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CT Contrast in Radiation Oncology Simulation
Get PDFObjectives: With IMRT and advanced radiation planning, anatomy and contouring is becoming increasingly important in the field of radiation oncology. The use of iodinated computed tomography (CT) contrast for radiation simulation CT scans can help define anatomy more precisely and thus improve contouring. The major risks of CT contrast (which at least partly accounts for the aversion by some departments to its routine use) are contrast induced nephropathy and allergic-like reactions.Results: The evidence of complications attributable to standard doses of contrast for diagnostic CT examinations is weak. The preponderance of data on contrast induced nephropathy has been compiled from interventional cardiology procedures, and the current guidelines regarding diagnostic CT contrast require extrapolation on mostly retrospective data. The evidence available suggests that CT contrast related adverse events are rare, and contrast related nephropathy most often spontaneously resolves without further decline in baseline renal function.Conclusion: The current data regarding safety of CT contrast provides a limited foundation on which to make evidence-based recommendations. We have reviewed the literature on CT contrast. By following some simple algorithms CT contrast can be safely utilized
Morbidity Patterns in Oncology Patients at FMRI, Gurgaon:A Hospital Based Study at a New Tertiary Care Institute
Get PDFObjective: This study aims to analyze the patterns of morbidity amongst cancer patients attending a tertiary care hospital.Materials and Methods: Data were collected from various departments dealing in cancer care. Patient’s data were categorized according to diagnosis and place of residence.Results: A total of 1490 new cancer patients were registered. Out of these 1140 were Indians from 22 different states {males= 609 (53.4%) and females= 531 (46.6%)} and remaining 350 patients were from 27 different countries {males= 223 (63.7%) and females=127 (36.3%)}. The five most common cancer site groups amongst all males (n=832) were digestive organs (18.6%) followed by lymphoid, hematopoietic and related tissue (16.8%); respiratory intrathoracic organs (14.1%); then eye, brain and other parts of central nervous system (11.4%) and lip, oral cavity and pharynx (9.5%) and in all females (n=658) the most common cancer site were breast (31.5%) followed by genital organs (17.3%); digestive organs (11.2%); lymphoid, hematopoietic and related tissue (9.3%) and eye, brain and other parts of nervous system (9.0%).Conclusions: The present study highlights the pattern of cancer among patients in a corporate tertiary health care institute. There is therefore an inherent bias, the leading sites of malignancies amongst Indian males and females varied from that in the Western population; this could be attributed to various cultural, environmental factors, life style, genetic factors etc. in different regions of India and different nations of the world.
Methacronous Intercostal and Peritoneal Metastases from Resected Well-differentiated Hepatocellular Carcinoma: Description of a Case and Review of Literature
Get PDFIntroduction: The aim of this report is to prove the possibility of simultaneous difficult cardiac and urologic operation. Important point to make in our report concerns the fact that the oncologic treatment was not delayed despite severe heart disease. There is also an advantage in avoiding second operation and hence anesthesiaCase Presentation: A 72 year old male presented to us with right renal mass lesion with tumour thrombus extending up to right atrium. He had undergone Percutaneous Transluminal Coronary Angioplasty 5 years ago and had two coronary stents in situ. Coronary angiography revealed triple vessel coronary re obstruction. After proper planning he underwent right radical nephrectomy with tumour thombectomy along with Coronary Artery Bypass Grafting in the same sitting.Conclusion: One-stage cardiac and uro-oncologic operation can be a safe and beneficial procedure, if performed in selected patients
Metastatic Eccrine Porocarcinoma Respond to Combination Chemotherapy Docetaxel, Cisplatin and Infusion 5 FU with Long Disease Control
Get PDFIntroduction: Eccrine porocarcinoma (EPC) is a rare tumor. It develops from the intraepidermal ductal portion of the eccrine sweat gland. Many chemotherapeutic agents were reported to have efficacy in treatment of metastatic EPC; two of very effective agents were docetaxel and 5FU.Case Presentation: We are reporting a case of 60 years old female who was diagnosed as metastatic eccrine porocarcinoma to mediastinum which was treated by systemic chemotherapy in the form of DCF: docetaxel 75 mg/m2 D1, cisplatin 75 mg/m2 D1 and continues infusion 5FU 750 mg/m2 from D1 to D4, and this regimen was repeated every 28 days for 6 cycles.Conclusion: DCF regimen can be one of the best options for stage IV EPC with long overall survival and best response rate
Hypofibrinogenemia Presenting as Intracranial Hemorrhage
Get PDFIntroduction: Factor I deficiency or fibrinogen deficiency, is a rare inherited bleeding disorder related to fibrinogen function in the blood coagulation cascade. They are classified into afibrinogenemia, hypofibrinogenemia and dysfibrinogenemia. Afibrinogenemia is defined as a lack of fibrinogen in the blood, i.e. 20 mg/dl of plasma with a frequency between 0.5 and 2 per million. Hypofibrinogenemia is partial deficiency of fibrinogen with levels of 20–80 mg/dl of plasma. Estimated frequency varies from 0.5 to 3 per million. Case Report: We report regarding a 46 year old female patient, who presented with complaints of severe headache and right sided weakness. Examination revealed right Hemiplegia with BP of 144/90 mm Hg. Investigations revealed Creatine Kinase: 470IU/L, normal Blood counts, ESR and CRP. Thyroid profile was normal. Fibrinogen levels were 17.9mg/dl and repeat test after 1 week showed 24.6mg/dl. ECG showed incomplete left bundle branch block. Echocardiography was normal. Conclusion: Hypofibrinogenemia rarely manifests as intracranial hemorrhage but, commonly presents with oral, mucosal and gastro intestinal tract bleeding. Patients admitted with stroke should be evaluated for fibrinogen deficiency and more emphasis to be laid in case of intracranial hemorrhage and previous history of bleeding
