Outcome of community based planned intervention targeting perceptions, attitudes and health seeking behaviour regarding cancers in New Delhi, India

Background: Cancer prevention and control needs to be based on effective implementation of all approaches. Community as well as individual level interventions to increase knowledge and early reporting have shown effectiveness. A community-based intervention trial was conducted to design, implement and test short-term outcomes of evidence based preventive strategies.Methods: A mixed methods, three phased study was conducted in three districts of Delhi, which were selected by a random process. Two randomly selected districts out of these three were intervention districts while third was the control. A total sample of 500 in each district was studied in quantitative pre and post -intervention phases. Multistage, stratified, cluster sampling was utilized. Pre-tested and validated tools were used.Results: Post intervention, statistically significant higher scores were observed in all domains in intervention districts as compared to control (p<0.01). Though comparison of slum versus non-slum showed significant increment in knowledge and practice scores, with higher scores for non-slum respondents, the attitudes were very similar (p>0.05). The increment score changes between males and females was similar in all classes of society versus control district. Comparison within the intervention and control groups revealed increased scores in intervention districts and decreased scores in control district, in all domains (p<0.05).Conclusions: Our study has helped in understanding the determinants of perceptions, attitude and practices regarding cancer in the community, This, helped in formulating the need-based intervention strategies. Testing the short-term outcome of intervention showed it to be effective.

The Scope Of Ayurvedic Medicine And Therapy In The Managment Of Infertility

Infertility is described as an inability to conceive despite unprotective sex for duration of one year or more. Male, female or both can be a victim for this disorder. There may be many biological causes of infertility including some can be treated with medical or surgical intervention. Ayurveda consider this problem as a cause of deterioration of quality of four factors i.e., time of ovulation, female health in context of reproductive system, quality of sperm and ovum and female抯 proper nutrition. There are different treatment methods and medicines used according to the deficit in male, female or in both. Vajikaran drugs like Ashwagandha, Madhuyasthi, Vidarikanda, Gokshura etc., are used in male fertility problems and Satavari, Punarnava, Dasmoola, Aloevera etc., used in female infertility problems. The purificatory procedures like Vamana, Virechana, Basti etc., are also found very effective to improve the quality and strength of required reproductive factors in both sexes. The effect of Uttar basti is also evidenced in different researches to treat female infertility.

Thoracic epidural versus general anaesthesia for MRM surgeries.

Background: General anaesthesia is still the preferred technique amongst many practitioners for oncologic breast surgeries. However the TEA technique has a lot of advantages over the conventional GA technique. Objective: We attempted to evaluate the two techniques of anaesthesia for MRM surgeries. Materials and method: Sixty ASA I-II patients undergoing MRM were randomly assigned to two study groups of 30 patients each. In the TEA group( group T), an epidural catheter was inserted at T7-T8 level, and 8-10 ml of 0.5% bupivacaine was titrated and administered.GA (group G) was induced with 2mg/kg of propofol and was maintained with Isoflurane ,intermittent inj. Vecuronium and 70% N2O in oxygen. The authors evaluated the adequacy of anesthesia, surgical condition, post anesthetic recovery, post anesthetic analgesia and patients’ satisfaction. Results: The intra operative haemodynamics was comparable in between the two groups. The incidence of nausea and vomiting was significantly lower in the TEA group ( 16.5% in group T and 39.6% in group G , P = 0.02).The mean immediate VAS score was also lower in TEA group ( group T =2.4 , group G =5.8,P = 0.001).Aldrete recovery score was 9/10 in 1st hr in a significant proportion in the TEA group (89.1% in group T v/s 59.4% in group G , P = 0.003).Patient satisfaction was significantly higher. The surgeons were however satisfied with both the methods. Conclusion: Use of thoracic epidural technique as a sole anaesthetic technique for MRM surgeries provides adequate operating conditions, better side effect profile, better pain management and patient satisfaction.

Clinical outcome of patients with primary gliosarcoma treated with concomitant and adjuvant temozolomide: A single institutional analysis of 27 cases.

