فهرست مطالب

  • Volume:6 Issue: 2, 2015
  • تاریخ انتشار: 1394/02/22
  • تعداد عناوین: 12
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  • J. Sathish Kumar*, Nim Narboo Bhutia, Tenzing Jigmee Bhutia, Pradip Malik, Madhumangol Singh, H. Priyoshakhi Devi Pages 71-78
    Background
    Cancer of the larynx is a common cancer of the head and neck. This cancer has an established correlation with smoking tobacco and alcohol as causative agents. This study has been conducted in a tertiary hospital in Northeastern India. Minimal data about laryngeal cancer from this area was published in the literature.
    Methods
    This prospective study was conducted for a period of two years and enrolled 30 patients. Patients were diagnosed, staged, and treated for the cancer, then followed for 12 months.
    Results
    This study showed that patients in the sixth decade of life were the most common patients that presented with this cancer. There was a male preponderance. Smoking and alcoholism were the most common associated risk factors. Most patients presented with hoarseness followed by a foreign body sensation in the throat. The majority presented with late stage disease. The most common larynx tumor in this study was glottic carcinoma. All cases were squamous cell carcinoma and most were moderately differentiated. Patients underwent treatment with radiation therapy and chemotherapy.
    Conclusion
    At the one year follow up, 36.67% of patients were found to be in remission. A total of two patients succumbed to this disease.
    Keywords: Laryngeal carcinoma, Smoking, Alcoholism, Treatment
  • Mohammad Faraji, Rad, Mehdi Khajavi, Mohammad Hassan Arjmand, Esmat Shajari, Daryoush Hamidi Alamdari* Pages 79-83
    Background
    Gliomas are the most common primary brain tumors of the central nervous system. Among a number of different bio-molecular events, molecular connections between oxidative stress pathways and their development is prevalent. Oxidative stress is the consequence of an imbalance between pro-oxidant factors and antioxidant defense. This imbalance may lead to DNA damage and changes in growth and function of cells in the brain. Many evidences show that reactive oxygen species in the mammalian brain are directly responsible for cell and tissue function and dysfunction. A brain tumor is correlated with oxidative stress. In this study, we determine the pro-oxidant – antioxidant balance in patients with grade IV brain tumors (glioblastoma multiforme) by the pro-oxidant – antioxidant assay.
    Methods
    We collected sera from 50 patients with high grade (IV) glioblastoma multiform and 49 healthy subjects. The pro-oxidant - antioxidant assay was measured.
    Results
    There was a significant increase in pro-oxidant - antioxidant values in patients (158.10±85.71 HK unit) compared to the control group (74.54±33.54 HK; P=0.001.
    Conclusion
    The pro-oxidant - antioxidant balance assay can show a high level of pro-oxidants in the sera of patients with glioblastoma which indicates the presence of oxidative stress in this group.
    Keywords: Glioblastoma multiform, Oxidative stress, PAB assay
  • Mona Mahmoud Sayed* Pages 85-90
    Background
    This study compared the efficacy of two commonly used fractionation schedules for palliative whole brain irradiation in patients with brain metastases, and assessed the association of the Radiotherapy Therapy Oncology Group (RTOG) Recursive Partitioning Analysis for brain metastases (RPA) to survival with each schedule.
    Methods
    Patients with multiple (more than three) brain metastases were assigned to receive whole brain irradiation in 20 Gy over 5 fractions (group 1) or 30 Gy over 10 fractions (group 2). Primary outcome was response and overall survival in each group. Secondary outcome was the RPA classification relation to overall survival and its possible role in the choice between schedules.
    Results
    There were 54 patients in group 1 and 39 in group 2. There was no significant difference in response (P=0.67) or overall survival between the two groups (P=0.55). However RPA 1 patients had significantly better overall survival than RPA 2 patients in both group 1 (P=0.02) and group 2 (P=0.0014), but no significant difference was found when overall survival of RPA 1 patients of both groups were compared (P=0.47) or that of RPA 2 patients in both groups (P=0.29).
