ABSTRACT
Oral squamous cell cancers involving the masticatory space are staged as unresectable cancers and their treatment is difficult. Curative treatment with extensive surgery followed by adjuvant therapy is one of the treatment options. In this retrospective study, the survival of 123 patients (93 with T4a cancers, 30 with T4b cancers), treated during the period August 2009 to August 2015, was evaluated. The majority had bucco-alveolar cancers (62.6%), were male (61.8%), and were tobacco users (76.4%). The select group of T4b oral cancer patients were treated with surgery, which included infratemporal fossa clearance in all 30 patients, followed by adjuvant therapy. The masseter was the most commonly involved masticatory muscle, and 24 patients had fewer than three involved structures. Free margins were obtained in 90.2% of cases; 41.5% of cases were node-positive. One hundred and four patients (84.6%) completed adjuvant treatment. The median follow-up was 42 months. For node-negative patients with T4a and T4b cancers, the 5-year overall survival was 59% and 50.2%, respectively (P= 0.62), and 5-year disease-free survival was 64.6% and 53.5%, respectively (P= 0.01). In conclusion, the select group of patients with T4b oral cancers and less than three masticatory space structures involved had comparable outcomes to those with T4a cancers after treatment with surgery and adjuvant radiotherapy.
Subject(s)
Head and Neck Neoplasms , Mouth Neoplasms , Female , Humans , Male , Mouth Neoplasms/pathology , Mouth Neoplasms/surgery , Neoplasm Staging , Patient Selection , Retrospective Studies , Survival AnalysisSubject(s)
Malaria, Falciparum/diagnosis , Plasmodium falciparum/isolation & purification , Reagent Kits, Diagnostic/standards , Adolescent , Animals , Child , Child, Preschool , False Negative Reactions , False Positive Reactions , Female , Humans , Infant , Infant, Newborn , Malaria, Falciparum/parasitology , Male , Sensitivity and SpecificityABSTRACT
The present paper describes the advantage/limitation of presently available 'in-vivo' methods to detect sensitivity status of Plasmodium falciparum to commonly used antimalarial drugs. The paper is based on a retrospective analysis of 890 P. falciparum cases and various parameters used to define the level of drug resistance. The presented quantification methodology with weightage system to different epidemiological variables of resistance may provide a guideline as to the level of parasite resistance, and a switch over to another antimalarial of firstline treatment which is of the considerable importance to provide early diagnosis and prompt treatment to avert the severe cases/deaths due to malaria.
Subject(s)
Antimalarials/therapeutic use , Malaria, Falciparum/drug therapy , Plasmodium falciparum/drug effects , Animals , Drug Resistance , Health Planning , Humans , India/epidemiology , Malaria, Falciparum/epidemiology , Malaria, Falciparum/parasitology , Prevalence , Retrospective StudiesABSTRACT
Plasmodium falciparum sensitivity test in "in-vivo" carried out in 450 patients revealed, parasite clearance in 66.45 percent cases with 25 mgm/kg body wt of chloroquine. Mean parasite clearance time (MPCT) of sensitive and R I, resistant cases reached near parallelism with an early recrudescence in RI cases indicating stabilisation of genetic change in the parasite strain. The analysis of data revealed that proportionately higher resistance was recorded in coastal area having deciduous (wet) forest ecotype followed by plains of deciduous dry forest and semi arid/arid ecotypes.
