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Journal Issue: Vol. 13, No. 3 - July 2014

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Causation Factors in Relation to Vulvar Cancer for Indigenous Women in East Arnhem Land, Northern Territory: Qualitative Insights from the Community

Prof Pam McGrath

  1. Prof Pam McGrath
    B.Soc.Wk., MA., Ph D
    Senior Research Fellow, Centre for Community Science, Population & Social Health Program, Griffith Health Institute, LO5, Level 1, Logan Campus rnGriffith University, Meadowbrook Qld 4131, Queensland

This paper explores beliefs about the possible causative factors of a vulvar cancer cluster of Indigenous women in East Arnhem Land, Northern Territory, Australia. Little is known about the causes or risk factors associated with vulvar cancer. This is seminal work in the area using qualitative methodologies to document the Indigenous perspective on causation and risk. The participants comprised of a purposive sample of Indigenous women with the condition, health professionals, and Aboriginal health workers. Data were obtained through the qualitative method of in-depth, open-ended interviews. There were a variety of possible causative factors put forward for the cancer cluster discussed under the three main sub-topics of: genetic connection, physical and environmental factors, and issues of culture and cultural breakdown. It is important to note that the collective factors outlined by the participants in the study and affirmed by the available literature, indicate that there is a wealth of high risk factors associated with vulvar cancer that may have contributed to the development of a cluster in East Arnhem Land. Thus, the findings are a serious reminder that there should not be complacency in addressing the many modifiable factors already known to be high risk indicators for the disease.


Acute Myeloid Leukaemia Presenting with Central Diabetes Insipidis

Assoc Prof Rosemary Harrup, My Pham, Dr Gerald McInerney

  1. Assoc Prof Rosemary Harrup
    Royal Hobart Hospital, Locked bag 1061, HOBART TAS 7001, Tasmania
  2. My Pham
    Medical student
    Royal Hobart Hospital, Tasmania
  3. Dr Gerald McInerney
    Royal Hobart Hospital, Tasmania

Acute myeloid leukaemia patients are often very unwell at presentation. Symptoms or biochemistry suggestive of central diabetes insipidis may be associated with either radiographic or karyotypic abnormality and can respond to desmopressin acetate prior to disease specific treatment.


Chromosomal Translocation and Immunophenotype Expression: Prognostic Marker for Acute Lymphoblastic Leukemia

Dr Samrat Paul, Dr Ashis Mukherjee, Dr Sudeshna Gangapadhya, Dr Swati Dasgupta

  1. Dr Samrat Paul
    Netaji Subhash Chandra Bose Cancer Research Institute, Kolkata
  2. Dr Ashis Mukherjee
    Netaji Subhash Chandra Bose Cancer Research Institute, Kolkata
  3. Dr Sudeshna Gangapadhya
    Netaji Subhash Chandra Bose Cancer Research Institute, Kolkata
  4. Dr Swati Dasgupta
    Netaji Subhash Chandra Bose Cancer Research Institute, Kolkata

Acute Lymphoblastic Leukemia Patients express various combination of malignant clone as surface agent which are the hallmark of the diseases diagonosis, monitoring, and prognosis, so our study is to be planed to assign Cytogenetics and Immunophenotype expression as a strong prognostic marker for therapeutic purpose. 260 patients from Eastern India with acute lymphoblastic leukemia in the age group of 2 to 18 were categorized in two different classes namely children and young adult and subjected to treatment and diagonised according to MCP 841 protocol. A metaphase chromosomal plate and immunophenotype expression by flowcytometry analysis were performed. Cytogenetic study on young adults show t(8;14) was observed in about 3% cases compared to t(7;10), t(7;9), t(11;14) in T-lineage ALL. Certain translocations, such as t(12;21), t(1;19), t(9;22), t(11;19), t(4;11), t(9;11) were found to be associated with pro-B, B-cell precursor ALL. Disease free survival (DFS) shows a better result (43.1%) for B-ALL patients. In case of overall survival, all the patients with T-cell translocations had a significantly higher Survival rate. Our study shows a pattern of increase prevalence of T- lineage ALL among Young adult in this region and karyotyping and immunophenotyping were associated with better prognosis and improved chance of remission.


Are Neck Flaps an Alternate to Radial Forearm Free Flap

Dr Kunal Mangale, Dr Parag Watve, Dr Nagendra Kadapa, Dr Munish Mahajan, Dr L. M. Chandrasekhara Rao. S, Dr T. Subramanyeshwar Rao

