Treatment options for patients with small upper aerodigestive tracts squamous cell carcinoma (T1, T2) with advanced neck disease (N2, N3) is a topic that generates controversy in terms of thereuptic stratagies. We present the retrospective analysis of 109 patients treated, between 1991 and 2008, by "Neck dissection first approach" for N2, N3 neck node, followed by external beam radiotherapy (RT) with or without chemotherapy for the operated neck and the primary, deemed radiocurable. 94 patients completed the planned treatment and formed the material for this study. The primary (tumor) stage was as follows: T1 (29) and T2 (65) commonly arising from oropharynx; the neck nodes were predominantly N2a (n = 54), followed by N2b (n = 26) and N3 (n = 14) disease. Complete nodal clearence was achieved in 89 patients, with no major post operative complications. With a median follow up of 24 months disease free survival of 70% and overall survival of 61% at 5 years. Recurrence at primary site was noted predominantly with pyriform fossa tumors (n = 8), followed by base of tongue (n = 5) and were T2 lesions. Failure in the neck was seen in predominantly N3 nodes, R1 resection and failure to comply with adjuvant treatment. Neck dissection first approach is a valid treatment option that allows a good control of the disease in the neck, where it often fails if only RT is administered, along with preserving the pharyngolaryngeal function. Care should be excercised so that there should be no delay in initiating the RT following surgery.
Introduction: Respiratory distress is the most common cause of NICU admissions in newborns. Early diagnosis of cause of respiratory distress is important in the management of neonatal distress for better outcome. The high incidence of maternal risk factors and newborn receiving poor antenatal care continues to test the abilities of the neonatologist. Inspite of recent advance in clinching diagnosis and management there are very less clinical studies on the neonatal respiratory distress in our country. Therefore, there is a need to know the etiological factors of the babies with respiratory distress. Materials and methods: A descriptive study of 150 neonates admitted to NICU of Sri Siddhartha Medical College and Hospital with clinical features suggestive of respiratory distress. All the newborn babies who developed respiratory distress within 72 hours of life were included in the study and those who developed respiratory distress after 72 hours of life was excluded from the study. Results: The commonest cause of neonatal respiratory distress in the present study was Respiratory distress syndrome (34%), followed by Transient tachypnoea of the newborn (30%), and Meconium aspiration syndrome (22.66%). LSCS was most common mode of delivery. Conclusion: The most common causes of respiratory distress were RDS, TTNB, MAS, and birth asphyxia. Proper antenatal care and early diagnosis of the antenatal complication and avoiding preterm deliveries will aid in the better outcome of the newborns. Early detection and appropriate management are essential to ensure better outcome in all infants presenting with respiratory distress.
EXPECT questionnaire was validated in the regional language, and it's an effective tool for capturing patient's preferences and expectation from chemotherapy.
Background: Down syndrome (DS) is the most common chromosomal abnormality associated with learning difficulties with reported incidence between1/600 -1/1000 live births. DS (trisomy 21) is the most common chromosomal abnormality seen in clinical practice. Most children with DS have trisomy 21, due to chromosomal non-disjunction during meiosis; however, other abnormalities, such as Robertsonian translocation, mosaic, double or triple aneuploidies have been reported. The association between DS and congenital heart disease (CHD) is well established. Congenital heart disease is the most common cause of death among patients with DS and affected children have an increased risk of mortality.Methods: The present descriptive study was conducted on children who had clinical features suggestive of Down syndrome and who were karyotypically proved as Down syndrome.Results: In 100 cases of down syndrome 60 children were males and 40 children were females. 45 children had congenital heart diseases. The frequency of CHD in down syndrome is 45%. Ventricular septal defect was the most common CHD found 40% children with down syndrome.Conclusions: All children with Down’s syndrome should have a cardiac evaluation at birth. Early referral and screening of all babies born with the clinical phenotype of DS should be encouraged due to the high prevalence of congenital heart defects.
BACKGROUNDUrinary Tract Infections (UTIs) in women are amongst the most common infections in the outpatient population and have a negative impact on the quality of life. The overall prevalence of lower urinary tract symptoms amongst women is 67%. In fact, the prevalence of LUTS in them is reportedly higher than many other chronic diseases. 1,2 Nearly 1 in 3 women will have at least one episode of UTI requiring antimicrobial therapy by the age of 24 years. Almost half of all women will experience one UTI during their lifetime. 3
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