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   2005| April-June  | Volume 42 | Issue 2  
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Pan masala advertisements are surrogate for tobacco products
C Sushma, C Sharang
April-June 2005, 42(2):94-98
DOI:10.4103/0019-509X.16699  PMID:16141509
BACKGROUND: Pan masala is a comparatively recent habit in India and is marketed with and without tobacco. Advertisements of tobacco products have been banned in India since 1st May 2004. The advertisements of plain pan masala, which continue in Indian media, have been suspected to be surrogate for tobacco products bearing the same name. The study was carried out to assess whether these advertisements were for the intended product, or for tobacco products with same brand name. MATERIALS AND METHODS: The programme of a popular television Hindi news channel was watched for a 24-h period. Programmes on the same channel and its English counterpart were watched on different days to assess whether the advertisements were repeated. The total duration of telecast of a popular brand of plain pan masala (Pan Parag) was multiplied by the rate charged by the channel to provide the cost of advertisement of this product. The total sale value of the company was multiplied by the proportion of usage of plain pan masala out of gutka plus pan masala habit as observed from a different study, to provide the annual sale value of plain pan masala product under reference. RESULTS: The annual sale value of plain Pan Parag was estimated to be Rs. 67.1 million. The annual cost of the advertisement of the same product on two television channels was estimated at Rs. 244.6 million. CONCLUSION: The advertisements of plain pan masala seen on Indian television are a surrogate for the tobacco products bearing the same name.
  13,860 680 22
Trends of prevalence and pathological spectrum of head and neck cancers in North India
Ravi Mehrotra, Mamata Singh, Raj Kishore Gupta, Manish Singh, Anil K Kapoor
April-June 2005, 42(2):89-93
DOI:10.4103/0019-509X.16698  PMID:16141508
BACKGROUND: Head and neck neoplasia constitute one of the commonest cancers in India. Use of smokeless tobacco (Pan masala, Zarda etc.) is on the increase in North India, especially in Uttar Pradesh, and is responsible for the large majority of these tumours. AIM: To assess the patients' characteristics, yearly prevalence and histopathological subtypes of the head and neck neoplasia (excluding oral cavity) in Allahabad and surrounding regions. SETTINGS AND DESIGN: A retrospective study of 11 years from 1990 to 2000 was designed. Data was collected year-wise using the tumor registry data. MATERIAL AND METHODS: All biopsies submitted for histopathology to the Pathology department were reviewed and analyzed for demographic data, site and diagnosis. STATISTICAL ANALYSIS: The Kolmogorov-Smirnov Two-Sample Test was utilized to determine whether two distributions are the same. RESULTS: A total of 40559 biopsies were examined in the department, of which, lesions of the head and neck region, excluding the oral cavity, constituted 694 biopsies (409 males and 285 females). One hundred and forty-four malignant lesions were reported, 114 being males and 30 females. A comparison of the age-specific prevalence rates of cancer during the study period showed that the prevalence was highest in patients belonging to the 50-59 years age group and squamous cell carcinoma Grade II was the most prevalent type. On an average, 58 new biopsies per annum were received. CONCLUSIONS: Properly structured site-specific data like this can augment the National Cancer Registry Programme and is an essential indicator for the magnitude and the pattern of the cancer problem in India.
  9,586 1,054 37
Desmoplastic small round cell tumor: Extra abdominal and abdominal presentations and the results of treatment
G Biswas, S Laskar, SD Banavali, S Gujral, PA Kurkure, M Muckaden, PM Parikh, Chandrika N Nair
April-June 2005, 42(2):78-84
DOI:10.4103/0019-509X.16696  PMID:16141506
BACKGROUND: Desmoplastic small round cell tumor (DSRCT) is a rare malignant neoplasm of adolescent males. Current multimodality treatment prolongs life and rarely achieves cure. Aim: To review the presenting features, histopathology and outcome of 18 patients with DSRCT treated at a single institution. Setting and Design: This is a retrospective observational study of patients with DSRCT who presented at the Tata Memorial Hospital between January 1994 to January 2005. Materials and Methods: Eighteen patients of DSRCT seen during this period were evaluated for their clinical presentation, response to chemotherapy and other multimodality treatment and overall survival. The cohort of 18 patients included 11 males (61%) and 7 females (39%) with a mean age of 16 years (Range 1½ - 30 years). Majority (83%) presented with abdomino-pelvic disease. The others, involving chest wall and extremities. There were 6 patients (33%) with metastatic disease at presentation. Results:The treatment primarily included a multimodality approach using a combination of multiagent chemotherapy with adjuvant surgery and radiotherapy as applicable. A response rate of 39% (CR-1, PR-6), with chemotherapy was observed. The overall response rate after multimodality treatment was 39% (CR-5, PR-2). The overall survival was poor except in patients who had complete excision of the tumor. Conclusion: Abdomino-pelvic site was the commonest presentation, the disease can occur at other non-serosal surfaces also. Despite aggressive treatment the outcome was poor. However, complete surgical excision seems to provide a better survival.
