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Spectrum of HIV Associated Malignancies: A Retrospective Study of 42 Patients over a Period of 16 Years Attending a Tertiary Care Hospital
Rajendra Kumar Tanwar,
Bharti Saxena,
Manu Singh Tanwar,
Abhirup Chatterjee,
Harsh Goyal,
Naveen Saxena,
Raghuveer Singh,
Madhu Saxena,
Uma Shankar Shukla
Issue:
Volume 9, Issue 3, September 2021
Pages:
131-139
Received:
15 June 2021
Accepted:
30 June 2021
Published:
7 July 2021
Abstract: Introduction: The Human immunodeficiency virus (HIV) infection remains a serious public health concern in India and around the world at large. Malignancy is frequent among people living with HIV (PLWH) has become the leading cause of death. The incidence of malignancy among PLWH depends on various factors; virological control under combined antiretroviral therapy (cART), the exposure to oncogenic virus is of utmost importance, which can be prevented with the implementation of specific screening programs. Drug-drug interactions between cART and oncologic treatments can lead to serious adverse effects or to a reduction in the therapeutic effects requiring close monitoring. Methods: This is a single center retrospective study conducted on 42 seropositive patients attending a tertiary care oncology department from July 2005 to June 2021 to assess the demographic profile; laboratory investigations, clinico-pathological correlation, treatment outcome and survival follow up. Results: A total of 26410 patients were registered in the department during this period, out of which 42 (0.16%) were found to be HIV positive. These included head & neck -13; uterine cervix-7; lung -4; esophagus-4; NHL-4; recto sigmoid -3; breast-3; gall bladder; endometrium, choriocarcinoma (CCA) and acute myeloid leukemia (AML) one each. Conclusion; Seropositive patients often present in advanced stage of disease but have a good prognosis if treated appropriately with anti-retroviral therapy (ART). Very few studies have been published in India regarding the incidence of malignancy in HIV patients credited as one of the largest study published till date.
Abstract: Introduction: The Human immunodeficiency virus (HIV) infection remains a serious public health concern in India and around the world at large. Malignancy is frequent among people living with HIV (PLWH) has become the leading cause of death. The incidence of malignancy among PLWH depends on various factors; virological control under combined antiret...
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Prognostic Significance of Platelet-to-Lymphocyte Ratio in Gliomas: A Meta-analysis
Huayue Cong,
Aixia Sui,
Liuyi Yang,
Huiling Song,
Jing Zhao,
Yong Liu,
Mingming Zhang,
Weiliang He
Issue:
Volume 9, Issue 3, September 2021
Pages:
140-147
Received:
20 June 2021
Accepted:
30 June 2021
Published:
7 July 2021
Abstract: Background and objective: Inflammatory factors are associated with tumour initiation, progression, invasion, and metastasis. It is a potential prognostic factor for multiple solid tumours. Such as cholangiocarcinoma, bladder cancer, nasopharyngeal carcinoma and so on. However, there is no clear evidence that elevation of the systemic inflammatory marker, platelet-to-lymphocyte ratio (PLR), has this type of predictive value in patients with glioma. This meta-analysis aimed to explored the prognostic significance of the preoperative inflammatory marker PLR in patients with glioma. Methods: Systematic retrieval of articles published between the time of their conception and September 2020 in PubMed, EMBASE, and Cochrane library databases, A meta-analysis was performed via Review Manager 5.3, using the hazard ratios (HRs) and 95% confidence intervals (95% CIs) for overall survival (OS) to assess the predictive significance of PLR in patients with glioma. Result: We selected nine studies and showed that in patients with glioma, increased PLR was correlated with poor OS (HR = 1.37, 95% CI: 1.09–1.71, P = 0.007, I2 = 55%). By analysing the I2, we estimated moderate heterogeneity in several of the published articles that were incorporated. Conclusion: Our meta-analysis provides evidence that increased PLR is correlated with poor OS in patients with glioma cancer.
Abstract: Background and objective: Inflammatory factors are associated with tumour initiation, progression, invasion, and metastasis. It is a potential prognostic factor for multiple solid tumours. Such as cholangiocarcinoma, bladder cancer, nasopharyngeal carcinoma and so on. However, there is no clear evidence that elevation of the systemic inflammatory m...
