Central giant cell granulomas (CGCGs) are intraosseous, non-neoplastic in nature and unpredictable in their clinical behavior. The spectrum of their clinical behavior is wide, ranging from mild, slow growing, aggressive and to be locally destructive lesions. In fact, it is this element of unpredictability that makes it difficult for the clinicians to design the most appropriate treatment plan. Based on the aggressiveness of these lesions, treatment options may include surgical enucleation and curettage, and en-bloc resection in addition to medical treatment.
Introduction: Acute myeloid leukemia is routinely stratified by cytogenetic analysis and common molecular alterations of FLT3, NPM1, c-KIT, IDH1/IDH2, and CEBPA genes. Although less known genetic aberrations can impact the prognosis significantly; comprehensive DNA analysis to identify these mutations is not routinely done due to time constrains and various technical challenges. These days next generation sequencing (NGS) is being used to identify less known genetic aberrations. We evaluated the feasibility and patient outcomes of an NGS panel based on MiSeq for patients with AML at a community-based, tertiary hospital system.Methods: A retrospective cohort study was performed on specimens collected between June 2013 and December 2014 from patients with a pathological diagnosis of AML and of 18 years of age or older. Stored bone marrow DNA samples were run on the Illumina MiSeq instrument using two custom panels: the Qiagen GeneRead panel and the Agilent Haloplex panel.Results: 31 patients were included. Other than the four common mutations, sixteen less common gene mutations were identified including DNMT3A, IDH2, WT1, TET2, NRAS, SRSF2, TP53. TP53 had significant impact on overall survival on univariate and multivariate analyses (P= 0.016 and P=0.021 respectively) and TET2 had a significant impact on event free survival (EFS) on univariate and multivariate analyses (P= 0.042 and P = 0.026 respectively). On stratifying patients by mutations within cytogenetically intermediate risk category, there was a significant difference (P= 0.0054) in EFS between intermediate and unfavorable groups. Mutation load also increased significantly from favorable to unfavorable categories based on cytogenetics and mutations.Conclusion: Comprehensive mutational analysis beyond routinely-tested mutations can detect rare mutations that may have significant prognostic value. Cytogenetically intermediate category benefits the most of such analysis.
Introduction: Hepatocellular carcinoma (HCC) is the sixth most common neoplasm and the third most frequent cause of cancer death. HCC is the leading cause of death in compensated cirrhotics. Curative options are available if detected early. The existing biomarkers as well as the newly identified biomarkers have many limitations regarding their sensitivity and specificity. Aim of this study is to assess the tumor marker alpha-fetoprotein (AFP) and its association with Child-Pugh (CP) score in HCC patients. Methods: We undertook a prospective observational study in patients diagnosed with HCC from October 2017 through February 2018. Blood samples were collected from 30 patients at Global Hospitals, Chennai. Serum was separated from the blood samples to perform laboratory investigations. Liver enzymes (ALP, ALT, AST & GGT) were determined for all samples. AFP and CP score were calculated. Results: Out of 30 samples from HCC patients, 16 samples showed increase in AFP and not increased in 14 patients. Liver parameters were also elevated in tumor patients. Because of the wide spectrum of histologic appearance of HCC, the differential diagnosis between HCC and other tumors involving the liver can be challenging. Conclusion: This study observes that the elevation of tumor marker AFP in 53.3% of HCC samples and also assess its significance association with CP score.
Urinary bladder cancer would be a serious health issue among human individuals. Current treatments are not effective so there is to be an optional therapy should be introduced to halt the reoccurrence of cancer. Phytochemicals does not own any adverse effect in patients with cancer. Our research is to investigate that the Diindolylmethane (DIM) and Lupeol treatment eliminates urinary bladder cancer development by activating the apoptosis by its anti-inflammatory properties. The male albino wistar rats were equally separated into 6 groups. Each group possesses 10 rats. G-I: Control. G-II: N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN) was administered orally for 8 weeks. After 8 weeks of BBN toxicity, Dimethylarsinic acid (DMA) was provided for 28 weeks in drinking water. G-III and G-IV: After BBN initiation, DMA was provided for 28 weeks in drinking water. Diindolylmethane and Lupeol were also administered orally for 28 weeks along with DMA. G-V and G-VI: Diindolylmethane alone and Lupeol alone were administered orally for 36 weeks. The experimental rats were euthanized at 36th week. The urinary bladder was macroscopically and microscopically analyzed in control and treated groups. Diindolylmethane and Lupeol therapy inhibited the tumor formation in the urinary bladder. Our study proved that both Diindolylmethane and Lupeol are being capable of targeting these signaling pathways which would make them potentially applicable to cancer chemoprevention and treatment.
