Cortisol response to arginine-vasopressin does not compare with cortisol response to insulin-hypoglycemia in pituitary tumors.

Timed cortisol responses to insulin-hypoglycemia (IH) and arginine-vasopressin (AVP) were compared in 16 patients with pituitary tumors and six healthy controls. Serum cortisol was estimated by a specific and sensitive radioimmunoassay as per the WHO protocol. The basal cortisol (AM) was normal (> 290 nmol/l) in 9 patients and low in seven. With IH peak cortisol response was normal (> 550 nmol/l) in 10 patients, 8 of whom had normal and 2 had low basal (AM) cortisol. In contrast AVP evoked normal cortisol responses in only 5 of these patients, all of whom had normal basal (AM) cortisol and none had low basal (AM) cortisol. The data indicate lower sensitivity for AVP stimulation test (50%) and favour IH as the standard cortisol stimulation test in patients with pituitary tumors awaiting surgery.

Cancer profile in western Rajasthan.

A retrospective study of malignancy was conducted in the arid region of Western Rajasthan over a period of five years (1984 to 1988) to determine the frequencies of various malignancies. This was the region where India's first nuclear explosion took place in 1974. During this period 2662 new cancer cases were recorded. In males, Oropharyngeal and Hypopharyngeal malignancies topped the list. Males had an overall higher incidence than females (1.28:1). Most of the cases were between 31 years and 60 years with male peak at 60 years and female at 50 years. In females, cancer of the cervix formed the largest group followed by Breast cancer. A comparatively high rate of skin, urinary bladder, bone malignancy, lymphoma and leukaemia was observed in this region. Limited investigational facilities, lack of trained personnel, tough working condition, extremes of temperature, long distances in the desert region, with associated poverty, illiteracy and ignorance were some of the factors responsible for majority of the patients presenting in advanced stages.