ABSTRACT
Background: Incidence and mortality estimates are used to measure the burden of cancer in a population and survival estimates are ideal for evaluating the outcome of cancer control activities. Survival studies evaluate the quality and quantity of life of a group of patients after diagnosing the disease. The patient survival after the diagnosis of cervical cancer is indirectly influenced by socio-economic factors. The present study was carried out with an aim to evaluate the success rate of chemo-radiation followed by brachytherapy to the patients of locally advanced carcinoma (Ca.) cervix in a tertiary care center.Methods: All cases were staged according to the International Federation of Gynaecologists and Oncologists (FIGO) staging system. To illustrate the observed survival of cancer patients Kaplan-Meier curve was plotted. All the patients, except one, completed chemo-radiation and were retrospectively analyzed for the presence of local residual disease, local recurrence, distant metastases, radiation reactions, disease-free survival, and overall survival.Results: There were 22 patients of Carcinoma cervix reported in the radiation oncology department in the year 2018 and 2019. The overall treatment time ranged from 30 days to 178 days, with a median of 63 days. All the patients had a complete response after the treatment. The median follow-up time for all the patients was 15 months. Three patients had a metastatic recurrence and one patient developed distant metastases as well as local recurrence. Overall survival rate was 100% while the disease-free survival rate was 81.82%.Conclusions: The response to chemo-radiation in the treatment of locally advanced Carcinoma cervix is comparable to historic data and is well tolerated.
ABSTRACT
Background: The World Health Organization raised pandemic H1N1 influenza alert level to phase 6 in June 2009 due to a widespread community transmission on two continents. The recent surge in positive H1N1 cases necessitates a revisit to the clinical profile of the 2009 pandemic. This study was aimed to analyse the clinical profile and outcome of swab positive H1N1 patients.Methods: A cross sectional analysis on the clinical presentation and primary out come in the confirmed H1N1 influenza cases was done. H1N1 confirmation was done using real time reverse transcriptase-Polymerase Chain Reaction in throat swab samples. The data were analysed statistically and presented in percentage.Results: Total 31 cases of severe H1N1 were included in the study. Majority of the cases (16/31) were between15 to 30 yrs of age. Among the total cases, 27 cases were females (87.1%) of which 11 cases were pregnant (35.5%). The predominant presenting symptoms were fever (100%), breathlessness (80.6%), body ache (45.2%), headache (29%) and sore throat (29%). Twenty three of the 31 patients (74.2%) survived while 8 succumbed to the illness (25.8%). All the patients required ICU admission and 8 underwent invasive ventilation. The mortality was high among the ventilated patients (p=0.0064).Conclusions: Pregnancy was associated with higher rate of complications. Early respiratory support did not help in preventing progression to respiratory failure in most of the patients. Vaccination, early recognition of the disease and prompt initiation of treatment appear to be the only way to reduce H1N1 disease progression and mortality.