BACKGROUND:Risk factors such as chronic use of tobacco, smoking and alcohol consumption of individual's lifestyle may possibly influence the significant role in the etiopathogenesis of precancerous lesions (PL) and Conditions (PC) and lead to oral cancer. Previous studies have revealed that genetic factors have contributed to a remarkable extent in the development of this chronic disease. Limited studies have confirmed that ABO blood groups remain reportedly possible genetic factor to the specific disease such as oral malignant. In this context, we have reported that individuals in a particular blood group are more prone to develop lesions and certain types of cancer. This has thrown a light to take up an effort to conduct this present study.MATERIALS AND METHODS:The present study covering 105 patients and grouped into three subjects with 35 participants in each. a) oral squamous cell carcinoma b) oral leukoplakia and c) submucous fibrosis. Gender and age group impact was also made to understand the interaction between the focused sample groups. A separate control was gathered from a same geographical population composed of gender-matched healthy volunteers. Slide agglutination was employed for blood grouping and results were tabulated for statistical analysis.RESULTS:Blood group "A" exhibited a significant relationship between oral squamous cell carcinoma patient and odd ratio shown 1.74 times higher risk of developing oral cancer. Gender different and habit stimulation have increased the risk. A significant relationship was observed between ABO blood group and oral leukoplakia and oral submucous fibrosis.CONCLUSION:Study inferred that blood group "A" is found to be at the high risk in developing oral malignant syndrome due to its susceptibility, whereas oral pre-cancer is hypothesized that individual habits are the host risk factor and transformed to carcinoma by interacting genetic factors to act upon ABO blood group.
OBJECTIVE:Among the various histopathological variants of oral squamous cell carcinoma, clear cell variant is a rarity. (1) This report is a compilation of two cases which showed the presence of clear cells. The clear cells were of koilocytic type. Although clear cell variant of squamous cell carcinoma is more common in skin, few cases have been found in oral region also. (2) This variant is considered more aggressive than the others, and hence requires more aggressive treatment protocol. Being rare, the percentage of clear cells determines whether it should be considered as a clear cell variant. The literature has been evaluated for similar cases, and discussed about the clear cells and their origin. An effort has also been made to compile the reported cases of clear cell variant of OSCC.
OBJECTIVE:We searched thiol/disulphide homeostasis and ischemia modified albumin (IMA) in patients with and without endometrial polyp (EP) to evaluate whether there is an association between serum oxidative stress markers and EPs.METHODS:A total of 87 women were enrolled into this study. All patients were evaluated with office hysteroscopy, and then those with EPs underwent operative hysteroscopy. 43 of these women had pathologically confirmed EPs (study group) and 44 had not (control group). Fasting blood samples were obtained from the antecubital vein before the procedure in all women. Thiol/disulphide levels were analyzed with a newly developed method by Erel et al. IMA measurement was performed using an indirect method based on the colorimetric assay as previously defined.RESULTS:There were no significant differences between the 2 groups in terms of demographic characteristics including age, body mass index, and past obstetric history. Similarly no significant difference was observed regarding infertility ratio and smoking status. Native thiol, total thiol, and disulphide levels were found to be 263.6±63.3 µmol/l vs. 280.9±63.8 µmol/l (p:0.208), 296.9±64.9 µmol/l vs. 315.2±67.3 µmol/l (p:0.202), and 16.6±6.5 µmol/l vs.17.1±7.8 µmol/l ( p:0.759) in the study and control groups, respectively. There was also no significant difference with regard to serum IMA level (46.5±12.1 vs. 44.9±12.6; p: 0.539).CONCLUSION:Serum thiol/disulphide homeostasis and IMA levels have no significant effect in the pathogenesis of EPs.
