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FLUORIDES AND ORAL HEALTH 氟化物与口腔健康
Pub Date : 2023-03-03 DOI: 10.11603/ijmmr.2413-6077.2022.2.13121
S. Boitsaniuk, M. Levkiv
Background. The importance of fluorides in caries prevention is discussed in the article and practical recommendations for the use of fluoride containing products are presented.Objectives. The primary objective of this systematic review is to assess the evidence on the comparative effectiveness of topical fluoride therapy (TFT) in the form of toothpastes, mouth rinses, gels and varnishes in prevention of dental caries in children and adolescents.Methods. A systematic electronic literature search was conducted in the PubMed and Web of Science databases using search terms. Current reports in the literature concerning means and methods of use of fluoride-containing medications are considered.Results. A large number of scientific studies, reviews based on them and meta-analyses conclude that the central element of caries prevention, on which the decrease in caries prevalence and caries experience is based, is the regular topical use of fluoride medications for oral cavity.Conclusions. Topical use of fluorides is a key element in successful caries prevention.
背景。本文讨论了氟化物在预防龋齿中的重要性,并提出了使用含氟产品的实用建议。本系统综述的主要目的是评估牙膏、漱口水、凝胶和清漆形式的局部氟化物治疗(TFT)在预防儿童和青少年龋齿方面的相对有效性的证据。利用检索词对PubMed和Web of Science数据库进行系统的电子文献检索。本文对目前文献中有关含氟药物使用手段和方法的报道进行了综述。大量的科学研究、基于这些研究的综述和荟萃分析得出结论,预防龋齿的核心要素是定期局部使用含氟口腔药物,这是龋齿发病率和龋齿经历下降的基础。局部使用氟化物是成功预防龋齿的关键因素。
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引用次数: 0
SICKLE CELL THALASSEMIA IN AN ADULT FROM CENTRAL INDIA SHOWING MASSIVE SPLENIC INFARCTION AND GAMNA-GANDY BODIES IN SPLENIC PARENCHYMA WITH CONCOMITANT PLASMODIUM FALCIPARUM INFECTION 印度中部1例成人镰状细胞性地中海贫血,表现为大面积脾梗死和脾实质中伴恶性疟原虫感染的伽玛体
Pub Date : 2023-03-03 DOI: 10.11603/ijmmr.2413-6077.2022.2.13152
T. Singh, R. Singh, R. Pandey
Background. Sickle cell thalassemia is a heterozygous state of HbS/β+ or HbS/β0 manifested clinically either as an asymptomatic carrier or have features akin to sickle cell anemia.Objective. The aim of the study is to review the literature and discuss the varied clinical manifestations and diagnosis of a case report of haemoglobinopathy in an adult from Central India.Methods. A case of haemoglobinopathy from central part of India is being investigated.Results. A case of haemoglobinopathy in an adult presenting to a tertiary hospital with chronic back ache was reported. The patient was found to have massive splenomegaly with evidence of splenic infarction. Gross examination of spleen revealed multiple soft yellowish pasty areas, which on microscopic examination showed significant necrosis with presence of great amount pale amorphous yellow substance, Gamna-Gandy bodies (GGBs) and massive foreign body cell reaction in splenic parenchyma. Post-splenectomy peripheral blood smear (PBS) showed thrombocytosis and plasmodium falciparum gametocytes. The Hb electrophoresis revealed both elevation of Hb S (49.7%), Hb F (46.7%); Hb A2 (3.0%) and (Hb A 0.7%) consistent with as Sickle Cell Thalassemia Hb S/β+ Thalassemia.Conclusion. Sickle cell thalassemia with long standing huge splenomegaly, splenic infarction with GGBs deposition and concomitant falciparum malaria in clinically stable patient is rare indeed.
