Head and neck carcinomas

To find out the effect of concomitant chemo-radiotherapy on the survival of patient, to assess the, toxicity of different treatments modalities and the effect of age, sex and bulk or tumour on survival. This study was carried out in the Department of Radiology and Oncology, Nishtar Hospital, Multan from January 2007 to December 2009. A total of 100 patients with biopsy proven diagnosis of squamous cell carcinoma of head and neck were included in the study. All patients were in advanced stage. All patients underwent complete clinical examination which includes physical examination, indirect/direct laryngoscopy. Patients were randomized into three groups i.e. group-A:- Induction chemotherapy with cisplatin and 5-FU infusion for 3 days followed by radiotherapy. Thirty five patients were included in this group. Group-B:- Radiotherapy alone with cobalt 60 - 6600 cGy in 6-7 weeks, Thirty three patients were included in this group. Group-C:- concomitant chemo-radiotherapy. Thirty two patients were included in this group. Out of 100 patients, 60 were male and remaining 40 were females. The mean age of the patients included in the study was 52 years, range being 22-60 years. The patients of head and neck cancer in the study had different sites of involvement. The patients presented with, various symptoms such as pain, swelling, ulcer, bleeding, dysphagia, hoarseness of voice etc. No patients had early stage disease. All the patients in this study had the experience of nausea and vomiting, it was more marked in patients having radiotherapy, either alone or concomitant with chemotherapy. The patients having concomitant chemo-radiotherapy of group-C also had diarrhea as a side effect. The effect on the liver function test was more pronounced in patients of group-A. The renal function was seen to alter more in patients receiving chemotherapy with cisplatin, whether as induction or as a concomitant to radiotherapy. Concomitant chemotherapy followed by radiotherapy and the standard radiotherapy alone

Various surgical options in the management of basal cell carcinoma in Nishtar hospital, Multan

To describe the prevalence, mode of presentation and various surgical options of reconstruction in the management of basal cell carcinoma [BCC] with a local perspective. The present descriptive study was conducted at Nishtar Hospital, Multan from 2006 to 2009. A separate file was maintained for each patient. A thorough history and full physical examination was conducted, relevant investigations were carried out. All this was recorded in data collection for and data analysed to find frequencies and percentages using SPSS-10. Out of sixty cases, 50 [83%] were male and 10 [17%] were female. Majority of the patients presented to us above the age of 45 years and the incidence of BCC increases with the age. The male to female ratio was 5:1. Out of 60 cases 26 [20 male, 6 female] 43.3% were farmer, 16 [all male] 26.6% wee construction workers, 10 [8 male, 2 female] 16.6% were unemployed and 8 [all female] 13.3% were household. No patient presented before 5 years after the development of the lesion. 34 [30 male, 4 female] 56.6% for the last 6-10 years, 20 [16 male, 4 female] 33.3% for the last 11-15 years, 2 [all male] 3.3% for 16-20 years and 4 [2 male, 2 female] 6.6% had lesions for> 20 years. All the lesions encountered in present study occurred on exposed head and neck region as. Most of the patients had the nodular pigmented type of BCC and majority of them were male. None of them have Gorlin's syndrome. Delay in presentation has an overall negative effect on the outcome. A simple excisional biopsy technique ensure margins clearance and give surgeon more freedom for reconstruction