OBJECTIVE:Since, it is essential to create awareness about chemotherapy among parents, this study assesses the effectiveness of structured teaching programme for mothers on knowledge and practice relating to care of child with leukemia. Pretest was conducted using structured questionnaire on knowledge about care of Leukemia. Teaching was administered to mothers on different aspects of cancer diagnosis and follow up. There was a statistically significant difference in knowledge and practice in post test and a significant correlation of knowledge and practice in post test, but not during pre test. Considering different aspects of care, mothers had only around 50 % knowledge which was close to 100 % post test. The study revealed that there was a significant association between knowledge with age of the child and number of the children, and in practice, association was found in gender of the child and the educational status of the mother. The current study results proved that willingness of parents to receive educational intervention on care of children with Acute Lymphoblastic Leukemia would definitely result in improvement of the quality of life of childhood survivors.
OBJECTIVE:Glandular odontogenic cyst is an extremely rare lesion of the jaw. Its aggressive behavior and high recurrence rate makes it important while excising. Both clinical and radiographic features were nonspecific due to the similarities with other lesions therefore it can be misdiagnosed very easily. This article presents another case of Glandular odontogenic cyst in 17 year of male patient who was unaware of the lesion which was detected on routine examination.
OBJECTIVE:Schwannomas are benign slow growing tumors that arise from myelin producing Schwann cells. Schwannomas developing in cervical-dorsal region are rare benign neoplasms which are emerges leisurely remains asymptomatic some times and functionally inactive tumours. Giant Schwannomas extending over two or more vertebral levels have been documented and attempts have been made to classify these in available literature, however inadequate. Advancement in imaging modalities and microsurgery has bettered management of these tumors. A rare case of intradural extramedullary cervicodorsal schwannoma extending along seven vertebral levels to thoracic levels is reported in a 55 year old male patient with progressive weakness and numbness of over one and a half years. MRI of cervical spine showed a heterogeneously lesion with cord oedema till D7 level on T1contrast saggital view. Histological examination revealed encapsulated spindle cell lesion with hypocellular and hypercellular areas with verucay bodies, occasional bizzare nuclei, hyalinized blood vessels, with no evidence of necrosis/atypical mitosis, suggestive of schwannoma. In the prone position, C4 to D7 enbloc laminotomy was done and total excision of intradural extramedullary lesion was done. Post-operative CT scans revealed normal spinal canal dimensions with implants in situ. At quarterly follow up upto one year post-operative, the patient had near normal power in all four limbs and normal bladder function.
BACKGROUND:The pathophysiological role of HCG is currently speculative and seems to be paradoxes as certain studies advice it has anti-cancer properties while few others found it to be pro-cancer agent. In this study we have evaluated the status of beta hCG receptors in patients with breast carcinoma and its association with various clinic-pathological factors.METHODS:A cross-sectional study was conducted on total of 57 patients who were enrolled in the study, all tests including metastatic work up were done. Patients underwent modified radical mastectomy on the affected side after being declared fit by the anaesthetist. Immunohistochemical analysis was done using ER antibody, PR88, CB11 and for beta hCG was done using ab-53087.RESULTS:The average age at diagnosis was 55.77 years. There was a significant correlation between age at diagnosis and age at first child birth. On correlating size of the tumour with Beta hCG receptor status, Patients with tumour size 2 to 5 cms have shown maximum positivity for beta hCG receptors. On correlating stage of the disease with Beta HCG receptor status, it was found that, carcinoma tissues showed more receptor positivity as the stage increased. In histological staining grade, Nottingham's scoring system was used which showed majority of patients belonged to grade 2.DISCUSSION:Comparison of other tumour characteristics such as histopathological type, grade, tumour size and nodal status were similar among the studies done in Western and Indian regions. The similarities of the current as well as the above mentioned Indian studies with Western countries could be attributed to increasing awareness and better screening protocols for breast carcinoma.
