scholarly journals A Comparative Study of Result of Treatment of Cancer Cervix Patients Treated by Two Separate Schedules of Radiotherapy

2013 ◽  
Vol 25 (2) ◽  
pp. 50-58 ◽  
Author(s):  
Parveen Shahida Akhtar ◽  
M Md Shakhawat Hossain ◽  
Zafor Md Masud ◽  
Naheed Ruksana ◽  
Shamsun Nahar ◽  
...  
Keyword(s):  
Overall Survival ◽  
Open Field ◽  
Local Control ◽  
External Beam ◽  
Cancer Cervix ◽  
Carcinoma Cervix ◽  
Who Grade ◽  
Group I ◽  
Group Ii ◽  
Age Range

Background: Cervical cancer is the most common cancer of Bangladeshi women diagnosed mostly (>80%) at stage II and stage III. Rdaiotherapy (both teletherapy and brachytherapy) is the most important modality of treatment at these stages.Objective: To compare the local control, diseases free survival and overall survival between the (cancer cervix) patients treated randomly by two schedules of radiotherapy. Method: From June 1996 to June 2005, patients with histologically confirmed carcinoma cervix (Ca.cervix) were treated by external beam therapy (EBRT) as well as intra cavitery brachytherapy (ICRT) along with concurrent/sequential chemotherapy with cisplatin and 5- Fluorouracil. EBRT was given by cobalt60 teletherapy machine and ICRT by caesium137 low dose rate machine. The patients were divided into two groups according to treatment schedules. Group I: the patients in this group received EBRT in whole pelvis in two steps, first with open field upto 10-20 Gy then by applying midline shield with lead block 30-40Gy in 25-28 total fractions, five days a week; they also received 50-70 Gy to point A by ICRT in 2-4 weekly fractions. Group II: patients in this group received with open field a dose of 45-50Gy in 25-28 fractions, 5 days a week by EBRT and 25-30 Gy at point A by ICRT in 1-2 weekly fractions.Result: In Group I, 96 out of 101 and in Group II, 104 out of 118 patients were eligible for evaluation. In both groups patients were distributed according to stages and age more or less equally; their age range were 30-70 years and mean age was 47.2 years in Group I and age range were 25-80 years and mean age was 46 years in Group II. Squamous cell carcinoma were found (90%) and performance status was WHO grade 0-1 (>75%) in both groups. Local control of disease at 5 years was 65% in group I and 51% in group II. Overall survival at 2 years, 5 years, 7 years and 9 years in group I, was 71%, 64%, 55%, 46% and in group II, 54%,50%, 43%,32% respectively. Distant metastasis occurred in 22% in-group I and 28% in-group II. Lymph node, lung, liver, peritoneum were common site of metastasis. Proctitis, cystitis, vaginal stenosis in group I was 80%, 33% 16% and in Group II 29%, 13% and 5% respectively. Conclusion: External beam therapy and brachytherapy was effective treatment in carcinoma. Cervix in both operable and inoperable stages. In small volume of tumor, both schedules of radiotherapy were more or less equivalent but in bulky diseases Group I schedule that was higher dose by brachytherapy at point A showed better result; though the complication was more DOI: http://dx.doi.org/10.3329/bjog.v25i2.13739 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(2) : 50-58

scholarly journals Elevated Level of Plasma B-Type Natriuretic Peptide (BNP) as a Prognostic Marker in Patients with Acute Coronary Syndrome

2019 ◽  
Vol 46 (2) ◽  
pp. 32-37
Author(s):  
Dilshad Parvin ◽  
Md Nasir Uddin ◽  
Md Shahjahn Kabir ◽  
Afsana Ahmed ◽  
SM Rahat Hossain ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Logistic Regression ◽  
Odds Ratio ◽  
Binary Logistic Regression ◽  
Prognostic Indicator ◽  
Morbidity And Mortality ◽  
Coronary Syndrome ◽  
Group I ◽  
Group Ii ◽  
Age Range

