Colorectal Origin: A Marker of Favorable Outcome in Krukenberg Tumor? Results from Clinical and Prognostic Analysis.

Purnima Thakur This study aimed to identify the prognostic factors affecting the survival of patients suffering from Krukenberg tumor (KT) and also to determine the survival in these patients. A retrospective review of patients diagnosed with KT between January 2015 and December 2021 was conducted at a tertiary cancer center. Clinicopathological variables were scrutinized, and survival analysis was performed. Thirty-six patients were enrolled in this study. The median age at diagnosis was 48 years (ranging from 22 to 71 years). The median overall survival (OS) was 9.9 months (95% confidence interval [CI]: 6.6 to 13 months). The mean OS for tumors originating in the colorectal region was longer compared to that for tumors of other sites (15.4 vs. 9 months, respectively; p = 0.048). In univariate analysis, patients who received chemotherapy had better survival, while those presenting with ascites had a poor prognosis. No correlation was observed between age, menstrual status, bilaterality, size of ovarian metastases, extent of metastatic disease, metastasectomy, and survival. Multivariate Cox regression analysis showed that chemotherapy predicted a favorable survival outcome (hazard ratio [HR] = 0.200, 95% CI: 0.046-0.877, p -value = 0.033). KT is an aggressive tumor with a median OS of less than a year. Chemotherapy may improve survival. Patients with a primary tumor in the colorectal region have a better outcome, while those presenting with ascites indicate a poor prognosis.

Comparison of iso-effective and cost-effective high-dose-rate brachytherapy treatment schedules in cervical cancer - regional cancer center experience.

PURPOSE: The study is to evaluate the difference between outcomes of two high-dose-rate fractionation schedules in the treatment of intracavitary brachytherapy (ICBT) of cervical cancer. MATERIAL AND METHODS: A retrospective analysis of 163 cervical cancer patients was completed. All patients received external beam radiotherapy (EBRT) to whole pelvis with concurrent weekly chemotherapy, followed by ICBT with either 7 Gy per fraction in three fractions (arm A) or 9 Gy per fraction in two fractions (arm B). Median follow-up was 19 months. The outcomes were compared in terms of 2-year actuarial local control, disease-free survival, overall survival, and late toxicity in the two treatment arms. RESULTS: The 2-year actuarial local control rates in arm A and arm B were 88.5% and 91.5%, respectively. The actuarial 2-year disease-free survival rates in arm A and arm B were 85.9% and 82.6%, respectively. The actuarial 2-year overall survival in arm A and arm B were 95.7% and 100%, respectively (p = 0.06). There were 12.7% and 15.2% local failures in arm A and arm B, respectively. Distant metastases were seen in 8.5% and 7.6% in arm A and arm B, respectively. The 2-year actuarial risk of developing late rectal toxicity in arm A and arm B were 5.6% and 5.4%, respectively. The 2-year actuarial risk of developing late bladder toxicity in arm A and arm B were 2.8% and 2.2%, respectively. CONCLUSIONS: ICBT treatment with 9 Gy in two fractions offers equivocal local control rates and survival rates in cancer cervix cases with many advantages of short overall treatment time, improved patient compliance, cost effectiveness, and reduced exposure to aesthetic agents. The toxicities observed were few, low grade, and easily manageable.

Knowledge of breast cancer risk factors and methods for its early detection among the primary health-care workers in Shimla, Himachal Pradesh.

BACKGROUND: Breast cancer is an increasing health problem in India. Screening for early detection should lead to a reduction in mortality from the disease. Majority of the population, especially in rural areas, contact health-care system through primary health-care workers. AIM: To know the knowledge of breast cancer risk factors and methods for its early detection among the primary health-care workers in Shimla district, Himachal Pradesh. MATERIALS AND METHODS: A descriptive cross-sectional study questionnaire study was conducted among primary health-care workers (both males and females) in Shimla district, Himachal Pradesh. The data were analyzed using SPSS software version 16. The statistical tests used were t-test, ANOVA, and Fisher's exact test. P = 0.05 was considered statistically significant. RESULTS: Out of a total of 120 patients, there were 46 males (38.3%) and 74 females (61.7%). The mean age of the population was 48.5 ± 5.3 years, with a range of 25 and 57 years. The mean knowledge score percent of the present population was 71.04 ± 18.3. The mean knowledge score was higher among males (73.9 ± 19.8) as compared to females (69.2 ± 17.2). Approximately 43.3% of the participants had very good knowledge about risk factors followed by 31.7% having excellent knowledge, 20% having good knowledge, and 5% having poor knowledge. CONCLUSION: The overall mean knowledge percent about breast cancers among primary health-care workers in this study was very good, slightly higher among males and postgraduates, but to make it universal, reinforcement of educational programs can be planned for them.

Oral health knowledge and practices among primary healthcare workers in Shimla District, Himachal Pradesh, India.

CONTEXT: Primary healthcare workers being grassroot workers in rural areas can be effective in oral health promotion in these areas. AIM: To assess oral health knowledge and practices among primary healthcare workers in Shimla district in Himachal Pradesh. SETTING AND DESIGN: A cross-sectional study. SUBJECTS AND METHODS: A cross-sectional study was conducted to assess oral health knowledge and practices of primary healthcare workers in Shimla using a self-administered questionnaire. STATISTICAL ANALYSIS USED: Data were analyzed using SPSS package version 16. The tests used were t-test and Fisher's exact test. A P value < 0.05 was considered statistically significant. RESULTS: Of 130 subjects, there were 60 (46.2%) males and 70 (53.8%) females. The mean age of the population was 48.4 ± 5.9 with a range of 25-57. The mean knowledge score percent of the population was 51.9 ± 18.2. It was higher for males (52.3 ± 15.0) when compared with females (51.5 ± 20.7). The mean knowledge score percent was positively associated with education and negatively associated with age. Tooth brush was used by 97.7% and tooth paste by 121 (93.1%). The frequency of brushing twice was reported by 79 (60.8%). CONCLUSION: Though the overall knowledge about oral health is good among primary healthcare workers, the understanding about various aspects is lacking. Therefore, it is recommended that health workers should be given education to enhance knowledge and practices toward oral healthcare and to increase their screening capacity for common dental problem which will serve the community in long way.

Breast cancer risk factor evaluation in a Western Himalayan state: A case-control study and comparison with the Western World.

CONTEXT: Breast cancer incidence is increasing rapidly in India. The lifestyle, built, genetic makeup, reproductive and breastfeeding patterns are quite different in Indian females when compared to the Western population. Generalizing the Western data to the population residing in the Himalayan region would breed inaccuracies. AIM: The aim of our study was to identify risk factors in our own population in a Western Himalayan state of Himachal Pradesh, India. SUBJECTS AND METHODS: A case-control study with 377 cases of invasive breast cancer and 346 hospital-based controls was conducted for 1 year. The data were collected by interviewing the individuals during their visit to hospital using a questionnaire. The data were analyzed using standard statistical techniques using SPSS version 17 software. RESULTS: Factors found to have strong association with invasive breast cancer on multivariate analysis are late age at first childbirth >30 years, which is the strongest risk factor associated, late age of menopause > 50 years, high socioeconomic class, and age of female above 50 years. CONCLUSION: In our females, age >50 years, late age of menopause (>50 years), late age at first childbirth (>30 years), and high socioeconomic status were found to be major risk factors associated with breast cancer. Several factors implicated in the Western data were not found to be significant in our study. We need to identify such aspects in reproductive and breastfeeding patterns of women and spread awareness regarding the same.