Extra capsular dissection (ECD) differs markedly from classic surgical approaches to the parotid neoplasm because facial nerve dissection is not performed. Factors noted to favor this approach ...include mobility of the tumor within the gland, a thin covering of capsule and glandular tissue, and a tumor large enough to allow digital manipulation during dissection. Imaging, fine needle aspiration cytology, and neuron-monitoring play a heightened role in ECD. The aim of this article is to report case series on surgical management of few types of parotid tumors by extra capsular dissection and to assess long-term results after the treatment of parotid tumors using surgical technique ECD.This case series includes five different parotid tumors such as Warthin’s tumor, Pleomorphic adenoma, Sialadenoma papilliferum of parotid, chronic sialoadenitis, parotid cystadenoma, out of 30 cases operated in our hospital. All the patients in this study received appropriate surgical treatment (ECD) and done a follow up evaluation every month.
Helicobacter pylori is one of the most common chronic bacterial infection in humans linked to acid peptic diseases, gastric carcinomas and lymphomas. The bacilli produces large amounts of urease and ...this property has formed the basis of detection of H. pylori by the Christensen's urease test. Where endoscopy is not clinically indicated, serology may be used to establish the diagnosis. This study was undertaken to diagnose H. pylori with the help of Christensen's urease test on endoscopic biopsy specimens & correlated with the detection in Sera, of IgG antibodies against H. pylori, by ELISA technique. The study was conducted on 100 patients suffering from acid peptic disorders out of which 40 (40%) tested positive for H. pylori both by urease and serology. Christensen's urease and ELISA were found to have sensitivities of 85.7% & 90.9% and specificities of 96% and 87.5% respectively. Christensen's urease was taken as a standard method of diagnosis and its correlation with ELISA worked out to (+1) which meant there was a strong positive association between both the tests. Hence either test could be used for primary diagnosis of H. pylori instead of histopathological study and/or culture of H. pylori.
In this study, we aim to explore ways to objectively assess cognitive deficits in the stroke and HIV/stroke populations, where cognitive and motor impairments can be hard to separate. Using an upper ...limb rehabilitation robot called the Haptic TheraDrive, we collect performance error scores and motor learning data on the impaired and unimpaired limb during a trajectory tracking task. We compare these data to clinical cognitive scores. The preliminary results suggest a possible relationship between unimpaired upper limb performance error and visuospatial/executive function cognitive domains, but more work needs to be done to further investigate this. The potential of using robot-assisted technologies to measure unimpaired limb kinematics as a tool to assess cognitive deficits would be useful to inform more effective rehabilitation strategies for HIV, stroke, and HIV/stroke populations.
OBJECTIVES: The objective was to evaluate the clinical efficacy and safety of combined targeted therapy against epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) ...pathways in patients with advanced Non-small-cell lung cancer (NSCLC). METHODS: Literature searches were conducted in Embase, PubMed and The Cochrane library databases using relevant search strategies. Studies retrieved from the databases were screened and extracted by two independent reviewers. Discrepancy was resolved by third reviewer. Randomized controlled trials which compared combined targeted therapy with control groups (placebo, chemotherapy, single EGFR or VEGF inhibition therapy or a combination of them) for the treatment of advanced NSCLC were included in the meta-analysis. Outcomes assessed included, progression free survival (PFS), objective response rate (ORR), and adverse events (AEs). Data was analyzed using Review Manager (v5.3). RESULTS: Of the 608 studies identified, 12 studies with 5485 patients were included for meta-analysis. Overall, combined targeted therapy was resulted in better PFS (HR: 0.86 95%CI: 0.71-1.04; n=ll) and ORR (RR: 1.09 95%CI: 0.81-1.47; n=ll) compared with control groups. However, no improvement was seen in OS with combined therapy (HR: 0.98 95%CI: 0.91-1.05; n=10). The subgroup analysis based on treatment line showed that combined therapy significantly improved PFS (HR: 0.77 95%CI: 0.66-0.89; n=8), and ORR (RR: 1.39 95%CI: 1.01-1.93; n=7) in the second-line treatment of NSCLC. Compared with control therapy, combination therapy had significant risk for grade 3/4 rash (RR: 2.63 95%CI: 1.31-5.30; n=10), diarrhea (RR: 4.0395%CI: 2.17-7.50; n=10) and hypertension (RR: 2.4495%CI: 0.77-7.78; n=9). CONCLUSIONS: The combined inhibition therapy against EGFR and VEGF pathways can significantly improve PFS and ORR in the second-line treatment of NSCLC. However, combined therapy has increased risk for grade 3/4 adverse events such as rash and diarrhea. Further large-scale trials would be helpful to validate these findings.
The present study was conducted to evaluate the efficacy of low dose cyclosporine-A in the patients of severe aplastic anaemia, who cannot afford allogenic bone marrow transplantation and ...immunosuppressive therapy with antithymocyte globulin.
The diagnosis of severe aplastic anaemia was established by standard criteria. Twelve patients were given cyclosporine-A orally at a dose of 6 mg/kg body weight in divided doses in two daily equal proportions for six months. Eleven patients were put on oral stanozolol in the dosage of 1 mg/kg body weight/day in divided doses. All surviving patients were evaluated at three and six months.
At the end of six months, 41.66% of twelve patients responded to cyclosporine-A. One patient had complete response and four patients had partial response. Only one out of 11 patients receiving stanozolol responded.
i) Cyclosporine-A is a viable therapeutic option in the treatment of severe aplastic anaemia, ii) Low dose cyclosporine-A is able to slow down the stormy course of the severe aplastic anaemia, iii) Androgens have very little effect on the survival of patients of severe aplastic anaemia.
PDF