    Conclusion
    The two schedules assessed are comparable in terms of response and overall survival. RPA 1 patients have better overall survival than RPA 2 patients regardless of the fractionation used. A schedule of 20 Gy over 5 fractions should be routinely considered for RPA 2 patients as they are less likely to experience late toxicity. This schedule may be considered for RPA 1 patients, however larger randomized trials are needed to confirm the results and assess differences in neurocognitive function.
    Keywords: Brain metastases, Radiotherapy, Fractionation, RP
  • Gayatri Ravikumar*, Pritilata Rout Pages 91-96
    Background
    Invasive ductal carcinoma is one of the most common type of tumors in females, constituting a single large group of breast cancers. There are various prognostic factors, of which tumor grade, size and axillary lymph node metastasis are among the important ones. Fine needle aspiration cytology is a commonly used diagnostic technique in the initial evaluation of breast lumps. In the era of neoadjuvant chemotherapy, the material obtained from fine needle aspiration cytology is often the only baseline morphology available for future evaluation. Therefore the assessment of cytological grade in fine needle aspiration cytology samples is useful. In addition, correlating cytological grade with axillary lymph node status is indicative of tumor aggressiveness. This study correlates the cytological grade with histological grade and axillary lymph node status.
    Methods
    Patients with cytological diagnosis of ductal carcinoma who underwent subsequent resection and axillary clearance over a period of five years were included in the study. Fine needle aspiration cytology smears were graded by Robinson’s method and compared with the Modified Bloom Richardson’s histopathological grading and axillary lymph node metastasis.
    Results
    There were a total of 98 cases of invasive ductal carcinoma. Patients’ ages ranged from 28 to 98 years with a mean of 52.17 years. In terms of cytology, there were 22 (22.4%) grade I cases, 61(62.2%) grade II, and 15 (15.3%) grade III. For histopathology, 22 (22.4%) were grade I, 56 (57.1%) were grade II, and 20 (20.4%) were grade III. In 76 (77.5%) cases the cytological grade correlated with histological grade, but did not show any significant positive correlation with axillary lymph node metastasis.
    Conclusion
    Cytological grade can be used as a predictor of histological grade, but may not predict axillary lymph node metastasis in patients with invasive ductal carcinomas.
    Keywords: Axillary lymph node metastasis, Cytological grading, Ductal carcinoma, Robinson's grading
  • Amir Musarezaie*, Mahboube Ghasemipoor, Tahere Momeni, Ghaleghasemi, Mahnaz Khodaee, Fariba Taleghani Pages 97-105
    Background
    Leukemia is the most common malignancy in young adults that has a life-threatening nature which increases the patient's spiritual needs, leading to emergence of spiritual crises. However, evidences indicate that spiritual needs of patients and their spiritual well-being are not emphasized among health care personnel. According to the cultural, religious and social backgrounds as well as contradictory findings in studies, this study intends to determine the effects of a spiritual-based intervention on spiritual well-being of patients with leukemia.
    Methods
    This randomized clinical trial was conducted at Sayyed-Al-Shohada Hospital (Isfahan, Iran) in 2012-2013. We randomly divided 64 adult patients with leukemia into experimental and control groups. In the experimental group, a spiritualbased intervention that included supportive presence and support for religious rituals was implemented for three days. Both groups completed the Palutzian and Ellison Spiritual Well-being Questionnaire before and after the intervention. Data was analyzed using ANCOVA, chi-square, the Mann-Whitney U-test, and paired and independent t-tests in SPSS (Version 18, SPSS Inc., Chicago, IL).
    Results
    There was a significant difference in the scores of the experimental group before and after the intervention (P<0.001). This difference was absent in the control group. According to ANCOVA results, the mean score of spiritual well-being after spiritual-based intervention in the experimental group was more than the mean score of spiritual well-being in the control group. This result was statistically significant (P<0.001, F=63.303)
    Conclusion
    Our spiritual-based intervention promoted the spiritual well-being of patients with leukemia. Therefore, in cases of refractory diseases such as leukemia, nurses should apply a holistic care approach with emphasis on spirituality-based intervention.
