RESUMO
To compare the results of sequential with concurrent chemo radiotherapy in locally advanced squamous cell carcinoma of esophagus in terms of loco regional control, toxicity profile and overall survival,65 patients were enrolled between Jan 2008 and Dec. 2010, of which 37 were male and 28 female. Patients had histologically confirmed squamous cell carcinoma with locally advanced disease with no prior treatment in the form of chemotherapy, radiotherapy or surgery. Patients were divided into two groups and were comparable in terms of patient characteristics. In Group-I, 35 were given sequentially paclitaxel 175mg/ m2, cisplatin 75mg/m2 on day 1 of every 21 days for 3 cycles followed by external beam Radiotherapy followed by 3 more cycles of same chemotherapy. In Group-II, 30 patients were given two cycles of Induction chemotherapy same drugs and dosage as in Group-I and was followed by EBRT concurrent with paclitaxel 30mg/m2 given on day 1 of every week during radiation therapy treatment. The overall objective response rate at the end of treatment was superior 93.33% in Group-II as compared to 74.28% in Group-I. Thrombocytopenia was 73.33% and 17.14% in Group-II and Group-I respectively. Similarly, mucosites was higher 56.66% in Group-II as compared to 22.85% in Group-I. At 2 years of follow up, there was no statistically significant difference seen in overall and disease free survival.
RESUMO
To determine frequency of postoperative wound infection with the use of scalpel /diathermy during elective cholecystectomy. Cross sectional [comparative] study. Surgical department unit IV, Military Hospital Rawalpindi and PNS Shifa Karachi, from September 2004 to March 2005. All patients [female and male] presenting with symptomatic gall stones who underwent open cholecystectomy through standard right upper transverse incision were included in the study. Patients were divided into two groups. Group A included 30 patients who underwent open cholecystectomy with scalpel and group B included 30 patients who underwent open cholecystectomy with diathermy. All patients who were having any co-morbid conditions like, diabetes mellitus, immuno-compromised state, pre existing infection at the site of skin incision and previous surgery were excluded. It was observed that out of 60 patients only 3 patients developed post operative wound infection In group A out of 30 patients with scalpel cutting only 1 patient developed wound infection which is 3.3% while in group B out of 30 patients with diathermy cutting only two patients developed wound infection which is 6.6%. Various other observations were found that males who developed cholelithiasis were 8.33% and females were 91.66%. Age distribution was minimum 27 years, maximum 75 years and mean age was 48.8 years. This study concluded that ratio of wound infection with scalpel cutting is less as compared to diathermic cutting and we can protect the patient from wound infection with the use of scalpel