背景。镰状细胞性地中海贫血是HbS/β+或HbS/β0的杂合状态,临床表现为无症状携带者或具有类似镰状细胞性贫血的特征。本研究的目的是回顾文献,并讨论血红蛋白病的各种临床表现和诊断病例报告在印度中部。印度中部地区的一例血红蛋白病正在调查中。一例血红蛋白病在成人呈现到三级医院慢性背部疼痛报告。患者被发现有大量脾肿大并有脾梗死的迹象。脾脏肉眼检查示多发淡黄色软糊状区,镜下见明显坏死,脾实质内可见大量淡黄色无定形物质、甘体及大量异物细胞反应。脾切除术后外周血涂片(PBS)显示血小板增多和恶性疟原虫配子细胞。Hb电泳显示Hb S升高(49.7%),Hb F升高(46.7%);Hb A2(3.0%)和Hb A(0.7%)与镰状细胞型地中海贫血Hb S/β+地中海贫血一致。镰状细胞性地中海贫血伴长期巨大脾肿大、脾梗死伴GGBs沉积并伴恶性疟疾在临床稳定患者中确实罕见。
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引用次数: 0
IMPACT OF COVID-19 PANDEMIC ON THE RADIOTHERAPY AND CANCER PATIENTS IN A TERTIARY HEALTH CARE CENTER OF ASSAM, NORTHEAST INDIA: A RETROSPECTIVE SINGLE INSTITUTION STUDY COVID-19大流行对印度东北部阿萨姆邦三级卫生保健中心放疗和癌症患者的影响:一项回顾性单机构研究
Pub Date : 2023-03-03 DOI: 10.11603/ijmmr.2413-6077.2022.2.13282
C. Baruah, K. Deka, T. Paul, B. Sarma, P. Patowary, S. Sreeni, B. Mahanta
Background. The COVID-19 pandemic has affected every sector of health care system including the cancer care. Objective. The purpose of the study is to analyse the impact of the current COVID‑19 pandemic on routine radiotherapy practice at a tertiary hospital of Northeast India.Methods. This is a retrospective study of all patients planned for radiotherapy at Assam Medical College, a tertiary care centre, in Assam, India from January 1, 2020 to May 31, 2020. The study samples are divided into two groups: group A – patients treated from January 1, 2020, to March 20, 2020 (pre-lockdown,) and group B – patients treated from March 21, 2020, to May 31, 2020 (lockdown). The department registration numbers of all the patients were collected from the entry register, and the respective paper files were then accessed to obtain the required data.Results. A total of 153 patients were planned for radiotherapy during the study period, of these 113 patients receiving radiotherapy in the pre-lockdown period and 40 patients receiving it in the lockdown period. The number of female patients decreased from 66 (58.40%) in the pre-lockdown period to 20 (50%) during the lockdown. The number of male patients also decreased from 47 to 20 but the proportion increased from 41.5% to 50%. The proportion of patients who completed radiotherapy was 90.8% in group B compare to 88.3% in group A.Conclusion. There was a decrease in number of cancer patients, especially female during the lockdown. The pandemic has severely disrupted every aspect of cancer care.
背景。COVID-19大流行已经影响到包括癌症治疗在内的卫生保健系统的各个部门。目标。本研究的目的是分析当前COVID - 19大流行对印度东北部一家三级医院常规放疗实践的影响。这是一项回顾性研究,研究对象是2020年1月1日至2020年5月31日在印度阿萨姆邦三级医疗中心阿萨姆医学院计划接受放疗的所有患者。研究样本分为两组:A组- 2020年1月1日至2020年3月20日(封锁前)治疗的患者;B组- 2020年3月21日至2020年5月31日(封锁)治疗的患者。从入科登记簿中收集所有患者的科室注册号,然后访问相应的纸质文件以获取所需的数据。在研究期间,共有153名患者计划接受放疗,其中113名患者在封锁前接受放疗,40名患者在封锁期间接受放疗。女性患者从封锁前的66人(58.40%)减少到封锁后的20人(50%)。男性患者也从47人减少到20人,但所占比例从41.5%增加到50%。B组放疗完成率为90.8%,a组为88.3%。在封锁期间,癌症患者的数量有所减少,尤其是女性患者。这种流行病严重扰乱了癌症治疗的各个方面。
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引用次数: 0
PROSPECTIVE DESCRIPTIVE STUDY OF NON-THYROIDAL NECK SWELLINGS IN WESTERN INDIAN POPULATION 西印度人群非甲状腺性颈部肿胀的前瞻性描述性研究
Pub Date : 2023-03-03 DOI: 10.11603/ijmmr.2413-6077.2022.2.13120
J. Husain, S. Rajagopalan, V. Nair, R. Nagamahendran, P. Sharma, N. Roy, P. P. Rao
Background. Nonthyroidal neck swellings are common and cause diagnostic challenges. This study highlights various diagnosis associated with non-thyroidal neck swellings and their management challenges. Objective. This pilot study highlights the various diagnosis associated with nonthyroidal neck swellings and their management challenges. The clinical spectrum of two most common aetiology of nonthyroidal neck swelling: tubercular cervical lymphadenopathy and lymphomas, are also compared.Methods. This prospective study was conducted in a tertiary care teaching hospital from 01 Jun 2018 to 31 Dec 2019. The first 100 nonthyroidal neck