CONTEXT AND AIM: The prognosis of primary gliosarcoma (PGS) remains dismal with current treatment modalities. We analyzed the outcome of PGS patients treated with concurrent and adjuvant temozolomide (TMZ). SETTINGS AND DESIGN: Retrospective single institutional analysis. MATERIALS AND METHODS: We retrospectively evaluated 27 patients of PGS treated with radiotherapy (RT) and TMZ during 2007‑2012. STATISTICAL ANALYSIS USED: Overall survival (OS) was estimated by the use of Kaplan Meier method and toxicities were evaluate using common terminology criteria for adverse events version 2.0 (National Cancer Institute, USA). RESULTS: Median age at presentation and Karnofsky performance status was 45 years and 90 respectively and male: female ratio was 20:7. Patients received adjuvant RT to a total dose of 60 Gy at 2 Gy/fraction. All patients except 5 received adjuvant TMZ to a median number of 6 cycles. Grade 2 and 3 hematological toxicity was seen in 8% and 4% of patients respectively during concurrent RT. During adjuvant chemotherapy, 13.6% had Grade 3 thrombocytopenia and 9.5% had Grade 3 neutropenia. Median OS was 16.7 months (1 year and 2 year actuarial OS was 70.8% and 32.6% respectively). Adjuvant TMZ was associated with a better survival (median survival 21.21 vs. 11.93 months; P = 0.0046) on univariate analysis and also on multivariate analysis (hazard ratio 1.82, 95% confidence interval: 1.503‑25.58; P = 0.012). CONCLUSIONS: The results of our study, largest series of patients with PGS treated with concurrent and adjuvant TMZ shows an impressive survival with acceptable toxicity. We suggest TMZ be included in the “standard of care” for this tumor.

Postnatal developmental anatomy of testes and epididymis of Gaddi goats / Desarrollo anatómico postnatal de los testículos y epidídimo de cabras Gaddi

The study revealed that the testes of one-day-old Gaddi goats have descended in the scrotum along with adnexa. They were elongated compressed latero-medially and became ovoid during their postnatal growth and morphogenesis. The two testes were not different significantly in their weight and measurement. The average weight which was about 2.9 gm at birth grew to 107 gm (40X) in pubertal animals and nearly maintained it during the post-puberty (113 g). The mean length (1.46 cm), width (0.85 cm) and thickness (0.62 cm) also grew by 47, 60, and 83 times, respectively. In post-pubertal animals it measured 7.06 x 5.20 x 5.10 cm. The study indicated a very fast growth of the testes from birth to puberty, which did not alter significantly after that. A relatively much faster growth in thickness and width over the length was the reason behind the change of the morphology from more elongated shape at birth to ovoid shape on maturity. The mediastinum testis was grossly discernible in the testis even at birth. Epididymis was identifiable into caput, corpus and cauda. The gross linear mensuration of these components did not differ in the caput and cauda regions on either side, whereas the length of corpus was more on the left side in all age group of animals. The growth curve revealed a continuous growth of all segments, but the fastest growth occurred in the early postnatal life (at 12­18 month age).

El estudio reveló que los testículos de las cabras Gaddi, de un día de edad, descienden al escroto junto con sus anexos. Se elongaron en dirección latero-medial y convirtieron en ovoides durante su crecimiento postnatal y en la morfogénesis. Los dos testículos no fueron significativamente diferentes en su peso y medidas. El peso promedio fue aproximadamente de 2,9 g al nacer, y aumentó a 107 g (40X) en animales púberes y casi mantuvo su peso durante la post-pubertad (113 g). La longitud (1,46 cm), ancho (0,85 cm) y espesor (0,62 cm) también crecieron unas 47, 60 y 83 veces, respectivamente. En los animales post-puberales las medidas fueron de 7,06 x 5,20 x 5.10 cm. Se observó un crecimiento muy rápido de los testículos desde el nacimiento hasta la pubertad, sin alterarse de manera significativa posteriormente. Un crecimiento relativamente mucho más rápido en espesor y anchura, sobre la longitud, fue la razón detrás del cambio de la morfología desde la forma más alargada, presente en el nacimiento, a la forma ovoide de la madurez. El mediastino testicular fue claramente identificado en el testículo, inclusive en el nacimiento. En el epidídimo se identificaron las porciones de la cabeza, cuerpo y cola. La medición lineal de estos componentes no difirió en las regiones de la cabeza y cola de cada lado, mientras que la longitud del cuerpo fue mayor en el lado izquierdo en todos los grupos. La curva de crecimiento reveló un crecimiento continuo de todos los segmentos, pero el mayor crecimiento se produjo en la vida postnatal temprana (entre los 12 y 18 meses).