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A Preliminary Study on Lung Cancer Prevalence Among Patients with Tuberculosis in Lesotho
Mopa Alina Sooro,
Thibello Malikelle,
Refiloe Leteka,
Lejeremane Kobo,
Maseabata Ramathebane
Issue:
Volume 9, Issue 3, September 2021
Pages:
148-153
Received:
18 June 2021
Accepted:
29 June 2021
Published:
13 July 2021
Abstract: Tuberculosis (TB) is one of the major causes of ill health associated with infection in approximately a quarter of the global population. Lesotho has been ranked among the top 30 high TB burden countries; however the prevalence of lung cancer in Lesotho has been ranked fifth among the top 5 cancers in men. This seemingly lower prevalence of lung cancer could be masked by the fact that there are a number of cancer cases among TB patients that remain undiagnosed. Therefore, a cross-sectional study was done at the 3 TB centers in Lesotho to investigate the prevalence of lung cancer among patients with TB. This study was done over a 2 months period in April and May 2019. TB patients undergoing treatment at Queen Elizabeth II hospital, St. Joseph’s Hospital and Senkatana center were invited to respond to a questionnaire, where socio-demographic data was gathered, including smoking history, occupation, method of cooking in their homes. The clinical characteristics that patients presented with were also recorded. Among patients who were aged 55 and above, 7 (6.5%) patients had smoking history of more than 30 pack-years. These patients also had family history of lung disease and had worked in the mines or factory in the past. The 7 patients also presented with more than 90% of the clinical symptoms under investigation. Of these 7 patients; 2 (6.3%) were found at Queen II, 1 (4.2%) at St. Joseph while 4 (7.7%) were found at Senkatana hospital. 48% of the study participants were aged 55 and above, while 40% smoked for more than 30 years and 56% were male. 33% of the patients had a family history of lung disease, 21% had worked in mines or factories and 11% had been exposed to prolonged indoor air pollution. Studies show that the risk of lung cancer is 1.7 - fold higher in patients infected with Tuberculosis. It is therefore recommended that lung cancer screening with low dose computed tomography (LDCT) should be done on all Lesotho patients with active TB infection, who report to have smoked for more than 30 years and are aged greater or equal to 55 years.
Abstract: Tuberculosis (TB) is one of the major causes of ill health associated with infection in approximately a quarter of the global population. Lesotho has been ranked among the top 30 high TB burden countries; however the prevalence of lung cancer in Lesotho has been ranked fifth among the top 5 cancers in men. This seemingly lower prevalence of lung ca...
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To Explore the Mechanism of Prunella Vulgaris on Lymphoma Based on Network Pharmacology and Molecular Docking
Xiaohong Wu,
Huiling Song,
Aixia Sui,
Xinyu Zhao,
Hongtao Zhang
Issue:
Volume 9, Issue 3, September 2021
Pages:
154-161
Received:
22 June 2021
Accepted:
2 July 2021
Published:
13 July 2021
Abstract: Background. Although the traditional Chinese medicine Prunella vulgaris may be effective in treating lymphoma, its mechanism of action remains unclear. The purpose of this paper is to explore the mechanism of Prunella vulgaris against lymphoma by combining network pharmacology and molecular docking. Methods. The potential active ingredients of Prunella vulgaris were queried in the TCMSP database. Lymphoma-related genes were searched in the DisgeNet database. After removing the duplicates, the remaining active targets were compared with lymphoma genes to obtain the key target and analyzed using a Venn map. Building a network of protein interactions through String platforms. The GO and KEGG databases were used for enrichment analysis of the key targets with the help of the DAVID analysis platform. Results. A total of 39 potentially active components and 125 targets were identified from Prunella vulgaris, 7592 lymphoma-related target genes, and 101 key target genes for the intersection of Prunella vulgaris and lymphoma. GO entries were related to biological processes including enzyme binding, protein binding, positive regulation of transcription, regulation of cell proliferation, and negative regulation of cell death. KEGG analysis identified the signalling pathways of HIF-1, estrogen, NOD-like receptors, PI3K-Akt, and TNF. The binding between the selected compounds and the target molecules was modelled by molecular docking. Conclusion. Through network pharmacology, it is predicted that Prunella vulgaris may regulate multiple signalling pathways through numerous targets, and thereby affect the functions of multiple cells and playing a role in the treatment of lymphoma.