swellings presented to the surgical outpatient department were included and assessed clinically, radiologically and histopathologically. Comparison was carried out between the first two common diagnosis of tubercular cervical lymphadenitis and lymphoma. Continuous variables were analysed using Student’s t-test and categorical data were analysed using the Chi square test. A statistical p value <0.05 was taken as significant.Results. There were 73 lymph node swellings and 27 non-lymph node swellings in the study. The most common diagnosis was tubercular cervical lymphadenitis (n=38) and lymphoma (n=17). The mean volume of lymph nodes in the lymphoma group (38.72±22.12 cm3) was significantly bigger than in the tuberculosis group (9.44±5.99 cm3) P=0.00001. The mean age (33.81±11.8 years) of tubercular patients was significantly less than the lymphoma (52.38±25.3 years) with P=0.000167. The clinical diagnosis was nearly accurate in 85% of cases. However, in 15 cases clinical diagnosis was changed after fine needle aspiration cytology.Conclusions. Ultrasonography and fine needle aspiration cytology are very useful adjunct in arriving at a definite diagnosis of a lymph node swelling in neck. Tubercular cervical lymphadenopathy and lymphoma were two major diagnosis. Tubercular cervical lymphadenopathy is significantly different from lymphomas in terms of early age of presentation and smaller size at the time of presentation.
背景非甲状腺性颈部肿胀是常见的,并引起诊断挑战。这项研究强调了与非甲状腺性颈部肿胀相关的各种诊断及其管理挑战。客观的这项试点研究强调了与非甲状腺性颈部肿胀相关的各种诊断及其管理挑战。还比较了非甲状腺性颈部肿胀的两种最常见病因的临床谱:结核性颈部淋巴结病和淋巴瘤。方法。这项前瞻性研究于2018年6月1日至2019年12月31日在一家三级护理教学医院进行。对门诊外科就诊的前100例非甲状腺性颈部肿胀进行了临床、放射学和组织病理学评估。对结核性颈淋巴结炎和淋巴瘤的前两种常见诊断进行了比较。连续变量采用Student t检验进行分析,分类数据采用卡方检验进行分析。统计学上的p值<0.05被认为是显著的。后果研究中有73例淋巴结肿大和27例非淋巴结肿大。最常见的诊断是结核性颈淋巴结炎(n=38)和淋巴瘤(n=17)。淋巴瘤组的平均淋巴结体积(38.72±22.12 cm3)显著大于结核组的平均体积(9.44±5.99 cm3)P=0.0001。结核患者的平均年龄(33.81±11.8岁)显著低于淋巴瘤患者(52.38±25.3岁),P=0.0000167。85%的病例的临床诊断几乎准确。然而,在15例病例中,细针抽吸细胞学检查后改变了临床诊断。结论。超声检查和细针抽吸细胞学检查是非常有用的辅助手段,可以明确诊断颈部淋巴结肿大。颈淋巴结结核和淋巴瘤是两个主要的诊断。结节性颈部淋巴结病与淋巴瘤在发病年龄早期和发病时体积较小方面有显著差异。
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引用次数: 0
COMMUNICATION OF ONCOLOGICAL PATIENTS WITH ONCOLOGISTS: MAIN PROBLEMS AND PROBLEM-SOLVING STRATEGIES 肿瘤学患者与肿瘤学家的沟通:主要问题及解决策略
Pub Date : 2023-03-03 DOI: 10.11603/ijmmr.2413-6077.2022.2.13594
V. Zub, A. Kotuza, O. Tolstanov
Background. Physician-patient сommunication is one of the main supportive care provided to oncological patients. It affects treatment outcomes, as well as the interaction of patients within the society, their family and colleagues. Furthermore, COVID-19 and military invasion of Russia into Ukraine makes the issue of improvement of physician-patient communication urgent. Objective. The aim of the study is to develop recommendations based on the analysis of denfined problems in physician-patient communication in of oncological treatment. Methods. The sociological research involved 419 patients during their inpatient treatment in the period from November 2021 to February 2022 using the EORTC QLQ-COMU26 questionnaire. Results. In the pre-war period, in Ukrainian patients with oncological diseases the worst indicators were established for “Active role of a patient” (82.00) and “Correction of misunderstandings by a specialist” (89.19). The best indicators were established for “Skills of the specialist (verbal/non-verbal)” with the score of 93.25 by a 100-point grading scale, as well as “Satisfaction with communication” – 97.04 by a 100-point grading scale. Conclusions. When developing programs for organization of oncological care, mechanisms for providing psychological care to patients through effective communication between patients and specialists regarding providing medical and psychological care must be taken into account.
