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Biomedical subjects

A K Anand

Publications and source records attributed to A K Anand.

At least 19 recordsLinked to original sources
PubMed2006

Can dose reduction to one parotid gland prevent xerostomia?--A feasibility study for locally advanced head and neck cancer patients treated with intensity-modulated radiotherapy.

AIMS: Dryness of the mouth is one of the most distressing chronic toxicities of radiation therapy in head and neck cancers. In this study, parotid function was assessed in patients with locally advanced head and neck cancers undergoing intensity-modulated radiotherapy (IMRT) with or without chemotherapy. Parotid function was assessed with the help of a questionnaire and parotid scintigraphy, especially with regards to unilateral sparing of the parotid gland. MATERIALS AND METHODS: In total, 19 patients were treated with compensator-based IMRT between February 2003 and March 2004. The dose to the clinical target volume ranged between 66 and 70 Gy in 30-35 fractions to 95% of the isodose volume. Ipsilateral high-risk neck nodes received an average dose of 60 Gy and the contralateral low-risk neck received a dose of 54-56 Gy. Eight of 19 patients also received concomitant chemotherapy. RESULTS: Subjective toxicity to the parotid glands was assessed with the help of a questionnaire at 0, 3 and 6 months and objective toxicity was assessed with parotid scintigraphy at 0 and 3 months. The mean dose to the ipsilateral parotid gland ranged from 19.5 to 52.8 Gy (mean 33.14 Gy) and the mean dose to the contralateral gland was 11.1-46.6 Gy (mean 26.85 Gy). At a median follow-up of 13 months, 9/19 patients had no symptoms of dryness of the mouth (grade I), 8/19 had mild dryness of the mouth (grade II) and only 2/19 had grade III xerostomia, although the parotid gland could only be spared on one side in most of the patients. CONCLUSIONS: Minimising the radiation dose to one of the parotid glands with the help of IMRT in patients with advanced head and neck cancers can prevent xerostomia in most patients and parotid scintigraphy is a useful method of documenting xerostomia.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2003

Pericardial synovial sarcoma.

A 29-year-old young man presented with acute breathlessness. After investigative work-up he was found to have a massive pericardial tumour. Thoracotomy and near total surgical excision of the pericardial tumour was carried out. Histopathology and immunohistochemical markers study revealed it to be a synovial sarcoma arising from the left lateral pericardial surface. Postoperatively, he received external radiation and chemotherapy. Thirteen months after surgery he developed local recurrence which was unresectable.

Adult↗
PubMed1993

Vertebral haemangioma presenting as Kasabach-Merritt syndrome.

A case of spinal cord compression due to vertebral haemangioma is described as presenting as part of the Kasabach-Merritt syndrome, which is characterized by bleeding disorder, thrombocytopenia and leukopenia. A dramatic improvement in neurological status and coagulation profile following surgical decompression and postoperative radiotherapy is reported. A brief review of the literature on the usefulness of radiotherapy is discussed.

Adult↗
PubMed1992

Anomalous lateral sulcus asymmetry and cognitive function in first-episode schizophrenia.

This study examines the cognitive functioning of first-episode schizophreniform patients within several weeks of hospitalization and at 2 years into the illness. Differences between patients and controls are also reported for measurements of the length of the lateral sulcus, which borders the planum temporal, an area of the brain integral to language function. Neuropsychological test results are also correlated to magnetic resonance imaging structural variables at the time of first hospitalization. Findings on neuropsychological summary scales reveal a diffuse pattern of cognitive impairment in schizophreniform patients compared to controls, which appears to improve over time. An atypical pattern of anatomic lateral symmetry is found in female schizophreniform patients, with female appearing to have a reduction in the normally occurring left greater than right length of the lateral sulcus. Such atypical asymmetry of the lateral sulcus is also associated with better cognitive function, particularly in schizophreniform patients. These findings suggest that atypical lateralization in an area critical to language function may be related to cognitive function in schizophreniform illness.

Adult↗
PubMed1991

Brain morphology in first-episode schizophrenic-like psychotic patients: a quantitative magnetic resonance imaging study.

Brain morphology was examined using magnetic resonance imaging in 30 first-episode patients with a schizophreniclike psychosis, 15 chronic schizophrenics, and 20 neurological controls. Statistical analyses of computer-generated measurements of regions of interest were controlled for gender, age, social class, and total brain volume. Lateral ventricular size was increased in both first-episode and chronic schizophrenic patients, with greater significance on the left than on the right side. Only the chronic patients, however, had reduced temporal lobe size, which also was greater on the left side. No major correlations of regional brain morphological measurements with cognitive functioning were found, although some measurements of verbal memory were correlated with parahippocampal size. This is a report of a preliminary study that suggests that some morphological brain changes may be present at the time of first treatment for a psychotic illness, whereas others may occur later in the course of illness. Future prospective studies may determine the clinical significance of these changes and whether they progress with the development of illness chronicity.

Adolescent↗
PubMed1991

Selective embolization of internal iliac artery for massive haemorrhage from bladder secondary to carcinoma.

Uncontrolled haemorrhage from the urinary bladder secondary to carcinoma can at times be a life-threatening complication. We report a case of recurrent carcinoma of bladder where all the conservative measures for controlling hematuria had failed. Selective embolization of both internal iliac arteries was undertaken which controlled haematuria within 12 hours of the procedure. The procedure had not caused any complication up until the patient was last seen 5 months after the procedure.

