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1.
Article | IMSEAR | ID: sea-218490

ABSTRACT

Introduction: WHO defines it as a ‘‘carcinoma within which there are some elements resembling a squamous cell carcinoma that are admixed with a spindle cell component. Spindle cell carcinoma is an uncommon poorly differentiated type of SCC com- prising up to 3% of SCC and it is also known as sarcomatoid carcinoma which is a rare biphasic malignant neoplasm. . Case Report: A 20 year old female patient complains of pain and growth in lower front teeth region since 3 months and gave a history of growth 2yrs back in the front teeth region for which she has been operated but it has recurred again. Discussion: The histological features mimicked other connective tissue sarcomas & spindle cell malignancies at light micro- scopic level. Hence, after undergoing immunohistochemistryA careful study based on clinical, radiological and histopathologi- cal and immunohistochemical examination was done and a final diagnosis of spindle cell carcinoma was given.

2.
Article | IMSEAR | ID: sea-218489

ABSTRACT

Introduction: The plasma cell neoplasms may present in soft tissue as extramedullary plasmacytomas, bone as a solitary plas- macytoma of bone, or as part of the multifocal disseminated disease multiple myeloma. Aim of study: The study aims to report solitary plasmacytoma in the gnatic bone oral cavity, which is also mimicking as malig- nant neoplasm of bone, seen in a female patient. Case Report: A 38-year-old female patient reported to the outpatient department of our hospital complaining of pain and swelling over the left lower one-third region of the face for one month CBCT analysis shows a hypodense area involving 35 regions extending towards ascending rami of the mandible. Conclusion: Plasmacytoma, despite being a lesion with slow, asymptomatic growth, can assume large volumes, making proper treatment difficult. When there is no bone involvement and it is diagnosed early, the success of treatment is generally higher. The treatment of choice is radiotherapy, with good results for the remission of the lesion

4.
Indian J Cancer ; 2016 Jan-Mar; 53(1): 147-151
Article in English | IMSEAR | ID: sea-176800

ABSTRACT

AIM OF STUDY: Breast conserving surgery (BCS) is the standard treatment for stage I and II breast cancer. Multiple studies have shown that recurrences after lumpectomy occur mainly in or near the tumor bed. Use of accelerated partial breast irradiation (APBI) allows for significant reduction in the overall treatment time that results in increasing patient compliance and decreasing healthcare costs. We conducted a treatment planning study to evaluate the role of intensity modulated radiation therapy (IMRT) with regards to three‑dimensional conformal radiation therapy (3DCRT) in APBI. MATERIALS AND METHODS: Computed tomography planning data sets of 33 patients (20 right sided and 13 left sided) with tumor size less than 3 cm and negative axillary lymph nodes were used for our study. Tumor location was upper outer, upper inner, central, lower inner, and lower outer quadrants in 10, 10, 5, 4 and 4 patients, respectively. Multiple 3DCRT and IMRT plans were created for each patient. Total dose of 38.5 Gy in 10 fractions were planned. Dosimetric analysis was done for the best 3DCRT and IMRT plans. RESULTS: The target coverage has been achieved by both the methods but IMRT provided better coverage (P = 0.04) with improved conformity index (P = 0.01). Maximum doses were well controlled in IMRT to below 108% (P < 0.01). Heart V2 Gy (P < 0.01), lung V5 Gy (P = 0.01), lung V10 Gy (P = 0.02), contralateral breast V1 Gy (P < 0.01), contralateral lung V2 Gy (P < 0.01), and ipsilateral uninvolved breast (P < 0.01) doses were higher with 3DCRT compared to IMRT. CONCLUSION: Dosimetrically, IMRT–APBI provided best target coverage with less dose to normal tissues compared with 3DCRT‑APBI.

