Analysis of brain tumors in Kashmir Valley - A 10 year study.

Background: Geographically Kashmir valley is isolated from the rest of the country. It has a different climate with people having different social and dietary habits. Gastric cancer, esophageal, and skin (Kangri) cancer have a higher prevalence but there is little data available on the cancers of brain. Objectives & Methodology: Aim was to study brain tumors prospectively and retrospectively, to analyse brain tumors geographically and to analyse the age and sex ratio of brain tumors in Kashmir valley. In this Retrospective and Prospective study, retrospectively (initial seven years) all patients were analyzed for their clinical symptoms, age, sex, residence, histopathologic characteristics of tumors. Prospectively (later three years) after get-ting the radiological diagnosis pathological diagnosis was arrived by procedures like open, stereotactic, and endoscopic procedures. All patients were then analysed for age, sex, residence, signs and symptoms and histopathological characteristics. Follow up was done for gliomas. Mortality and morbidity was analysed for gliomas in these 3 years. Patients who lost the follow up were considered dead. Out of 1730 patients included in our study, there were 1031 males and 699 females. The most common age group was between 41-50 years. Results: The most common tumor was gliomas followed by meningiomas. Gliomas were most common in men and meningiomas in females. Out of all the histological grades in gliomas, the glioblastoma multiforme (GBM) was the most common, and frontal lobe was the commonest anatomical site involved. The most common symptom in our study was headache followed by vomiting.

Cancer trends in Kashmir; common types, site incidence and demographic profiles: National Cancer Registry 2000-2012.

BACKGROUND: An assessment of cancer incidence in population is required for prevention, early diagnosis, treatment and resource allocation. This will also guide in the formation of facilities for diagnosis, treatment, rehabilitation and follow‑up for these patients. The demographic trend of cancer will help to identify common types and etiological factors. Efforts at clinical, research and administrative levels are needed to overcome this problem. SETTINGS AND DESIGN: Present retro prospective study was conducted in regional cancer center of a tertiary care hospital. MATERIALS AND METHODS: After permission from ethics committee, a retro prospective study of 1 year duration was undertaken to study the profile of cancer patients and to compare it with other cancer registries in India. STATISTICAL ANALYSIS: Pearson’s Chi‑square test and simple linear regression were used. Statistical Package for the Social Sciences version‑16 (University of Bristol information services (www.bristol.ac.uk/is/ learning/resources) was used. RESULTS: The overall incidence of cancer in Kashmir is on the increase and common sites of cancer are esophagus and gastroesophageal (GE) junction, lung, stomach, colorectal, lymphomas, skin, laryngopharynx, acute leukemias, prostate and brain in males.In females common sites are breast, esophagus and GE junction, ovary, colorectal, stomach, lung, gallbladder, lymphomas, acute leukemias and brain. CONCLUSION: Cancers of esophagus, stomach and lungs have a high incidence both in men and women in Kashmir. Future studies on sources and types of environmental pollution and exposures in relation to these cancers may improve our understanding of risk factors held responsible for causation of these malignancies in this region. This will help in the allocation of available resources for prevention and treatment strategies.

Listeria monocytogenes meningoencephalitis in an immunocompetent, previously healthy 20-month old female child.

Invasive listeriosis predominantly affects pregnant women, neonates, elderly and people with a compromised immune function. For more than 80 years since the discovery of Listeria in 1924, only a few reports of invasive listeriosis in humans have emerged from India, with all of them in patients having an underlying predisposition. We, however, report Listeria monocytogenes meningoencephalitis in an immunocompetent, previously healthy, 20-month-old female child with no underlying predisposition. The patient showed poor response to empirical treatment with vancomycin and ceftriaxone but improved dramatically after substitution with ampicillin and amikacin. She had a complete recovery other than left lateral rectus palsy that persisted.

Acute bilateral extradural hematomas.

The occurrence of bilateral extradural hematomas is an uncommon consequence of craniocerebral trauma and its incidence is variable in various studies ranging from 2-25%.1 We studied all cases of head injury brought to our institute over a period of 6 months and found the incidence of bilateral extradural hematomas to be 13.3%.

Paraneoplastic limbic encephalitis associated with bronchogenic carcinoma: a case report.

Paraneoplastic limbic encephalitis is a rare clinical entity, associated most often with the oat cell carcinoma of the lung. Clinically, it presents with affective changes in personality, memory loss, confusional state, hallucinations, and seizures; with dementia being the common feature as the disorder progresses. Response to treatment is disappointingly poor.

Osteoblastoma. Cause for wry neck.

A 14 year old boy with a relatively uncommon benign osteoblastoma of C5, C6 vertebrae presenting with wry neck is described with a brief review of literature.