Carcinoma, Transitional Cell↗
PubMed1990

Metastatic carcinoma in the cervical lymph nodes from an occult primary: a conservative approach to the role of radiotherapy.

This retrospective study examines the results of treatment for cervical lymph node metastases from an unknown primary epithelial cancer of squamous cell or anaplastic histology. The analysis covers a series of 87 consecutive unselected patients at the Middlesex Hospital, London, in the years between 1954 and 1986. Fifty-eight patients received radiation therapy with a view to cure, 25 patients were treated with radiotherapy to a palliative dose, 1 patient only had a radical neck dissection, and 3 patients received no treatment apart from excision biopsy. In contrast to common practice in the United States, only a single patient received prophylactic radiation to the nasopharynx as part of the initial therapy. Overall actuarial survival for all patients (87) at 2 years was 43% and at 5 years 33%, and in the radically treated group (58) it was 52% and 40%, respectively. Only 6 of the 87 patients (7%) subsequently revealed a primary tumor above the clavicles. Overall disease control above the clavicles was achieved in 53% (46/87), but was 64% (37/58) in the radically treated group. Guidelines for radiation therapy are discussed in view of these results.

Adolescent↗
PubMed1990

Cerebral venous thrombosis in a child with iron deficiency anemia and thrombocytosis.

We describe a 22-month-old boy with iron deficiency anemia and reactive thrombocytosis who developed vomiting, headache, mental status changes, and seizures. Computed tomography showed infarction of the basal ganglia and thalami. Magnetic resonance imaging revealed cerebral venous thrombosis, delineated the extent of the vascular and associated parenchymal involvement, showed the infarcts to be hemorrhagic (a finding not imaged by computed tomography due to our patient's depressed hemoglobin level), and obviated the need for invasive angiography.

Anemia↗
PubMed1989

Metastatic adenocarcinoma in the cervical lymph nodes from an occult primary.

Cervical lymph node metastases as the only site of disease is a rare presentation of an adenocarcinoma of unknown primary origin. This retrospective analysis examines the records of ten consecutive patients at the Middlesex Hospital with this diagnosis between 1954 and 1986. The diagnostic protocol employed and the results of radical treatment are evaluated. Nine patients received radiation therapy with intent to cure, and one patient had a radical neck dissection. Overall actuarial survival for all patients (10) at 2 years was 23% and at 5 years 0%. Only two of the 10 patients subsequently revealed a primary tumour--both below the clavicles. Disease control above the clavicles was not achieved in a single patient despite radical treatment.

Adenocarcinoma↗
PubMed1989

Lyme neuroborreliosis: central nervous system manifestations.

We evaluated 85 patients with serologic evidence of Borrelia burgdorferi infection. Manifestations included encephalopathy (41), neuropathy (27), meningitis (2), multiple sclerosis (MS) (6), and psychiatric disorders (3). We performed lumbar punctures in 53, brain MRI in 33, and evoked potentials (EPs) in 33. Only patients with an MS-like illness had abnormal EPs, elevated IgG index, and oligoclonal bands in the cerebrospinal fluid. Twelve of 18 patients with encephalopathy, meningitis, or focal CNS disease had evidence of intrathecal synthesis of anti-B burgdorferi antibody, compared with no patients with either MS-like or psychiatric illnesses, and only 2/24 patients with neuropathy. MRIs were abnormal in 7/17 patients with encephalopathy, 5/6 patients with an MS-like illness, and no others. We conclude that (1) intrathecal concentration of specific antibody is a useful marker of CNS B burgdorferi infection; (2) Lyme disease causes an encephalopathy, probably due to infection of the CNS; (3) MS patients with serum immunoreactivity against B burgdorferi lack evidence of CNS infection with this organism.

Acute Disease↗
PubMed1985

Posttraumatic cerebrospinal fluid cyst of the orbit. Case report.

A 27-year-old man sustained a fracture of the orbital roof and a basofrontal dural tear in a motor-vehicle accident. One week later, he developed an orbitocranial dural fistula manifested by an orbital cyst, pulsatile proptosis, and serous drainage from the eye. Specific diagnosis was established only after computerized tomography metrizamide cisternography demonstrated direct communication of the orbital cyst with the subarachnoid space. The pertinent literature is reviewed.

Adult↗
PubMed1985

Cervical diastematomyelia: a case report with operative management.

A case of midcervical diastematomyelia presenting as acute traumatic hemiplegia in an adult is discussed, with emphasis upon features reflecting this particular location. Advantages of metrizamide computed tomographic imaging in the diagnosis of this entity are presented, and a method of operative management is outlined.

Adult↗
PubMedDate not supplied

Lumbosacral epidural metastases: CT evaluation and comparison with myelography.

Computerized tomography (CT) of lumbosacral region and lumbar myelograms of 100 patients with primary tumours were evaluated independently for evidence of epidural metastases. An attempt was made to predict myelographic abnormalities (or absence of such) on the basis of CT appearance at the spine and spinal canal contents. The overall accuracy of computed tomography was found to be 80%. There was a good correlation with myelography in patients without evidence of epidural lesions (79%). However, in group of patients with positive myelograms, CT was rather unreliable with high number of false negative studies (50%).

Epidural Space↗