5.
Indian J Cancer ; 2015 Apr-June; 52(2): 234-235
Article in English | IMSEAR | ID: sea-173647
10.
Article in English | IMSEAR | ID: sea-1030

ABSTRACT

A prospective study was done on 54 patients aged over 6 months with cleft lip with or without cleft palate admitted in the department of pediatric surgery of Mymensingh Medical College Hospital during the period from Oct 2002 to Dec 2004. The anthropometrical surgical outcome was evaluated by measuring the length, diameter and thickness of hemilip and diameter of nostril both pre and postoperatively (according to schedule). Patients were categorized into three groups according to their age. Mean Corrective rate was evaluated and it was shown 95% in the 1(st) age group, 93% in 2(nd) age group and 95.55% in the 3(rd) group. Complication was evaluated in only 16.66% of patients. Regarding the out come scar, cupid's bow, notching, labial and nasal symmetry were taken in consideration. Beside these this study might play a comparative role with the results of correction of cleft lip in early age.


Subject(s)
Adolescent , Age Factors , Anthropometry , Child , Child, Preschool , Cleft Lip/surgery , Cleft Palate/surgery , Female , Humans , Infant , Male , Prospective Studies , Treatment Outcome
11.
Neurol India ; 2005 Sep; 53(3): 297-301; discussion 301-2
Article in English | IMSEAR | ID: sea-120041

ABSTRACT

BACKGROUND: Hyperhomocysteinemia has been proposed as an important risk factor for ischemic stroke worldwide, but data available from the Indian subcontinent is scarce. AIM: To study homocysteine levels in patients with ischemic stroke and compare it with age- and sex-matched controls. SETTINGS AND DESIGN: Case-control prospective study. MATERIALS AND METHODS: Fifty-seven patients with ischemic stroke and 30 controls were recruited for the study. They were subdivided into two subgroups (< 40 years and> 40 years of age) and plasma fasting total homocysteine (tHcy) levels were measured. STATISTICAL ANALYSIS USED: Student's 't' test and chi-square test. RESULTS: The tHcy were significantly high in patients with stroke, compared to controls (9.91 +/- 2.25 vs 8.00 +/- 2.74 micromol/l; P vs 8.45 +/- 2.72 micromol/l; P = 0.01) and female patients compared to controls (9.08 +/- 1.81 vs 6.79 +/- 2.60 micromol/l; P = 0.04). The tHcy levels were significantly high in patients with hypertension compared to normotensive patients (10.96 vs 9.49 micromol/l; P = 0.01) and smokers compared to nonsmokers (11.17 vs 9.33 micromol/l; P = 0.01). CONCLUSIONS: Hyperhomo-cysteinemia emerged as an important independent risk factor for ischemic stroke. A strong positive correlation was also observed between hypertension, smoking, and high-tHcy levels in the present study.


Subject(s)
Adult , Brain Ischemia/epidemiology , Case-Control Studies , Female , Humans , Hyperhomocysteinemia/complications , India/epidemiology , Male , Middle Aged , Risk Factors , Stroke/epidemiology
12.
Indian Pediatr ; 2005 Mar; 42(3): 223-31
Article in English | IMSEAR | ID: sea-13406

