Preoperative Versus Postoperative Chemoradiation in Stage III Cancer Rectum: A Single Institution Experience

The optimal management of locally advanced rectal cancer requires a multidisciplinary strategy involvingsurgical resection with total mesorectal excision and combined use of radiotherapy and chemotherapy. Thesequence of treatment can either be preoperative chemoradiation followed by surgery or upfront surgeryfollowed by postoperative chemoradiation. This study compared survival outcomes of these two aforementionedapproaches in 76 stage III rectal cancer patients, identified in the hospital database and treated between 2008and 2014. The median locoregional recurrence free survival in the preoperative group was 34 months whereasit was 33 months in the postoperative group (p=0.583). The median distant metastases free survival was 17months in the preoperative group versus 38 months in the postoperative group (p=0.039). The mean survivalin the whole cohort was 46.97 months with 27 deaths reported at the time of last follow up. The meansurvival in the preoperative group was 35.927 months versus 51.519 months in the postoperative radiotherapygroup (p=0.129). In our set of patients, the sequence of chemoradiation whether preoperative or postoperativedoes not lead to differential survival.

Elastography evaluation of normal thyroid gland and its comparison with diffuse non nodular enlarged thyroid gland using strain ultrasound elastography

Background: The thyroid gland is located in the anterior part of neck, spanning between C5 and T1 vertebra and is located anterior to the thyroid and cricoids cartilage of larynx and first three tracheal rings. Ultrasonography has been widely used for diagnosis of thyroid disease it is highly regarded for its ease of use, real-time capability, portability and low cost.Methods: The current observational study was conducted in Department of Radiology, Dr. BRAM Hospital, Pt. JNM Medical College, Raipur, India. Consecutive sampling method was used for the study. All the cases coming to radiology department during the study period were taken as study subjects.Results: Of the normal subjects, author found 107 normal thyroid subjects and 53 patients were categorized into cases with diffuse non-nodular thyroid swelling groups. Of the diffuse thyroid swelling group about 85% of the study population is between 20-50 years of age group, 13.2% were <20 years of age and one patient is >50 years of age. Females to male ratio for diffuse thyroid disease is 3.4:1.Conclusions: Ultrasound elastography (USE) is a newly developed non-invasive method to evaluate and compare the elasticity of the thyroid gland and other organs like liver, prostate, parotid, breast pathologies. Its use is based on the principle that pathological changes in a tissue also changes its elasticity.

Pectoralis major myocutaneous flap in head and neck reconstruction: an interesting experience from central India regional cancer center.

Background: Head and neck cancer are sixth most common cancers worldwide with cancer of oral cavity most common. The primary treatment modality for oral cavity cancer has been surgery and defects resulting from the ablation of the tumors require reconstruction. the PMMC flap offer an easy, less time consuming with minimal postoperative complication as a reconstructive option in the hands of reconstructive surgeon. The objective of our study was to give a precise description of our experience with the PMMC flap as a reconstructive option in post-ablative head and cancer surgery. Methods: The current prospective study was conducted in the Department of Surgical Oncology, Regional cancer center, Pt. JNMC, Raipur (C.G.), India from the January 2014 to June 2015. Detailed clinical history and examination of the patients were recorded. All Investigations relevant to the study were done before the surgical procedure. Procedure was performed as per standard protocol and reconstruction was made with PMMC flap. Data was compiled in MS Excel and checked for its completeness and correctness. Then it was analyzed. Results: In the present study male to female ratio was 2:1. Most of the patients belongs to the age group of 41-60 (55.55%) followed by 21-40 (30.15%). In the present study majority of patient of oral malignancy presented with lower alveolus malignancy (36.5%) followed by buccal mucosa malignancy (19.06%). Conclusions: Pectoralis major myocutaneous flap was found to be a versatile flap for reconstruction of large defects in Head and Neck region with minimal complication rate.

Diagnosing acrocallosal syndrome.

A 3-month-old male child presented with typical features of acrocallosal syndrome. He satisfies Courten's diagnostic criteria for acrocallosal syndrome.

Cutaneous Metastasis :A rare Clinical Entity.

An interesting and rare case of cutaneous metastasis in xiphisternal region is being reported. The patient presented with a fungating nodule in xiphisternal region of 3 months duration. The biopsy showed metastatic carcinomatous deposits (Keratin ising Squamous cell carcinoma). Primary lesion was later localised in the right lung.