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R Sarin

Publications and source records attributed to R Sarin.

At least 19 recordsLinked to original sources
PubMed2000

Primary carcinoma of the vagina: Tata Memorial Hospital experience.

PURPOSE: Carcinoma of the vagina is a rare gynecological malignancy comprising approximately 2% of all the gynecological malignancies. We have analyzed the treatment outcome of the patients treated at the Tata Memorial Hospital from January 1984 to December 1993. METHODS AND MATERIALS: In this 10-year period, 134 patients of primary vaginal cancers were registered at our hospital. Of these, 75 patients received complete treatment and are analyzed. RESULTS: Disease-free survival (DFS) for the whole group is 50%, and overall survival (OAS) is 60%. Most locoregional recurrences and distant failures are noted in the 2 years following treatment. DFS at 5 years is as follows: Stage I (5 patients), Stage IIA (37 patients), Stage IIB (15 patients), Stage III (14 patients), and Stage IV (4 patients); are 40%, 55%, 60%, 50%, and 25%, respectively. The DFS for patients with complete response (42 patients) to external radiation at 5 years is 68%, with partial response (25 patients) is 35%, and with poor or no response (6 patients) is 18% (p = 0.0000). We observed that brachytherapy was an important part of the treatment, and patients who received brachytherapy (59 patients), either with a vaginal intracavitary applicator (30 patients) or interstitial implant (29 patients) had a DFS of 53% and 56%, respectively, while 15 patients who received external radiation alone had a DFS of 30%. Patients receiving brachytherapy within 4 weeks of external radiation had a DFS of 60% as compared to 30% when the interval was more than 4 weeks. CONCLUSION: The factors indicating prognosis are: site and extent of involvement, presence of lymph nodes at presentation, technique of brachytherapy, and interval between external radiation and brachytherapy.

Adolescent↗
PubMed1999

Single fraction radiotherapy for bone metastases: are all questions answered?

All randomized trials show comparable pain relief rates with single or fractionated radiotherapy (RT) in selected patients. Further studies are required to determine the optimal single dose (our analysis suggests 6-8 Gy), its efficacy in preventing fractures/cord compression and defining criteria for recommending fractionated RT for a select few. Besides this, a 'lingua franca' for pain assessment tools is urgently required.

Bone Neoplasms↗
PubMed1999

Calcific uremic arteriolopathy in association with low turnover uremic bone disease.

We report seven cases (out of 100 dialysis patients) at the University of Kentucky who were diagnosed with calciphylaxis syndrome between 1993 and 1998. Of note is the fact that five of these patients had bone biopsy-proven adynamic renal bone disease, rather low intact PTH, and relatively low calcium-phosphorus product. This is in contrast to the previous view that calciphylaxis is usually seen in patients with excessive parathyroid activity. The reemergence of calciphylaxis with renal bone disease is an intriguing finding and does not correspond to earlier reports associating calciphylaxis with hyperparathyroid bone disease. This report reviews the clinical, biochemical, and bone histology findings of these patients, and provides a review of the literature.

Adult↗
PubMed1998

Sulfalene concentrations in plasma and blood cells of Plasmodium falciparum malaria cases after treatment with metakelfin using high-performance liquid chromatography.

A reversed-phase high-performance liquid chromatographic method using acetonitrile-methanol-1 M perchloric acid-water (25:9:0.8:95, v/v/v) at a flow-rate of 1.0 ml min(-1) on LiChrospher 100 RP 18 column (250 x 4 mm; 5 microm) with UV (254 nm) detection has been developed for the determination of sulfalene in plasma and blood cells after oral administration of the antimalarial drug metakelfin. Calibration curves were linear in the range 0.5-100 microg ml(-1). The limit of quantification was 50 ng ml(-1). Within-day and day-to-day coefficients of variation averaged 3.84 and 5.31%, respectively. Mean extraction recoveries of sulfalene from plasma and blood cells were 87.21 and 84.65%, respectively. Mean concentrations of sulfalene in plasma of P. falciparum cases on days 2, 7 and 15 were 44.58, 14.90 and 1.70 microg ml(-1), respectively; in blood cells concentrations of sulfalene were 7.77, 3.25 and 0.75 microg ml(-1), respectively, after oral treatment with two tablets (1000 mg) of metakelfin. Significant difference was recorded on day 2 for sulfalene concentration in blood cells of healthy and P. falciparum cases (t=9.49; P<0.001).

Adult↗
PubMed1997

Treatment results and prognostic factors in 101 men treated for squamous carcinoma of the penis.