ABSTRACT

OBJECTIVE: To compare the efficacy of crystalloid (Normal saline) and colloid (polymer from degraded Gelatin in saline Haemaccel) intravenous fluid in restoration of circulating volume in children with septic shock. DESIGN: Prospective, randomized, open-label trial. SETTING: Pediatric Emergency and Intensive Care Unit of a tertiary care referral and teaching hospital. SUBJECTS AND INCLUSION CRITERIA: Sixty patients, between 1 month to 12 years of age, with septic shock, without clinical evidence of organ failure at admission or underlying immunodeficiency. INTERVENTION: Resuscitation with normal saline or polymer from degraded gelatin (Haemaccel) in the boluses rate of 20 mL/kg till hemodynamic stabilization or if central venous pressure (CVP) exceeded 10 mmHg (fluid requirement beyond 40 mL/kg guided by BP and CVP). METHODS: Hemodynamic parameters (heart rate, capillary filling time, pulse volume, and blood pressure) were recorded before and during resuscitation, and then 2 hourly for 12 hours. Central venous pressure line was placed within first hour, soon after starting fluids. Estimation of plasma volume and body water was done at the end of first hour of fluid resuscitation. OUTCOME MEASURES: Hemodynamic stabilization (heart rate, capillary refill time, systolic BP in normal range), plasma volume at the end of fluid resuscitation and incidence of organ dysfunction. RESULTS: 31 patients were randomized to normal saline and 29 to gelatin polymer. Both the groups were similar with respect to age, gender, primary diagnosis, initial hemodynamic parameters and PRISM score. Pneumonia (n = 22; 36%), gut-associated sepsis (n = 13), and dengue hemorrhagic fever (n = 11) were the common primary diagnosis. Initial hemodynamic stabilization was achieved in all. The mean (SD plasma volume (saline--53.4 (2.0 mL/kg, gelatin polymer--53.2 (1.9 mL/kg), extracellular fluid volume, total body water and interstitial fluid volume at the end of first hour of resuscitation were similar. The requirement of inotropes, incidence of organ dysfunction and case fatality rate (Saline--29%, gelatin polymer--31%), were similar in two groups. CONCLUSION: Both normal saline and gelatin polymer solution were equally effective as resuscitation fluid with respect to restoration of plasma volume and hemodynamic stability. Normal saline upto 110 mL/kg, and gelatin polymer solution upto 70 mL/kg may be required in first hour for successful fluid resuscitation of septic shock in children.


Subject(s)
Child , Child, Preschool , Female , Fluid Therapy/methods , Humans , Infant , Infant, Newborn , Intensive Care Units, Pediatric , Isotonic Solutions/therapeutic use , Male , Plasma Substitutes/therapeutic use , Polygeline/therapeutic use , Prospective Studies , Shock, Septic/therapy
13.
Indian J Chest Dis Allied Sci ; 2005 Jan-Mar; 47(1): 13-7
Article in English | IMSEAR | ID: sea-29704

ABSTRACT

BACKGROUND: Surfactant protein-A (SP-A), which is an important constituent of natural surfactant, occurs physiologically in small amounts in blood. Tobacco smoke induces increased alveolo-capillary leakage of surfactant proteins into blood and its level in blood may help in the assessment of lung injury caused by smoke. Little is known on the SP-A levels in patients with chronic obstructive pulmonary disease (COPD). METHODS: Prospective analytical study of 30 patients with clinical diagnosis of chronic bronchitis, which was made on the basis of symptoms, signs and chest radiographic findings. Serum SP-A and serum cotinine levels were measured. RESULTS: Out of 30 patients, 21 were smokers and nine were non-smokers. The serum SP-A level in smokers with chronic bronchitis is significantly higher than the non-smokers. The plasma cotinine levels are also high in smokers. However, there was no correlation between the serum SP-A level and plasma cotinine level (r=0.044). Serum SP-A levels were related to age in smokers (r=0.566, p<0.01) but not in non-smokers with chronic bronchitis (r=0.017, p>0.05). CONCLUSION: The increase in SP-A level in smokers with chronic bronchitis suggests that tobacco smoking causes a chronic increase in permeability of the lung parenchyma. The SP-A, a lung-specific secretory protein, is a potential marker for non-invasive assessment of the integrity of the lung epithelium. Further studies are required to find out whether SP-A can be used as a marker for early identification of smokers who are at risk of COPD.