Limb Girdle Muscular Dystrophy with Cardiac Conduction Block
Get PDFIntroduction: Limb-girdle muscular dystrophy refers to disorders that cause wasting and weakness of the muscles around the shoulders and hips with autosomal pattern of inheritance. Most common features are muscle weakness and atrophy, myoglobinuria, myotonia, elevated serum kinase, and cardiomyopathy in about 20% cases.Case Report: We report a sporadic case in an 18 year old male patient, who presented with complaints of difficulty in walking on toes, squatting, climbing stairs and breathlessness on exertion since 6 months. Examination revealed weakness of shoulder girdle and hip muscles bilaterally with achilles tendon contractures. Investigations revealed creatine kinase of 1870IU/L, normal blood counts, ESR and CRP. Thyroid profile was normal. MRI spine was normal. Nerve conduction study was normal. Electromyography showed short duration, low-amplitude motor unit potentials, increased proportion of polyphasic potentials, and early recruitment with a full interference pattern. ECG showed incomplete left bundle branch block. Echocardiography showed generalized hypokinesia with ejection fraction of 40%. Quadriceps muscle biopsy confirmed muscular dystrophy.Conclusion: Cardiac conduction abnormalities are rarely reported in cases of limb girdle muscular dystrophy. Automated LGMD Diagnostic Assistant (ALDA) suggests patient has medium probability and concordance of LGMD subtypes LGMD2G (36.90) and LGMD2I (23.92). Genetic study confirmed LGMD2G
The Effect of Heat Treatment on Nanoparticle Size and ORRActivity for Carbon-supported Pd–Fe Alloy Electrocatalysts
Get PDFThe synthesized carbon-supported Pd-Fealloy electrocatalysts were characterized for the purpose of the fuel cell cathode oxygen reduction reaction (ORR). The synthesized catalysts were characterized in terms of structural morphology and catalytic activity by XRD and electrochemical measurements. Surface cyclic voltammetry was used to confirm the formation of the Pd–Fe alloy. The catalysts were heat-treated at temperatures ranging from 300 ◦C to 700 ◦C for different ageing times, in order to improve activity and stability. The average particle size of 10.16 nm, and the highest ORR catalytic activity were obtained at the optimal heat-treatment temperature 300 ◦C for 3h. Electrocatalytic ORR activity was also examined in an acidic solution containing methanol. The results showed that the synthesized Pd–Fe/C catalyst has methanol tolerant capabilities
Investigation on the Bio-degradability of the Starch Modified Polypropylene with the Help of Maleic Anhydride as a Coupling Agent
Get PDFPolypropylene was modified with starch in 1/20 ratio by adding a coupling agent in the absence and presence of a compatiblizer so as to produce a modified polypropylene with the advantage of bio-degradability in lesser time as compare to normal time span of degradation. As polypropylene a hydrophobic material and starch a hydrophilic material, so maleic anhydride was used as a coupling agent and PVA used as a compatiblizer to produce proper formation of bond. For the proper inter-mixing of the polymers they were swollen by aromatic compound such as toluene at elevated temperature. The material produced was tested in IR spectroscopy, universal testing machine, water absorption test, soil burial test and scanning electron microscopy for the checking of proper inter-mixing, change in mechanical properties and to check the bio-degradability respectively
Metachronous Bilateral Adenoid Cystic Carcinoma of the Lacrimal Gland
Get PDFBackground: To report an aggressive and treatment-resistant adenoid cystic carcinoma (ACC) of the lacrimal gland (LG).Case report: A 29-year-old woman with diagnosis of LG-ACC had operations 7 times, radiotherapy 3 times and systemic chemotherapy 2 times. Although she generally responded therapies, the duration of remissions was short lived and the tumor progressed locally and did hematogen metastases.Conclusion: LG-ACC presents a therapeutic challenge despite its slow growth rate and lower likelihood of lymph-node metastasis. Postoperative radiotherapy with wide margins should be utilized —even after a complete resection— because of persistent recurrences, perineural invasion and hematogenous spread.
Skin Mass as a Presenting Feature of Renal Cell Carcinoma: Need for High Index of Suspicion
Get PDFIntroduction: Renal cell carcinoma is the most common form of malignant renal tumor. Clinical presentation of Sarcomatoid Renal Cell Carcinoma (sRCC) varies widely and is dependent on the stage at which the diagnosis has been reached. At the time of diagnosis, about one-third of patients develop metastasis affecting the lung, lymphatic, liver, bone, contralateral kidney, adrenal glands, and brain. Case Report: A 46 year old Hispanic female with no significant past medical history presents to the Emergency department with recurrent episodes of dizziness, difficulty breathing, dry mouth, weakness, and productive cough without blood. She initially presents with a rare initial dermatological finding related to her current condition.Conclusion: Sarcomatoid Renal Cell Carcinoma is a rare variant of RCC with stage-dependent outcomes. Initial presentations may not be very obvious in suspicion of sRCC. However, in this particular case, the external findings happened to be the initial presentation, prompting further evaluation of the patient. Delving into the features of sRCC and maintaining all possibilities may allow future workup of the more common variants of RCC to be included in the investigation of sentinel lesions seen in the more rare variants