Effects of tamoxifen therapy on plasma lipid profile in patients of breast cancer.

AIM: To evaluate the effects of tamoxifen therapy on plasma lipid profile in patients of breast cancer. METHOD: A total of 55 postoperative patients of breast cancer were given tablet tamoxifen 20mg orally daily for 6 months. Estimation of plasma lipid by standard method was carried out in both pre-menopausal and postmenopausal new patients of early stage breast cancer at 0 day, 3rd month and 6th months of therapy. RESULTS: Suggested that in pre-menopausal and postmenopausal patient's TC and LDL-c levels were reduced significantly, whereas, TG, VLDL-c and HDL-c were not altered. Comparison of the effects of tamoxifen in pre-menopausal and postmenopausal patients on lipid profile revealed that fall in TC and LDL-c was significantly higher at both 3 and 6 months in postmenopausal patients. CONCLUSION: The study demonstrates that tamoxifen to favorably alter the markers of cardiovascular risk in both pre-menopausal and postmenopausal patients of breast cancer.

Osteoarthritis.

Osteoarthritis (OA) is a chronic degenerative disorder of multifactorial etiology characterized by loss of articular cartilage and periarticular bone remodelling. OA causes joint pain, typically worse with weight-bearing and activity as well as can manifest with stiffness after inactivity. It can present as localized, generalized or as erosive osteoarthritis. Primary osteoarthritis is mostly related to aging, whereas, secondary osteoarthritis is caused by another disease or condition. X-rays, arthrocentesis and arthroscopy remain the main diagnostic tools. Blood tests are performed to exclude diseases that can cause secondary osteoarthritis. The treatment of osteoarthritis includes non-pharmacological management, pharmacological treatment in the form of drugs which can modify symptoms, symptomatic slow acting drugs for OA or structure modifying OA drugs depending upon the clinical requirement of the patient. Patients with persistent pain and progressive limitation of daily activities despite medical management may be the candidates for surgery.

Antinociceptive activity of Vitex-negundo Linn leaf extract.

Tail flick test in rats and acetic acid induced writhing in mice were employed to study the antinociceptive activity of ethanolic leaf extract of Vitex-negundo (VN) (100, 250 and 500 mg/kg, p.o). The effect was compared with meperidine (40 mg/kg, sc) in tail flick method and aspirin (50 mg/kg, p.o) in writhing test as a standard control respectively. An interaction with naloxone hydrochloride was also studied in tail flick method for its mechanism of central analgesic action. The test drug showed significant analgesic activity in dose dependant manner in both the experimental models. In comparison to standard drug (meperidine), more than ten times dose of VN extract was required to produce comparable significant antinociceptive activity. The sub-effective dose (5 mg/kg, po) of VN potentiated the analgesic activity of meperidine (4 mg/kg, sc) and aspirin (25 mg/kg, po). Naloxone (1 mg/kg, sc) did not reverse the analgesic effect of VN extract. Our observations suggest that VN possesses both central and peripheral analgesic activity. The central analgesic action does not seem to be mediated through opioid receptors. It, may prove to be a useful adjuvant therapy along with standard analgesic drug.

An experimental evaluation of anticonvulsant activity of Vitex-negundo.

Maximal electroshock seizures (MES) in albino rats and pentylenetetarazole (PTZ) induced seizures in albino mice were used to study anticonvulsant activity of Vitex-negundo leaf extract. The ethanolic leaf extract of Vitex-negundo was administered orally in graded doses (250, 500 and 1000 mg/kg p.o) in both the experimental models and the effects were compared with diphenylhydantoin in MES method and valporic acid in PTZ induced seizures method as standard control respectively. The Vitex-negundo in the doses (250, 500 and 1000 mg/kg, p.o) did not show protection against MES to any significant extent but significant post-ictal depression was observed in the dose of 1000 mg/kg body weight in comparison to control. However, sub-protective dose of test drug (100 mg/ kg, p.o) potentiated the anticonvulsant action of diphenylhydantoin. The test drug in the dose (1000 mg/kg, po) showed 50% protection in clonic seizures and 24-hour mortality against PTZ induced seizures. It also decreased number and duration of convulsions significantly. Vitex-negundo potentiated anticonvulsant activity of valporic acid. The anticonvulsant activity of Vitex-negundo has not been found equi-effective with standard drugs. These findings suggest that Vitex-negundo possesses anticonvulsant activity particularly against PTZ induced convulsions. Moreover, the potentiation of diphenylhydantoin and valporic acid by Vitex-negundo indicates that it may be useful as an adjuvant therapy along with standard anticonvulsants and can possibly lower the requirement of diphenylhydantoin and valporic acid.

Squamous cell carcinoma of thyroid gland.

We present the clinical manifestation, management and outcome in two cases of squamous cell cancer arising in the thyroid gland which is a rare entity. Both cases had advanced disease invading adjacent structures. At the followup of three to six months, one patient developed recurrence and died.

Unusual presentation of polycystic liver disease in a young man.

Polycystic disease of the liver is usually asymptomatic. The main symptoms of cystic disease are those of an enlarging liver or due to compression of the adjacent organs caused by a large cyst. Less than 5% of these patients present with clinically challenging and life threatening complications. We present a patient with polycystic disease of the liver who developed an aneurysm arising from the right hepatic artery presenting with surgical obstructive jaundice. In spite of intraperitoneal rupture of the aneurysm the patient was managed successfully.

Adjuvant therapy in invasive thymoma: an audit of cases treated over an 8 year period.

Invasive thymomas comprise 0.1%-0.2% of all malignancies in India. This report is an audit of 11 cases (10 males and 1 female) at a mean age of 36.6 years (range 25-52 years) of invasive thymoma accrued over an eight year period treated by combined modality treatment. Nine of these presented with myaesthenia gravis. All patients underwent initial surgery (3 partial and 8 total resections) and postoperative radiotherapy. Two of the three partially resected patients received one course of chemotherapy prior to radiotherapy consisting of cyclophosphamide, vincristine, procarbazine and prednisolone. At a median follow up of 28 months (range 2-87) there have been no local relapses, one distant metastasis and one death due to uncontrolled myaesthenia. The treatment strategies with invasive thymomas would depend upon the extent of resection. Postoperative radiotherapy appears to be indicated in all cases, however the role of chemotherapy may be limited to those with partial resection.

An unusual presentation of pulmonary echinococcosis.

A case of pulmonary hydatid disease presenting with right supraclavicular cystic swelling is being reported. Radiologically, the cyst had an extension into the chest wall with bony involvement in the form of destruction and thinning of the first and second ribs on the right side. The patient responded to albendazole therapy.