Acute coronary syndrome (ACS), a life-threatening manifestation of coronary artery disease, ranges from unstable angina (UA) to acute myocardial infarction (AMI). To reduce the morbidity and mortality resulting from acute coronary syndrome, we should have to find out some predictor or prognostic indicator. A prognostic indicator should be available at the time of initial patient’s evaluation, in order to maximize the potential benefits of early risk assessment. This study designed to evaluate plasma BNP as a prognostic tool in patients with acute coronary syndrome. A prognostic cohort study was carried out with 90 (ninety) acute coronary syndrome patients on the basis of their clinical and laboratory criteria with age range of 30 to 90 years in the department of biochemistry, BSMMU, in collaboration with department of cardiology, NICVD, BSMMU and BIRDEM. Plasma BNP concentrations were measured on enrollment and then grouping of the study subjects were done on the basis of their empirical cut off value of plasma BNP concentration. All the patients were free from heart failure, renal disease, thyroid disease and hepatic disorder. Main outcomes were mortality, morbidity and survival after hospital discharge with or without any disability. All the subjects were categorized into two and to see the significance between two groups in relation to age and sex Unpaired –t test and Chi square test were done. Finally, Binary logistic regression was done. Among 90 acute coronary syndromes patients, there were 74(82.2%) male and 16(17.8%) female with mean age of the study population 51.8 years and the age range of 30 t0 90 years. Among enrolled patients, 24 (26.7%) were NSTEMI and 66 (73.3%) were STEMI that includes 29 (32.2%) anterior MI, 21 (23.3%) inferior MI, 16 (17.8%) other varieties of MI. All the study subjects were grouped into two on the basis of empirical cut off value of plasma BNP 640pg/ml on enrollment. Group I with plasma BNP level less than 640pg/ml includes 57 (63.3%) subjects and group II with plasma BNP more than 640pg/ml includes 33 (36.7%) subjects. Among group I (n=57) good recovery, morbidity and mortality found to be in 41(71.9%), 15(26.3%) and 1(1.8%) patients and those in group II (n=33) found in 6(18.2%), 19(57.6%) and 8(24.2%) patients respectively. Keeping the group I in reference category binary logistic regression analysis done, showing odds ratio 11.5 with p- value 0.000. The odds ratio 11.5 indicates that there is 11.5 times higher chance of getting bad outcome in ACS patients having higher plasma BNP concentrations. Bangladesh Med J. 2017 May; 46 (2): 32-37

scholarly journals Impact of Age on Short- and Long-Term Outcomes after Pancreatoduodenectomy for Periampullary Neoplasms

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Mario Gruppo ◽  
Francesca Tolin ◽  
Boris Franzato ◽  
Pierluigi Pilati ◽  
Ylenia Camilla Spolverato ◽  
...  
Keyword(s):  
Overall Survival ◽  
Elderly Patients ◽  
Adjuvant Treatment ◽  
Long Term Outcomes ◽  
Group I ◽  
Periampullary Neoplasms ◽  
Short And Long Term ◽  
Group Ii ◽  
The Impact

Background. Although mortality and morbidity of pancreatoduodenectomy (PD) have improved significantly over the past years, the impact of age for patients undergoing PD is still debated. This study is aimed at analyzing short- and long-term outcomes of PD in elderly patients. Methods. 124 consecutive patients who have undergone PD for pancreas neoplasms in our center between 2012 and 2017 were analyzed. Patients were divided into two groups: group I (<75 years) and group II (≥75 years). Demographic features and intraoperative and clinical-pathological data were collected. Primary endpoints were perioperative morbidity and mortality; complications were classified according to the Clavien-Dindo Score. Secondary endpoints included feasibility of adjuvant treatment and overall survival rates. Results. A total of 106 patients were included in this study. There were 73 (68.9%) patients in group I and 33 (31.1%) in group II. Perioperative deceases were 4 (3.6%), and postoperative pancreatic fistulas were 34 (32.1%). Significant difference between two groups was demonstrated for the ASA Score (p=0.004), Karnofsky Score (p=0.025), preoperative jaundice (p=0.004), and pulmonary complications (p=0.034). No significance was shown for diabetes, radicality of resection, stage of disease, operative time, length of stay, postoperative complications according to the Clavien-Dindo Score, postoperative mortality, pancreatic fistula, and reoperation rates. 69.9% of the patients in group I underwent adjuvant treatment vs. 39.4% of the older ones (p=0.012). Mean overall survival was 28.5 months in group I vs. 22 months in group II (p=0.909). Conclusion. PD can be performed safely in elderly patients. Advanced age should not be an absolute contraindication for PD, even if greater frailty should be considered. The outcome of elderly patients who have undergone PD is similar to that of younger patients, even though adjuvant treatment administration is significantly lower, demonstrating that surgery remains the main therapeutic option.