OBJECTIVE:Cervical carcinosarcomas (Malignant Mixed Mullerian Tumour [MMMT] ) are very rare neoplasms. Fewer than 100 cases were documented until recently. Because of the rarity, etiologic factors, prognosis and treatment modalities are unclear. A 53 year-old woman presented with postmenauposal vaginal bleeding and abnormal cervical cytology. Cervical biopsy followed by loop electrosurgical excision procedure (LEEP) and cold knife conisation (CKC) was documented as cervical intraepithelial neoplasia III (CIN III). Without follow-up, two years later, the patient was referred with a cervical 6,5 cm mass invading vagina, parametriums and rectum. Biopsy was reported as cervical carcinosarcoma with squmous carcinoma and homologous sarcoma component. Neoadjuvant chemotherapy provided partial response. Subsequently external beam whole pelvis radiotherapy with chemotherapy and brachytherapy was applied. In despite of the treatment, the patient developed sistemic recurrence and died of disease within 10 months. In previous reports most of the patients were in early stage and had better prognosis than uterine carcinosarcomas. Here in we present a case who had a history of high-grade cervical displasia and presented at advanced stage, managed with neoadjuvant chemotherapy and definitive chemoradiotherapy.
BACKGROUND:Continuation maintenance therapy with pemetrexed (PEM) and bevacizumab (BEV) following induction therapy with cisplatin (CDDP), PEM, and BEV is beneficial in advanced non-squamous non-small-cell lung cancer (NS-NSCLC), but the survival benefit of addition of BEV to CDDP/PEM as induction therapy is still unclear. The aim of this phase II study was to evaluate the feasibility and safety of a CDDP/PEM/BEV regimen in Japanese patients with EGFR wild-type NS-NSCLC.PATIENTS AND METHODS:This study included 25 patients who receive intravenous CDDP, PEM, and BEV (15 mg/kg) from August 2010 to February 2013. The primary endpoint of this study was the response rate (RR) and the secondary endpoint was progression free survival (PFS), overall survival (OS), and safety.RESULTS:The median cycles of induction chemotherapy were four (range 1-6). RR was 64%. Most patients (64%) transitioned to maintenance therapy. The median PFS was 9.7 months. Median OS was 21.6 months. Haematological adverse events reaching grade 3 to 4 were neutropenia (8%) without febrile neutropenia, thrombocytopenia (4%), and anemia (4%). BEV-related non-haematological toxicities of grade 3/4 were hypertension (16%), thrombosis (4%), and gastrointestinal perforation (4%). Each adverse events was controllable, and there were no treatment-related deaths.CONCLUSIONS:CDDP/PEM/BEV regimen is effective and tolerable in patients with EGFR wild-type advanced NS-NSCLC, but should be paid attention to some BEV-related toxicities.
OBJECTIVE:Pancreatoduodenectomy is the procedure of choice for treating periampullary and pancreatic head malignancy. The procedure has been standardized and the mortality has reduced considerably to fewer than 5% in high volume centers specializing in pancreatic surgeries. Unfortunately, the morbidity still hovers around 40%. The Achiles heal of pancreatoduodenectomy is the pancreatoenteric anastamosis, the failure of which leads to significant morbidity. Literature is flooded with a plethora of techniques of reconstruction, and the results are variable. In this present study, we have analyzed a technique in which we used a single layer full thickness duct to mucosa pancreatojejunostomy. Among the 25 subjects in this study, there was only one case of one mortality due to drug-induced cardiac arrhythmia, and no mortality secondary to pancreas-specific complications were reported. The present study was a pilot study compared with historical controls, where these results were comparable to the historical data reported earlier as well as our own historical data of two-layered anastamosis. The results of this pilot study supported our concept of single layer full thickness duct to mucosa anastamosis being least traumatic to the pancreas and having an equal efficacy to that other conventional techniques.
