not respond at all. On follow-up, 7 (33.33%) histopathological positive cases needed abdominoperineal resection with good recovery. After 2 years of follow-up 14 (66.67%) cases were free from the disease and 3 (14.28%) were alive with the disease. The median duration of follow-up was 36 months.
Subject(s)
Adult , Aged , Antibiotics, Antineoplastic/administration & dosage , Antimetabolites, Antineoplastic/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Anus Neoplasms/drug therapy , Carcinoma, Squamous Cell/drug therapy , Chemotherapy, Adjuvant , Female , Fluorouracil/administration & dosage , Follow-Up Studies , Humans , Male , Middle Aged , Mitomycins/administration & dosage , Radiotherapy, Adjuvant , Remission Induction , Survival AnalysisABSTRACT
Blood utilization in 40 patients undergoing elective valve surgery was prospectively studied. The patients had valvular lesions of rheumatic origin with a mean age of 29.1 years and a mean preoperative hematocrit of 35.23 +/- 4.16. Blood was removed from all patients after induction of anesthesia and reinfused after bypass (mean 365.12 +/- 66.96 ml). Membrane oxygenator was used in all the patients. All discard suction was routed through a regionally heparinised collecting and processing system, and the resulting red cell concentrate was transfused. At the conclusion of bypass, all blood remaining in the pump oxygenator was also processed by cell saver and used for subsequent reinfusion. Normovolemic anemia was accepted in hemodynamically stable patients. Thirty two patients (80%) received no bank blood or blood products during their entire hospital course. A total of twelve units of whole blood was transfused into eight patients.
Subject(s)
Adolescent , Adult , Blood Preservation/methods , Blood Transfusion, Autologous , Female , Heart Valve Diseases/blood , Hematocrit , Humans , Male , Middle Aged , Oxygenators, Membrane , Prospective StudiesABSTRACT
Cardiac myxomas are rare cardiac lesions, though they are the commonest tumours of the heart. Seventeen cases of cardiac myxomas have been operated during the last one decade. Exertional dyspnoea, palpitation and chest pain were the main presenting symptoms. Echocardiographic assessment was the only definitive diagnostic investigation required prior to surgery. Early surgical excision was planned in all the cases. Irrespective of the exposure techniques, removal of the tumour with wide excision of its base was practised. There was one early death due to low cardiac output in a patient brought in a shock like state. Follow up study has revealed 14 patients in NYHA class I and two patients are having class II symptoms. Periodic echocardiographic follow up study has not revealed any recurrence till date. It is concluded that an early diagnosis and surgery gives excellent long term results in these cases.