Sexual Activity and Urinary Incontinence in Women

2009 ◽  
Vol 76 (3) ◽  
pp. 203-206 ◽  
Author(s):  
G. Minaldi ◽  
B. Ventimiglia ◽  
M. Finocchiaro ◽  
I. Fanzone ◽  
A. Tsirgiotis ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Urinary Tract ◽  
Sexual Intercourse ◽  
Stress Incontinence ◽  
Pelvic Prolapse ◽  
Group I ◽  
Pressure Flow Study ◽  
Group Ii ◽  
Detrusor Hyperactivity ◽  
Age Range

Urinary incontinence during sexual intercourse refers to overactive bladder (OAB) syndrome and it is divided in incontinence during penetration and during orgasm. 480 women with low urinary tract symptoms (LUTS) were divided in a) affected by probable genuine stress incontinence, b) probable Urge-stress incontinence, c) probable Urge Incontinence, to specify incidence. Materials and Methods In Group C (186 women) 36 women, age range 24 to 56 years, with urinary incontinence only during sexual intercourse, were selected: 16 during orgasm (group I), 20 during penetration (group II). These patients filled in specific validated questionnaires (ICI-9), urinary recordings and, after urine exam, they underwent US study of urinary tract with post-micturition evaluation. The patients with other urological diseases or pelvic prolapse in stage II of POP-Q or higher were excluded. Patients were referred to physiatric evaluation and urodynamic exam with cystomanometry and perineal EMG, with provocative tests and after pressure-flow study. Results Cystocele was found in 4 out of 16 women in Group I, and in 6 out of 20 in Group II. No patients showed basic detrusor hyperactivity during cystomanometry. In Group I: 50% had detrusor hyperactivity and 18.75% had prolonged perineal relaxation. In Group II 30% had detrusor hyperactivity and 35% had prolonged perineal deficit. Results suggest parasympathetic deficiency in Group I and sympathetic deficiency in Group II.

scholarly journals A comparative study in between tropical honey and povidone dressing in diabetic wounds in a medical college of Northern India

2018 ◽  
Vol 5 (10) ◽  
pp. 3391
Author(s):  
Akhilesh Kumar Yadav ◽  
Sankalp Dwivedi ◽  
Siddharth Desai
Keyword(s):  
Hospital Stay ◽  
Diabetic Foot ◽  
Povidone Iodine ◽  
Subsequent Treatment ◽  
Medical College ◽  
Northern India ◽  
Group I ◽  
Stay Time ◽  
Group Ii ◽  
Age Range

Background: The study was done to compare outcomes with dressings of honey to povidone iodine in the management of diabetic foot ulcers.Methods: The present study was carried out for a period of three years from June 2016 to July 2018 in a medical college of northern India. About 200 patients who presented with features of diabetic foot were selected randomly and included in this study and divided into two groups based upon the subsequent treatment of raw area with honey and povidone- iodine respectively.Results: A total of 200 patients were studied. Group I consist of 100 patients out of which 58 were males and 42 females while in Group II there were 56 males and 44 females. The age range in group I was 46 to 75 years while the age range in group II was 48 to 82 years.  In case of group I time of healing was 7- 75 days with median of 28 while in group II time of healing was 7- 60 days with median of 18 days. In case of group II time of healing was 7-60 days with median of 18 days, hospital stay was 7- 34 days with median of 12 days.Conclusions: In terms of hospital stay, time of healing, allergy to material and need for amputation honey was found to be better than povidone iodine solution for dressing of diabetic foot ulcers.

