Quantitative tumor volume vs. TNM staging: the impact on prognosis in head and neck cancer

To evaluate the prognostic value of tumor volume [TV] by clinical method [CM] and Computerized Tomography [CT] scan in head and neck [H and N] cancer. Total 25 patients' [pts] pretreatment tumor volume [PT TV] was assessed clinically by cuboid volume method. Afterwards contrast enhanced computerized tomography [CECT] images of the pts were transferred to workstation by DICOM software. The computerized tomography tumor volume [CT TV] was obtained on Radworks 6.0, using mouse control cursor. After assessment, the patients were given 3 cycles of neoadjuvant chemotherapy followed by radiotherapy by conventional method on Co-60 Theratron 780 C. After 1 month of treatment, TV was again measured. Statistical analysis was done on MSTAT statistical analysis software. Two-tailed student t test, chi square test and test for two proportions for significance had been used. Large variations in tumor volume were found both in intra as well as inter T-stages. As the tumor size increases with T stages, the differences in measurement of TV by both methods decreases. CT TV results pre as well as post-treatment were more consistent than clinical method. The use of TV as a prognostic factor by CT scan seems to be more useful parameter than the CM. TV should be included in the TNM [tumor, node, and metastasis] classification after setting the strict guidelines for tumor delineation, to solve the discrepancy of treatment outcome in the same clinical stage

Clinical presentations, diagnosis and pattern of intestinal tuberculosis our experience, Nishtar hospital Multan, Pakistan

To discuss clinical presentations, diagnosis and pattern of intestinal tuberculosis of the patients presenting in surgical department. Design. Retrospective study. Place and duration of study. Nishtar Hospital Multan, Pakistan during the period of January 2002 to August 2004. Patients and methods. 109 diagnosed cases of intestinal tuberculosis were included in this study. Patients with intercurrent illness and patients proved to have other diagnosis after full work up were excluded from the study. A detailed history and full physical examination of all patients was recorded. Later on various investigations, operative findings were also noted. Results. The ages of patients were in range of 12-54 years. Male to female ratio was approximately 1:2. Clinical presentation was quite variable ranging from abdominal pain present in 100 patients [91.74%] to weight loss noted in 54 patients [49.54%]. Endoscopic biopsy and PCR analysis were most useful in diagnosing intestinal tuberculosis in elective ca ses. Strictures of the small bowel were commonest pattern noted. Past history of pulmonary tuberculosis was present in 8 patients [7.33%] while 18 patients [16.51%] had previous history of intestinal tuberculosis. 35 patients [32.11%] had positive family history of tuberculosis. 18.34% of the patients had secondary tuberculosis. Conclusion. Intestinal tuberculosis is a common disease in third decade in the developing countries. Females are more affected than males. Primary tuberculosis is more common than secondary tuberculosis. Intestinal tuberculosis may present with a variety of abdominal symptoms and signs. Endoscopy and PCR analysis can be considered as reliable investigation in elective cases. Strictures, mass abdomen and intestinal perforation are the most common pattern observed

Effect of aluminum and chromium on the germination and growth of two Vigna species

The study deals with the effect of metal toxicity [aluminum, chromium and combination of both the metals] on seed germination, root length, shoot length, seedling length and dry biomass of Vigna radiata and V. sinensis. Chromium adversely affected the seedling by significantly reducing the growth whereas aluminum did not show such effect in both the species. Percentage of germination was good in both the species at different concentration of treatment [aluminum, chromium and combined treatment]. Shoot length was also not much affected in V. sinensis as it was greatly inhibited in V. radiata. Both the species showed the purpling of stem. Dry biomass of V. radiata showed positive effect than V. sinensis. However, dry biomass decreased to a lesser extent when treated with aluminum, chromium and combined treatment as compared to control

Effect of aluminum and chromium on the growth and germination of mesquite [Prosopis juliflora swartz.] DC.

Prosopis seeds were grown under controlled environment in solution of aluminum and chromium at different concentration alone as well as combined together. The effect of these metals was studied on seed germination, root length, shoot length, seedling length and dry biomass. Aluminum and chromium alone, and combined together showed no effects on germination and dry biomass. Chromium alone was found toxic to root, shoot and seedling length. However, application of different concentrations of aluminum increased the root, shoot and seedling growth. It may be concluded that aluminum is not as toxic as chromium, and their combined treatment showed the intermediate effect by ameliorating the impact of one another

Phytotoxic effect of aluminum and chromium on th germination and early growth of wheat [Triticum aestivum] varieties Anmol and Kiran

A greenhouse experiment was conducted to determine the phytotoxic effect of aluminum and chromium on the germination and early growth of two wheat [Triticum aestivum] varieties Anmol and Kiran. Seed were treated with 40, 80, 120 and 160 ppm of aluminum and chromium solution individually and in combined form. Observations were made on seed germination, root, shoot and seedling length, and dry biomass. Seed germination and dry biomass showed no effect of aluminum, chromium and combined treatment. Root, shoot and seedling length of both the varieties showed significant [P<0.05] decrease as compared to control. The growth was also reduced as the concentration of aluminum and chromium increased. Seedling length decreased in both the varieties at all the concentration of different treatment of aluminum, chromium and combined treatment. Attempts are being made in different laboratories to construct novel plants using genetic manipulation technologies that may have a greater tolerance to the presence of toxic metals. The results of the present study may help in understanding the mechanisms involved and their possible use in pytoremediation

Chronic suppurative otitis media: a prospective study

This is a prospective study of 183 patients with chronic suppurative otitis media who attended the E.N.T. clinic at the Jordan University Hospital between 1978-1983. The cases were assessed according to a preset protocol where history, clinical examination, and special investigations were recorded. Cases were categorised according to the presence of cholesteatoma and the type of perforation into three groups: group I consisted of patients with central perforations without cholesteatoma [151 ears], group II with attic and marginal perforation [54 ears], and group III with central perforation and cholesteatoma [39 ears]. The present article includes the findings in group I and II; those of group III were previously reported. The peak incidence of the disease in both groups was in the second decade of life, no correlation between the duration of discharge and the presence of cholesteatoma was noticed, and no firm association between nasal and throat pathology on the one hand and chronic ear suppuration on the other could be elicited. Complications occured in cases where cholesteatoma was present. The majority of the cases are speculated to be sequela of secretory otitis media

Peripheral nerve tumor involving maxillary sinuses: a case report and review of the literature

Nerve sheath tumors of the paranasal sinuses are uncommon. Those confined to the maxillary antrum are rare, four only being on world record. We present an additional case with review of the literature. First described by Verocay[1] in 1910 under the term neurinoma, schwannoma [neurolemmoma] has frequently been reported in many anatomical locations wherever Schwann cell wrapping of a nerve occurs. Among other sites the tumor was reported to occur in the thorax[2-3], oral cavity, middle ear and orbit[4], breast[5] and bone of which the most common sites of involvement have been the mandible, scapula and ribs[6-7] though rare sites such as the femur have also been reported. However, up to 45% of schwannomas develop about the head and neck[9]; comprising the highest proportion in an anatomical body location. Yet, the tumor rarely involves paranasal sinuses. In this report we describe a case of solitary schwannoma developed in the left maxillary sinus, an extremely rare site of occurrence according to the English literature. The present case is the first to be reported in Jordan