Abstract: Background. Although the traditional Chinese medicine Prunella vulgaris may be effective in treating lymphoma, its mechanism of action remains unclear. The purpose of this paper is to explore the mechanism of Prunella vulgaris against lymphoma by combining network pharmacology and molecular docking. Methods. The potential active ingredients of Prun...
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Carcinoid Syndrome in a Patient with Duodenal Carcinoid Tumor
Khan Mohammad Nazmus Saqeb,
Fariah Sharmeen,
Farzana Hafiz
Issue:
Volume 9, Issue 3, September 2021
Pages:
162-165
Received:
10 July 2021
Accepted:
27 July 2021
Published:
4 August 2021
Abstract: Duodenal carcinoid tumors accounts for 5% of all Gastrointestinal Neuroendocrine Tumors (GI-NETs). Only 4% of all duodenal carcinoid tumors present with a full-blown carcinoid syndrome. We report a case of duodenal carcinoid tumor presenting as carcinoid syndrome in a 58 year old man, who presented with upper abdominal discomfort, diarrhoea, hot flushes and occasional wheezing. Histopathology following endoscopic resection of the tumor and 24 hour urinary 5-Hydroxyindolacetic acid (5-HIAA) confirmed the diagnosis. Duodenal carcinoid tumors are one of the rarest tumors of gastrointestinal tract and their association with a typical carcinoid syndrome is not that common. A high level of suspicion is required for an early diagnosis. With proper resection (endoscopic or surgical) of a localized tumor, recurrence and progression of the disease can be halted. Symptoms of carcinoid syndrome should be controlled by antidiarrheal agents, inhaled β-adrenergic agonist bronchodilators and somatostatin analogs (octreotide, lanreotide). Patients should be advised to avoid stress and conditions or substances that precipitate these symptoms. Dietary supplementation with nicotinamide can help in this regard. Patients with hepatic metastases are treated with synthetic analogues of somatostatin (octreotide, lanreotide). Systemic chemotherapy is not recommended in metastatic disease by the current guidelines. Patients should be followed up by monitoring serum chromogranin and urinary 5-HIAA. EUS, CT, MRI & somatostatin receptor scintigraphy can also be used for following up the patients.
Abstract: Duodenal carcinoid tumors accounts for 5% of all Gastrointestinal Neuroendocrine Tumors (GI-NETs). Only 4% of all duodenal carcinoid tumors present with a full-blown carcinoid syndrome. We report a case of duodenal carcinoid tumor presenting as carcinoid syndrome in a 58 year old man, who presented with upper abdominal discomfort, diarrhoea, hot fl...
