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Abstract Background: Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive technique that acts on the activity of the cerebral cortex employing electrical currents. Aim: The objective of this project is to evaluate the effectiveness of rTMS on pain and quality of life in patients with chemotherapy-induced peripheral neuropathic pain. Method: Ten patients with chemotherapy-induced peripheral neuropathic pain received 20 sessions of rTMS, consisting of 15 minutes of treatment repeated 5 times per week for four weeks (10 Hz, 20s, 30 trains with 81% intensity). Patients were evaluated using the Brief pain inventory (BPI) and the Functional Assessment of Cancer Therapy and neurotoxicity (FACT-GOG-NTX 13). Results: There were significant differences in BPI mean severity, interference score and FACT-GOG-NTX 13 (p<0,05). Conclusion: The pilot study results suggest that rTMS is potentially beneficial for the treatment of chemotherapy-induced peripheral neuropathy. rTMS over the M1 had an important reduction in pain severity, interference with daily activities, and quality of life scores. However, results should be taken with caution due to the small sample size, absence of a control group and short period of follow-up.
Resumen Antecedentes: La estimulación magnética transcraneal repetitiva (EMTr) es una técnica no invasiva que actúa sobre la actividad de la corteza cerebral, empleando corrientes eléctricas. Objetivo: El objetivo de este proyecto es evaluar la eficacia de la EMTr sobre el dolor y la calidad de vida en pacientes con dolor neuropático periférico inducido por quimioterapia. Métodos: Diez pacientes con dolor neuropático periférico inducido por quimioterapia recibieron 20 sesiones de EMTr que consistieron en un tratamiento de 15 minutos repetido 5 veces por semana durante cuatro semanas (10 Hz, 20 s, 30 trenes con 81 % de intensidad). Los pacientes fueron evaluados mediante el Inventario Breve de Dolor (BPI) y la Evaluación Funcional de la Terapia del Cáncer y la neurotoxicidad (FACT-GOG-NTX 13). Resultados: Hubo diferencias significativas en la severidad media del dolor del BPI, la puntuación de interferencia y el FACT-GOG-NTX 13 (p<0,05). Conclusión: Los resultados del estudio piloto sugieren que la rTMS es potencialmente beneficiosa para el tratamiento de la neuropatía periférica inducida por la quimioterapia. La rTMS sobre M1 tuvo una reducción importante de la severidad del dolor, la interferencia con las actividades diarias y las puntuaciones de calidad de vida. Sin embargo, los resultados deben tomarse con cautela debido al pequeño tamaño de la muestra, la ausencia de un grupo de control y el corto período de seguimiento.
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Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological condition characterized by headaches, seizures, confusion, and visual impairment. It typically causes transient lesions in the posterior white matter in magnetic resonance imaging (MRI) of the brain. PRES induced by chemotherapy is uncommon in oncology but can be a significant neurological event. The exact cause of PRES remains unclear. This case report describes a 15-year-old female patient with acute lymphoblastic leukemia who developed PRES following chemotherapy with prednisolone (100 mg), vincristine (2 mg), and daunorubicin (40 mg) as per the modified Berlin-Frankfurt-Munster (95/2002) protocol. She developed headaches, partial seizures, and elevated blood pressure 1 day after starting chemotherapy. Brain MRI showed T2 and fluid-attenuated inversion recovery hyperintensities in the bilateral cerebral parenchyma, brainstem, and cerebellum. She was treated with levetiracetam (500 mg stat and then 1.5 g BD) for seizures, amlodipine (5 mg) for hypertension, and paracetamol (650 mg TDS) for headaches. Her symptoms improved and resolved within 2 days. The event was deemed possibly related to the chemotherapy drugs according to the World Health Organization-Uppsala Monitoring Centre causality assessment system.