PURPOSE: This retrospective study was performed to assess the treatment outcome and prognostic factors in 101 men with invasive squamous carcinoma of the penis treated at the Royal Marsden Hospital between 1960-1990. METHODS AND MATERIALS: The tumor was confined to the glans penis (T1) in 79 patients, 82 were node negative (N0), and two patients had distant metastases at presentation. The histology was Grade 1 (G1) in 36, Grade 2 (G2) in 18, Grade 3 (G3) in 28, and unknown in 19 patients. Node-positive disease was commoner in patients with G3 (p = 0.02) or T2/3/4 tumors (p = 0.007). Treatment for the primary tumor was external beam radiotherapy (EBRT) in 59, interstitial brachytherapy in 13, and partial or total penectomy in 29 patients. The median dose, dose/fraction, and treatment time for EBRT was 60 Gy, 2 Gy/fraction, and 46 days, respectively. Eighty patients received no inguinal node treatment, 13 had EBRT (4 with chemotherapy), and 8 underwent groin dissection at presentation. RESULTS: During a median follow-up of 5.2 years (2 months-22 years), 56 patients died (penile cancer 31, intercurrent illness 23 and unknown cause 2), giving 10 year overall and cause-specific survival (CSS) of 39 and 57%, respectively. Adverse prognostic factors for CSS on univariate analysis were G3, ulcerative/fungating or T2/3/ 4 tumors, node positive, Jackson's Stage 2/3/4, and surgical treatment for the primary. All but the last two were significant independent prognostic factors for CSS on multivariate analysis. Penile or perineal recurrence or residual disease after initial treatment was seen in 36 out of 98 evaluable patients, giving a 10-year local failure rate (LFR) of 45%. Local failure after initial treatment was successfully salvaged in the majority (26 out of 36) of patients with further surgery or radiotherapy, and local control was achieved ultimately in 74 out of 77 T1, 7 out of 12 T2; 3 out of 3 T3, and 3 out of 5 T4 tumors. In the 44 evaluable patients with T1 tumors treated by EBRT the only adverse RT parameter approaching prognostic significance (p = 0.052) was a BED value corrected for recovery of <60 Gy (alpha/beta 10, K = 0.5 Gy/day, mean = 21 days). CONCLUSION: Invasive squamous carcinomas of the penis carry a significant risk of loco-regional recurrence after initial radiotherapy and this can be successfully salvaged in most patients with further treatment. This mandates close follow-up to detect loco regional recurrence early.

Adult↗
PubMed1996

High-performance liquid chromatographic determination of primaquine and carboxyprimaquine concentrations in plasma and blood cells in Plasmodium vivax malaria cases following chronic dosage with primaquine.

A reversed-phase HPLC method using acetonitrile-methanol-1 M perchloric acid-water (30:9:1:95, v/v) at a flow-rate of 1.5 ml/min on a mu-Bondapak C18 column with UV detection at 254 nm was developed for the separation of primaquine, its major metabolite carboxyprimaquine and other metabolites such as N-acetylprimaquine, 4-hydroxyprimaquine, 5-hydroxyprimaquine, 5-hydroxy-6-methoxyprimaquine, demethylprimaquine and 6-methoxyprimaquine, and also other antimalarials. The calibration graphs were linear in the range 0.025-100 micrograms/ml for primaquine and 4-1000 micrograms/ml for carboxyprimaquine. The within-day and day-to-day coefficients of variation averaged 3.65 and 6.95%, respectively, for primaquine and 3.0 and 7.52%, respectively for carboxyprimaquine in plasma. The extraction recoveries for primaquine and carboxyprimaquine were 89 and 83%, respectively. The mean carboxyprimaquine concentration was much higher in plasma and blood cells of Plasmodium vivax patients than that in plasma from healthy subjects. The carboxyprimaquine level was also higher in blood cells than plasma whereas the primaquine concentration was the same in both cases.

Adolescent↗
PubMed1996

A study of ectopic pregnancy and high risk factors in Himachal Pradesh.

Although the total number of pregnancies have declined over the past decade, the rate of ectopic pregnancies has increased dramatically. Incidence was maximum in 26-30 years of age group (37.6%) and in para 2 (32.9%). Pain was the commonest symptom (91.7%) followed by bleeding per vaginum (71.7%) and amenorrhoea (41.4%). High risk factors were present in 67% of cases (57 out of 85 cases, 7 patients had 2 high risk factors).

Adult↗
PubMed1994

Sulphadoxine concentrations in plasma, red blood cells and whole blood in healthy and Plasmodium falciparum malaria cases after treatment with Fansidar using high-performance liquid chromatography.

