ABSTRACT
Background: In order to document the understanding of current evidence for the management of triple negative breast cancer and application of this knowledge in daily practice, we conducted an interactive survey of practicing Indian oncologists. Materials and Methods: A core group of academic oncologists devised two hypothetical triple negative cases (metastatic and early breast cancer, respectively) and multiple choice options under different clinical circumstances. The respondents were practicing oncologists in different Indian cities who participated in either an online survey or a meeting. The participants electronically chose their preferred option based on their everyday practice. Results: A total of 152 oncologists participated. Just over half (53.8%) preferred taxane based chemotherapy as first-line chemotherapy in the metastatic setting. In the adjuvant setting, a taxane regimen was chosen by 61%. Over half of respondents (52.6%) underestimated the baseline survival of a patient with node positive triple-negative tumor and 18.9% overestimated this survival compared to the estimate of the Adjuvant! program. Discussion: This data offers insight into the perceptions and practice of a diverse cross-section of practicing oncologists in India with respect to their therapeutic choices in metastatic and adjuvant settings in triple negative breast cancer.
Subject(s)
Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Breast Neoplasms/pathology , Chemotherapy, Adjuvant , Cyclophosphamide/administration & dosage , Doxorubicin/administration & dosage , Female , Humans , India , Lung Neoplasms/drug therapy , Lung Neoplasms/secondary , Lymphatic Metastasis , Medical Oncology , Middle Aged , Practice Patterns, Physicians' , Receptor, ErbB-2/metabolism , Receptors, Estrogen/metabolism , Survival Rate , Taxoids/administration & dosage , Treatment OutcomeABSTRACT
A 13-year-old boy was diagnosed as a case of idiopathic pulmonary haemosiderosis on the basis of clinical presentation, radiological assessment and open lung biopsy. The patient had a complete clinical and radiological remissions with oral corticosteroids.
Subject(s)
Adolescent , Hemosiderosis/drug therapy , Humans , Lung Diseases, Parasitic/drug therapy , Male , Prednisolone/therapeutic useABSTRACT
Peak expiratory flow rate (PEFR) measurement is the easiest and cheapest method to evaluate respiratory functions. So, the study was carried out to evaluate PEFR of healthy Nepalese adults and compare their values with healthy Indian counterparts to know whether Indian prediction equations for PEFR can be used for Nepalese adult population or not. One hundred twenty-three healthy, young, non smoker adult Indian (64: 28 Males, 36 Females) and Nepalese (59: 32 Males, 27 Females) medical students of 18 to 20 years of age participated in the study. The mean PEFR of Indian (male: 490.4 liter/min, female: 386.0 liter/min) and Nepalese (male: 485.9 liter/min, Female: 365.2 liter/min) young adults were found to have no significant differences. As there is no significant difference in the mean PEFR of Indian and Nepalese young adults, prediction equations made for Indian adults can be used to predict PEFR of Nepalese subjects. Therefore, an attempt has been made to formulate a regression equation from the combined Indian and Nepalese subjects. A stepwise, multiple, linear, regression analysis was performed for this purpose. The analysis showed that height is the best predictor for PEFR in the present study. The regression equation based on height for the combined Indian and Nepalese young adults is calculated as: PEFR = 5.687 x Height (cm) - 495.787. However, a stepwise, multiple, linear, regression equation with residual analysis for the best fit model was performed to formulate prediction equation for PEFR and this showed a change of the earlier regression equation to PEFR = 5.930 x Height (cm) - 536.131.
Subject(s)
Academies and Institutes , Adolescent , Adult , Age Factors , Cross-Sectional Studies , Female , Health Status , Humans , India , Linear Models , Male , Nepal , Peak Expiratory Flow Rate , Regression Analysis , Respiration , Respiratory Physiological Phenomena , Respiratory System , SpirometryABSTRACT
Hypereosinophilic syndrome (HES) is classically defined as prolonged, unexplained peripheral eosinophilia in a patient presenting with evidence of end-organ damage. The heart is involved in two forms; endomyocardial fibrosis (Davies disease) and eosinophilic endocarditis (Loffler's endocarditis). It was first reported in 1968 by Hard and Anderson. Chusid and co-workers formulated a definition with strict criteria for the diagnosis of HES as 1) peripheral blood eosinophilia more than 1500 cells/cu mm for at least six months duration 2)signs, symptoms of end-organ (heart, lungs, gastrointestinal tract, skin, bone-marrow, brain) involvement with eosinophil tissue infiltration/injury 3) exclusion of known secondary causes of eosinophilia. We report a case of hypereosinophilic syndrome with Loffler's endocarditis, in the absence of endomyocardial fibrosis. The patient presented with a eosinophilic vegetation over the posterior leaflet of the mitral valve. There was complete resolution of the vegetation after two months of corticosteroid therapy.