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Background: Cancer is the word used for a tumor that spreads & destroys the host and is one of the leading causes of morbidity and mortality in developed and developing countries. Good nutrition is important for good health. Methods: Non-experimental descriptive research design was adopted for a study to assess knowledge on meeting nutritional needs among 100 oncology patients receiving chemotherapy at Bhagwan Mahaveer Cancer Hospital & Research Centre, Jaipur. Sample selection using a non-probability convenient sampling technique. Data were collected through a self-developed structured knowledge questionnaire. Results: Our results revealed that the majority of cancer patients, 43%, were in the age group of 31-40 years, 39% had no formal education, 32% had secondary education, and 17% had primary education. 76% were males, 24% were female, and 87% of participants did not have a family history of cancer. 55.23% of patients reported that nurses did counselling. The majority (67%) of respondents reported that they had previous information on meeting nutritional needs through diet counselling, and 33% reported they didn’t have any information about meeting nutritional needs. Most (45%) of cancer patients had poor knowledge, 26% had average knowledge, and 29% had good knowledge scoring. Conclusion: We concluded that results show that most (45%) of oncology patients receiving chemotherapy had poor knowledge of meeting nutritional needs during chemotherapy. However, the researcher developed an information booklet, and he hopes that the booklet will surely enhance the oncology patient’s knowledge of meeting nutritional needs during chemotherapy.
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Sweet syndrome is a rare, etiologically unknown dermatosis that can be idiopathic or associated with certain clinical conditions. Among these conditions are infections, autoimmune diseases, inflammatory bowel diseases, vaccinations, the use of medications, and neoplasias. Hematological neoplasias, particularly acute myeloid leukemia, are the most commonly described; however, the condition may also be related to solid tumors, being those of the genitourinary tract the most associated with the syndrome. Drug?induced Sweet syndrome has also been reported; however, it is rarely seen. We report a case of 59 years old male patient with a diagnosis of carcinoma urinary bladder, who developed skin eruption after infusion of the first cycle of chemotherapy (gemcitabine and cisplatin) and resolved after treatment with steroids. The diagnosis of Sweet syndrome was confirmed only after skin biopsy, cultures and laboratory investigations. Malignancy as the cause of skin eruptions was eliminated by the fact that it occurred only after infusion of chemotherapy and the tumor was still there in the bladder, and skin eruptions did not occur after stopping steroids.
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Background: Esophageal cancer (EC) is an extremely aggressive tumor with one of the highest geographic, ethnic, and gender variations. Various factors including tobacco consumption, unhealthy diet, and socioeconomic status have been implicated in the etiology of EC. Despite the advent of modern treatments, the prognosis of EC is dismal. This study has been undertaken to review the clinical and pathologic profiles, treatment approach, and survival pattern in patients with EC in a tertiary care hospital in northeast India. Materials and Methods: A retrospective descriptive study was done with 179 EC patients presented to our department between January 2013 and December 2020. Statistical analysis was done by using IBM Statistical Package for the Social Sciences version 21.P- value <0.05 was considered significant. Results: The majority of the patients presented in the sixth decade of life from rural areas with male to female ratio of 3.7:1. Dysphagia was the most common presenting feature. High incidence of tobacco and alcohol use was found. Mid-esophagus is the most common site and squamous cell carcinoma is the most common type. Fifty-two (29.1%) and 71 (39.6%) patients presented in stages III and IV, respectively. Twenty-four (13.4%) patients presented with metastatic disease, the lung being the most common site. Patients were treated with surgery, chemotherapy, radiotherapy, or combination of any of these. Overall median survival for the EC patients was 6 months. Patients treated with concurrent chemoradiation had better survival. Conclusion: EC is a serious malignancy with a dismal prognosis due to the advanced stage at presentation. Larger clinical trials using new therapeutic strategies are the need of the hour.