Subject(s)
Age Factors , Bronchitis, Chronic/blood , Cotinine/blood , Female , Humans , Male , Middle Aged , Prospective Studies , Pulmonary Disease, Chronic Obstructive/blood , Pulmonary Surfactant-Associated Protein A/blood , Smoking/blood , Statistics, Nonparametric
14.
Article in English | IMSEAR | ID: sea-65543

ABSTRACT

Hepatic encephalopathy is a neuropsychiatric syndrome associated with acute liver failure, chronic parenchymal liver disease, or portosystemic anastomosis. Many approaches have been used to develop suitable models of hepatic encephalopathy, each with specific advantages and disadvantages. The most commonly used models have been the surgical hepatectomy and liver devascularization procedures, and hepatotoxins such as galactosamine and acetaminophen. Drug-toxicity models may be clinically more relevant. The specific requirements of experiments to study a particular aspect of encephalopathy also influence the choice of animal model. Animal models will play a central role in future research into hepatic encephalopathy to better understand its pathophysiology and to develop newer therapeutic modalities for this condition.


Subject(s)
Animals , Disease Models, Animal , Hepatic Encephalopathy
15.
Indian J Dermatol Venereol Leprol ; 2003 Mar-Apr; 69(2): 178-9
Article in English | IMSEAR | ID: sea-52155

ABSTRACT

A healthy elderly man presented with localized isolated erythematous tender, anesthetic, oval plaque with little scaling near the medial angle of right eye, of 3 years' duration without any obvious nerve thickening, treated irregularly with WHO MDT for 3 months, clinically simulating BT leprosy with downgrading reversal reaction. Histology showed a BL granuloma with plenty of solid staining AFB within the foamy macrophages. Lepromin test was very weakly positive. The case is discussed in the light of clinicohistological disparity in leprosy cases with review of relevant literatures. A stress is laid on the importance of newer MDT in such cases to prevent drug-resistance, relapse and recurrence.

16.
Article in English | IMSEAR | ID: sea-22457

ABSTRACT

BACKGROUND & OBJECTIVES: The decrease in surfactant protein-A (SP-A level) has recently been implicated in the pathophysiology of acute respiratory distress syndrome (ARDS). Mechanical ventilation is the main modality of treatment of ARDS. But information on the SP-A levels after mechanical ventilation is scanty. We therefore studied the effect of mechanical ventilation on SP-A levels in patients with ARDS. METHODS: In a prospective, observational study conducted in the Respiratory Intensive Care Unit of a tertiary care hospital in north India, 13 patients with ARDS requiring mechanical ventilation were included. SP-A levels in the bronchial aspirates were serially estimated by ELISA at the start of mechanical ventilation and after 24 and after 48 h. RESULTS: The SP-A level at the start of mechanical ventilation was 3.06 +/- 2.56 microg/ml. The levels gradually increased to 3.99 +/- 2.39 and 6.64 +/- 2.72 microg/ml, at 24 and 48 h respectively, and this increase was statistically significant (P < 0.05). Patients having an infectious etiology had lower SP-A levels compared to those with non-infections causes. Neither the initial SP-A level nor the increase in SP-A level correlated with the improvement in lung function or duration of ventilation. INTERPRETAION & CONCLUSION: The present study showed a progressive increase in the SP-A levels in patients with ARDS on mechanical ventilation. Further studies are required to confirm that the increase in SP-A levels may be one of the contributors for recovery in ARDS.


Subject(s)
Acute Disease , Adolescent , Adult , Bronchi , Enzyme-Linked Immunosorbent Assay , Female , Humans , Lung/metabolism , Male , Middle Aged , Pneumonia/genetics , Prospective Studies , Pulmonary Surfactant-Associated Protein A/metabolism , Respiratory Distress Syndrome/metabolism
17.
Article in English | IMSEAR | ID: sea-90239

