Post-tsunami changes in the littoral environment along the southeast coast of India.

The 26th December 2004 Indian Ocean tsunami devastated coastal regions of the Indian subcontinent. Andaman and Nicobar Islands, coastal stretches of Tamil Nadu, Andhra Pradesh and Kerala were the most affected regions of India. Changes in the beach profiles, long shore currents, breaking wave characteristics in the surf zone at selected locations along the Tamil Nadu coast were studied during January, April, October 2005 and January 2006. Long shore sediment transport rates were estimated from the observed parameters. Studies were carried out earlier (1995-1996 and 1998) to understand the coastal environment over a one-year cycle in the study region. The post-tsunami observations were compared with the earlier studies to establish the variations in the littoral environment and to ascertain the normalcy of the littoral environment in the post-tsunami scenario. From the changes in the beach profiles, the shoreline was observed to recede by about 20 m and built-up of backshore by about 0.5 m at most locations. Observations from the field investigations and comparisons with earlier studies along this stretch of the coastline indicate that the coastline is yet to return completely to normalcy.

Carcinoma of the vulva: a retrospective review of 37 cases at a regional cancer centre in South India.

A retrospective review of 37 cases of carcinoma of the vulva presenting between 1996 and 2000 has been carried out. Thirty-three cases were managed with curative intent and four cases with advanced loco-regional disease were managed with palliative intent. The surgical treatment consisted of wide excision in one case, radical vulvectomy (RV) in six cases, radical vulvectomy and bilateral groin node dissection (RV+BGND) in 25 cases and radical vulvectomy and unilateral groin node dissection in one case. Nine of these 33 women also received adjuvant chemotherapy preoperatively in the hope of achieving better tumour-free surgical margins. Eight cases had a partial response and one case achieved complete response; the surgical margins were free in all these patients. One case received neoadjuvant radiotherapy to the vulva and pelvis followed by RV+BGND, which revealed no residual tumour. Overall, 26/33 cases had groin/inguinal node dissection and 23 (88.4%) of them had groin wound dehiscence. Thirteen of these 26 patients (50%) had inguinal node metastases (Stage III, four patients; Stage IV, nine patients). All the patients with negative nodes were free of disease while three of four patients with Stage III and two of nine patients with Stage IV with nodal metastases remained free of disease. The only patient with Stage III disease plus inguinal node metastases who recurred had multiple positive nodes with extracapsular spread. It appears that although bilateral involvement of the inguinal lymph nodes carries a worse prognosis, unilateral involvement with or without vaginal involvement carries an excellent prognosis provided multiple nodes are not involved. The role of neoadjuvant chemotherapy as compared to neoadjuvant radiotherapy, in locally advanced tumours, needs to be explored further.