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Currently, natural products of herb medicinal plants are widely reported as a supplement to cancer chemotherapy. The cytotoxic effect of a dichloromethane (DCM) extract of Cyrtostachys renda root and its flow cytometric profile against a human breast cancer cell line (T47D) were investigated in this study. The 3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromid assay was used to assess the combined cytotoxic effects of fraction A3 C. renda root and doxorubicin. The combination index (CI) criteria was used to analyze the synergistic effect of fraction A3 and doxorubicin. The cell cycle and apoptosis profiles were completed using flow cytometric labeling with propidium iodide/RNase and Annexin V. Cell morphological changes were observed using an inverted microscope. Single cytotoxicity fraction A3 of DCM extract was effective against T47D cells with an IC 50 value of 43.03 ?g/ml. Fraction A3 and doxorubicin at half of IC 50 combined had a strong synergistic effect on T47D cells with a CI of 0.2. The cell cycle analysis results showed that this combination caused cell cycle arrest in the G1 and S phases. This observation is consistent with the results of single fraction A3 and doxorubicin treatments, which resulted in cell cycle arrests in the G1 and S phases, respectively. The result of single fraction A3 treatment, combined with doxorubicin for 24 hours, can also induce apoptosis against T47D cells. When the control and treatment groups were compared, the test cell shape altered.
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Although empirical data on the influence of Ayurveda on Chemo/Radiotherapy-induced side effects are limited, its methodological framework, grounded in a ’systems thinking’ perspective, enables the precise delineation of the pathogenic stage of these side effects. This, in turn, facilitates the development of a strategy to address the decline in the quality of life parameters commonly associated with cancer treatment. Ayurveda personalized approach to disease management typically involves providing customized diets, lifestyle adjustments, medica- tions, and detoxification therapies that target the entire body. We present a case involving a patient with numbness and pain in the right hand after undergoing chemo- therapy who was referred to us by an oncologist for symptom management. This case report demonstrates the Ayurveda approach for establishing the etiology, pathogenesis, pathophysiology, and treatment of Chemotherapy-Induced Peripheral Neuropathy (CIPN) resulting from taxane-based chemotherapy. Following Ayurveda intervention, the patient exhibited significant improvements in symptoms and quality of life parameters. This case report systematically illustrates the application of Ayurveda approach in CIPN management.
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Abstract Primary anal cancer accounts for 1% to 3% of gastrointestinal cancers. The most common histology is squamous cell carcinoma, with an incidence of 0.5 to 2 per 100,000 people. The main risk factor is infection with the human papillomavirus, particularly subtypes 16 and 18, which represent 85% to 93% of cases. Treatment and prognosis depend on the stage of the tumor. Localized tumors can be treated with curative surgery, but locally advanced stages require a combination of chemotherapy and radiation. Advanced-stage tumors (IIIC and IV) have a poor prognosis even with chemotherapy. In recent years, immunotherapy and targeted therapies have shown promise in improving survival for patients with advanced, recurrent, or difficult-to-treat disease. We present the case of a 69-year-old woman with moderately differentiated squamous cell carcinoma (T2N1M0, stage IIIA) of the anal canal who, after treatment with chemoradiotherapy and checkpoint inhibitors and subsequent disease progression, received targeted therapy (cetuximab) and achieved complete remission with a sustained response for over 18 months. This case highlights the challenges of treating advanced anal cancer and the potential benefits of targeted therapy, particularly cetuximab, in achieving long-term responses. Further research and large-scale studies are needed to determine the role of targeted therapy and immunotherapy in the treatment of anal canal cancer.
Resumen El cáncer anal primario representa del 1% al 3% de los cánceres gastrointestinales. La histología más común es el carcinoma escamocelular, con una incidencia de 0,5 a 2 por cada 100.000 personas. El principal factor de riesgo es la infección por el virus del papiloma humano, especialmente los subtipos 16 y 18, que representan del 85% al 93% de los casos. El tratamiento y el pronóstico dependen del estadio del tumor. Los tumores localizados se pueden tratar con cirugía curativa, pero las etapas localmente avanzadas requieren una combinación de quimioterapia y radiación. Los tumores en estadio avanzado (IIIC y IV) tienen un mal pronóstico incluso con quimioterapia. En los últimos años, la inmunoterapia y las terapias dirigidas son prometedoras para mejorar la supervivencia de los pacientes con enfermedad avanzada, recurrente o difícil de tratar. Se presenta el caso de una mujer de 69 años con carcinoma escamocelular moderadamente diferenciado (T2N1M0, estadio IIIA) del canal anal que, después del tratamiento con quimiorradioterapia e inhibidores de punto de chequeo y luego de la progresión de la enfermedad, recibió tratamiento con terapia blanco (cetuximab) y logró la remisión completa de la enfermedad y una respuesta mantenida por más de 18 meses. Este caso destaca los desafíos del tratamiento del cáncer anal avanzado y los beneficios potenciales de la terapia dirigida, especialmente cetuximab, para lograr respuestas a largo plazo. Se necesitan más investigaciones y estudios a gran escala para determinar el papel de la terapia blanco y la inmunoterapia en el tratamiento del cáncer del canal anal.