Modern chemoradiation practices for malignant tumors of the trachea: An institutional experience.

Background: Malignant tumors of the trachea are rare. A multimodality treatment approach is often necessary. Outcomes of radical non-surgical approaches are sparse. Radiation combined with sequential or concurrent chemotherapy is an important treatment option. Materials and Methods: We present an analysis of outcomes using modern radiotherapy and chemotherapy for tracheal tumors. Results: Radiation dose escalation using modern techniques is of benefit for these tumors. The results with chemotherapy are encouraging. Conclusions: Radiation plays a distinct role and should be a part of treatment for these tumors. The role of chemotherapy needs to be studied further.

Role of computed tomography (CT) scan in staging of cervical carcinoma.

Background & objectives: Staging of cervical carcinoma is done clinically using International Federation of obstetrics and Gynecology (FIGO) guidelines. It is based on physical examination findings and also includes results of biopsy, endoscopy and conventional radiological tests like chest radiograph, intravenous urography and barium enema. These conventional radiological investigations have largely been replaced by computed tomography (CT) and magnetic resonance imaging (MRI) at present. FIGOo staging system does not consider CT and MRI mandatory; however, use of these modalities are encouraged. tThis prospective study was conducted to determine the role of CT in staging work up in women diagnosed with cervical carcinoma. Methods: Fifty three women diagnosed with cervical carcinoma were evaluated with contrast enhanced CT scan of abdomen and pelvis. CT scan images were especially evaluated to determine tumour size, invasion of parmetrium, pelvic walls, rectum, urinary bladder and ureters, pelvic or retroperitoneal lymphadenopathy and distant metastases. CT findings were associated with clinical findings and staging, including findings from cystoscopy and sigmoidoscopy. Results: There was a poor agreement between clinical and CT staging of cervical carcinoma. Primary tumour was demonstrated on CT in 36 (70%) of 53 patients. CT underestimated the parametrial, vaginal and pelvic wall invasion when compared with physical examination. CT overestimated the urinary bladder and rectal invasion when compared with cysto-sigmoidoscopy, however, CT had 100 per cent negative predictive value (NPV) to exclude bladder and rectal involvement. CT detection of lymph node enlargement and lung metastases influenced the management. Interpretation & conclusions: Our findings show that CT scan does not reliably correlate with clinical FIGOo staging of cervical cancer. However, it can detect urinary obstruction as well as nodal or distant metastases and thus improves the clinical FIGOo staging

Postnatal development of testis in gaddi goat (capra hircus) / Desarrollo postnatal del testículo en la cabra gaddi (capra hircus)

A study was conducted on the testicles of 30 male Gaddi goats, divided into 3 groups viz; prepubertal (0 day to 18 months), pubertal (<18 months to >5 yrs) and post- pubertal (>5 yrs) ages. The study revealed that the testis was covered by fibroserous tunica albuginia having outer fibrous layer and inner vascular layer with smooth muscle fibers at birth. The tunica albuginia continuously grew in thickness from prepubertal to postpubertal animals. The septula testis arising from the tunica albuginia, divided the parenchyma in lobules and converged at mediastinum testis. Few differentiated and undifferentiated Leydig cells were present in the intertubular spaces of neonates, which enormously increased in pubertal animals and replaced by fibroblasts in the postpubertal animals. The parenchyma comprised of solid sex cords in new born kids. These were converted into luminated tubules after 6 months of age and had clear cut tubuli contorti and tubuli recti leading to the mediastinum testis. In "0" day old kids, sex cords were filled with undifferentiated small cells located peripherally along the basement membrane and large primordial germ cells located centrally. By six months of age, latter started showing sign of degeneration and thus luminization of tubules started. Spermatogenesis startedin the seminiferous tubules of 12-18 months goat. In pubertal animals all the stages of spermatogenic cells and Sertoli cells were identified in the seminiferous tubules. The population of gonia cells and primary + secondary spermatocytes were 35% and 30% respectively. In postpubertal animals gonia cells were reduced to <30% and Primary + secondary spermatocytes were <20%. Many degenerating seminiferous tubules showed hyalinization, fibrosis and giant cells. The stroma and parenchyma ratio which was 35:65 at birth became 30:60 at 6 months, 25:75 at 12 months and 15:85 in pubertal and 20:80 in postpubertal animals. Increased stroma in last phase was associated with replacement of seminiuferous tubules by fibrous elements.