背景医患沟通是为肿瘤学患者提供的主要支持性护理之一。它影响治疗结果,以及患者在社会中、家人和同事之间的互动。此外,新冠肺炎和俄罗斯对乌克兰的军事入侵使改善医患沟通的问题变得紧迫。客观的本研究的目的是在分析肿瘤治疗中医患沟通中存在的问题的基础上提出建议。方法。这项社会学研究涉及2021年11月至2022年2月期间住院治疗的419名患者,使用EORTC QLQ-COMU26问卷。后果在战前,乌克兰肿瘤疾病患者的最差指标是“患者的积极作用”(82.00)和“专家纠正误解”(89.19)。最佳指标是“专家的技能(语言/非语言)”,100分评分表得分为93.25,以及“沟通满意度”–97.04(满分100分)。结论。在制定肿瘤护理组织计划时,必须考虑通过患者和专家之间关于提供医疗和心理护理的有效沟通为患者提供心理护理的机制。
{"title":"COMMUNICATION OF ONCOLOGICAL PATIENTS WITH ONCOLOGISTS: MAIN PROBLEMS AND PROBLEM-SOLVING STRATEGIES","authors":"V. Zub, A. Kotuza, O. Tolstanov","doi":"10.11603/ijmmr.2413-6077.2022.2.13594","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.2.13594","url":null,"abstract":"Background. Physician-patient сommunication is one of the main supportive care provided to oncological patients. It affects treatment outcomes, as well as the interaction of patients within the society, their family and colleagues. Furthermore, COVID-19 and military invasion of Russia into Ukraine makes the issue of improvement of physician-patient communication urgent. \u0000Objective. The aim of the study is to develop recommendations based on the analysis of denfined problems in physician-patient communication in of oncological treatment. \u0000Methods. The sociological research involved 419 patients during their inpatient treatment in the period from November 2021 to February 2022 using the EORTC QLQ-COMU26 questionnaire. \u0000Results. In the pre-war period, in Ukrainian patients with oncological diseases the worst indicators were established for “Active role of a patient” (82.00) and “Correction of misunderstandings by a specialist” (89.19). The best indicators were established for “Skills of the specialist (verbal/non-verbal)” with the score of 93.25 by a 100-point grading scale, as well as “Satisfaction with communication” – 97.04 by a 100-point grading scale. \u0000Conclusions. When developing programs for organization of oncological care, mechanisms for providing psychological care to patients through effective communication between patients and specialists regarding providing medical and psychological care must be taken into account.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46920792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
FETAL BILATERAL ADRENAL HEMORRHAGE 胎儿双侧肾上腺出血
Pub Date : 2023-03-03 DOI: 10.11603/ijmmr.2413-6077.2022.2.13162
J. S. Randhawa, R. Nagamahendran, R. Shankaran
Background. Fetal supra renal mass revealed incidentally by routine antenatal ultrasound is a great challenge for diagnosis and management by a surgeon. This is a matter of parental anxiety and diagnostic dilemma to a physician. Indeed, such masses turn out to be complicated by an intra-tumor hemorrhage in neuroblastoma or antenatally diagnosed adrenal hemorrhage. The first one needs intensive management and the latter needs watchful observation.Objective. A case of bilateral fetal adrenal mass revealed by routine fetal ultrasound examination at 28th week of gestation which turned out to be adrenal hemorrhage is presented. This is aimed to make awareness to ensure that clinicians always keep benign etiologies first and thoroughly investigate in case of incidentally detected fetal adrenal mass.Methods. The study is a single case report of incidentally revealed supra renal mass. This case report encompasses differentiating features between the two and investigations that aid the surgeon to avoid unnecessary intervention in a benign hemorrhage.Results. The baby was kept on follow up with serial ultrasound scans in the postnatal period and by the second scan in a month, the hemorrhage had resolved completely.Conclusion. In cases of benign looking masses like adrenal hemorrhage or spontaneously resolving neuroblastoma, appropriate antenatal assessment and close monitoring with serial ultrasound scans can avoid surgery.