  9,172 868 42
Isolated testicular relapse in acute lymphoblastic leukemia - Effective treatment with the modified CCG-112 protocol
Goyal Shama, Roshni Bhagwat, Suresh K Pai, Purna A Kurkure, Chandrika N Nair, Purvish M Parikh, Maryann A Mukaden, Shripad D Banavali
April-June 2005, 42(2):65-69
DOI:10.4103/0019-509X.16694  PMID:16141504
BACKGROUND: The testes have been considered a sanctuary site for leukemic cells and testicular relapses used to account for a major proportion of the poor outcome of boys with acute lymphoblastic leukemia. With use of aggressive chemotherapy which includes intermediate or high dose methotrexate, the incidence of testicular relapses has declined. However once these patients have received cranial irradiation as a part of the front line protocol, high dose methotrexate needs to be avoided because of risk of developing leucoencephalopathy. AIM: To study the use of non cross resistant chemotherapeutic agents along with a regimen containing lower doses of methotrexate in patients of isolated testicular relapse (ITR). MATERIALS AND METHODS: This is a retrospective analysis of 12 consecutive patients with ITR treated with modified version of the CCG-112 protocol which consists of intensive systemic chemotherapy, cranial chemoprophylaxis along with testicular irradiation. RESULTS: One patient died of regimen related toxicity. Two patients relapsed in the bone marrow during maintenance. Of the nine patients who completed treatment, eight are alive and in remission. One patient had a bone marrow relapse two months after completing treatment. The Kaplan Meier estimates give us an Event Free Survival (EFS) of 66.7% at 10 yrs. CONCLUSIONS: Thus, though the incidence is very low, patients with ITR should be treated aggressively since they have an excellent chance of achieving a long term EFS.
  6,166 589 8
5-Fluorouracil, epirubicin and cisplatin in the treatment of metastatic gastric carcinoma: A retrospective analysis of 68 patients
Kanat Ozkan, Evrensel Turkkan, Kurt Ender, Demiray Mutlu, Arslan Murat, Babacan Nalan, Yildiz Abdülmecit, Manavoglu Osman
April-June 2005, 42(2):85-88
DOI:10.4103/0019-509X.16697  PMID:16141507
BACKGROUND: Gastric cancer is one of the most common types of cancer and one of the most frequent causes of cancer-related death. The majority of gastric cancers show distant metastasis at the time of diagnosis. At present, there is no general agreement over one standard chemotherapy regimen for metastatic gastric cancer. AIMS: We evaluated the activity and toxicity of the combination of 5-Fluorouracil (5-FU), epirubicin and cisplatin (FEP) in previously untreated patients with metastatic gastric cancer. SETTING AND DESIGN: Medical Oncology Department of Uludag University Faculty of Medicine, Bursa; retrospective study. MATERIAL AND METHODS: Sixty-eight patients received 5-FU 300 mg/m2 on Days 1-5, epirubicin 50 mg/m2 on Day 1 and cisplatin 60 mg/m2 on Day 1, every 4 weeks. A median of 3.5 cycles was administered. The response rate, time to disease progression, survival and toxic effects were analyzed. STATISTICAL ANALYSIS USED: Overall survival and time to progression were estimated using Kaplan-Meier method. RESULTS: There were 4 partial responses and 1 complete response (overall response rate 7.3%); 16 patients had stable disease. Median progression-free and overall survival rates were 3.1 months (95% CI 1.9-4) and 6 months (95% CI 4.2-7), respectively. The principal toxicity was myelosupression. Grade 3-4 neutropenia occurred in 27.9%, anemia in 17.6%, and thrombocytopenia in 11.7% of patients. Non-hematological toxicity was mild and manageable. CONCLUSIONS: We concluded that FEP combination as used at the doses and schedules in this study has inferior activity against metastatic gastric cancer.