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Objective: The current study aimed to investigate the dynamic changes in brain glymphatic function during chemotherapy in breast cancer patients (BCP) and their correlation with cognitive function. Materials and Methods: A total of 40 healthy female participants (control group) and 80 female BCP were included. Various cognitive assessment tools were used to evaluate cognitive function. Diffusion tensor imaging along the perivascular space was employed to measure brain glymphatic function. Results: Following chemotherapy, BCP exhibited a significant decline in various cognitive scores. After chemotherapy, the along the perivascular space index, a parameter indicating brain glymphatic function, was slightly higher than that at baseline and the control group levels and was correlated with cognitive scores. Conclusion: This study unveiled a close relationship between the dynamic changes in brain glymphatic function after chemotherapy and cognitive function in BCP. Our findings contribute to a deeper understanding of the brain mechanisms underlying chemotherapy?related cognitive impairment and provide a theoretical basis for future interventions and treatments. In addition, they offer a new perspective for exploring the relationship between brain function and cognitive states. KEY WORDS: Brain glymphatic function, breast cancer, chemotherapy?related cognitive impairment (CRCI), diffusion tensor imaging along the perivascular space (DTI?ALPS)
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The treatment of retinoblastoma, the most common malignant eye tumour in children, has considerably evolved with the combination of chemotherapy and adjuvant treatments. This study conducted a systematic literature review to analyse the effectiveness of chemotherapy associated with different adjuvant therapies, such as thermotherapy, cryotherapy, and immunotherapy, in controlling retinoblastoma. Through a comprehensive search strategy in electronic databases, relevant studies published to date were identified and selected. The inclusion criteria were rigorously applied to ensure the relevance of the selected articles. The qualitative and quantitative analysis of the extracted data revealed patterns and trends regarding the effectiveness of these therapeutic combinations. The results indicated that integrating chemotherapy with adjuvant treatments significantly improved clinical outcomes, promoting better vision preservation and reducing recurrence rates. However, variability in treatment response and the need for an individualised approach were highlighted as fundamental factors for therapeutic success. This systematic review reinforced the importance of a multimodal approach and continuous research to improve therapeutic strategies in the treatment of retinoblastoma, pointing to the need for future investigations that can consolidate and innovate clinical practices in this field.