背景。摘要胎儿肾上包块在常规超声检查中偶然发现,对外科医生的诊断和处理是一个巨大的挑战。对医生来说,这是一个父母焦虑和诊断困境的问题。事实上,这种肿块会并发成神经细胞瘤的肿瘤内出血或产前诊断的肾上腺出血。前者需要强化管理,后者需要警惕观察。本文报告一例妊娠28周胎儿常规超声检查发现双侧胎儿肾上腺肿块,结果为肾上腺出血。目的是提高临床医生的认识,确保在偶然发现胎儿肾上腺包块的情况下,始终以良性病因为先,彻底调查。本研究是一例偶然发现的肾上肿块。本病例报告包括区分两者的特征和检查,以帮助外科医生避免不必要的干预良性出血。婴儿在产后继续接受连续超声扫描,一个月后第二次扫描,出血完全消失。在肾上腺出血或神经母细胞瘤等良性肿块的病例中,适当的产前评估和连续超声扫描的密切监测可以避免手术。
{"title":"FETAL BILATERAL ADRENAL HEMORRHAGE","authors":"J. S. Randhawa, R. Nagamahendran, R. Shankaran","doi":"10.11603/ijmmr.2413-6077.2022.2.13162","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.2.13162","url":null,"abstract":"Background. Fetal supra renal mass revealed incidentally by routine antenatal ultrasound is a great challenge for diagnosis and management by a surgeon. This is a matter of parental anxiety and diagnostic dilemma to a physician. Indeed, such masses turn out to be complicated by an intra-tumor hemorrhage in neuroblastoma or antenatally diagnosed adrenal hemorrhage. The first one needs intensive management and the latter needs watchful observation.\u0000Objective. A case of bilateral fetal adrenal mass revealed by routine fetal ultrasound examination at 28th week of gestation which turned out to be adrenal hemorrhage is presented. This is aimed to make awareness to ensure that clinicians always keep benign etiologies first and thoroughly investigate in case of incidentally detected fetal adrenal mass.\u0000Methods. The study is a single case report of incidentally revealed supra renal mass. This case report encompasses differentiating features between the two and investigations that aid the surgeon to avoid unnecessary intervention in a benign hemorrhage.\u0000Results. The baby was kept on follow up with serial ultrasound scans in the postnatal period and by the second scan in a month, the hemorrhage had resolved completely.\u0000Conclusion. In cases of benign looking masses like adrenal hemorrhage or spontaneously resolving neuroblastoma, appropriate antenatal assessment and close monitoring with serial ultrasound scans can avoid surgery.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46661337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
HYPOFRACTIONATED RADIOTHERAPY WITH CONCURRENT CHEMOTHERAPY WITH WEEKLY CISPLATIN IN LOCALLY ADVANCED RELATIVELY RADIORESISTENT SUBSITES OF HEAD AND NECK CANCERS 头颈癌局部晚期相对放射耐药亚位的低分割放疗联合化疗联合每周顺铂治疗
Pub Date : 2023-03-03 DOI: 10.11603/ijmmr.2413-6077.2022.2.13118
K. Baidya, Y. Devi, A. S. Devi, Y. Singh, D. Das, R. Mahawar, N. Devi
Background. Locoregionally advanced head and neck cancers are more aggressive and locoregional failure rate after conventional radiotherapy is high.Objective. The aim of the study is to assess the tumor response and toxicities of hypofractionated radiation therapy with concurrent chemotherapy in treatment of four relatively radioresistent tumor sites of head and neck. Methods. A prospective randomised control trial was conducted in 27 head and neck cancer patients. All patients were treated with hypofractionated radiotherapy at 250cGy/fraction once daily to a maximum of 62.5Gy in 25 fractions with concurrent cisplatin 30 mg/m2. Data were evaluated with SPSS version 21.0 for Windows with p-value <0.05.Results. Complete and partial responses were achieved in 15 (57.7%) and 8 (30.8%) patients respectively with an overall response rate of 88.5% and three patients having stable disease. Grade 3 and 4 acute mucositis was experienced by 17 patients (65.4%) and seven patients (27%), respectively. Grade 3 dysphagia was found in 21 patients (80.7%) and grade 3 and 4 skin reactions – in 11 and 2 patients, respectively. Most patients had manageable acute toxicities. Most of the late complications were of grade 2 and 3. The median time to locoregional recurrence was 12 months and one year progression-free survival attained by 61.5% patients. Conclusion. Treatment with hypofractionated radiotherapy with concurrent cisplatin appears feasible and safe and is associated with a good response rate. Although grade 3 and 4 toxicities were comparatively high but it was manageable. Late toxicities were within tolerable levels.