Se realizó un estudio en 30 testículos de cabras Gaddi machos divididos en 3 grupos: prepúberes (0 días a 18 meses), púberes (<18 meses y >5 años) y post-púberes (>5 años). El estudio reveló que los testículos al nacimiento estaban cubiertos por una túnica albugínea fibroserosa con una capa fibrosa externa y otra capa vascular interna con fibras musculares lisas. En los animales prepúberes hasta los pospúberes, la túnica albugínea mostró un crecimiento continuo de espesor. El septo testicular derivado de la túnica albugínea, divide el parénquima en lóbulos convergentes en el mediastino testicular. En los espacios intertubulares de los testículos de los recién nacidos, se observaron escasas células interticiales diferenciadas e indiferenciadas, sin embargo, se registró un aumento importante en los animales púberes las cuales fueron reemplazadas por fibroblastos después de la pubertad. El parénquima en los testículos de los animales recién nacidos estaba compuesto por cordones sexuales continuos. Estos se convierten en túbulos luminados después de los 6 meses de edad, evidenciando túbulos contorneados y rectos que conducen al mediastino testicular. En animales de 0 días de edad, los cordones sexuales presentaban pequeñas células no diferenciadas y situadas periféricamente a lo largo de la membrana basal y grandes células germinales primordiales céntricas. A los seis meses de edad, este último comenzó a mostrar signos de degeneración. La espermatogénesis se inició en los túbulos seminíferos desde los 12 a 18 meses de edad. En los animales púberes se identificaron en los túbulos seminíferos todas las etapas de las células de espermatogénesis y células sustentaculares. La población de células gonia fue del 35% y de espermatocitos primarios más secundarios 30%. En los animales pospúberes las células gonia se redujeron a <30% y espermatocitos primarios más secundarios a < 20%. Muchos túbulos seminíferos presentaron degeneración. La relación parénquima/estroma fue 35:65 al nacer, luego de 30:60 a los 6 meses, de 25:75 a los 12 meses, de 15:85 en animales prepúberes y 20:80 en la pubertad. El aumento del estroma en la última fase fue asociado con el reemplazo de los túbulos seminíferos por elementos fibrosos.

Role of extracorporeal irradiation in malignant bone tumors.

Aims and Objectives: Extracorporeal irradiation (ECI) is relatively a rare method used in the management of malignant bone tumors (MBT). It consists of en-bloc removal of the tumor bearing bone segment, removal of the tumor from the bone, irradiation, and re-implantation back in the body. We report our preliminary experience of using ECI for management of MBT. Materials and Methods: From year 2009 to 2010, 14 patients with primary MBT were enrolled into this study. The eligibility criteria included histopathological proof of malignancy, no evidence of distant metastases, and suitability for limb preservation therapy. Surgery was performed about 4 weeks after completion of neoadjuvant chemotherapy. The affected bone segment was resected, irradiated extracorporeally with a dose of 50 Gy and reimplanted. Local control, complications and short-term survival were studied. Functional outcome was assessed by Musculoskeletal Tumor Society (MSTS) scoring system. Results: There were 10 males and four females with median age of 14 years. Histopthologically, nine patients had osteosarcoma (OS) and five had Ewing's sarcoma family of tumors (ESFT). Distribution of primary site was as follows: Femur eight patients, tibia five patients and humerus one patient. At a median follow-up was 22 months, three patients (two OS, one ESFT) had local recurrence. Two patients (14%) developed wound infection in the perioperative period. The 2 year local recurrence free survival was 73% and mean MSTS score was 88. Conclusion: Results of our study suggest that ECI is technically feasible in the management of MBT and provides decent local control and short-term survival rates.

Comparison of Low- and High-dose Rate Brachytherapy in Carcinoma Cervix: Results From a Randomized Study.