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Introduction: Saliva is a convenient and non-invasive source for exploring biomarkers in postoperative oral squamous cell carcinoma (OSCC) patients. Salivary proteomics is a promising technique for discovering potential disease progression and treatment response biomarkers, especially within extracellular vesicles (EVs). However, the impact of salivary flow and consistency on postoperative OSCC monitoring is not fully understood. This study aims to fill this gap by examining the effect of chemotherapy and radiotherapy on salivary parameters, which can significantly impact the well-being and survival of OSCC patients. Materials and Methods: This study analyzed the medical records of 155 postoperative oral squamous cell carcinoma (OSCC) patients over one year. The data collected included demographics, treatment modalities, and salivary parameters. To investigate the correlations between these factors, statistical analyses were carried out. The study received institutional approval and adhered to ethical guidelines. Results: The study cohort had a larger sample size (n=150) with diverse demographic and clinical variables. While correlations between salivary parameters and demographic or clinical variables were observed, the lack of statistical significance in some associations raised questions about the strength of the relationships. Additional analyses were conducted to explore potential confounding variables and improve methodological clarity. The salivary flow rate and viscosity showed variation within the group. However, salivary characteristics, comorbidities, age, site, or treatment did not show significant interactions (p > 0.05). Salivary flow and consistency were satisfactory for predictive and survival analysis after the surgery. Conclusion: This research provides essential information on monitoring oral squamous cell carcinoma (OSCC) after surgery, emphasizing the necessity of detailed assessments beyond initial improvements in salivary indicators. Additional investigation is needed to comprehensively understand the complex relationship between salivary biomarkers, treatment outcomes, and patient well-being in OSCC survivors
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Background: Cancer is a set of diseases that include the unchecked proliferation and spread of abnormal body cell types. The primary treatment modalities are surgery, radiation, chemotherapy, immunotherapy, and hormones. As it describes the scope, nature, and causes of drug exposures, drug use research is a key and vital component of pharmacoepidemiology. Aim and Objectives: To conduct a study in a tertiary care teaching hospital to examine drug usage patterns among indoor radiotherapy patients. Materials and Methods: A prospective, cross-sectional, observational study was conducted in indoor patients of the radiotherapy department of a tertiary care teaching hospital. Six hundred patients of different types of cancers were involved in the study. At the end of data collection, the data were entered and analyzed with Microsoft Excel 2019. Descriptive statistics were used to analyze the results. Results: Buccal mucosa, tongue, and breast cancers had the highest admission rate with 24.17%, 13.33%, and 12.83%, respectively. The average number of drugs per encounter was 13.58 with a range of 5–17. The most frequently used anticancer drugs were cisplatin, carboplatin, paclitaxel, 5-fluorouracil, cyclophosphamide, and Adriamycin. Out of 32 drugs, 30 drugs were prescribed from the World Health Organization Model List of Essential Medicines, 2021, and National List of Essential Medicines, 2022, and 8 drugs were prescribed by brand name. Conclusion: Compared to other systems such as the pulmonary, breast, genitourinary, and gastrointestinal tract, oral malignancies were more common. The most frequently used anticancer drugs were cisplatin, carboplatin, paclitaxel, 5-fluorouracil, cyclophosphamide, and Adriamycin. Prescribing drugs were mainly from Essential Drug List with generic names.
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Introduction: Telehealth is increasingly being used for symptom management among cancer patients on chemotherapy. Objective of the study is to develop Nurse-led Tele-health Oncology Clinic for GI cancer patients regarding ‘Home Management during Chemotherapy’. Methods: The study will follow sequential explanatory mixed method design where during quantitative phase, using RCT (CTRI/2024/01/062028), GI cancer patients of age 18-65 years and undergoing 2nd or 3rd chemotherapy cycle will be randomised after obtaining consent to experimental (EG) & control (CG) groups. Ethical Clearance is already obtained. EG will be followed through Nurse-led Clinic which includes multiple virtual educational & counselling sessions, e-booklet on side effects management, PMRT, Support groups & telephonic follow ups. Effectiveness will be measured in terms of Quality of life, severity of side effects and Anxiety using FACT-G, CTCAE and DASS respectively. In qualitative phase, using extreme case sampling, in-depth interviews from consented participants will be conducted to explore experiences towards intervention. Analysis: Analysis of quantitative data will use descriptive and inferential statistics. This follows thematic analysis and integration of data. Conclusion: The study protocol will provide guidance to optimize utility of tele-medicine technology to improve healthcare outcomes especially for the GI cancer patients.
