BACKGROUND Cervical and breast cancers are the common malignancies among female population in India. Though there are approved screening methods available to prevent and detect these cancers at an early stage, there is a lack of awareness about cancer screening among general public as well as the health care professionals. This study is aimed to identify the knowledge, attitude and practice (KAP) among the nursing staff regarding cancer screening in these two diseases. METHOD A cross-sectional interview based survey was conducted among 303 female nursing staff working in a government medical college hospital from November 2015 to December 2015. Ethical committee approval was taken. Verbal informed consent was sought from the study subjects. Nursing staff who gave consent to participate in the study were enrolled. There were no specific inclusion or exclusion criteria for the study subjects. A structured pretested questionnaire regarding knowledge, attitude and practice (KAP) was used to collect the data. The questions were open-ended. Recall and recognition type of questions were used. The data was entered into MS Excel worksheet and analysed using descriptive statistics. RESULTS Total of 303 nurses included in the study. The age ranged from 21 to 64 years. Median age is 38 years. Only 24.4% (74/303) of Nurses were aware of cancer screening and many of them were aware of Pap smear (55.1%, 167/303) and mammogram (66.3%, 201/303) as investigational tools in diagnosing cancer. Only 17 out of 303 (5.6%) nurses had Pap smear test done with an average of 1.23% Pap smear per individual. Mammogram screening was done in 13% (15/115) of the eligible nurses with an average of 1.2% mammogram per individual. The most common reason for not undergoing screening as expressed was they did not feel the need to be screened unless they were symptomatic (55%), they are too young for screening (14.8%), shyness (11.1%), fear (11.1%) and lack of time (7.4%). However, 90% of them were willing to undergo screening if conducted by the institute. The limitation of this study is small number of subjects; this may not represent the view of nursing staff in general. Large multi-institutional studies have to be undertaken to assess KAP among the nursing staff regarding cancer screening. CONCLUSION This data suggests that levels of knowledge and practice of cancer screening are very poor among nursing staff working in government medical college hospital. Cancer screening program should also include health care professionals in addition to general population.
INTRODUCTIONRadiotherapy is the standard treatment in locally advanced (IIB-IVA) and early inoperable cases. The current standard of practice with curable intent is concurrent chemoradiation in which intracavitary brachytherapy is an integral component of radiotherapy. This study aims at assessing the efficacy of HDR ICBT (High-dose rate intracavitary brachytherapy) in terms local response, normal tissue reactions, and feasibility. METHODS AND MATERIALSA total of 20 patients of stage IIIB cancer of the uterine cervix were enrolled in the study and were planned to receive concurrent chemotherapy weekly along with EBRT (external beam radiotherapy) to a dose of 50 Gy/25 Fr. Suitability for ICBT was assessed at 40 Gy/20 Fr. 6/20 patients were suitable at 40 Gy and received HDR ICBT with a dose of 5.5 Gy to point A in 4 sessions (5.5 Gy/4 Fr). The remaining 14/20 patients completed 50 Gy and received HDR ICBT with a dose of 6 Gy to point A in 3 sessions (6 Gy/3 Fr). RESULTSA total of 66 intracavitary applications were done and only one application required dose modification due to high bladder dose, the pelvic control rate was 85% (17/20). 10% (2/20) had stable disease and 5% (1/20) had progressive disease at one year of follow up. When toxicity was considered only 15% developed grade I and grade II rectal complications. Patient compliance and acceptability was 100%. Patients were very comfortable with the short treatment time as compared with patients on LDR ICBT (low-dose rate intracavitary brachytherapy) treatment interviewed during the same period. CONCLUSIONThis study proves that HDR brachytherapy is efficacious and feasible in carcinoma of cervix stage IIIB. It also proves that good dose distribution can be achieved with HDR intracavitary facility by the use of dose optimization. The short treatment time in HDR ICBT makes it possible to maintain this optimised dose distribution throughout the treatment providing a gain in the therapeutic ratio and ensuring zero radiation hazards to the medical personnel. KEYWORDSCancer cervix, Brachytherapy, High-dose rate, Low-dose rate.HOW TO CITE THIS ARTICLE: Maruthavanan S, Shanthilal M. High-dose rate brachytherapy in carcinoma cervix stage IIIB.
BACKGROUNDThis study is aimed to evaluate the effect of fluconazole on prevention of oral candidacies and in reduction of severity of oral mucositis induced by radiotherapy. METHODSThe study was conducted on 48 head and neck cancers patients. Cases were randomised into study (22/48) and control groups (26/48). Both groups received radiotherapy with or without chemotherapy. Oral swabs were collected before start of radiation three weeks later and at the end of radiation. Oral swabs were cultured for candidial growth. Study group patients received oral fluconazole 50 mg/day throughout the course of radiation and control group patients received no fluconazole prophylaxis. Patients were examined weekly for oral mucositis and were graded according to CTC version 2.0. RESULTSOral swabs were taken from all patients before start of radiotherapy showed candidial growth in 22.9% (11/48). During the course of radiation treatment, oral candidial culture was positive in 42.3% (11/26) of control group patients and 40.9% (9/22) of study group (p=0.644). There was statistically significant reduction in the severity of mucositis in the study arm (p=0.021). In the study arm, there was grade 0 in 27.2% (6/22), grade 1 in 27.2% (6/22), grade 2 in 31.8% (7/22), grade 3 in 22.7% (5/22), and no grade 4. In the control arm, there was no grade 0 noted, grade 1 was seen in 19.2% (5/26), grade 2 in 61.5% (16/26), grade 3 in 15.3% (4/26), and no grade 4. Patients in whom candidial culture was negative had less severe mucositis as compared to patients with positive candidial culture (p=0.029). CONCLUSIONProphylactic use of oral fluconazole is effective in reducing the severity of oral mucositis by reducing oral candidiasis.
INTRODUCTIONColorectal cancer is the third most common cancer which can be detected early by implementation of cancer screening. This has led to decline in colorectal cancer related morbidity and mortality in elderly patients. However, there is increase in the incidence of this cancer in young individuals. This study was undertaken to study the characteristics of young colorectal cancer patients. METHODS AND MATERIALSThe study was conducted from 2014 to 2016. All colorectal cancer patients attending the Department of Oncology, who were less than or equal to 50 years of age were included. Patients' demographic data as well as data regarding the colorectal cancer was collected. The data was entered into MS Excel worksheet and analysed using descriptive statistics. RESULTSThis study included 28 patients with a median age of 40 years and equal sex distribution. History of smoking in 85.7% (12/14) and alcohol (moderate) consumption in 64% (9/14) was present in male patients. There was no history of alcohol or smoking was present among female patients. However, tobacco chewing habit was present in 28% (4/14) of female patients. History of multiple sexual partners in 14% (4/28) of cases and 78% (22/28) were non-vegetarians. Nearly 85% (24/28) of patients presented with an advanced stage disease. The analysis showed involvement of left side of colon in 50% (14/28), rectum in 39% (11/28) and right side of colon in 11%(3/28). Except for two patients who were in stage -1, all other patients received chemotherapy. CONCLUSIONThe incidence of colorectal cancer in young individuals is constantly rising. The reason for this increase is unclear and the relative contributions of genetic versus environmental factors remain relatively unexplored.
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