Purpose: We are reporting results of a randomized study with the aim to compare the results of low-dose rate (LDR) versus high-dose rate (HDR) brachytherapy in locally advanced carcinoma cervix patients. Material and methods: Sixty cases of carcinoma of uterine cervix in Stage IIB-IIIB (FIGO) were included from a period of January 2002 to March 2003 and were randomized into HDR brachytherapy (6 Gy/fraction for 4 sessions) or LDR brachytherapy (27 Gy/single session) arm after completion of external beam radiotherapy (50 Gy/25#/5 weeks). Results: In HDR arm, 16/30 (53.33%) patients experienced complete response. In LDR arm, complete response was experienced by 13/30 (43.33%) of patients. Locoregional control in HDR group was 54.54%, 57.14% and 71.42% at 6, 9 and 12 months, respectively. Locoregional control in LDR group at 6, 9 and 12 months was 45%, 63.63% and 42.85%, respectively. Conclusion: The results of our study indicate that LDR and HDR groups are similar in locoregional control in the management of carcinoma uterine cervix. HDR brachytherapy can safely substitute LDR brachytherapy applications.

Gross anatomical, histological and histochemical studies on the postnatal development of the prostate gland of Gaddi goat / Estudios anatómicos macroscópicos, histológicos e histoquímicos sobre el desarrollo postnatal de la glándula prostática de la cabra Gaddi

The study was conducted on the prostate gland of Gaddi goat from one day old to more than five years of age divided into three groups viz; prepubertal (1 day old to < 18 months of age), pubertal (18 months to < 5 yrs of age) and postpubertal (> 5 yrs of age). The prostate comprised of corpus prostatae, a band like structure close to the junction of vesicular gland with the urethra, and the pars disseminate which extended in urethra well from its origin to the point of duct of bulbourethral gland. Microscopically, the corpus prostatae comprised of two compact glandular masses lying one over the other, dorsally over the origin of pelvic urethra covered by a thick fibro-reticular capsule. The gland composed of end pieces (luminated and non-luminated acini) and ducts arranged in lobulated fashion. The thickness of inter and intralobular connective tissue decreased with increased age at the expense of the growth of paraenchyma. With age the luminated secretory end pieces increased, while the non-luminatedend pieces decreased in the lobules of the gland. Glandular parenchyma were rich in mucous components by 6 month age serous and mucous components became almost equal and at 12 month age majority of the secretory end pieces turned in to serous type. The excretory ducts which were lined by stratified cuboidal epithelium in one day old kids changed to transitional epithelium in late prepubertal and pubertal animals. The glandular elements were PAS and Best's carmine reactive while interstitial connective tissue was non reactive. Mild alkaline phosphatase reaction was evident in the interstitial connective tissue cells. A strong acid phosphatase reaction was evident in the endothelium. BPB reaction for protein was moderate to intense. Ducts and acini were PAS and Alcian Blue reactive. The reaction for glycogen and AMPS contents in the gland increased with age. It was very intense in the pubertal animals. Moderate DNA activity, mild to moderate alkaline and acid...

Se realizó un estudio de la glándula próstatica de la cabra Gaddi, desde el día uno de nacimiento hasta después de los cinco años de edad, divididos grupos prepuberal (1 día a 18 meses de edad), puberal (18 meses a <5 años de edad) y post-púberes (más de 5 años de edad). La próstata estaba constituida por un cuerpo prostático, estructura como una banda cercana a la unión de la glándula vesicular con la uretra, y una pars diseminada la cual se extendía en las paredes de la uretra desde su origen hasta el punto de los conductos de la glándula bulbouretral. Microscópicamente, el cuerpo prostático está compuesto por dos masas compactas glandulares situadas una sobre la otra, dorsalmente sobre el origen de la uretra pélvica cubierta por una gruesa cápsula fibro-reticular. La glándula compuesta por piezas terminales (acinos luminal y no luminal) y conductos dispuestos en forma lobulada. El espesor del tejido conectivo inter e intralobulillar disminuyó con el aumento de la edad a expensas del crecimiento del parénquima. Con la edad aumentaron las piezas terminales secretoras luminales, mientras que en las piezas terminales no luminales, disminuyeron en los lóbulos de la glándula. El parénquima glandular era abundante en componentes mucosos a la edad de 6 meses, mientras que los componentes serosos y mucosas se equilibraron a los 12 meses de edad; la mayoría de las piezas finales secretoras se transformaron a tipo serosa. Los conductos excretores que estaban revestidos por epitelio cúbico estratificado en el día uno de las crías, cambió a epitelio de transición en los animales prepúberes y púberes. Los elementos glandulares fueron reactivos al PAS y al carmín de Best, mientras que el tejido conectivo intersticial no fue reactivo. Una reacción leve a la fosfatasa alcalina fue evidente en las células del tejido conectivo intersticial, mientras que una reacción fuerte se evidenció en el endotelio. La reacción de BPB para proteína fue de moderada a intensa. Los conductos...