  1. Dr Kunal Mangale
    DNB (General Surgery)
    Surgical Oncology Resident, Department of Surgical Oncology, Basavatarakam Indo American cancer Hospital and Research Institute, Banjara Hills Rd No 14, Hyderabad-500034, India.
  2. Dr Parag Watve
    MS. (ENT),
    Registrar,rnDepartment of Surgical Oncology, Basavatarakam Indo American cancer Hospital and Research Institute,rnBanjara Hills Rd No 14, Hyderabad-500034, India.rn
  3. Dr Nagendra Kadapa
    MS. (ENT)
    Registrar,rnDepartment of Surgical Oncology, Basavatarakam Indo American cancer Hospital and Research Institute,rnBanjara Hills Rd No 14, Hyderabad-500034, India.rnrn
  4. Dr Munish Mahajan
    MS. ( General Surgery)
    Surgical Oncology Resident,rnDepartment of Surgical Oncology, Basavatarakam Indo American cancer Hospital and Research Institute,rnBanjara Hills Rd No 14, Hyderabad-500034, India.rnrn
  5. Dr L. M. Chandrasekhara Rao. S
    MCh (Head and Neck Oncology)
    Senior Consultant, rnHead and Neck OncoSurgeon,rnDepartment of Surgical Oncology, Basavatarakam Indo American cancer Hospital and Research Institute,rnBanjara Hills Rd No 14, Hyderabad-500034, India.rnrn
  6. Dr T. Subramanyeshwar Rao
    MCh. (Surgical Oncology)
    Professor and HOD, Dept. Surgical oncology,rnDepartment of Surgical Oncology, Basavatarakam Indo American cancer Hospital and Research Institute,rnBanjara Hills Rd No 14, Hyderabad-500034, India.rn

Background: Pectoralis major myocutaneous flap is the work horse flap for head and neck reconstruction. With the advances in reconstructive techniques and availability of modern microscope and instruments, free tissue transfers have become the more preferred modality of treatment for the oral cavity reconstructions. Material , Methods and Objectives: In this era of free tissue transfer, we have tried to evaluate the reliability of some of the neck flaps in oral cavity reconstruction. In this article we describe our experience with few such neck flaps which includes the platysmal myocutaneous flap(PMF), infrahyoid myocutaneous flap(IHMF) and submental myocutaneous flap(SMF) for the reconstruction of oral cavity defects after ablation of cancer. The objective of this study was to see the reliability of neck flaps in the reconstruction of oral cavity. Results: The study included a total of 34 patients who underwent reconstruction of oral cavity with flaps from the neck region after cancer ablation. Six patients had PMF, 12 had IHMF and 16 had SMF. Two patients had complications in the form of donor area breakdown and infection which healed with secondary intention. For the reconstruction of buccal mucosa, platysmal myocutaneous flap was used most commonly. For the floor of mouth and tongue defects infrahyoid myocutaneous flap was used. Submental myocutaneous flap was used for defects of buccal mucosa and tongue. Conclusion: In selected patients, with small to moderate sized defects, neck flaps provide a good alternative to lengthy, cumbersome, technically more challenging free flaps.


Nonbacterial Thrombotic Endocarditis in Metastatic Urothelial Carcinoma: Case Report and Review of the Literature.

Dr Loretta Carr, Dr Jason P Denman, Dr Boris Terry

  1. Dr Loretta Carr
    BSc, MBBS (Hons)
    Cardiology Registrar, rnRoyal Brisbane and Womenís Hospital, Brisbane, Qld, The University of Queensland.
  2. Dr Jason P Denman
    B.App.Sc, MBBS (Hons), FRACP
    Consultant General Physician,rnToowoomba Hospital, Pechey St, Toowomba Qld 4350.
  3. Dr Boris Terry
    MBBS, FRACP
    Consultant Pathologist, rnToowoomba Hospital, Pechey St, Toowoomba Qld 4350.

Nonbacterial thrombotic endocarditis (NBTE) is the formation of aseptic vegetations on cardiac valves, most commonly seen as a manifestation of the hyper-coagulable state of malignancy. Most reported cases of NBTE occur in tumours of adenocarcinoma cell type. We describe a case of NBTE occurring in metastatic urothelial carcinoma.Keywords: Marantic endocarditis, nonbacterial thrombotic endocarditis, transitional cell carcinoma, urothelial cell carcinoma.


Ryle Tube Causing Bowel Perforation: A Case Report

Dr Siddhartha Gelivi, Dr Chinna Babu S., Dr V S Attili


Peripheral Primitive Neuroectodermal Tumor of Small Bowel Mesentry Presenting as Intestinal Obstruction: A Case Report.

Dr Rachan Shetty, Dr J A Naveen, Dr C S Premalatha, Dr K C Lakshmaiah

  1. Dr Rachan Shetty
    Senior Resident - Department of Medical Oncology, rnKidwai Memorial Institute of Oncology, M.H Marigowda Road, Bangalore-560029, Karnataka, India.
  2. Dr J A Naveen
    Senior Resident - Department of Medical Oncology, rnKidwai Memorial Institute of Oncology, M.H Marigowda Road, Bangalore-560029, Karnataka, India.
  3. Dr C S Premalatha
    Associate Professor - Department of Pathology,rnKidwai Memorial Institute of Oncology, M.H Marigowda Road, Bangalore-560029, Karnataka, India.
  4. Dr K C Lakshmaiah
    Professor and HOD - Department of Medical Oncology,rnKidwai Memorial Institute of Oncology, M.H Marigowda Road, Bangalore-560029, Karnataka, India.

