ABSTRACT
INTRODUCTION: Parkinson's disease is the most common form of a group of progressive neurodegenerative disorders. The use of levodopa as dopamine - replacement therapy is highly effective in ameliorating the symptoms of the disease and remains the standard drug with which other therapies are compared. AIM: To study the change in Unified Parkinson's Disease Rating scale (UPDRS) scores in patients receiving levodopa and carbidopa treatment (levodopa- carbidopa combination). MATERIALS AND METHODS: Study was conducted in Department of Neurology, Government Medical College, Trivandrum, India on 75 patients. All patients diagnosed with Idiopathic Parkinson's disease (PD) satisfying inclusion criteria were enrolled into the study. Informed written consent was taken from all patients. Baseline UPDRS scores were recorded followed by reassessment at the end of six month. Data was analysed using paired t-test with help of SPSS-16 statistical software. RESULTS: Baseline UPDRS was collected and after 6 months of treatment, it was reassessed. Baseline total score was 49.8; the follow-up score was 39.5. A decrease in score was seen in various components of UPDRS. CONCLUSION: Upon statistical analysis this difference was found to be significant, which implies that, there is improvement in patient's condition. Improvement was noted in Mentation, behaviour, mood, activities of daily living and motor functions. Hence there is positive treatment response for levodopa carbidopa therapy in patients with idiopathic PD.
ABSTRACT
INTRODUCTION: A 5-flurouracil, Adriamycin, Cyclophosphamide (FAC) and Adriamycin, Paclitaxel (AT) are two popular chemotherapeutic regimens for treatment of breast carcinoma. The most time tested and popular regimen is FAC. It is extensively studied for efficacy and toxicity. But data regarding toxicity profile and efficacy of AT regimen is sparse. AIM: To study the toxicity profile, severity of toxicities and clinical response rate of FAC and AT regimens in patients with locally advanced breast carcinoma. MATERIALS AND METHODS: A prospective observational study with 50 patients in each treatment arm. Study duration was 12 months from November 2012 to October 2013. Consecutive patients with locally advanced breast carcinoma receiving treatment with either FAC or AT regimen, satisfying inclusion criteria were enrolled into the study after getting informed written consent. Prior to initiation of treatment detailed medical history was taken from all patients. General clinical examination, examination of organ systems and local examination of breast lump were done. After each cycle of chemotherapy and after completion of treatment patients were interviewed and examined for clinical response and toxicities. Toxicities were graded with WHO toxicity grading criteria. All data were entered in a structured proforma. At least 50% reduction in tumour size was taken as adequate clinical response. STATISTICAL ANALYSIS: Data was analysed using Chi-square test with help of Excel 2007 and SPSS-16 statistical software. RESULTS: Different pattern of toxicities were seen with FAC and AT regimens. Anaemia, thrombocytopenia, stomatitis, hyperpigmentation, photosensitivity and diarrhoea were more common with patients receiving FAC regimen. Leucopenia, peripheral neuropathy, myalgia, arthralgia, vomiting and injection site reactions were more common in AT regimen. Both FAC and AT regimens gave 100% clinical response. CONCLUSION: FAC and AT regimens are equally efficacious but have different toxicity profiles. Patient's predisposition to toxicities may govern the selection of a particular regime.