Clinical and pathological response rates of docetaxel-based neoadjuvant chemotherapy in locally advanced breast cancer and comparison with anthracycline-based chemotherapies: Eight-year experience from single centre.

Introduction: The administration of neoadjuvant chemotherapy (NACT) prior to local therapy is advantageous for women with locally advanced breast cancer (LABC), since it can render inoperable tumors resectable and can increase rates of breast conservative surgeries. Materials and Methods: We retrospectively analyzed LABC patients who received NACT from January 2000 to December 2007. Out of 3000 case records screened, 570 (19%) were LABC and 110/570 (19%) treatment-naïve patients started on NACT were analyzed. Ninety-one (37 docetaxel [D], 54 anthracycline [A]) patients were eligible for response and survival analysis. Pathological complete remission (pCR) was defined as no evidence of malignancy in both breast and axilla. Results: Median age of the whole cohort was 45 years (range 25-68 years). Premenopausal were 42% and estrogen receptor + 49.5%. Most (90%) were T4 tumors and 70% were Stage IIIB. Median numbers of preoperative cycles were six and three in the D and A group respectively. Overall clinical response rates for breast primary were 74.3% and 53.7% (CR 28.6% vs. 16.7%, P=0.58) while for axilla ORR were 75.7% vs. 54.8% (51.4% vs. 40.4% CR, P=0.77) respectively for D and A. Corresponding pCR rates were 19% vs. 13% respectively. There was no significant difference in disease-free (three-year 56.84% vs. 61.16%, P=0.80) and overall survival (three-year 70% vs. 78.5%, P=0.86) between the two groups. Conclusions: Although pCR rates were higher with docetaxel-based NACT, it did not translate into superior disease-free survival / overall survival compared to anthracycline-based chemotherapies.

Age Related Structural Changes in the Bulbourethral Gland of Gaddi Goat (Capra hircus) / Cambios Estructurales Relacionados con la Edad en la Glándula Bulbouretral de la Cabra Gaddi (Capra hircus)

A study was conducted on the bulbourethral glands of 30 Gaddi goats, divided into three groups of 10 animals in each viz; Prepubertal (1 day old to < 18 months of age), Pubertal (18 months to < 5yrs of age) and Postpubertal (>5yrs of age). The study revealed that the glands grew at a faster speed up-to 6 months of postnatal life after which the pace slowed down considerably. Almost 10 times increase in weight and more than three times increase in all the linear mensurations were observed in prepubertal group from the time of birth. The stroma vs parenchyma ratio which was 80:20 in one-day-old kids showed three times increase in parenchyma in prepubertal animals, and the ratio became 43:57. In one day old kids luminated and non-luminated secretory end pieces were arranged in small groups around widely luminated duct; the forerunner of the central cistern. Initially the gland contained serous as well mucous end pieces; the latter being more preponderant. But in pubertal animals it became a mucous type gland, with only a little numbers of serous end pieces. Histochemically, the glandular acini were reactive to PAS and Alcian blue indicated the presence of glycol-muco-complex in the secretory components of gland.