A reversed-phase high-performance liquid chromatographic method using acetonitrile-methanol-(1M) perchloric acid-water (30:9:0.8:95, v/v/v/v) at a flow of 1.5 ml min-1 on mu-Bondapak C18 column with UV (254 nm) detection has been developed for the separation of sulphadoxine, sulphalene and sulphamethoxazole from other antimalarials. Calibration curves were linear in the range 0.5-100 micrograms ml-1. The limit of quantitation was 50 ng ml-1. Within-day and day-to-day coefficients of variation averaged 2.1 and 6.45%, respectively. The extraction recovery of sulphadoxine from plasma, red blood cells and whole blood was 90.28, 92.05 and 94.69%, respectively. The method has been used for the determination of sulphadoxine concentrations in plasma, red blood cells and whole blood of eight healthy and 50 Plasmodium falciparum malaria cases after administration of two tablets of Fansidar. Mean sulphadoxine concentration in plasma was higher than red blood cells or whole blood. Sulphadoxine concentration in plasma and whole blood of P. falciparum malaria cases was significantly higher as compared to healthy volunteers while it was the same in red blood cells. Sulphadoxine was absorbed much less in red blood cells than in plasma or whole blood.

Adult↗
PubMed1993

Therapeutic factors influencing the cosmetic outcome and late complications in the conservative management of early breast cancer.

PURPOSE: To investigate the impact of clinical and physical parameters on the cosmetic result and complications, in cancer breast treated with conservative surgery and definitive irradiation. METHODS AND MATERIALS: Between October 1980 and December 1990, 289 patients were treated with lumpectomy and/or axillary dissection, radical irradiation with or without adjuvant therapy. The radiation therapy technique consisted of external beam therapy followed by an Ir-192 implant or electron beam boost. Univariate and multivariate analysis were used to evaluate the correlation between multiple factors affecting the cosmetic outcome and the complications. RESULTS: Of 289 patients, cosmesis was evaluable in 285 and recorded as excellent to good in 226 (79%), fair in 35 (12%), and poor in 24 (9%). On multivariate analysis of these results, a high dose per fraction (p = .0018), and use of electrons as boost to the tumor bed (p = .001) were found to be significant. When patients boosted with electrons were excluded, a high boost dose (p = .0433) was also found significant. Fifteen (5%) patients developed severe late radiation sequelae and 14 (5%) moderate or severe arm edema. On multivariate analysis only dose per fraction of 2.5 Gy (p < .0001) and higher boost doses (p = .017) were significant. CONCLUSION: In 289 patients of early breast cancer treated with conservative surgery and radical irradiation, multivariate analysis suggests that higher dose per fraction with teletherapy and higher brachytherapy boost dose adversely affect cosmesis and contribute to the late complications.

Adult↗
PubMed1993

Influence of dose-rate and dose per fraction on clinical outcome of breast cancer treated by external beam irradiation plus iridium-192 implants: analysis of 289 cases.

PURPOSE: To study the influence of Iridium 192 implant dose-rate and dose per fraction of external irradiation on clinical outcome, the results in 289 patients with early breast cancer were analyzed retrospectively. METHODS AND MATERIALS: From 1980 to 1990, 118 T1 and 171 T2 lesions of breast were treated definitively by radiotherapy, following conservative surgery. External irradiation dose of 45 Gy was delivered either with 2.5 Gy or 1.8 Gy per fraction to the entire target volume, plus boost to the primary tumor. Boost dose of 15 to 30 Gy was given to the primary tumor either with iridium-192 implants or electrons. The implant dose-rate varied between 20 cGy/hr to 160 cGy/hr. RESULTS: The minimum follow-up was of 12 months and maximum of 11 years (median: 56 months). Out of 273 tumors boosted with implants, the 270 patients were divided into five groups according to dose-rate as, groups 1 (20-29 cGy/hr, n = 17), group 2 (30-49 cGy/hr, n = 144), group 3 (50-69 cGy/hr, n = 69), group 4 (70-99 cGy/hr, n = 27) and group 5 (100-160 cGy/hr, n = 13). The local failure rate was significantly increased in the group of patients treated with implant dose-rate < 30 cGy/hr (p < 0.05). While the incidence of late normal tissue complications and poor cosmetic outcome was significantly higher in the group of patients treated with implant dose-rate > 100 cGy/hr (p < 0.05). CONCLUSION: The present analysis indicate that the implant dose-rate should be maintained between 30-70 cGy/hr to maximize local control and reduce the late normal tissue injury. Also the increase in dose per fraction of external irradiation while not influencing local control rate was crucial for incidence of late complications and cosmetic outcome.

Adult↗
PubMed1993

Determination of quinine in serum, plasma, red blood cells and whole blood in healthy and Plasmodium falciparum malaria cases by high-performance liquid chromatography.

