ABSTRACT
Background: Differentiated thyroid carcinoma, arising from thyroid follicular epithelial cells, accounts for the vast majority of thyroid carcinomas. Of the differentiated cancers, papillary cancer comprises about 85% of cases compared to about 12% that have follicular histology, including conventional and oncocytic (Hurthle cell) carcinomas, and <3% that are poorly differentiated tumors. In general, stage for stage, the prognoses of PTC and follicular cancer are similar. The aim of this study is to evaluate the benefit of central compartment lymph node dissection in accurate staging of the disease and plan radioiodine treatment and dosing. And also to assess the morbidity associated with central neck dissection. Materials and methods: This was a prospective clinical study conducted at MNJIO and RCC, Hyderabad. 20 patients with carcinoma thyroid who underwent total thyroidectomy and prophylactic central compartment lymph node dissection from December 2015 to December 2017 were included. The protocol was submitted to the ethics committee at Osmania Medical College and was approved. Results: We analyzed the number of patients of that age in whom the disease stage changed due to the presence of central nodal dissection. Prophylactic CND resulted in upstaging of tumour in 2/20 (10%) patients from stage I to stage II. Also in 4/20 (20%) patients, the evidence of node metastases influenced also the therapeutic strategy because these patients would not have been treated with 131-I if the prophylactic central neck dissection had not been performed. Thus a prophylactic CLND may play an even larger role in determining RAI use. A prophylactic CLND that demonstrates a lack of lymph node metastasis would strengthen the case not to use RAI treatment in a low-risk patient. Nived Rao, M. Muralidhar, M. Srinivasulu. The role of prophylactic central compartment lymph node dissection in differentiated thyroid carcinoma. IAIM, 2018; 5(9): 91-98. Page 92 Conclusion: With the available evidence, we advocate a selective approach to performing prophylactic CND and to be done in high volume centres. Routine prophylactic central lymph node dissection should be avoided in the absence of involved lymph nodes, reserving the procedure to “high-risk” patients as defined by ATA and European Society of Endocrine Surgeons, which include extremes of ages, large primary tumor size, and male gender, which were similar to high risk cases seen in our study.
ABSTRACT
Background: The advances in diagnosis and treatment, in the management of breast cancer have led to excellent cure rates for tumors detected in early stage. Even patients with stage III disease have 5 years survival rates in the range of 50-70%. The search for predictive and prognostic factors in breast cancer represents a major challenge. It is important to distinguish prognostic factors from predictive factors. Aim: The aim of the surgery was to compare the immunohistochemical expression of estrogen, progesterone and Her-2 receptor status in breast cancer before and after neo-adjuvant chemotherapy. Materials and methods: In this study, the total of 50 cases of locally advanced breast cancers was included. Cases of carcinoma breast requiring preoperative chemotherapy from January 2015 to January 2017 were recruited in to the study after informed consent. Results: In this study, the total of 50 cases of locally advanced breast cancers was included. Among them most of the cases belonged to the age group of 40 to 60. The extremes of ages (<30 and >60) comprised of only 14 % of the cases. In total of 50 cases 32 patients were pre-menopausal which was accounting for 64% of cases, and remaining patients were post-menopausal. Out of 20 cases of triple negative in this study complete response was seen in 6 cases accounting for about 30%. In our study there were a total of 24 changes in the receptor status post chemotherapy altogether out of which 11 changes were seen in Her2neu group. Changes in the ER and PR group accounted for 8 and 5 cases respectively. Out of 14 cases of ER positive before chemotherapy, conversion was seen in 8 cases accounting for change in ER status of 57%. Similarly 5 changes were seen in PR receptor expression E. Rajesh Goud, M. Muralidhar, M. Srinivasulu. A Study to Evaluate the Effect of Neo-adjuvant Chemotherapy on Hormonal and Her-2 Receptor Status in Carcinoma Breast. IAIM, 2018; 5(9): 83-90. Page 84 accounting for 62% of change. All the changes found were loss of expression of receptor after NACT means receptor positive cases became receptor negative. Conclusion: Breast cancer subtypes are associated with the response to NACT. The response rates for the HE and TN subtypes were significantly higher than for the luminal subtypes. So it is mandatory for a patient with breast cancer who is scheduled for NACT should be assessed for the subtype of breast cancer before NACT, by using IHC, for planning treatment. This study also revealed that change in receptor status did occur after neo-adjuvant chemotherapy.