背景。局部进展期头颈部肿瘤侵袭性强,常规放疗后局部失败率高。本研究的目的是评估低分割放疗联合化疗治疗头颈部四个相对放射耐药肿瘤部位的肿瘤反应和毒性。方法。对27例头颈癌患者进行前瞻性随机对照试验。所有患者均接受250cGy/分次低分割放疗,每日1次至最大62.5Gy,分25个分次放疗,同时顺铂治疗30 mg/m2。数据采用SPSS 21.0版本进行评估,p值<0.05。完全缓解15例(57.7%),部分缓解8例(30.8%),总缓解率88.5%,3例病情稳定。急性3级黏膜炎17例(65.4%),急性4级黏膜炎7例(27%)。3级吞咽困难21例(80.7%),3级和4级皮肤反应分别为11例和2例。大多数患者有可控的急性毒性。晚期并发症多为2级和3级。局部复发的中位时间为12个月,61.5%的患者达到了1年的无进展生存期。结论。低分割放疗联合顺铂治疗似乎是可行和安全的,并与良好的反应率相关。虽然3级和4级的毒性比较高,但是可控的。晚期毒性在可耐受水平内。
{"title":"HYPOFRACTIONATED RADIOTHERAPY WITH CONCURRENT CHEMOTHERAPY WITH WEEKLY CISPLATIN IN LOCALLY ADVANCED RELATIVELY RADIORESISTENT SUBSITES OF HEAD AND NECK CANCERS","authors":"K. Baidya, Y. Devi, A. S. Devi, Y. Singh, D. Das, R. Mahawar, N. Devi","doi":"10.11603/ijmmr.2413-6077.2022.2.13118","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.2.13118","url":null,"abstract":"Background. Locoregionally advanced head and neck cancers are more aggressive and locoregional failure rate after conventional radiotherapy is high.\u0000Objective. The aim of the study is to assess the tumor response and toxicities of hypofractionated radiation therapy with concurrent chemotherapy in treatment of four relatively radioresistent tumor sites of head and neck. \u0000Methods. A prospective randomised control trial was conducted in 27 head and neck cancer patients. All patients were treated with hypofractionated radiotherapy at 250cGy/fraction once daily to a maximum of 62.5Gy in 25 fractions with concurrent cisplatin 30 mg/m2. Data were evaluated with SPSS version 21.0 for Windows with p-value <0.05.\u0000Results. Complete and partial responses were achieved in 15 (57.7%) and 8 (30.8%) patients respectively with an overall response rate of 88.5% and three patients having stable disease. Grade 3 and 4 acute mucositis was experienced by 17 patients (65.4%) and seven patients (27%), respectively. Grade 3 dysphagia was found in 21 patients (80.7%) and grade 3 and 4 skin reactions – in 11 and 2 patients, respectively. Most patients had manageable acute toxicities. Most of the late complications were of grade 2 and 3. The median time to locoregional recurrence was 12 months and one year progression-free survival attained by 61.5% patients. \u0000Conclusion. Treatment with hypofractionated radiotherapy with concurrent cisplatin appears feasible and safe and is associated with a good response rate. Although grade 3 and 4 toxicities were comparatively high but it was manageable. Late toxicities were within tolerable levels.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64620435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
INTRAOPERATIVE STATE OF THE HEMOCOAGULATION SYSTEM IN PATIENTS WITH OPEN AND ENDOVASCULAR REVASCULARIZATION OF INFRAINGUAL ARTERIAL SEGMENT IN THE PRESENCE OF STENOTIC-OCCLUSIVE PROCESS OF TIBIAL ARTERIES 伴有胫动脉狭窄闭塞的舌下动脉段开放血管内重建术患者术中凝血系统的状态
Pub Date : 2023-03-03 DOI: 10.11603/ijmmr.2413-6077.2022.2.13197
I. Venger, S. Kostiv, B. P. Selskyy, M. P. Orlov, N. Tsiupryk
