Relationship of size of corpus callosum with white matter changes in elderly population; A retrospective analytical cross-sectional study.

Purpose: To study the relationship of size of corpus callosum with white matter changes in the elderly population. Materials and methods: This was a retrospective analytical cross-sectional study. The relationship between the corpus callosum and white matter changes was studied using the magnetic resonance imaging technique, where white matter changes were graded based on Fazekas grading. The Spearman rank order correlation was used to assess the relationship between the size of corpus callosum and white matter changes. Results: The whole corpus callosum (ρ = 0.165, p = 0.044) and rostrum (ρ = -0.232, p = 0.004) was significantly correlated with white matter changes based on Fazekas severity grading. Similarly, in bivariate regression analysis, white matter changes were strongly correlated with rostrum (standardized ß-coefficient = -0.186, p = 0.023). While taking gender in sub-group analysis, white matter changes were significantly correlated with rostrum (ρ = -0.252, p = 0.021) and splenium (ρ = -0.229, p = 0.036) in male and with rostrum (ρ = -0.245, p = 0.048) only in female groups. Conclusions: Corpus callosum size is associated with white matter changes in the elderly population. This association can give insight into the neuropathology of diseases involving the central nervous system.

Ewing Sarcoma in Nepal Treated With Combined Chemotherapy and Definitive Radiotherapy.

PURPOSE: To our knowledge, we conducted the first prospective oncologic clinical trial in Nepal aimed at providing state-of-the-art chemotherapy to patients with Ewing sarcoma. The efficacy of external-beam radiotherapy (RT) as the sole local treatment modality was explored and deemed justified as a result of the lack of available advanced tumor-orthopedic services in Nepal. PATIENTS AND METHODS: Twenty patients, 11 female and 9 male patients between the ages of 6 and 37 years, with newly diagnosed Ewing sarcoma were enrolled. Neoadjuvant combination chemotherapy, comprising well-established drug combinations, was administered in five courses before external-beam RT, during which one course of etoposide and ifosfamide was given. After RT, six additional chemotherapy courses were scheduled. RESULTS: RT was tolerated well, providing rapid symptom relief and local tumor control, with no pathologic fractures observed among the 15 patients who received such treatment. Eleven patients completed the entire treatment protocol; seven patients were under continued follow-up, with no evidence of disease in six patients at a median follow-up time of 2.3 years (range, 1.3 to 3.1 years) and one patient alive but with a regional recurrence. Four patients experienced metastatic relapse and died as a result of their disease. Three treatment-related deaths linked to toxicity from chemotherapy occurred. Four of the six patients who refused to complete the treatment protocol and were lost to follow-up experienced progressive disease and were assumed dead. CONCLUSION: This study was feasible with RT as the sole local treatment modality in combination with chemotherapy. As a result of the high number of patients lost to follow-up, no firm conclusions can be drawn, but the majority of the patients who completed treatment obtained durable long-term remissions.

Human papillomavirus genotype distribution in cervical cancer biopsies from Nepalese women.

BACKGROUND: Cervical cancer (CC) is the leading cause of morbidity and mortality from cancer in Nepalese women. Nearly all cases of CC are caused by infection with certain genotypes of human papillomavirus (HPV). Data on HPV genotype distribution in Nepalese CC patients is sparse. We aimed to determine the distribution of HPV genotypes in biopsies of CC tissue from Nepalese women. METHODS: This study examined 248 archived paraffin-embedded tissue specimens from CC cases from patients of B.P. Koirala Memorial Cancer Hospital, Bharatpur, Chitwan, Nepal. DNA was extracted from the biopsies and HPV detection performed by PCR. HPV genotyping was then carried out by a reverse line hybridization technique capable of identifying 36 distinct HPV genotypes. RESULTS: Most of the samples were from tumors that had been designated by hospital pathologists as squamous cell carcinoma (77.6%). 165 of the 248 samples contained DNA of sufficient quality for rigorous PCR testing. All the analyzable specimens were positive for HPV. The most common HPV genotypes, in decreasing order of frequency were 16, 18, 45, 33, 52, 56 and 31; most were found as single infections (94.5%). Together, HPV types 16, 18, and 45 were found in 92% of the tumor samples. CONCLUSION: This study strengthens the knowledge-base of HPV genotype distribution in CC cases in Nepal. Hopefully, this information will be useful to the medical community and public health policy-makers in generating improved HPV-surveillance, -prevention and -treatment strategies in Nepal.