Objective: Prevalence is a statistic of primary interest in public health. In the absence of good follow-up facilities, it is often difficult to assess the complete prevalence of cancer for a given registry area. An attempt is made to arrive at the complete prevalence including limited duration prevalence with respect of selected sites of cancer for India by fitting appropriate models to 1, 3 and 5 year cancer survival data available for selected registries of India. Methodology: Cancer survival data, available for the registries of Bhopal, Chennai, Karunagappally, and Mumbai was pooled to generate survival for the selected cancer sites. With the available data on survival for 1, 3 and 5 years, a model was fitted and the survival curve was extended beyond 5 years (up to 30 years) for each of the selected sites. This helped in generation of survival proportions by single year and thereby survival of cancer cases. With the help of estimated survived cases available year wise and the incidence, the prevalence figures were arrived for selected cancer sites and for selected periods. In our previous paper, we have dealt with the cancer sites of breast, cervix, ovary, lung, stomach and mouth (Takiar and Jayant, 2013). Results: The prevalence to incidence ratio (PI ratio) was calculated for 30 years duration for all the selected cancer sites using the model approach showing that from the knowledge of incidence and P/I ratio, the prevalence can be calculated. The validity of the approach was shown in our previous paper (Takiar and Jayant, 2013). The P/I ratios for the cancer sites of lip, tongue, oral cavity, hypopharynx, oesophagus, larynx, nhl, colon, prostate, lymphoid leukemia, myeloid leukemia were observed to be 10.26, 4.15, 5.89, 2.81, 1.87, 5.43, 5.48, 5.24, 4.61, 3.42 and 2.65, respectively. Conclusion: Cancer prevalence can be readily estimated with use of survival and incidence data.
Purpose: This study aims to determine the incidence, histology, clinical extent of disease, and trends of gastrointestinal (GI) cancers in India. Methods: GI cancer cases diagnosed between 2012-2016 from 28 Population-Based Cancer Registries and 58 Hospital Based Cancer Registries under the National Cancer Registry Programme were included. Crude incidence rate and age-standardized incidence rates (AARs) were calculated. Joinpoint regression program, 4.0.1 was used for trend analysis for data from 1982 to 2016, and a P-value of <<0.05 was considered statistically significant. Results: GI cancers' occurrence was more common among men (60.5%) than in women (39.5%). The incidence of GI cancer was highest in India's northeast region, Aizawl district (AAR 126.9) among males, and in Papumpare district (AAR 75.9) among females. The commonest cancer among men was cancer of the esophagus (28.2%), followed by stomach cancer (21%) and rectum cancer (14.3%). Among women, cancer of the esophagus (25.7%), gallbladder (23.8%), stomach (14.8%), and rectum (14.6%) were common. Adenocarcinoma (57.83%) was the commonest type of GI tumors, followed by Squamous Cell neoplasms (25.99%). Majority of the GI cancers presented at the locoregional stage, but cancer of the gall bladder and pancreas presented at advanced stages. A rising trend for cancers of the colon, rectum, liver, gall bladder, pancreas was seen, while a declining trend was observed for stomach and oesophageal cancer. Conclusion: Our study highlights an increasing magnitude of GI cancers across different regions of India. Cancer registries form an essential tool for surveillance of GI cancers thus guiding prevention, early detection, and control programs.
INTRODUCTION: Pulmonary alveolar microlithiasis (PAM) is a rare chronic lung disease characterized by deposition of calcium phosphate microliths in the alveoli. CASE PRESENTATION: A 44 year old gentleman presented for right sided flank pain for 6 days. His past medical history included asthma and infertility. His vitals were stable. Physical exam was significant for mild tenderness in the right lower quadrant. CT of the abdomen showed multiple renal stones bilaterally and a 7 mm stone in the lower one third of right ureter. On day 2, he developed dyspnea. Physical exam revealed diffuse bilateral wheezing and coarse crackles. Chest X-ray showed bilateral diffuse micro-nodular opacities. CT of the chest showed bilateral diffuse calcified micronodules, interlobular septal thickening and pleural calcification. Biopsy of the lung showed concentrically arranged laminated calcified bodies and PAS-positive psammoma bodies-like microliths consistent with PAM. Considering his infertility and the diagnosis of PAM, an ultrasound of the scrotum was done, which revealed multiple calcified microliths in both the testes and epididymis.
Anastomotic biliary strictures after LDLT are a source of significant morbidity. Endoscopic stenting is preferred first-line therapy due to its less invasive nature and the surgical challenges of dealing with high biliary strictures. However, where strictures are complex and have debris and biliary casts within the intrahepatic biliary radicals and cannot be effectively cleared by endoscopic therapy alone leading to recurrent low-grade cholangitis, an open approach may be preferable. We report a pediatric LDLT recipient who underwent Roux-en-Y hepaticojejunostomy for an early duct-to-duct anastomotic stricture. Three months after the after the conversion of duct-to-duct to the Rouxen-Y hepaticojejunostomy, she expelled a large residual biliary cast.
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