Background. Among all postoperative complications associated with revascularization of atherosclerotic steno-occlusive process of the femoral-distal artery, thrombosis of the reconstruction segment is 6-32%.Objective. Prevention of thrombotic complications through vascular revascularization of the lower extremity by using a pathogenetically reasonable system of postoperative thromboprophylaxis.Methods. The study involved 97 patients with atherosclerotic stenotic-occlusive process of the infrainguinal artery in cases of stenotic-occlusive lesions of the tibial arteries. In order to study the state of the hemocoagulation system on patients, the methods for studying the indicators of coagulation, fibrinolytic and aggregation systems were used.Results. Development of hypercoagulable disorders in the patients who underwent endovascular revascularization of the arterial segment is more intense than in those who underwent open vascular revascularization methods. Hypercoagulation of blood at the intraoperative stage of revascularization takes place primarily due to the activity of factor IIa of the hemocoagulation cascade. Taking into account these circumstances, already at the surgery stage for thromboprophylaxis non-fractionated heparin (NFH) should be prescribed. At the same time for prevention of thromboembolic complications double anti-thrombocyte therapy: clopidogrel, acetylsalicylic acid should be prescribed.Conclusion. Hypercoagulant ability of the blood system, which develops after arterial reconstructive interventions, takes place against the background of low activity of the fibrinolytic blood system, nevertheless a gradual increase in the activity of the aggregation capacity of the blood. Development of hypercoagulable disorders at the intraoperative stage of surgery in the patients with endovascular methods of arterial reconstructions is more intense than in those treated with open methods of arterial revascularization. Taking into account these circumstances, already at the surgery stage for thromboprophylaxis an anticoagulant should be prescribed that has a targeted effect on factor IIa of the hemocoagulant cascade with simultaneous prevention of thromboembolic complications – double anti-thrombocyte therapy.
背景。在股骨远端动脉粥样硬化性狭窄闭塞过程血运重建相关的所有术后并发症中,重建段血栓形成占6-32%。采用病理合理的术后血栓预防系统,通过下肢血管重建术预防血栓并发症。本研究涉及97例伴有胫动脉狭窄闭塞病变的腹股沟下动脉动脉粥样硬化性狭窄闭塞过程患者。为了研究患者的凝血系统状态,采用凝血、纤溶和聚集系统指标的研究方法。接受动脉段血管内重建术的患者发生高凝血障碍的情况比接受开放式血管重建术的患者更严重。术中血运重建阶段的高凝主要是由于血凝级联因子IIa的活性。考虑到这些情况,已经在手术阶段的血栓预防应规定非分级肝素(NFH)。同时预防血栓栓塞并发症的双重抗血栓细胞治疗:应给予氯吡格雷、乙酰水杨酸。在动脉重建干预后,血液系统的高凝能力发生在纤溶血系统活性低的背景下,然而血液聚集能力的活性逐渐增加。血管内动脉重建术患者术中高凝障碍的发生比开放动脉重建术患者更严重。考虑到这些情况,在血栓预防的手术阶段就应该开一种抗凝剂,这种抗凝剂对凝血级联的IIa因子有针对性的作用,同时预防血栓栓塞并发症——双重抗血小板治疗。
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引用次数: 0
A RARE TUMOR – ADRENAL ANGIOSARCOMA 一种罕见的肿瘤&肾上腺血管肉瘤
Pub Date : 2023-03-03 DOI: 10.11603/ijmmr.2413-6077.2022.2.13221
A. Kumar M, N. Roy, H. Jafri, V. Popli, V. Karthik, T. Phuntsho
Background. Primary adrenal angiosarcoma is an exceptionally rare tumor with an incidence of <1% of soft tissue sarcomas. Less than 50 cases being described in literature; most of them were nonfunctional presenting with symptoms of abdominal lump, weight loss, fatigue or weakness. The treatment remains multi-modal with involvement of surgeon as well as medical oncologist.Objective. The aim of this case report is to describe an entity which is rare in terms of incidence. It was functional as well as metastatic and managed with multimodality therapy.Methods. The case is a 47-year-old man diagnosed with metastatic adrenal angiosarcoma. The patient was managed with chemotherapy followed by surgery.Results. The final histopathological examination of the specimen and immunohistochemistry revealed angiosarcoma. At present the patient is under follow-up.Conclusion. Even though surgery forms the main stay of management, the role of multi-modality therapy forms the cornerstone for adrenal angiosarcomas.