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Background: Sleep deprivation and cognitive impairment represent significant issues among cancer patients undergoing chemotherapy, significantly impacting their daily activities and treatment journeys. The side effects of chemotherapy frequently contribute to disturbances in sleep and cognitive functions in these individuals. Recognizing the scope of these difficulties is essential for developing tailored interventions that cater to the specific requirements of cancer patients, ultimately improving their quality of life and treatment results. Materials and Methods: The research took place at a tertiary cancer care hospital, where 83 eligible chemotherapy patients were enlisted and assessed for sleep quality using the PSQI questionnaire and cognition using MoCA. Each questionnaire was administered only once. A PSQI total score of ?5 indicated good sleep quality, while a score exceeding 5 indicated poor sleep quality. Similarly, a MoCA score below 26 suggested impaired cognition. Results: Among the entire sample, sleep deprivation was observed in 80.7% of chemotherapy patients, while cognitive impairment was identified in 44.6% of chemotherapy patients. Conclusion: The study deduces that sleep deprivation and cognitive impairment are exceedingly prevalent among cancer patients undergoing chemotherapy.
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Background: Sleep quality in cancer patients often does not receive sufficient attention from their treating physicians and nurses. This report aims to highlight this under-researched issue among colorectal cancer patients scheduled to receive adjuvant chemotherapy. Materials and Methods: This is a secondary analysis of data from 129 participants from a randomized controlled trial conducted to determine the nurse-led intervention’s effect on cognitive and non-cognitive functions and serum TNF-alpha levels in patients receiving chemotherapy for colorectal cancer at Tata Memorial Hospital. The Pittsburgh Sleep Quality Index was used to collect data on sleep quality. The study also explored potential reasons for the reported poor sleep quality in the selected cohort. Results: The prevalence of poor sleep quality was approximately 60%. Sleep was primarily affected due to poor sleep latency and sleep efficiency. Also, women were more likely to experience issues related to sleep. Patients did not consider it a significant issue to report to their treating physicians and nurses. Factors contributing to poor sleep quality included financial concerns, child-rearing responsibilities, and anxiety about disease outcomes. Conclusion: Cancer patients do experience poor sleep quality, and it is crucial to assess and address this issue promptly to prevent adverse responses to cancer therapy, which can lead to increased morbidity and mortality.
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Background: Chemotherapy, a cornerstone treatment for childhood cancers, can negatively impact oral health. This study aimed to evaluate the prevalence and evolution of oral complications in these patients. Materials and Methods: A prospective observational study enrolled 44 children diagnosed with malignancy undergoing chemotherapy at a tertiary care institute in central India. Oral examinations were performed at baseline, with follow-ups at 3–6 and 9–12 months. Data collected included demographics, medical history, oral hygiene practices, and oral lesions. Blood counts and World Health Organization grading for mucositis were used. Descriptive statistics and appropriate statistical tests analyzed the data (P ? 0.05). Results: Acute lymphoblastic leukemia (ALL) was the most prevalent malignancy. Children reported various oral complaints such as ulcers, bleeding gums, and difficulty eating. Mucositis prevalence significantly decreased over follow-up visits (baseline: 56.8% and second follow-up: 13.3%). Gingival inflammation was present, though mean scores decreased over time. Oral hygiene scores varied without significant changes. Caries experience scores increased from baseline to follow-up. Conclusion: This study identified a high prevalence of ALL and diverse oral complications in children undergoing chemotherapy. While mucositis severity lessened over time, other issues such as caries persisted. These findings highlight the critical need for preventive oral care strategies to safeguard this vulnerable population’s oral health.
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Vascular leiomyosarcomas are extremely rare tumours, accounting for less than 1% of all malignant tumours. Venous leiomyosarcomas occur five times more frequently than arterial leiomyosarcomas. These are most often found in the large vessels and less than 50% occur in the peripheral circulation. Median survival has not been quantified. It can be good if radical surgery is performed. Treatment, whatever the stage, requires multidisciplinary management. Surgery with en bloc resection remains the treatment of choice for localised disease; in patients with unresectable locally advanced or metastatic disease, systemic treatment with essentially palliative aims may be proposed. Anthracycline-based treatment is the standard first-line therapy. We report a case report of a 50-year-old female patient with local, pulmonary and bone relapse of an operated left femoral artery leiomyosarcoma in whom we undertook palliative mono-chemotherapy. Conclusion: Vascular leiomyosarcomas are extremely rare tumours, accounting for less than 1% of all malignant tumours. Median survival is dramatic for metastatic patients, with a median survival of 8 months, ranging from 5 to 20 months. Surgery remains the standard curative treatment for the localised stage; for stage 4, single chemotherapy is the treatment of choice.