ABSTRACT
Introduction: The excess accumulation of free fluid in the peritoneal cavity is due to its multitude causes. Certain cytological and biochemical markers are reported for the differential diagnosis of ascites. In the present study, ascitic patients with liver cirrhosis and ovarian carcinoma are investigated. Aim: To study the concentrations of certain trace elements and ceruloplasmin levels in ascitic fluid and in serum of patients with liver cirrhosis in comparison to ovarian cancer patients. Study Design: The study includes 170 patients with liver cirrhosis, 95 patients with ovarian cancer and 100 serum controls. Place and Duration of Study: The study is performed in the department of Gastroenterology, Osmania General Hospital Hyderabad, A.P, INDIA, between December 2011 to July 2013. Methodology: The trace elements such as magnesium, copper, zinc, iron and ceruloplasmin were investigated in 170 patients with liver cirrhosis (120 males, 50 females, 22-75 years; mean age 46.2±11.2) and 95 ovarian cancer patients (19-84 years; mean age 50.2±12.2). All the analysts were measured in serum and ascitic fluid by using standard commercial kits. 100 serum samples from healthy controls were also included in the study. Results: The mean serum concentrations of copper and ceruloplasmin were significantly increased in ovarian cancer patients when compared to that of liver cirrhosis and healthy controls (P<. 001, P<. 001) respectively. The mean zinc levels in serum samples were low in both the groups when compared to controls (P<. 001). The ascitic fluid zinc levels in ovarian cancer were higher when compared to that of liver cirrhosis (P<. 001). Similar results were noted in the serum iron levels in both the groups. The serum magnesium levels in liver cirrhosis are comparable to that of controls but the levels of magnesium in ovarian cancer ascitic patients are high when compared to that of controls. Conclusion: Our results showed that there are differences in trace elements and ceruloplasmin levels in liver cirrhosis and ovarian cancer patients in both serum and ascitic fluid samples. The cutoff value of copper and ceruloplasmin in serum samples are 134.5 μg/dl and 43.5 mg/dl, while in ascitic fluid were 46.5 μg/dl and 21.0 mg/dl respectively. As the diagnostic efficiency of copper and ceruloplasmin in serum and ascitic fluid samples are 97% to 99% with highest sensitivity and specificity, analysis of trace elements with ceruloplasmin in depth with their ratios may be helpful in differentiating the cirrhotic and neoplastic illness.
ABSTRACT
Talinum Triangulare (Family: Portulacaceae) is an herbaceous perennial plant widely grown in tropical regions as a leaf vegetable with a blood-glucose-lowering effect, but its mechanism of action are still unknown. Here we report a hypoglycemic activity of Methanolic Extract of Talinum Triangulare Leaf (METTL) in healthy, glucose loaded and Streptozotocin (STZ)-induced diabetic rats. Animals either healthy or STZ-induced diabetic show significantly lowered blood glucose levels after 2 weeks of METTL treatment (250 mg/kg), it significantly reduced blood glucose levels compared with that in diabetic control rats. Additionally, the increase in blood glucose levels after administration of glucose (1.2 g/kg) in normal rats is significantly decreased and the oral glucose tolerance (OGTT) of STZ-induced diabetic rats is largely improved by METTL treatment. However, co-administration of METTL with glipizide, an oral hypoglycemic drug, it produces synergistic effect. We conclude that METTL has a significant anti hyperglycemic effect. Continuous glucose monitoring is needed in diabetic patients.
ABSTRACT
L-Lactate dehydrogenase is an oxidoreductase that catalyzes the reversible inter-conversion of pyruvate to L-lactate under anaerobic conditions. Levels of Lactate dehydrogenase are known to be elevated in the blood stream following severe tissue injuries and necrosis. Since cancer is a proliferating and invasive disease known to cause severe tissue damage and tumour cells respire anaerobically, the present study was planned to evaluate variations in the levels of serum LDH in breast cancer as compared to normal. LDH levels were estimated in 130 patients with a confirmed diagnosis of breast cancer and also in 110 healthy age matched randomly selected controls. Appropriate statistical tests were used to assess variations in LDH levels with respect to the presence of disease, age at onset and menopausal status of the proband, stage of the disease and mode of anti-cancer therapy followed Lactate dehydrogenase levels were found to be significantly elevated in breast cancer (302.45 + 7.67) as compared to control (173.77 + 3.4). Significant elevations in LDH levels were also observed with increasing age at onset, onset of menopause, advance stage of cancer and due to the anti-cancer treatment followed. These results suggest an immense potential for LDH as a prognostic marker for breast cancer.