Venous thromboembolism incidence in radiation oncology: Retrospective trial.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18289-e18289
Author(s):  
Mikhail A Cherkashin ◽  
Natalia A Berezina
Keyword(s):  
Radiation Therapy ◽  
Venous Thromboembolism ◽  
Outpatient Setting ◽  
External Beam Radiation Therapy ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Group Iii ◽  
Group I ◽  
Group Ii

e18289 Background: Venous thromboembolism (VTE) prevention in oncology patients during external beam radiation therapy (RT) in outpatient setting is the challenging question. We performed analysis of our own data. The aim of study is the clear assessment of VTE incidence in these patients Methods: In retrospective analysis 5134 patients' medical records were included (2612 with RT and 2522 with chemotherapy). Inclusion criteria were: RT in outpatient setting and chemotherapy in outpatient setting. Exclusion criteria: combined radiochemotherapy, hospitalzation, central venous catheter, palliative treatment. 487 patients were selected for the final analysis and stratified in 3 groups: group I (n = 165) 3D-conformal RT for brain tumors or brain metastasis; group II (n = 158) RT for body tumors (abdominal, retroabdominal, pelvic, chest, breast); group III (n = 164) was control –brain and body tumors on chemotherapy. Mean fraction numbers were 25 (11 - 32), mean total dose – 52 Gy (22 - 66). VTE assessment based on clinical data, ultrasound examination (US) and chest CT. Statistical analysis was performed by OpenEpi, Version 3 software pack. Results: Deep vein thrombosis (DVT) was detected in 10 cases (6.06%) in group I, 4 cases in group II and 4 case in control group. VTE patients has a different tumors (astrocytomas, brain trunk tumors, skull basis cancer, rectal cancer, breast cancer). 3 patients were available for long-term outcomes assessment (12 months after radiation therapy). During 1-year period we haven’t detected thrombosis recurrence. One patient on 11th follow-up month was exposed with repeated course of RT without any complications. The difference between VTE incidence for group I and group III characterized by statistical significance (p = 0.018). Risk difference for these groups was 5% (p < 0.05). Conclusions: Based on study results we suggest that external beam radiation therapy is potentially an independent risk factor for VTE development even in outpatient settings. High degree of clinical suspicion and aggressive diagnostic work-up in case of suspicion is necessary. In our opinion low molecular weight heparins prevention should be considered at least during active radiation therapy.

scholarly journals Comparative evaluation of concomitant chemoradiation with weekly cisplatin and gemcitabine versus weekly cisplatin in the management of locally advanced carcinoma of uterine cervix

2016 ◽  
Author(s):  
Vikas Gupta ◽  
Ashok Kumar Chauhan ◽  
Paramjeet Kaur ◽  
Anil Khurana ◽  
Yashpal Verma ◽  
...  
Keyword(s):  
External Beam Radiotherapy ◽  
Locally Advanced ◽  
Definitive Treatment ◽  
High Dose ◽  
Carcinoma Cervix ◽  
Advanced Carcinoma ◽  
Group I ◽  
Concomitant Chemoradiation ◽  
Group Ii ◽  
Weekly Cisplatin

Aim: To evaluate feasibility of concomitant chemoradiation with weekly cisplatin and gemcitabine, and comparing the advantage of using this regimen over cisplatin alone in terms of disease control and toxicities in management of locally advanced carcinoma cervix. Materials and Methods: The study has been conducted on fifty previously untreated, histopathologically proven FIGO stage II B - IV A patients of carcinoma cervix, attending the Department of Radiotherapy, Post Graduate Institute of Medical Sciences, Rohtak for definitive treatment by radiation therapy. The patients were divided randomly in two groups of 25 patients each. Group I received cisplatin 40 mg/m2 and gemcitabine 125 mg/m2 with concomitant external beam radiotherapy 50 Gy/25 fractions/5 weeks, followed by intracavitary high dose rate brachytherapy 7 Gy to point A, for 3 times, once in a week. Group II received concomitant chemotherapy with cisplatin 40 mg/m2 weekly alone while radiotherapy schedule were same as in group I. Results: Total treatment duration in group I and II were 9-11 and 8-10 weeks respectively. Complete response rate in group I and II were 92% and 80%. Grade III skin and mucosal reactions was 20% in group I and none in group II. Diarrhoea was 24% in group I & 8% in group II. Grade II & III leucopenia was seen in 28% and 4% cases of group I & group II respectively. Upper gastrointestinal and renal toxicities were comparable in both arms. After six month of follow up, no evidence of disease was seen in 92% and 80% cases of group I and group II. Conclusion: If the toxicity is managed adequately in platinum based doublet group, it may produce improvement in response. Study is ongoing.

