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Biomedical subjects

S Dixit

Publications and source records attributed to S Dixit.

At least 37 records · Page 2Linked to original sources

Rectosigmoid complications of radiotherapy in stage 3B carcinoma of the cervix.

A retrospective analysis of 165 patients with Stage 3 B carcinoma of the cervix treated with radiotherapy alone was done; 120 patients were treated with a combination of external radiotherapy and intracavitary treatment while 45 patients received external radiotherapy only. Early rectosigmoid reactions were seen in 65% of cases with Grade 1, 2 and 3 reactions in 40%, 20% and 5% of cases respectively. Late rectosigmoid sequelae were observed in 25 patients (16%) with moderate complications in 5%. Severe rectal complications were seen in 2 women only. Rectosigmoid complications are the most common sequelae of pelvic irradiation and seen more in advanced stages where a greater dose is given by external radiotherapy. The role of rectal dosimetry is equivocal if proper precautions are taken during intracavitary treatment.

Brachytherapy↗

The nutritional impact of breakfast consumption on the diets of inner-city African-American elementary school children.

To determine the contribution of breakfast-eating behavior to dietary adequacy among low-income African-American children, 1151 children attending grades two through five at four elementary schools in East Orange, New Jersey were studied. Results of a 4-day eating behavior survey and a 24-hour dietary recall reveal that on any given day, 12% to 26% of children attend school without having eaten anything. Thirty-six percent of the children were obese, which did not vary with breakfast-eating behavior. A significantly greater proportion of the children who skipped breakfast compared to those who ate breakfast failed to achieve dietary adequacy for nearly every nutrient studied. More than one third of breakfast skippers consumed < 50% of the recommended dietary allowance for vitamins A, E, B6, and folacin, and nearly one fourth consumed < 50% of the recommended dietary allowance for calories, vitamin C, calcium, and iron. Not eating breakfast results in substantial deficits in dietary intake of a variety of essential nutrients among low-income African-American school children. Efforts to improve the nutritional status of children should include nutrition education to promote breakfast.

Black or African American↗

Post orchiectomy management in stage II testicular seminoma.

Twenty eight patients with stage II A and twenty patients with stage II B testicular seminoma were treated at this institute between January 1982 and December 1988. The three year crude survival observed in this retrospective analysis was 82% and 75% respectively. Post orchiectomy infradiaphragmatic radiotherapy was the mainstay of the treatment. In stage II A 4 patients were administered adjuvant chemotherapy as well. Prophylactic Mediastinal Irradiation (PMI) was not employed as a routine in this subgroup. Eight patients (28%) relapsed (Mediastinal Nodes--4, Pulmonary--3, Scrotal--1). In stage II B twelve patients were treated with primary abdominal radiotherapy and of them 4 were delivered PMI as well. Induction chemotherapy was administered in remaining 8 patients. Seven patients (35%) relapsed (Pulmonary-4, Mediastinal Nodes-3). Mediastinal recurrence was noted only in those who were treated with abdominal radiotherapy alone. Though salvage chemotherapy proved successful in 5 of the seven patients (70%) with nodal relapse, none of the patients with extranodal relapse responded to subsequent chemotherapy. For stage II A we recommend abdominal radiotherapy alone and for stage II B Induction chemotherapy is advised keeping radiotherapy reserved for residual mass. We do not advocate PMI as a routine in stage II testicular seminoma as no survival benefit is observed.

Adolescent↗

Squamous cell carcinoma of the vagina: a review of 70 cases.

Seventy cases of squamous cell carcinoma of the vagina registered between 1985 and 1989 were analyzed. The overall 2-year disease-free survival was 33%. Stagewise 2-year survivals were as follows: stage I, 100% (8/8); stage II, 70% (7/10); stage III, 19% (8/42); and stage IV, 0% (0/10). Incidentally, 60% of the cases presented below 50 years of age, and the majority of these were in advanced stage (p < 0.02). Due to the relatively greater number of cases of advanced disease in the elderly age group treated with external radiotherapy alone, a significant survival difference between the two age groups was not apparent (P > 0.10). External radiotherapy alone yielded poor results. External radiotherapy in combination with brachytherapy in the form of either vaginal cylinders or uterine tandems with vaginal cylinders resulted in 42 and 50% 2-year disease-free survivals, respectively. Advanced stage, more than two-thirds to full vaginal length involvement, and multiple vaginal wall involvement were found to be poor prognostic factors. The majority of cases had tumor grades 2 and 3. No association between tumor grade and survival was observed. To improve survival, downstaging of the disease through routine gynecological checkup, even in premenopausal women, and delivery of high doses through a judicious combination of external radiotherapy and brachytherapy are needed.

Adult↗

Post-orchiectomy management in stage I testicular seminoma: elective irradiation or surveillance?