Se realizó un estudio sobre las glándulas bulbouretrales de 30 cabras Gaddi, divididas en tres grupos de 10 animales cada uno; prepúberes (desde 1 día de edad hasta <18 meses), púberes (desde 18 meses hasta <5 años de edad) y postpuberales (>5 años de edad). El estudio reveló que las glándulas crecen a una mayor velocidad hasta los 6 meses de vida postnatal, después de lo cual el ritmo baja considerablemente. En el grupo prepuberal se observó un aumento casi 10 veces en peso y más de tres veces en todas las mediciones lineales. La relación estroma v/s parénquima fue de 80:20 el primer día postnacimiento, mostrando un aumento de tres veces en el parénquima en los animales prepúberes, llegando a una proporción 43:57. En una de las cabras de un día de edad las piezas terminales secretoras luminal y no-luminal se organizaron en pequeños grupos alrededor del conducto luminal; el precursor de la cisterna central. Inicialmente la glándula contenía piezas terminales serosas y mucosas. Esta última tenía una mayor preponderancia. Sin embargo, en animales puberales se convirtió en una glándula de tipo mucosa, con sólo un pequeño número de piezas terminales serosas. Histoquímicamente, los acinos glandulares reactivos al PAS y azul Alcian indicaron la presencia de glicol-muco-complejos en los componentes de secreción de la glándula.

Outcome of combined modality treatment including neoadjuvant chemotherapy of 128 cases of locally advanced breast cancer: Data from a tertiary cancer center in northern India.

Background: Breast cancer is now the most common cancer in many parts of India and the incidence varies from 12 to 31/100000, and is rising. Locally advanced breast cancer (LABC) accounts for 30 - 35% of all cases of breast cancers in India. LABC continues to present a challenge and imposes a major health impact in our country. Materials and Methods: We carried out a analysis of our LABC patients who received neoadjuvant chemotherapy (NACT) at our hospital over a 10-year period, from January 1995 to December 2004. We analyzed the response to NACT, disease-free survival (DFS), and overall survival (OS). Results: Patients with stages IIIA, IIIB, and IIIC were included. LABC comprised of 26.24% (609 patients) of new patients. One hundred and twenty-eight (31.1%) patients received NACT. Median age was 48 years and estrogen receptor was positive in 64%. Chemotherapy protocol was an FEC (5-Fluorouracil, Epirubicin, Cyclophosphamide) regimen in the following doses: Cyclophosphamide 600 mg/m2, 5-FU 600 mg/m2, and Epirubicin 75 mg/m2 given every three weeks, six doses, followed by modified radical mastectomy (MRM) and locoregional radiotherapy. The overall response rate (complete response (CR) + partial response (PR)) was 84.4%, clinical CR (cCR) was 13.3% and pathological CR (pCR) was 7.8%. Median DFS and OS were 33 and 101 months, respectively. The disease-free survival (DFS) and overall survival (OS) at five years were 41 and 58%, respectively. Conclusions: This study analyzes the outcome in patients who received NACT, in the largest number of LABC patients from a single center in India, and our results are comparable to the results reported from other centers.

Radiation dose escalation by percutaneous interstitial brachytherapy in locally advanced non-small cell lung cancer.

Management of locally advanced non-small cell lung cancer is associated with a poor overall survival using concurrent chemoradiotherapy. Therefore, newer approaches to treatment which enable dose escalation are warranted. Interstitial brachytherapy in lung is a new emerging concept with many distinct advantages. We report here a case of locally advanced non-small cell lung cancer with residual disease after conventional treatment. The patient was successfully treated using percutaneous interstitial brachytherapy and is disease-free at 18-month follow-up.

Gerentological studies on the gross and histomorphology of the vesicular gland of gaddi goat (Copra hircus) / Estudios gerontológicos en anatomía e histomorfología de la glándula vesicular de cabra gaddi (Cabra hircus)

The study was conducted on the vesicular glands of 30 entire pure male Gaddi goats from birth to 5yrs and 6 months of age, divided into three equal size groups of 10 animals in each viz; Pre-pubertal (lday old to <18 months of age), Pubertal (18 months to < 5years of age) and Post-pubertal (>5 years) age groups. In new born kid the glands were small, white cord like. It became "?" shaped at 6 months and "S" shaped at 12 months of age. A significant growth in size and weight of gland occurred at 6 month, then up to 12 month and beyond it grew slowly. The secretory acini of the lobules were lined by pseudostratified ciliated columnar epithelium which contained A-tall columnar, B-basal and C-narrow columnar type of cells. The number per unit area and size of the gland increased with age significantly from birth in the prepubertal animals and up to puberty. In post-pubertal animals it did not grow significantly, rather the connective tissue elements were increased in the capsule (adventitia). The intralobular connective tissue however, decreased at the expense of growth of acini at all ages.

