Plaque brachytherapy for choroidal melanoma with vitreous haemorrhage: a therapeutic challenge.

A 47-year-old man presented with profound loss of vision in right eye and relative afferent pupillary defect. On fundus examination, posterior pole details were obscured due to dense vitreous haemorrhage. B-scan ultrasonography was performed that revealed a mushroom-shaped hyperechoic lesion with medium internal reflectivity on A-scan ultrasonography. After performing contrast-enhanced MRI of the orbit, a diagnosis of choroidal melanoma was established. Patient was managed using plaque brachytherapy based on multiplanar MRI. This was followed 10 months later by pars plana vitrectomy and cataract extraction. Vision postoperatively improved to 20/60. A systematic clinical assessment along with supportive ancillary investigations augments diagnostic accuracy and reduces delay in definitive management.

Complementary and alternative medicine use among the cancer patients in Northern India.

BACKGROUND: Cancer has emerged as a major public health problem. People often turn to complementary and alternative medicine (CAM) when they have a long-lasting problem. CAM is a group of diverse medical and healthcare systems, practices, and products that are not generally considered part of conventional medicine. The present study was conducted to find prevalence rate of CAM use among cancer patients undergoing allopathic treatment in a health facility and to compare the CAM usage patterns among different subgroups of patients at different stages. Further to investigate some psychosocial, cultural, and demographiccorrelates/predictors of CAM use. MATERIALS AND METHODS: Present hospital-based cross sectional study was conducted among cancer patients attending Radiotherapy Outpatient Department (OPD) of a Government Medical College and Hospital (GMCH). A total of 1,117 cancer patients participated in the study. Statistical methods like normal test of proportions, Chi-square (χ(2)) test, logistic regression analysis for estimation of risk factors of CAM use were applied to carry out the data analyses using Statistical Package for Social Sciences (SPSS)-16 software package. RESULTS: The most common CAM therapy in use was found to be ayurvedic treatment reported by 187 (16.7%) patients. Overall CAM use was found to be 38.7%. Sixty percent of patients who were aware of CAM were not using CAM, only 40% aware were using CAM. Low socioeconomic status contributed maximum to proportions of CAM use; wherein out of all users, 175 (40.5%) patients were using CAM. Maximum degree of relief was found due to homeopathic treatment (78.4%). Reasons of using CAM therapies reported by the users were mainly on the advice of family members or friends (23.1%). CONCLUSIONS: There is an urgent need of conducting further in-depth epidemiological studies to evaluate the efficacy of various CAM therapies in use for cancer. The high utilization of CAM among cancer patients and nondisclosure proportions suggests prioritizing research investigating reasons to use CAM and efficacy and safety of CAM use.