Glioblastoma remains the most common primary brain tumor after the age of 40years. Maximal safe surgery followed by adjuvant chemoradiotherapy has remained the standard treatment for glioblastoma (GBM). But recurrence is an inevitable event in the natural history of GBM with most patients experiencing it after 6-9months of primary treatment. Recurrent GBM poses great challenge to manage with no well-defined management protocols. The challenge starts from differentiating radiation necrosis from true local progression. A fine balance needs to be maintained on improving survival and assuring a better quality of life. Treatment options are limited and ranges from re-excision, re-irradiation, systemic chemotherapy or a combination of these. Re-excision and re-irradiation must be attempted in selected patients and has been shown to improve survival outcomes. To facilitate the management of GBM recurrences, a treatment algorithm is proposed.
government policy have been endorsed in vitamin A deficiency causation 5-9 and the vitamin A deficiency prevalence is diagnosed using clinical or biochemical parameters. 1 This condition can cause xeropthalmia, anemia and liable to lead infection and risk of growth retardation and death in severe condition. 1,10,11
Background: Water quality impacts the performance of the hospitals and leads to drastic health service deterioration affecting infection control programs, along with safety of the patients and staff. Good quality water is an essential prerequisite to ensure optimal patient care, and the well-being of the staff and visitors in a hospital environment. Objectives was to study the current water supply and treatment system in the cancer hospital. Also, to carryout root cause analysis of the causes of episodes of diarrhoea amongst patients and staff and to identify the source of infection and suggest improvement in the existing system to prevent recurrence.Methods: There were 25 reported cases of diarrhoea and other gastrointestinal symptoms between May 12 and June 2 2017, allegedly due to water contamination occurring in admitted patients and staff of a tertiary care cancer hospital in north India. This was reported to Hospital Administration, which prompted an epidemiological investigation.Results: Formation of Biofilms on the plastic taps was found to be the main reason for contamination of water.Conclusions: It was very clear that deposition of biofilm within the plastic taps was the main reason of diarrhea among the patients.
Objective: To determine the efficacy of functional endoscopic sinus surgery on treating nasal polyps in terms of improvement in the Lund-MacKay score.
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of ENT, Combined Military Hospital, Rawalpindi Pakistan, Jul 2021 to Jan 2022.
Methodology: Seventy patients suffering from chronic rhino-sinusitis were included in this study. All patients were assessed before and three weeks after treatment using the Lund-MacKay computed tomography score. Group-A patients received management with a hybrid therapy using functional endoscopic sinus surgery and drug therapy, while Group-B patients received conservative management alone.
Results: The majority of the patients in our sample were males 43(61.4%), a mean duration of complaints of 6.47±1.91 months.Hybrid therapy showed a significantly higher improvement in relieving nasal obstruction when compared to conservative management alone (p=0.033). Conservative management appeared to be more effective in relieving nasal discharge and headache, although this did not approach statistical significance (p=0.11 and 0.43, respectively). Facial pain and olfactory function showed a greater improvement with hybrid therapy, which was not statistically significant (p=0.097 and 0.131, respectively).The Lund-MacKay computed tomography scores with conservative and hybrid therapy were 13.91±4.11 and 11.17±4.17 at the end of treatment (p=0.007), demonstrating that hybrid therapy was superior.
Conclusion: Functional Endoscopic Sinus Surgery combined with limited medical therapy is superior to pure medical therapy in terms of improvement in Lund-MacKay CT scores and relief in symptoms of nasal obstruction.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.