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H K Malhotra

Publications and source records attributed to H K Malhotra.

4 recordsLinked to original sources

Cardiac function after chemoradiation for esophageal cancer: comparison of heart dose-volume histogram parameters to multiple gated acquisition scan changes.

In this paper we determine if preoperative chemoradiation for locally advanced esophageal cancer leads to changes in cardiac ejection fraction. This is a retrospective review of 20 patients treated at our institution for esophageal cancer between 2000 and 2002. Multiple gated acquisition cardiac scans were obtained before and after platinum-based chemoradiation (50.4 Gy). Dose-volume histograms for heart, left ventricle and left anterior descending artery were analyzed. Outcomes assessed included pre- and postchemoradiation ejection fraction ratio and percentage change in ejection fraction postchemoradiation. A statistically significant difference was found between median prechemoradiation ejection fraction (59%) and postchemoradiation ejection fraction (54%) (P = 0.01), but the magnitude of the difference was not clinically significant. Median percentage volume of heart receiving more than 20, 30 and 40 Gy were 61.5%, 58.5% and 53.5%, respectively. Our data showed a clinically insignificant decline in ejection fraction following chemoradiation for esophageal cancer. We did not observe statistically or clinically significant associations between radiation dose to heart, left ventricle or left anterior descending artery and postchemoradiation ejection fraction.

Aged↗

Dhat syndrome: a culture-bound sex neurosis of the orient.

The Indian Dhat syndrome is a culture-bound symptom complex. The clinical picture includes severe anxiety and hypochondriasis. The patient is preoccupied with the excessive loss of semen by nocturnal emissions. There is a fear that semen is being lost, and mixed in urine. A study was carried out to investigate the cultural basis of the Dhat syndrome. One hundred and seven respondents from the general public were interviewed. A vignette describing an individual having nocturnal emissions was read aloud to the respondents. Attitudes toward nocturnal emission, its causes, and its management were investigated. A large segment of the general public from all socioeconomic classes believed that semen loss is harmful. Seminal fluid is considered an elixir of life both in the physical and in the mystical sense. Its preservation guarantees health, longevity, and supernatural powers. This belief is more frequent in lower socioeconomic classes. The susceptible individual reacts to the prevalent belief system and to the fears of semen loss. The symptoms usually disappear if the misconceptions about semen loss are effectively dealt with. It is expected that with increasing literacy and progress in sex knowledge the syndrome will become less common.

Adult↗