scholarly journals Combined Office-based Vergence Therapy and Home Therapy System for Convergence Insufficiency in Egyptian Children

2018 ◽  
Vol 12 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Tarek Nehad ◽  
Tamer Salem ◽  
Mohamed Nagy Elmohamady
Keyword(s):  
Home Therapy ◽  
Vision Disorder ◽  
Convergence Insufficiency ◽  
Group I ◽  
Egyptian Children ◽  
Insufficient Response ◽  
Group Ii ◽  
Age Range ◽  
Vision Therapy

Background: Convergence Insufficiency (CI) is a common binocular vision disorder characterized by exophoria more at near than at far, a receded Near Point of Convergence (NPC), and decreased Positive Fusional Vergence (PFV) at near. This disorder is often associated with several symptoms that may disturb the person’s quality of life. Therefore, diagnosis and treatment of CI is a vital issue. Objectives: To compare therapeutic yield of Office Based Vision Therapy (OBVT) and combined OBVT with Home Therapy System (HTS) in patients with CI. Methods: The study included 102 patients with age range of 7-13 years. All patients underwent Convergence Insufficiency Symptom Survey (CISS) scoring, estimation of Near Point of Convergence (NPC) and determination of Positive Fusional Vergence at near (PFV) using Sheard’s criterion. Patients were randomly allocated in two groups: Group I: received Office-based Vision Therapy (OBVT) and Group II: received OBVT with home reinforcement using the Home Therapy System (HTS). At the end of 12th week of therapy; outcome was determined as Successful (all the following: CISS score of <16, NPC <6 cm and PFV >15Δ), Improved (CISS score of <16 or a 10 points-decrease and one of the following: NPC <6cm or improved by >4 cm, PFV >15Δ or increased by > 10Δ), Insufficient response (NPC <6cm or improved by >4 cm, PFV >15Δ or increased by > 10Δ) and non-responders. Results: At the end of the 12th week of therapy, the applied therapeutic polices were successful in 48 patients (47.1%), the symptoms were improved in 30 patients (29.4%), improvement was insufficient in 13 patients (12.7%) and 11 patients (10.8%) were considered as non-responders. There was significantly higher frequency of patients with improved outcome in group II (86%) compared to group I (69.2%). Conclusion: OBVT with home supplement using HTS provided a high success rate, and it seems to be superior to OBVT alone in treatment of children with convergence insufficiency after 12-week course of therapy.

scholarly journals Postoperative radiotherapy of the cervical carcinoma in elderly patients: Over 60 years

2007 ◽  
Vol 54 (3) ◽  
pp. 153-158 ◽  
Author(s):  
V. Plesinac-Karapandzic ◽  
S. Zoranovic ◽  
S. Plesinac ◽  
Z. Milosevic ◽  
D.M. Masulovic
Keyword(s):  
Elderly Patients ◽  
Cervical Carcinoma ◽  
Radiation Effects ◽  
Postoperative Radiotherapy ◽  
External Beam ◽  
External Beam Irradiation ◽  
Group I ◽  
Group Ii ◽  
Brachy Therapy

The purpose of the study was to analyze survival and late radiation effects according to performed surgery and radiation therapy in elderly patients. Between 1996-1997. year 44 patients with cervical carcinoma older then 60 years were treated with postoperative radiotherapy. Radiotherapy included external beam irradiation with TD 36-45 Gy in 18-22 fractions and endocavitar brachy-therapy with TD 28-35Gy in 4-5 fractions. We analyzed two groups of patients group I 29/44 (65,9%) had radical operation by Werthaim-Meigs vs group II 15/44 (34,1%) patients had standard operation. Median follow-up was 48 months. Survival for all patients was 70,43%. Late postirradiation effects in the gastrointestinal tract were 40,9% and in urinary tract 25% - in both groups. A larger percent of late postirradiation sequeles were on GIT in group I vs group II (44,8% vs 33,3%) and on UR tract also (31,03% vs 13,3%). The doses of external beam irradation were equalize in both groups, while brachytherapy regime 4xTD7,5Gy was more represent in group I. Late side effects and complications after postoperative radiotherapy are acceptable, but it is necessary to carry out randomized trials with different dose regime in brachytherapy.

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