Subject(s)
Adrenal Cortex Hormones/therapeutic use , Adult , Diagnosis, Differential , Endocarditis/complications , Humans , Hypereosinophilic Syndrome/complications , Male , Mitral Valve/physiopathology , Treatment OutcomeABSTRACT
OBJECTIVES: Cryptogenic Organizing Pneumonia (COP) is a relatively rare disorder which is gratifying to treat due to its prompt steroid responsiveness. There have been only 2 case reports on COP from India but no large series entity reported from this country. METHODS: The medical records of all patients with biopsy (histopathology) proven COP admitted in a tertiary care hospital in Mumbai (2000-2005) were retrospectively analyzed. We looked at clinical and radiographic profiles, initial diagnosis and treatment, lag period to starting definitive therapy and steroid responsiveness. RESULTS: When compared to other series of patients with COP, our series showed several similarities and some differences. Distinctive features were the striking female preponderance and the utility of transbronchial biopsies in establishing the diagnosis. Long delays in diagnosis with patients mislabeled as tuberculosis or pneumonia, lead to delays in starting steroids resulting in 21% of our patients continuing to deteriorate. CONCLUSIONS: This comprehensive review of COP, the first of its kind from India, reveals its varied clinical and radiographic spectrum. A high index of suspicion will lead to prompt steroid therapy which will result in better patient outcome.
Subject(s)
Adult , Aged , Cryptogenic Organizing Pneumonia/diagnosis , Female , Humans , Male , Middle AgedABSTRACT
A study was conducted to evaluate the RNTCP in Habra TB, unit North 24 Parganas district, in February 2004. We collected both primary and secondary data, cross-checked registers and records. The TB unit was catering 23% more population; 54% of patients belonged to backward section. All patients received free drugs and free microscopy services; 90% received DOT during intensive phase and 67% during continuation phase; DOT time was inconvenient to 20% patients and 30% in attending DOT; 14% patients did not give three sputum samples at diagnosis; 28.3% centers lacked expected facilities; inconsistency in 27.8% drug boxes; records lacking in address verification (74.4%) and defaulter retrieval activity (47.2%). Delay in diagnosis and initiation of treatment was also prevailed.
Subject(s)
Adolescent , Adult , Antitubercular Agents/therapeutic use , Directly Observed Therapy , Female , Guideline Adherence/statistics & numerical data , Health Policy , Humans , India , Interviews as Topic , Male , Medical Audit , Patient Compliance/statistics & numerical data , Tuberculosis/diagnosisABSTRACT
Salmonella typhi is known to produce acalculous cholecystitis and related gall bladder perforation. Following is a documentation of a patient of sub-phrenic abscess and gall bladder perforation which was possibly a result of Salmonella paratyphi A.
Subject(s)
Biopsy, Needle , Cholecystectomy/methods , Cholecystitis/complications , Fever of Unknown Origin/etiology , Follow-Up Studies , Humans , Laparotomy , Male , Middle Aged , Paratyphoid Fever/complications , Rupture, Spontaneous , Salmonella paratyphi A/isolation & purification , Subphrenic Abscess/complications , UltrasonographyABSTRACT
Fifty unrelated Indian Gurkha of Nepalese origin were studied to analyse the HLA antigen profile and their relation with other populations. Haplotype B35-Cw4 occurred with highest incidence and significant positive linkage disequilibrium in Gurkhas. Haplotype A10-B8 which occurs with the highest frequency in north Indians was also observed to occur with significant positive linkage in Gurkhas. HLA profile of Gurkhas thus may be the result of long-term isolation and genetic drift.