Peripheral primitive neuroectodermal tumors are soft tissue neoplasmís seen in children and young adults. We are reporting a rare case of peripheral primitive neuroectodermal tumor of ileal mesentry presenting with features suggestive of intestinal obstruction. Abdominopelvic computed tomography revealed 11x8.8x7cm pelvic mass suspicious of ovarian tumor. Following surgical resection, Histopathological examination of the resected specimen showed small round cell tumor. Further testing with Immunohistochemistry and polymerase chain reaction for EWS-FLI1 was suggestive of Peripheral primitive neuroectodermal tumor.


Complete Response of Brain Metastases in HER2 Positive Breast Cancer after Treatment with Lapatinib and Capecitabine

Dr Mohd Shafi Moona, Dr Arwa Nabhan, Dr Farah Waqar

  1. Dr Mohd Shafi Moona
    Department of Medical Oncology, King Abdullah Medical City & Oncology Center, Jeddah, Kingdom of Saudi Arabia.
  2. Dr Arwa Nabhan
    Department of Medical Oncology, King Abdullah Medical City & Oncology Center, Jeddah, Kingdom of Saudi Arabia.
  3. Dr Farah Waqar
    Department of Medical Oncology, King Abdullah Medical City & Oncology Center, Jeddah, Kingdom of Saudi Arabia.

A 45 year old female was diagnosed to have invasive ductal carcinoma of left breast. Following mastectomy and adjuvant chemotherapy and radiation therapy she progressed with brain metastases. After palliative chemotherapy based on lapatinib and capecitabine the brain metastases resolved completely. We report a patient with brain metastases from HER2 positive breast cancer that was successfully treated with radiation and a combination of lapatinib and capecitabine.


Comparative Study of 3DCRT versus IMRT in Post lumpectomy Early Stage Breast Cancer Patients

Dr Mudasir Ashraf, Dr Nandigam Janardhan, Dr Radhakrishana Shiva Kumar, Dr Anu Radha C, Dr Palreddy Yadagiri Reddy, Dr Perumal Bhavani, Dr Syed Ibrahim, Dr Malik Mohib-ul-Haq, Dr Nazir Ahmed Khan

  1. Dr Mudasir Ashraf
    Department of Radiological Physics and Bio-Engineering, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, India.rnDepartment of Physics, Osmania University, Hyderabad, India.rnrnSchool of Advanced Studies, Vellore Institute of Technology, Vellore, India.
  2. Dr Nandigam Janardhan
    Department of Radiotherapy, Omega Hospitals, A Unit of Hyderabad Institute of Oncology, Road No. 12, Banjara Hills, Hyderabad, India.
  3. Dr Radhakrishana Shiva Kumar
    Department of Radiotherapy, Omega Hospitals, A Unit of Hyderabad Institute of Oncology, Road No. 12, Banjara Hills, Hyderabad, India.
  4. Dr Anu Radha C
    School of Advanced Studies, Vellore Institute of Technology, Vellore, India.
  5. Dr Palreddy Yadagiri Reddy
    Department of Physics, Osmania University, Hyderabad, India.
  6. Dr Perumal Bhavani
    Department of Radiotherapy, Omega Hospitals, A Unit of Hyderabad Institute of Oncology, Road No. 12, Banjara Hills, Hyderabad, India.
  7. Dr Syed Ibrahim
    Department of Radiotherapy, Omega Hospitals, A Unit of Hyderabad Institute of Oncology, Road No. 12, Banjara Hills, Hyderabad, India.
  8. Dr Malik Mohib-ul-Haq
    Department of Radiological Physics and Bio-Engineering, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, India.
  9. Dr Nazir Ahmed Khan
    Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, India.

Purpose: The aim of this study is compare and analyze attempt to compare and analyze the dosimetric aspects of 3DRT over IMRT in the whole breast irradiation of post lumpectomy early stage breast cancer patients. Methods and Materials: Both right and left sided computed tomography simulations of 14 women with early breast cancer were fairly used for our retrospective study to compare the 3DCRT and IMRT. The dose prescribed was 50 Gy in 25 fractions to the whole breast PTV. The prescribed dose delivered in 5 fractions per week schedule. Treatment plans were compared for target minimum dose, maximum dose, mean dose, conformity index, heterogeneity index and organs at risk doses were compared and analysed. Results: The target coverage was achieved with 90% prescription to the 95% of the PTV. Conformity to the PTV was significantly higher with 3DCRT technique than IMRT. 3DCRT technique seems better in sparing critical organs parameters like lung V20 and Mean, heart, V25, Maximum, both lungs V20, Mean and Dose to the Normal Healthy tissue. Conclusion: We conclude from our study that treatment technique selection for whole Breast irradiation is an important factor in sparing the adjacent normal structures and in determining the associated risk. 3DCRT produces better conformity and heterogeneity indices of the target volume, also reduces dose to OARs the 3DCRT reduces the risk of radiation induced heart diseases.


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