Primary Ewing's Sarcoma of Body of Mandible, Multimodal Treatment with Excellent Spontaneous Bone Regeneration: a Case Report.

Ewing's sarcoma is an invariable manifestation in facial bones. Primary lesions in head and neck region had come up with better prognosis compared to other primary sites; hence, management of such jaw lesions is a challenge particularly in pediatric patients during first decade of life as functional impairment and facial disfigurement may affect the quality of life. Here, we are discussing a unique case of primary lesion of horizontal region of mandible with special focus on use of radiation therapy, radiation dose-related effects and spontaneous bone regeneration.

Is Optimal Cytoreduction Post Neoadjuvant Chemotherapy the Only Prognostic Factor in Advanced Ovarian Cancer?

Pravesh Dhiman, DNB (Medical Oncology).Background Epithelial ovarian cancer (EOC) is one of the leading causes of cancer-related death in women. Approximately 70% of patients with EOC are diagnosed in advanced stage [The International Federation of Gynecology and Obstetrics(FIGO stage III and IV)] with an expected 5-year survival rate of 30%. Numerous studies have shown that survival with neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is noninferior to primary debulking surgery followed by chemotherapy. Materials and Methods In this retroprospective observational study, 50 patients with advanced ovarian cancer, diagnosed from January 2012 to January 2015, were included and followed-up till January 2017. Correlation of NACT with patient profile, CA125 levels, clinicopathologic parameters, progression-free survival (PFS), and treatment response was studied. Statistical analysis was performed using log-rank test and Kaplan-Meir survival plots. Results The extent of cytoreduction significantly correlated with PFS. The PFS was maximum in patients who had optimal cytoreduction (19 months) and 10 months in patients with suboptimal cytoreduction with p -value < 0.05. The survival was not significantly correlated with other parameters such as age, stage, preoperative CA125 levels, and ascites. Conclusions The extent of cytoreduction following NACT in this study was associated with statistically significant PFS advantage in patients who were able to undergo optimal cytoreduction, but not significantly correlated to other factors such as age, stage, preoperative CA125 levels, and ascites. NACT followed by interval cytoreduction is an important modality affecting survival in advanced EOC. Further studies and longer follow-up are needed to demonstrate survival advantage over standard treatment.

Drug-induced infiltrative lung disease with weekly paclitaxel in breast cancer: Case series.

Drug-induced infiltrative lung disease (DI-ILD) can be caused by chemotherapeutic agents, antibiotics, antiarrhythmic drugs, and immunosuppressive agents. Common chemotherapeutic drugs causing DI-ILD include bleomycin, mitomycin C, bis (2-chloroethyl)-l-nitrosourea, cyclophosphamide, busulfan, and methotrexate. Taxanes and trastuzumab are also associated with lung injury. Estimated incidence of paclitaxel-induced lung injury is 0.73%-12%. Although cases of paclitaxel-induced lung injury have been reported previously, we found only one published case report of fatal lung injury caused by paclitaxel use. We are reporting the largest case series of seven patients who developed paclitaxel-induced lung injury along with review of literature.

Prevalence of congenital heart disease in rural population of Himachal - A population-based study.

AIM: There is no community-based study about the prevalence of congenital heart disease (CHD) in Himachal; hence, we undertook this study. METHODS AND RESULTS: A population-based survey was done in four villages of different districts of Himachal Pradesh. In total, 1882 persons were examined. 909 were male and 973 were female. There were 12 cases of CHD in the population (6.3/1000): four of these were male (33.3%) and 8 were female (66.6%). Mean age of these patients was 19.5±11.07 years. Atrial septal defect (ASD) was the commonest lesion followed by ventricular septal defect (VSD). CONCLUSION: Prevalence of CHD in general population was 6.3/1000. ASD was the commonest lesion. CHD was more common in female.

Prevalence of rheumatic fever and rheumatic heart disease in rural population of Himachal--a population based study.

PURPOSE OF STUDY: Rheumatic heart disease is still the commonest valvular heart disease in India. There is no population based study regarding the prevalence of rheumatic fever/rheumatic heart disease (RF/RHD) from Himachal and hence the purpose of study. METHODS AND RESULTS: A community based survey for prevalence of RF/RHD was done in four villages of different districts of Himachal. The subjects suspected to have RF/RHD on clinical ground were subjected to echocardiography to confirm the diagnosis. Total 1882 subjects were screened. 909 were male and 973 were female. 11 of these were found to have RF/RHD (5.8/1000). Mean age of these patients was 30.35 +/- 14.17 years. 10 of these were female and one was male. Mitral valve was the commonest to be involved. Seven were known to have RF/ RHD and five were on penicillin prophylaxis. CONCLUSION: RF/RHD is still common in rural population of Himachal. Mitral valve is commonest to be involved and prevalence is much more in female than in male.

Prevalence, awareness and control of hypertension in rural communities of Himachal Pradesh.

PURPOSE: There is no community based study of prevalence of hypertension from Himachal Pradesh, so we undertook this study. METHODS AND RESULTS: Population based survey was done in three villages of Himachal Pradesh of different Districts. Total 1092 adults of > or =18 years of age were examined. 507 (46.42%) were males and 573 (52.47%) were females. 392 (35.89%) were found to have hypertension (39.8% in males and 33.15% in females). 267 had their blood pressure in pre-hypertensive range (24.45%). Only 433 (39.6%) had their blood pressure in normal range. 84 (21.98%) of 392 hypertensive persons were aware of their hypertensive status and only 17 of these 84 (20.23%) had their blood pressure under control. CONCLUSION: Prevalence of hypertension was higher than the national average. Only one fifth of hypertensive persons were aware of their disease and only fifth of these had their blood pressure under control.