A normal-phase high-performance liquid chromatographic method using dichloromethane-methanol-1 M perchloric acid (100:9:0.4, v/v) at a flow-rate of 0.8 ml/min on a Zorbax-Sil column with fluorescence detection has been developed for the separation of quinine and quinidine from other antimalarials. Within-day and day-to-day coefficients of variation averaged 0.74 and 7.56%, respectively. The extraction recovery of quinine for plasma, serum, red blood cells and whole blood (filter paper) was 88.13, 87.12, 78.0 and 77.5%, respectively. The method is capable of separating quinine from dihydroquinine, a compound usually found as an impurity in authentic quinine samples. The method has been used for the determination of quinine in plasma, serum, red blood cells and whole blood (filter paper) of six healthy and twenty Plasmodium falciparum malaria cases. The average quinine concentration in P. falciparum malaria cases was three to four times higher than that in healthy volunteers. Quinine was absorbed much less in red blood cells than in plasma or serum.

Adult↗
PubMed1991

Determination of sulfalene in plasma, red blood cells and whole blood by high-performance liquid chromatography.

A normal phase high-performance liquid chromatographic method using dichloromethane-methanol-perchloric acid (1 M) (96:9:1, v/v) at a flow-rate of 1 ml/min on a Nucleosil 100-7 column (250 x 8 x 4 mm) and UV detection at 254 nm, has been developed to determine the concentration of sulfalene in plasma, red blood cells and whole blood after oral administration of the antimalarial drug metakelfin. The coefficient of variation was 7.1% and the extraction recovery was 82%. Mean concentrations of sulfalene on days 1, 7 and 15 were: 49.56, 10.46 and 2.24 micrograms/ml in plasma, 25.02, 4.34 and 0.84 micrograms/ml in red blood cells and 21.12, 4.44 and 1.00 micrograms/ml in whole blood, respectively. Quinine, chloroquine, desethylchloroquine, mefloquine, primaquine, sulfadoxine, pyrimethamine and dapsone did not interfere in the detection of sulfalene.

Administration, Oral↗
PubMed1991

Analysis of circulating immune complexes (CIC) in tuberculosis: levels of specific antibody and antigens in CIC and relationship with serum antibody.

Eighty sera from tuberculosis (TB) patients, 16 Indian and 10 American control sera were analyzed by ELISA for relative titres of antibody against mycobacterial antigens. Levels of specific antibody and mycobacterial Ag in circulating immune complexes (CIC) isolated from these sera were also studied. All these parameters were found to be elevated in TB sera as compared to control sera. Maximum increase was however noted in CIC specific antibody titres. A good correlation was observed between serum and CIC levels of specific antibody (r = 0.72) and between specific antigen (Ag) and antibody (Ab) levels within CIC (r = 0.64). In a few of the TB sera examined, CIC specific Ab contributed less than 1% to the Ab titres in sera. In order to examine the differences between different subgroups within TB patients, a statistical analysis of variance was performed. Sex of the patients had no effect on any parameter. Sputum-positive patients had significantly higher levels of CIC Ag and Ab than the sputum-negative patients, although no significant difference occurred in respect to serum Ab. All three parameters were significantly higher in patients on chemotherapy as compared to fresh untreated cases. The relevance of these observations to the development of a CIC-based immunodiagnostic assay for TB is discussed.

Analysis of Variance↗
PubMed1991

A comparative study between hysterosalpingography and laparoscopy in case of infertility.

From the present study it can be concluded that both the procedures have their own importance and no one can substitute the other, in diagnosing all the diseases. HSG has been found to be more rewarding in cases of abnormalities of the lumen of uterus and fallopian tubes for their patency. On the other hand laparoscopy has been more rewarding for the abnormalities of the surface of uterus, fallopian tubes and ovaries. It is suggested that in all the cases of infertility both the procedures should be done and the HSG should be done first followed by laparoscopy.

Adolescent↗
PubMed1990

Functional estrogen receptors as biochemical marker for the detection of hormone-dependent breast cancer.

The translocatable receptors categorized as functional receptors were quantitated in a cross-incubation study of breast cancer nuclei with receptor-rich uterine cytosol. Data demonstrated that tumors that contained cytosolic estrogen receptor (ER) but had translocation defect might not be hormone dependent, whereas tumors with low ER but intact nuclear translocation step will respond to antiestrogen therapy. Cytosolic ER was estimated in 114 primary breast cancer tissues and ten metastatic axillary lymph nodes; 58% of postmenopausal and 54% of premenopausal breast cancer tissues were ER+ with a cutoff value of 10 fmoles and 3 fmoles/mg protein, respectively. Of tumors in the premenopausal and postmenopausal state, 62% and 57%, respectively, were positive for nuclear ER, with a cutoff value of 10 fmoles/100 micrograms DNA. This study suggested that evaluation of functional ER level would reduce the number of false-negative and false-positive tumors.

Adult↗