PURPOSE:The short and long-term resolution of neoplastic conditions with conventional low molecular weight chemotherapeutics is frequently restricted by limitations associated dose-dependent toxic sequelae. Penetration into neoplastic cells occurs non-selectively where their intracellular concentration following simple passive diffusion from the extracellular fluid compartment becomes essentially equivalent to levels found in normal healthy cell populations residing within tissues and organ systems. Selective "targeted" delivery of conventional low molecular weight chemotherapeutics represents one molecular strategy that can both increase potency and reduce dose-dependent toxic sequela. A second strategy is the identification of synergistic or additive combinations of chemotherapeutics and pharmaceutical agents, in addition to the discovery of re-purposed pharmaceutical agents that possess anti-cancer properties.DISCUSSION:Mebendazole evoked anti-neoplastic cytotoxicity as both a single entity, and contributed to the potency of the covalent immunoglucocorticoid, dexamethasone-(C21-phosphoramidate)-[anti-EGFR] when applied in a dual-combination challenge against populations of pulmonary adenocarcinoma (A549). In this capacity mebendazole demonstrated a role as a candidate re-purposed pharmaceutical that possessing potential as a [-i-] substitute alternative for conventional tubulin inhibitors in scenarios of idiosyncratic reactions, therapeutic resistance, or anticipated toxic sequelae; [-ii-] a new monotherapy; or [-iii-] a component in the design of new multi-therapeutic protocols.
Objective To control the rate of growth of the cancer cell is the objective of this paper. In cancer, the rate of the growth of the cancer cell is indefinite. This paper proposes a method to transform into definite rate of growth of the cancer cell from indefinite. This indefiniteness lies with the set of unknown elements. This paper finds these unknown elements by matrix method.
OBJECTIVE:Candida yeast species are widespread opportunistic microbes and incidence of its carriage in diabetic patients compared with non-diabetic controls is not clearly defined. The present study was carried out to isolate and identify the candida species in type I, type II diabetes mellitus patients and in controls. Study comprised of 60 subjects in the age range of 20 to 65 years, consisting of two groups of diabetes patients with controlled diabetic status (20 subjects each with type I and type II) and 20 age and sex matched controls. Saliva samples were collected from all groups and inoculated on Sabouraud's Dextrose Agar (SDA) to check for the fungus growth. The confirmed candidal colonies were further inoculated on CHROMagar for different colour differentiation. Out of 60 samples, 40 (66.67%) showed a positive fungal prevalence. Out of 40 positive fungal prevalence 82.50% were representative of candida. The positive fungal prevalence for candida I was 48.48%, in group II was 30.30%, in group III was 21.21 %. Further speciation in CHROMagar revealed different species of candida predominantly of candida albicans 20% and few mixed culture of candida albicans with candida krusei 5% and candida albicans with candida tropicalis 5% in group I. In group II, candida albicans was 35% and mixed culture of candida albicans with candida glabrata was 5%. In group III, candida albicans was 25% and candida tropicalis was 5%. The findings confirm that diabetic patients harbor yeast in their oral cavity and are more susceptible to oral candidiasis and also that CHROMagar medium is a satisfactory isolation medium for oral cavity specimens, allowing rapid and accurate identification of yeast colonies with easy recognition of mixed culture and is easy to use.
Objective Large cell neuroendocrine carcinoma (LCNEC) of the ovary is a rare tumour. Its pure form without any associated surface epithelial stromal or germ cell component is more rarely seen. Its prognosis is generally very poor even when the diagnosis is made at an early stage. We report a case of pure large cell neuroendocrine tumour of ovary. The patient was a 73-year-old woman with symptom of pelvic pain. Ultrasonography detected an abdominal tumour larger than 10 cm. She underwent an exploratory laparotomy with resection of the pelvic mass. After the surgery six cycles of chemotherapy (Etoposide and Cisplatin) were administered to the woman. She is still healthy after the last chemotherapy. Due to the rarity of the disease, few number of reported cases and the lack of systematic population based studies or registry data, we reported this case.
Objective In the current scenario of medical sciences, homeopathy, the most popular system of therapy, is recognized as one of the components of complementary and alternative medicine (CAM) across the world. Despite, a long debate is continuing whether homeopathy is just a placebo or more than it, homeopathy has been considered to be safe and cost-effectiveness therapeutic modality. A number of human ailments ranging from common to serious have been treated with homeopathy. However, selection of appropriate medicines against a disease is cumbersome task as total spectrum of symptoms of a patient guides this process. Available data suggest that homeopathy has potency not only to treat various types of cancers but also to reduce the side effects caused by standard therapeutic modalities like chemotherapy, radiotherapy or surgery. Although homeopathy has been widely used for management of cancers, its efficacy is still under question. In the present review, the anti-cancer effect of various homeopathic drugs against different kinds of cancers has been discussed and future course of action has also been suggested.