Se realizó un estudio de las glándulas vesiculares de 30 cabras Gaddi, macho, totalmente puras desde el nacimiento hasta los 5 años y 6 meses de edad, divididas en tres grupos de 10 animales cada uno, pre-puberal (día 1 de edad a <18 meses de edad), pubertad (18 meses a <5 años de edad) y post-puberal (> 5 años). En el recién nacido las glándulas eran pequeñas, como un cordón blanco. Se presentó en forma de "?" a los 6 meses y de "S" a los 12 meses de edad. Un importante crecimiento en tamaño y peso de la glándula se produjo a los 6 meses, luego de 12 meses y más, creció lentamente. Los acinos secretores de los lóbulos se alinearon como epitelio columnar ciliado pseudoestratificado, los cuales contienen células de tipo A-columnar alto, B-basal y C-columnar estrecho. El número por unidad de área y el tamaño de la glándula aumentó significativamente con la edad desde su nacimiento en los animales prepuberes y hasta la pubertad. En animales post-puberales no creció significativamente, y los elementos del tejido conectivo se incrementaron en la cápsula (adventicia). Sin embargo, el tejido conectivo intralobular, disminuyó a expensas del crecimiento de los acinos, en todas las edades.

Field-in-field technique for upper abdominal malignancies in clinical radiotherapy.

BACKGROUND: In upper abdominal malignancies (UAM), due to the presence of multiple inhomogeneous tissues, a wedge-based conformal treatment planning results in high-dose regions inside the target volume. AIM: This study was designed to explore the feasibility of using a field-in-field (FIF) technique in different UAM and its efficacy in reducing the high-dose regions. MATERIALS AND METHODS: Twelve patients of UAM (which included malignancies of the gastroesophageal junction, stomach, gall bladder, and pancreas) were selected for this study. Computed tomography (CT) scans were performed and three-dimensional conformal wedge plans were generated for all the cases. The same plan was copied with the wedges removed and a FIF plan was generated. The two plans were compared for mean, maximum, and median doses; dose received by 2% (D2) and 98% (D98) of the target volume; volume receiving> 107% (V > 107%) and < 95% (V Statistical Analysis: Statistical analysis was performed with SPSS, version 10.0. RESULTS: For all the cases, the FIF technique was better than wedge-based planning in terms of maximum dose, D2, V > 107%, and CI; there was a statistically significant reduction in monitor units. With regard to doses to critical structures, there was marginal dose reduction for the kidneys and spinal cord with FIF as compared to wedge-based planning. CONCLUSION: The FIF technique can be employed for UAM in place of wedge-based conformal treatment plans.

Normal tissue complication probability of fibrosis in radiotherapy of breast cancer: accelerated partial breast irradiation vs conventional external-beam radiotherapy.

AIMS: Radiotherapy forms an integral part of breast-conserving treatment in early-stage breast cancer. Subcutaneous fibrosis of the treated breast is an important late effect in whole-breast irradiation. The aim of this study was to compare the normal tissue complication probability (NTCP) for radiation-induced fibrosis in treated breast using accelerated partial-breast irradiation (APBI) vs conventional treatment. MATERIALS AND METHODS: Ten postoperative early-stage breast cancer patients (T1N0M0) were included in this dosimetric analysis. APBI treatment was planned using conformal radiotherapy technique and conventional treatment plans included two tangential portals. All the APBI treatment plans were made with five non-coplanar beams with 6 MV photons. The prescription dose was 38 Gy in 10 fractions for the APBI treatments and 50 Gy in 25 fractions, followed by a boost dose of 16 Gy in 8 fractions, for the conventional treatments. We used Lyman's relative-seriality model and the breast fibrosis NTCP model fitting parameters for the study. RESULTS: The equivalent uniform dose (EUD) was 30.09 Gy and 50.79 Gy in APBI and conventional treatment, respectively. The mean NTCP values for ipsilateral breast fibrosis in APBI and conventional treatment were 0.51 and 25.66%, respectively. Using the paired t-test, a statistically significant difference was seen in the breast fibrosis NTCP values for APBI vs conventional treatment (P < 0.001). CONCLUSIONS: APBI reduces the ipsilateral breast fibrosis compared to conventional whole-breast treatment in early-stage breast cancer.

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.