    Keywords: Iran, Leukemia, Nursing, Spirituality
  • Kavita Mardi*, Neelam Gupta, Shivani Sood, Manju Rao Pages 107-110
    The sex cord-like variant of endometrioid carcinoma is a rare subtype with a close histological resemblance to the sex cord-stromal tumor of the ovaries, in particular the Sertoli cell tumor. However, very few cases of the granulosa cell tumor-like variant have been reported since it is commonly misdiagnosed as a granulose cell tumor. Immunohistochemistry is useful in the diagnosis of these tumors as they are typically negative for inhibin alpha. We herein describe the histological and immunohistochemical features of a rare case of granulosa cell tumor-like variant of endometrioid carcinoma of the ovary with extensive areas of hyalinization, calcification and osseous metaplasia in a 45-year-old female patient.
    Keywords: Endometrioid carcinoma, Sex cord variant, Granulose tumor, like variant, Ovary
  • Sonia Chhabra, Kanika Taneja*, Megha Ralli, Sunita Singh, Aditi Arora, Sohrab Arora, Pansi Gupta Pages 111-114
    Long bone metastasis in cervical cancer is a rare presentation generally seen in the lumbar column or ribs. The reported rates of bone metastases are between 15%-29%. It is associated with poor prognosis. Bone scan and magnetic resonance imaging are useful techniques for diagnosis. In this case report, a 32-year old female with a previous history of cervical carcinoma FIGO stage IIIA presented with severe pain and swelling in her right humerus. X-ray and magnetic resonance imaging findings were non-conclusive and suggestive of a lytic lesion. She was diagnosed with metastatic cervical cancer according to fine needle aspiration cytology. Fine needle aspiration cytology is considered an important means to confirm clinical suspicion of local recurrence or metastasis of a known cancer without subjecting the patient to further surgical intervention. Suspicious bone lesions, especially in the patient with a past history of cancer should be promptly investigated as they can represent evidence of advanced malignant disease, thereby leading to early therapeutic intervention and decreased morbidity in such patients.
    Keywords: Cervical cancer, Metastasis, Humeral, FNAC
  • Manjusha Nair*, Reghu Kesavapillai Sukumaran Nair, Rajeev Kavalakara Raghavan, Kusumakumary Parukkutty, Renu Sukumaran Pages 115-120
    Ewing’s sarcoma is a common malignancy of the bone and soft tissues in pediatric patients. It mostly affects the long bones and pelvis, and less commonly the flat bones and vertebrae. Primary Ewing's sarcoma affecting the spine is very rare. The patient has non-specific symptoms for a prolonged period of time before the correct diagnosis is given. Patients can present with acute paraplegia due to spinal cord compression, which needs prompt surgical intervention. Early diagnosis and treatment is important for neurological recovery. The definitive management includes three main modalities: surgery, radiotherapy, and combination chemotherapy. Adequate surgical excision may not be feasible because of anatomical limitations and local control is mainly achieved by radiotherapy. Because of the low incidence of these tumors, a multitude of therapeutic strategies have been employed with varying success. Currently there are no clinical guidelines outlining optimal management. We present a series of six cases of primary Ewing's sarcoma of the spine, analysis of presenting complaints, examination findings, diagnostic investigations, treatment, outcome and review of relevant literature. Five out of the six patients had prolonged musculoskeletal symptoms before they were correctly diagnosed and three presented with acute paraplegia. All have received aggressive multimodality therapy with complete neurological recovery and are surviving.
    Keywords: Ewing's sarcoma, Spine, Pediatric
  • Shamsiah Abdul Hamid *, Nur Adura Yaakup Pages 121-124
    The brain is a rare site for metastasis in most extracranial pediatric solid tumors, including Wilm’s tumor. Outcome for these patients are generally dismal. Very few cases have been reported to have good survival even after therapy. This paper reports a case of stage IV Wilm’s tumor with lung metastases in a patient who developed a solitary brain metastasis five months after completion of chemotherapy. She underwent resection of the brain tumor followed by chemotherapy and radiotherapy. The patient was alive at the 20-month follow up after diagnosis of brain metastasis and was considered to have radiologically stable disease.
    Keywords: Wilm's tumor, Solitary brain metastasis, Pulmonary metastasis
  • Mahdi Shahriari*, Fazl Saleh Pages 125-127
  • Shahram Paydar, Behnam Dalfardi* Pages 129-130
  • Mohammad Reza Bordbar, Fazl Saleh, Babak Abdolkarimi* Pages 131-132