背景原发性肾上腺血管肉瘤是一种非常罕见的肿瘤,软组织肉瘤的发病率<1%。文献中描述的病例不到50例;大多数患者无功能,表现为腹部肿块、体重减轻、疲劳或虚弱。治疗仍然是多模式的,包括外科医生和肿瘤学家。客观的本病例报告的目的是描述一种罕见的实体。它具有功能性和转移性,并通过多种方式治疗。方法。病例为一名47岁男性,诊断为转移性肾上腺血管肉瘤。病人接受了化疗,然后进行了手术。后果标本的最终组织病理学检查和免疫组织化学检查显示血管肉瘤。目前该患者正在接受随访。结论:尽管手术是治疗的主要手段,但多种治疗方式的作用是肾上腺血管肉瘤的基石。
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引用次数: 0
ANTHROPOMETRIC VARIABLES IN BREAST LESIONS OF WOMEN OF REPRODUCTIVE AGE IN UNIVERSITY OF PORT HARCOURT TEACHING HOSPITAL 哈考特港大学教学医院育龄妇女乳腺病变的人体测量变量
Pub Date : 2023-03-03 DOI: 10.11603/ijmmr.2413-6077.2022.2.13154
C. Orupabo, C. G. Odoya
Background. Benign breast diseases are a potential health concern to a large number of women. The incidence of cancer is increasing worldwide. A steady increase in incidence has been observed in most developed and developing counties.Objective. Thus, our study seeks to investigate the anthropometric variables implicated in breast lesions of women of reproductive age.Methods. This is a descriptive and prospective study with a random sampling method; the data was obtained from the Department of Surgery, Radiotherapy and Oncology Unit of University of Port Harcourt Teaching Hospital. A total number of 146 subjects (18-49 years) were involved into this study. A number of 90 were breast lump patients and 56 were breast cancer patients.Results. Data obtained was analysed with Microsoft Excel. Our results show no statistically significant difference (P> 0.05) in the body mass index (BMI) and waist-hip-ratio (WHR) of both the breast lump and breast cancer patients. This study supports the fact that high BMI is a predictive marker for breast lumps and cancer in women.Conclusion. The study has also identified that high BMI favours the incidence of breast lumps and breast cancers in women of reproductive age.
背景良性乳腺疾病是许多妇女潜在的健康问题。癌症的发病率在全球范围内呈上升趋势。在大多数发达和发展中的县,发病率稳步上升。客观的因此,我们的研究试图调查与育龄妇女乳腺病变有关的人体测量变量。方法。这是一项描述性前瞻性研究,采用随机抽样方法;数据来自哈科特港大学教学医院外科、放射治疗和肿瘤科。本研究共涉及146名受试者(18-49岁)。90例为乳腺肿块患者,56例为乳腺癌症患者。后果使用Microsoft Excel对获得的数据进行分析。我们的结果显示,乳腺肿块和乳腺癌症患者的体重指数(BMI)和腰围(WHR)没有统计学上的显著差异(P>0.05)。这项研究支持这样一个事实,即高BMI是女性乳腺肿块和癌症的预测标志。结论该研究还发现,高BMI有利于育龄妇女乳腺肿块和乳腺癌的发生。
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International Journal of Medicine and Medical Research
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