  5,416 406 5
T- cell prolymphocytic leukemia - A rare case
Sharmila Ghosh, Suresh H Advani
April-June 2005, 42(2):104-106
DOI:10.4103/0019-509X.16702  PMID:16141512
T- cell Prolymhocytic leukemia (T-PLL) is a rare mature post-thymic T-cell malignancy that is usually reported in the elderly and follows an aggressive course. A 68 year old male presented with a history of weakness and weight loss of two months duration. Clinical examination revealed pallor, enlarged cervical and axillary lymph nodes and splenomegaly. He also had a maculo- papular skin rash. There was marked leucocytosis, anemia and thrombocytopenia (WBC 445 x103sub/ml, Hb 8.5gm/dl, Platelet 25x103/µl) with 60% prolymphocytes in the peripheral blood. Bone marrow was hypercellular with an excess of prolymphocytes. Flow cytometric analysis of the bone marrow showed positivity for CD2, CD3, CD4, CD5 and CD7. T- PLL is a rare T cell disorder with characteristic clinical and laboratory features.Currently, no optimal treatment exists although there has been some success with 2'- deoxycoformycin or Campath-1H
  4,610 329 4
Variations in clinical estimates of tumor volume regression parameters and time factor during external radiotherapy in cancer cervix: Does it mimic the linear-quadratic model of cell survival?
NR Datta, A Rajkumar, R Basu
April-June 2005, 42(2):70-77
DOI:10.4103/0019-509X.16695  PMID:16141505
BACKGROUND: Tumor regression parameters and time factor during external radiotherapy (EXTRT) are of paramount importance. AIMS: To quantify the parameters of tumor regression and time factor during EXTRT in cancer cervix. SETTINGS AND DESIGN: Patients, treated solely with radiotherapy and enrolled for other prospective studies having weekly tumor regressions recorded were considered. MATERIALS AND METHODS: Seventy-seven patients received 50Gy of EXTRT followed by intracavitary brachytherapy. Loco-regional regressions were assessed clinically and regression fraction (RF) was represented as RF = c + a1D + a2D2- a3T, with c, D and T as constant, cumulative EXTRT dose and treatment time respectively. STATISTICAL ANALYSIS USED: Step wise linear regression was performed for RF. Scatter plots were fitted using linear-quadratic fit. RESULTS: Coefficients of parameters D, D2 and T were computed for various dose intervals, namely 0-20 Gy, 0-30 Gy, 0-40 Gy and 0-50 Gy. At 0-20 Gy and 0-30 Gy, only the coefficient of D2 was significant (P < 0.001), while both D2 and T turned significant (P < 0.001) at 0-40 Gy. For the entire range of 0-50 Gy, all the coefficients of D, D2 and T showed significance, leading to an estimate of 26 Gy for a1/a2 and 0.96 Gy/day for a3/a1. CONCLUSIONS: As with a/β and g/a of post-irradiation cell survival curves, a1/a2 and a3/a1 represents the cumulative effect of various radiobiological factors influencing clinical regression of tumor during the course of EXTRT. The dynamic changes in the coefficients of D, D2sub and T, indicate their relative importance during various phases of EXTRT.
  4,545 338 4
Gastric outlet obstruction and cutaneous metastasis in adenocarcinoid tumor of stomach - Unusual presentations with cytologic and ultra structural findings
Bharat Rekhi, Chintamani , Sunita Saxena
April-June 2005, 42(2):99-101
DOI:10.4103/0019-509X.16700  PMID:16141510
Neuroendocrine tumors, including carcinoids account for less than 1% of gastric tumors. Various subtypes of gastric carcinoids have been reported earlier. The present case deals with two unusual presentations, diagnosis and course of a gastric neuroendocrine tumor in an adult patient. A 35-years-old male initially presented with gastric outlet obstruction for an antral growth in the emergency ward. He underwent radical gastrectomy and was diagnosed with a gastric carcinoid tumor, on histopathology. After 6 months, he developed hepatic along with nodular cutaneous lesions over the scalp. Aspiration cytology (FNAC) from these metastatic lesions showed two distinct cell types with rosette formation. Ultrastructural findings showed neurosecretory granules in some cells. Subsequently, he underwent 2 cycles of chemotherapy. After a total duration of 9 months, he finally succumbed to the disease. We present a case of a gastric adenocarcinoid tumor, with 2 rare presentations. The metastatic lesions exhibited neuroendocrine features on cytology and electron microscopy.
  4,438 307 4
Paraneoplastic papilloedema in a child with neuroblastoma
Julius Xavier Scott, Prabhakar D Moses, HR Somashekar, T Sathish Kumar
April-June 2005, 42(2):102-103
DOI:10.4103/0019-509X.16701  PMID:16141511
Non-metastatic neurological disease complicating neuroblastoma is well recognized. Gross papilloedema in the absence of intracranial disease as initial manifestation of neuroblastoma is reported in adults. We report for the first time a case of bilateral papilloedema in a child with neuroblastoma in the absence of intracranial disease and hypertension.
  3,466 275 5
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