The efficacy of an ayurvedic preparation of yashtimadhu (Glycyrrhiza glabra) on radiation-induced mucositis in head-and-neck cancer patients: A pilot study

Background: Oral mucositis is a common and debilitating painful side effect of many forms of chemotherapy and radiation therapy. Mucositis may lead to dose reductions and unplanned interruptions of chemotherapy and/or radiotherapy (RT) and often affects patients' quality of life. Aim: The objective of the study was to assess the efficacy of the ayurvedic preparation in decreasing the severity of mucositis in head-and-neck cancer patients receiving concomitant chemoradiotherapy. Materials and Methods: In this prospective randomized study, the patients were divided into three groups. Group 1 patients received conventional mucositis treatment, whereas Group 2 patients received ayurvedic preparation Yashtimadhu in addition to conventional treatment. Group 3 patients received honey for local application in oral cavity as well as one tea spoon of honey twice daily orally in addition to routine conventional treatment. All the patients were assessed for mucositis at the end of every week during the RT for a period of 6 weeks. Results: A significant difference was observed between the groups at each time point. Nearly 42.85% of patients in conventional treatment arm developed Grade 3 mucositis, 20% of patients developed Grade 3 mucositis in group where honey was given, and only 15.5% of patients developed Grade 3 mucositis in Yastimadhu group. Unplanned treatment breaks and hospitalization of patients were reduced with the use of yashtimadhu as compared to other two groups. Conclusion: Yashtimadhu was observed to be effective and delayed the development of severe form of mucositis. The drug appeared to be more efficient in the management of radiation-induced mucositis

Prevalence and correlates of psychological distress among cancer patients in a tertiary care hospital in northern India

Background: Patients diagnosed with cancer are usually exposed to high level of mental stress and hence invariably lend in psychological distress. This study aimed to estimate the prevalence of psychological distress amongst cancer patients and determine its association with socio-demographic factors. Methods: This hospital based cross-sectional study was conducted at a cancer research institute of district Dehradun. Purposive sampling was used to select the hospital and recruiting patients. All eligible patients, giving written consent for the study were interviewed and distress related information was gathered using the Hospital Anxiety and Depression Scale (HADS). The data were collected for two months and sample size of 208 was achieved. Data was entered in SPSS 22.0 and association of different variables with psychological distress was determined by chi-square test.. Results: The mean age of the surveyed cancer patients was 51.05±15.68 years and the male female ratio was 1.7. Prevalence of psychological distress was found to be 38.5% and significantly more female patients than male patients (47.4% and 33.3% respectively) had distress. The association between psychological distress and increasing age, sex, literacy and employment status was found to be significant. Conclusions: Approximately 39% of cancer patients had psychological distress (anxiety/ depression/ both). The prevalence of psychological distress was found to be significantly higher in female patients, older age, patients with no formal education, unemployment and lower socio-economic status. Appropriate psychiatric interventions/ counselling following diagnosis and during therapy may be effective in reducing distress and improving quality of life in cancer patients.

Desmoplatic Small Round Cell Tumor Of Paratesticular Origin

Desmoplastic Small Round Cell Tumor (DSRCT) of the paratesticular region is an extremely rare mesenchymal tumor occurring in adolescence with a tendency for extensive metastases. We report a rare case of DSRCT of paratesticular origin in a 24 year old male who presented with painless right testicular mass and disseminated abdominal disease. The patient underwent right inguinal orchidectomy and on Histopathology and Immunohistochemistry the diagnosis was confirmed. The patient was treated with multi agent chemotherapy with partial remission. Prognosis of such patients is generally dismal despite multimodality treatment.

Assessment of Awareness and Presence of Risk Factors for Cancer in a Rural Community Of Uttarakhand, India.

Background: Cancer has become one of the major threats to public health in the developed world and increasingly in the developing world. Cancer rates in India are lower than those seen in western countries, but are rising with increasing migration, increase in life expectancy and changes in lifestyles. This study was planned to elicit the presence of risk factors for cancer in a rural community and to assess the awareness of people about risk factors of cancers. Methods and Material: This cross sectional study was conducted in a randomly chosen block in district Dehradun. Overall 1731 people were interviewed by trained personnel and data was entered and analysed in SPSS software (21.0 versions). Results: Overall 9.7 % respondents reported presence of the warning symptoms of different cancers. Regular smokers were 7.3% (16.3 % males and 1.4 % females), while 8.3 % respondents (males-18.6%, females-1.4%) accepted regular use of smokeless tobacco. 87 % of the surveyed people had the knowledge that cancer can be prevented by changing the lifestyle. Conclusions: Increasing incidence of various cancers is of concern to the public health. In developing countries like ours, preventive programs should be directed towards masses with focus on behaviour change communication.

Cytohistopathological Correlation in Palpable Breast Lesions.

The objective was to study the correlation between cytological and histopathological features and to find out the sensitivity and specificity of Fine Needle Aspiration Cytology (FNAC) in the diagnosis of breast lesions. Two hundred patients were studied; 150 were retrospective and 50 were prospective cases. Only those patients who had FNAC followed by histopathological examination were included. Useful cytological parameters for diagnosis of malignancy were loss of cell cohesion, cell size, nuclear crowding and overlapping, nuclear size, type of chromatin, absence of bipolar naked nuclei and infiltration of stroma. In present study complete sensitivity was 96.2%, absolute sensitivity was 86.7%, predictive value was 100%, false negative were 1.9%. No false positive smear was seen. We concluded that a definitive diagnosis of malignancy by FNAC could be safely used for definitive treatment but the same was not true for non-malignant, suspicious or atypical smears. In these situations surgical biopsy was considered to be essential for definitive diagnosis.

Intrapulmonary teratoma presenting with tricoptysis: A case report and review of the literature.

Intrathoracic teratoma usually occurs in the mediastinum but rarely, these may originate from the lung. We report a case of an intrapulmonary teratoma in a 34-year-old male.

Apical mass presentation of brachial plexus Schwannoma.

Neurogenic tumours arising from the brachial plexus are rare. Most of these present as palpable cervical mass with tenderness and pain radiating to the arm along the distribution of the affected nerve. Here we report a case with radiological presentation mimicking an apical mass in the right chest with minimal symptoms. The mass was successfully and completely removed at thoracotomy preserving the integrity of the lower trunk of the brachial plexus. There was some evidence of neuroparesis in the immediate post-operative period but the patient made a very good recovery 10 weeks after surgery.