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Paclitaxel Based CCRT Is an Acceptable Alternative for Cisplatin Based CCRT in the Treatment of Locally Advanced (Stage IVA) Head Neck Carcinoma
Md. Zillur Rahman Bhuiyan,
Rokaya Sultana,
Ranjan Kumar Bhoumic,
Sayed Farhan Ali Razib,
Ashish Kumar Shaha,
Ariful Haque
Issue:
Volume 9, Issue 3, September 2021
Pages:
166-170
Received:
3 August 2021
Accepted:
12 August 2021
Published:
24 August 2021
Abstract: Introduction: Head neck carcinoma is the sixth most common cancer in the world. Concurrent chemo radiation became standard protocol for patients with locally advanced squamous cell carcinoma of head neck where curable surgery is not feasible. Study Design and Objective: This quasiexperimental study done to compare the treatment response and acute toxicities with the treatment of low dose weekly Paclitaxel with radiation versus weekly Cisplatin with radiation therapy for histologically proven Stage- IVA squamous cell carcinoma of head neck. Methods: All the patients were divided in two groups. Arm-A, 45 number patients received injection Paclitaxel 40 mg/m2, i/v in 1 hr. infusion weekly for 6 weeks and in Arm- B, 45 number patients received injection Cisplatin 30 mg/m2, i/v in 2 hrs infusion weekly for 6 weeks. All patients received 66 Gray (Gy) radiation at the rate of 2 Gy/day, 5 fractions in a week for 6.5 weeks. Results: In this study about 65.55% patients were smoker. Most common sub site was larynx (41.46%) followed by oral cavity (25.00%) The most common presenting features were cervical lymphadenopathy (100.00%) followed by pain (70.00%), sore throat (43.33%) and hoarseness of voice (41.11%). Complete response showed in the patients of Arm-A, 73.33% among the smoker and 66.67% in non-smoker, whereas 72.41% in smoker and 62.50% in non-smoker showed complete response in the patients of Arm-B. Common toxicities related to treatment were mucosities, skin reaction, vomiting, nausea, weight loss, anaemia, leucopcnia, thrombocytopenia and diarrhoea. The toxicities in Arm-A were more than that of Arm-B, but were manageable. Conclusion: In this study it is evident, the concurrent chemo radiotherapy with weekly Paclitaxel is suitable alternative when Cisplatin cannot be given safely.
Abstract: Introduction: Head neck carcinoma is the sixth most common cancer in the world. Concurrent chemo radiation became standard protocol for patients with locally advanced squamous cell carcinoma of head neck where curable surgery is not feasible. Study Design and Objective: This quasiexperimental study done to compare the treatment response and acute t...
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A Phase 1 Dose Escalation Study of Eribulin in Combination with Weekly Carboplatin for the Treatment of Metastatic Breast Cancer
Aixa Elena Soyano,
Michael Shafique,
Roohi Ismail-Khan,
Dawn Goodridge,
David Boulware,
Hatem Soliman,
Hyo Sook Han
Issue:
Volume 9, Issue 3, September 2021
Pages:
171-175
Received:
2 August 2021
Accepted:
24 August 2021
Published:
31 August 2021
Abstract: Background: Metastatic breast cancer is a common and devastating diagnosis. New strategies for treatment are needed to help improve outcomes. Eribulin is an anti-microtubule agent approved in 2010 for advanced breast cancer. Combination with other chemotherapeutic agents provides an alternative treatment option for these patients. Purpose: This study evaluates the safety, tolerability and activity of eribulin and weekly carboplatin in a dose-escalation schema in patients with metastatic breast cancer. Methods: Patients were treated with eribulin and carboplatin AUC 2 administered on the first and eighth days of a 21-day cycle. Three doses of eribulin (0.9, 1.1 and 1.4 mg/m2) were examined. An additional 10 patients were enrolled into an expansion cohort at the recommended Phase 2 dose. Results: A total of 19 patients were treated, including 10 patients in the dose expansion cohort. There was no dose limiting toxicity related to the study therapy in the dose escalation cohorts. Grade 3 toxicities included neutropenia (21%), anemia (10%), fatigue (10%), peripheral sensory neuropathy (10%), infusion related reactions (5%), pericardial effusion (5%), diarrhea (5%) and pleural effusion (5%). Twenty-six percent of patients had grade 4 neutropenia, but there were no events of sepsis or febrile neutropenia. The maximum tolerated dose (MTD) of eribulin in combination with carboplatin AUC 2 was determined to be 1.4 mg/m2. Four patients experienced clinical benefit, 2 patients with stable disease greater than 6 months and 2 patients with partial response, demonstrating a clinical benefit rate of 21%. Conclusion: Eribulin and weekly carboplatin appeared to be safe and well tolerated with demonstrated clinical benefit. The recommended Phase 2 dose level was 1.4 mg/m2 of eribulin. Further studies can be pursued for this combination regimen to establish its efficacy.
Abstract: Background: Metastatic breast cancer is a common and devastating diagnosis. New strategies for treatment are needed to help improve outcomes. Eribulin is an anti-microtubule agent approved in 2010 for advanced breast cancer. Combination with other chemotherapeutic agents provides an alternative treatment option for these patients. Purpose: This stu...
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