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Chemotherapy-induced nausea and vomiting (CINV) affects over 50% of pediatric patients undergoing chemo- therapy, a higher proportion than in adults. CINV often occurs despite adequate antiemetic prophylaxis, hampering patients’ willingness to continue the chemotherapy regimen. As an ayurvedic medicine, ginger (Zingiber officinale) has an antiemetic effect by inhibiting serotonin in gastrointestinal nerves and as an NK1 antagonist. Therefore, we aimed to review oral ginger supplementation in children with CINV systematically. Systematic searching was performed in June 2023 from Pubmed, Embase, CINAHL, Cochrane, and hand searching. The search consisted of PICO “children chemotherapy”, “ginger”, and “CINV incidence”. We limited the search to only human studies. Studies that meet inclusion and exclusion criteria were included for analysis. Out of 116 studies found with our selection criteria, four were compatible with inclusion and exclusion criteria. Two studies had a small Risk of Bias (RoB), while the others had a high RoB. All studies statistically significantly reduced acute and delayed CINV with the number needed to treat (NNT) 2–4. No adverse effects were reported. However, these studies still had high heterogeneity based on cancer treatment, chemotherapy regimen, ginger dosing, and ginger processing. Ginger has the potential to reduce both the acute and delayed phases of CINV in children. Additional research employing standardized methodologies is recommended to validate this effect.
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This case report documents a woman in her sixties who initially presented with cardiac symptoms such as heart palpitations, shortness of breath, and fluctuating blood pressure. Following her hospital admission, she received a diagnosis of paroxysmal atrial fibrillation and underwent successful electrical cardioversion. Despite this intervention, her symptoms persisted, necessitating radiofrequency ablation of the Cavo-tricuspid isthmus, which proved to be highly effective. Subsequent diagnostic testing revealed the presence of coronary artery disease, atherosclerotic cardiosclerosis, and mitral valve abnormalities, all of which were managed appropriately. Upon discharge, the patient was prescribed a medication regimen comprising anticoagulants, hypotensive therapy, and statins, which she tolerated well. However, her symptoms deteriorated, leading to a referral to a specialized center where she was promptly diagnosed with cardiac amyloidosis (CA) and received appropriate treatment. Adjustments to her treatment plan were made based on this diagnosis, and a cardiac MRI confirmed the presence of amyloidosis. A biopsy of the buccal mucosa further confirmed the presence of AL-amyloidosis based on immunohistochemistry test results. The patient commenced chemotherapy, which unfortunately led to kidney damage but ultimately resulted in significant improvement in her condition. Recurrent atrial fibrillation episodes necessitated further interventions, which were performed swiftly and effectively. Multi-organ assessments revealed numerous abnormalities, guiding tailored management strategies. A multidisciplinary team comprising cardiology, hematology, and general practice specialists coordinated the patient's care, focusing on pharmacotherapy and lifestyle modifications, which were found to be highly effective. Emphasis was placed on continuous monitoring and adherence to treatment plans for long-term management, resulting in positive outcomes.
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Dysgerminoma is a malignant germ cell tumour (GCT) accounting for less than 1% of ovarian neoplasm. It is analogous to seminoma in males. It is a tumour of young age, affecting women of reproductive age group. In most of the cases, due to its clinical features of it is often, misdiagnosed as abdominal tuberculosis. It is one of the rare tumours, which have excellent response to chemotherapy and radiotherapy. It is tumour in whom, surgery followed by radiotherapy and chemotherapy gives excellent prognosis even in advanced stage. This is a rare case report of 16-year-old girl with primary amenorrhoea, abdominal mass and pleural effusion, when undergone staging laparotomy � had ovarian tumour with torsion which histopathologically came out to be, dysgerminoma.