ABSTRACT

BACKGROUND: Alterations in surface-active material may contribute to the pathogenesis of idiopathic pulmonary fibrosis both by increasing the elastic recoil due to surface forces and by promoting alveolar collapse. This study intends to evaluate the surfactant protein-A levels in bronchoalveolar lavage in patients of idiopathic pulmonary fibrosis. MATERIAL AND METHODS: Ten patients of idiopathic pulmonary fibrosis (IPF) of either sex were taken up for estimation of surfactant protein-A (SP-A) levels in bronchoalveolar lavage. The final diagnosis of IPF was based on histopathology and high resolution CT. Ten controls were taken out of which five patients were histopathologically proven cases of sarcoidosis and five patients with normal chest X-ray and CT scan. History, physical examination and routine investigations were done to rule out any concomitant illness. RESULTS: Age range of patients varied from 37-65 years (mean +/- SD of 50.65 +/- 9.05) and controls 30-62 years (42.50 +/- 9.95). Fiberoptic bronchoscopy and bronchoalveolar lavage was carried out and fluid aspirated was studied for surfactant protein-A. The level of surfactant protein-A recovered was lower in patients with idiopathic pulmonary fibrosis in comparison to control group p < 0.01 (1.86 +/- 1.26 and 5.76 +/- 2.0 microg/ml respectively). The levels of surfactant protein-A also revealed that the level decreased with derangement of pulmonary function. CONCLUSIONS: The study thus showed that the level of surfactant protein A is reduced in patients with idiopathic pulmonary fibrosis. It is likely that they have a significant role in pathogenesis of idiopathic pulmonary fibrosis and its progression. Surfactant-A may have important therapeutic implications. Further studies are required for a definite answer.


Subject(s)
Adult , Aged , Bronchoalveolar Lavage Fluid/chemistry , Female , Humans , Immunoassay , Male , Middle Aged , Pulmonary Fibrosis/pathology , Pulmonary Surfactant-Associated Protein A/analysis , Random Allocation , Spirometry
18.
Indian J Chest Dis Allied Sci ; 2002 Jan-Mar; 44(1): 21-4
Article in English | IMSEAR | ID: sea-29689

ABSTRACT

Idiopathic pulmonary fibrosis is a chronic inflammatory disorder of unknown aetiology with a number of inflammatory cells playing a role in its pathogenesis. In this study, we have attempted to find out the possible role of nitric oxide in its pathogenesis by way of measuring the nitrite and nitrate levels in the bronchoalveolar lavage fluid. Ten patients of histologically proved idiopathic pulmonary fibrosis and 10 controls (5 with normal chest skiagrams and 5 with sarcoidosis) were included in the study Bronchoalveolar lavage was carried out in these cases. The levels of nitrates and nitrites were increased in cases of idiopathic pulmonary fibrosis (0.77+/- 0.36 and 8.93 +/- 2.63 nmol/mg of protein) compared to those in controls (0.38 +/- 0.06 and 3.80 +/- 1.11, respectively for sarcoidosis patients); (0.39 +/- 0.13 and 6.56 +/- 1.61 for subjects with normal chest skiagrams). These differences were statistically significant (p < 0.05 to 0.01). These findings suggest a possible role of nitric oxide in the pathogenesis of idiopathic pulmonary fibrosis.


Subject(s)
Adult , Aged , Bronchoalveolar Lavage Fluid/chemistry , Female , Humans , Male , Middle Aged , Nitric Oxide/analogs & derivatives , Pulmonary Fibrosis/physiopathology
19.
Bull Indian Inst Hist Med Hyderabad ; 2001 Jul-Dec; 31(2): 139-53
Article in English | IMSEAR | ID: sea-1878

ABSTRACT

Etymologically, the word 'Caesar' originates from the Latin word 'Caedaere' meaning - 'to cut'. So cutting remains the core point, but little is known about the real origin of the history of Caesarean Section. There is evidence that, the ancient Hindus excelled in surgery and many operations were performed, including caesarean section. This operation was mentioned several times in the Mishnah of Rabbi Judah, the first large commentary on the Hebrew Bible. There are also several mythological anecdotes in Hindu, Buddhist and Greek mythologies. The myth of caesarean section did not even escape the keen eyes of William Skakespeare. The landmarks, treatises and the advancement in this operative procedure are presented in this article.


Subject(s)
Cesarean Section/history , History, Ancient , History, Early Modern 1451-1600 , History, Medieval , History, Modern 1601- , Obstetric Surgical Procedures/history , Terminology as Topic
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