Fifty-six patients with stage I testicular seminoma were treated at this institute between January 1982 and December 1988. Post-orchiectomy elective radiotherapy to ipsilateral iliac-inguinal and para-aortic lymph nodes was delivered in 54 cases. An overall 3 year survival rate of 96% was observed in this series. Four patients (7%) relapsed (one junctional recurrence in iliac node region, two mediastinal/hilar nodes and one skeletal metastasis). Salvage chemotherapy proved successful in two out of three cases with nodal relapse. No dose limiting acute or late radiation related complications were noticed. No definite correlation was found between the patients who relapsed and various known adverse prognostic factors. We recommend elective irradiation of the draining lymph nodes in stage I seminoma, particularly at centres where surveillance is not feasible.

Adult↗

Primary radiation therapy in the management of glomus tumours.

The records of five patients who received local irradiation for incompletely excised or inoperable glomus tumour were retrospectively reviewed. Age ranged from 25 to 46 years. There were two female and three male patients. Two patients who were solely treated by radiation therapy remain clinically disease free at 30 and 42 months respectively. Of the remaining three patients, where radiotherapy was delivered post operatively, one achieved complete remission and is well and alive at 60 months, whereas the other two patients were lost to follow up at 22 and 26 months respectively after showing an early clinical improvement. We advocate the efficiency of radiation therapy as primary treatment in the management of primary glomus tumour.

Adult↗

The role of radiation therapy in the management of spinal cord compression due to extramedullary haematopoiesis in thalassaemia.

Extramedullary haematopoiesis associated with thalassaemia leading to spinal cord compression is an extremely rare event in the course of the disease. The efficacy of radiation therapy is advocated in the management of such a complication. Two patients with thalassaemia, who had presented with spinal cord compression, were successfully treated by a modest dose of local radiotherapy. In one of the patients, however, radiotherapy was resorted to after an initial decompressive laminectomy and partial removal of the intraspinal haematopoietic mass proved unsuccessful. The other patient was managed solely by radiation therapy.

Adult↗

Hyperfractionation in advanced head and neck cancer.

This preliminary study was undertaken to observe tumour response and normal tissue tolerance to hyperfractionation. This study showed encouraging locoregional control rate in advanced head and neck cancer. Responses T4 tumors are poor and are prone to recur. This indicates that probably greater dose is needed to control T4 disease. We used 7920 cGy for T4 and late T3 status tumour. This dose is well tolerated by patients. Control of T4 tumours may further be increased by increasing total dose, but in view of inadequate clear cut numerical data of tissue tolerance derived by L-Q = Linear Quadratic formula which is still under clinical trial, further increase in total dose cannot be overemphasized. Longer follow up is necessary to assess the long term control rate and late tissue reaction. There is a need of randomized controlled clinical trial to compare hyperfractionation and conventional fractionation. In next phase we are undertaking randomized study of twice daily, daily and weekly fractionation in advanced head and neck cancer.

Carcinoma, Squamous Cell↗

Validity of the 'Ten Questions' for screening serious childhood disability: results from urban Bangladesh.

A survey of 2576 children aged two to nine years was carried out in Dhaka, Bangladesh, as part of a collaborative study to test the validity of a questionnaire (the Ten Questions) for screening severe childhood disabilities in community settings. Approximately 7% of the children were positive on the screen and this rate was slightly higher in boys than girls. The sensitivity, specificity and negative predictive value of the Ten Questions were perfect or nearly perfect for severe and moderate (serious) disabilities. The positive predictive value was only 22% for serious disabilities, but 70% of children classified as false positives were found to have mild disabilities or other conditions (such as ear infections) for which early detection and treatment could be beneficial. No major age or gender differences in the validity of the questionnaire were apparent, but this finding needs additional study and confirmation with studies based on larger samples. In general, the results indicate that the Ten Questions is a valid tool for screening serious disabilities in children and can potentially improve the efficiency of health services by reducing the number of children requiring attention from professionals. Future studies using the Ten Questions should foster greater attention to the dimensions of childhood disability as a public health problem in the less developed world.

Bangladesh↗

Limited proliferative response to type II collagen in rheumatoid arthritis.

In order to define the potential importance of type II collagen in the activation of rheumatoid arthritis (RA) synovial fluid (SF) lymphocytes, we examined the proliferative response of matched peripheral blood and SF lymphocytes to type II collagen. The mean proliferative response to the collagen was somewhat greater (p less than 0.05) with SF, compared to peripheral blood lymphocytes. However, the magnitude of this response was relatively weak as determined by stimulation indices, and it did not approach that observed with peripheral blood lymphocytes in response to tetanus toxoid. Sixty-seven percent of peripheral bloods and 50% of SF demonstrated positive responses to the control antigen, tetanus toxoid. In contrast, only 6 and 28%, respectively, were positive in response to type II collagen. The addition of exogenous interleukin 2 augmented responses to the tetanus toxoid, however, no such enhancement with type II collagen was noted in our patients. Our collagen was arthritogenic in experimental animals. These observations do not support the existence of T cell specificity toward type II collagen as a common mechanism for the expansion of synovial lymphocytes in RA.

Adult↗