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Biomedical subjects

Manoj Pandey

Publications and source records attributed to Manoj Pandey.

At least 19 recordsLinked to original sources
PubMed2004

Open Access to essential health care information.

Open Access publishing is a valuable resource for the synthesis and distribution of essential health care information. This article discusses the potential benefits of Open Access, specifically in terms of Low and Middle Income (LAMI) countries in which there is currently a lack of informed health care providers - mainly a consequence of poor availability to information. We propose that without copyright restrictions, Open Access facilitates distribution of the most relevant research and health care information. Furthermore, we suggest that the technology and infrastructure that has been put in place for Open Access could be used to publish download-able manuals, guides or basic handbooks created by healthcare providers in LAMI countries.

Journal Article↗
PubMed2004

Primary sarcoma of the breast.

BACKGROUND AND OBJECTIVES: Primary sarcoma occurring in breast is rare and comprises 0.5-1% of all breast neoplasm. Majority of the series include both stromal and cystosarcoma phyllodes, only a few hundred cases of sarcomas other then cystosarcoma are reported. PATIENTS AND METHODS: We carried out a retrospective analysis of 19 patients with primary sarcoma of the breast treated between 1982 and 2002. RESULTS: Mean age of the patients was 38.6 years (12-70 years). Gradually progressive swelling was the commonest presenting feature. There were eight cases of angiosarcoma, four cases of spindle cell sarcoma, two each of pleomorphic sarcoma and stromal sarcoma, and one each of malignant fibrous histiocytoma, embryonal rhabdomyosarcoma, and sarcoma (NOS). Eight of these were high-grade (42%). Eight patients underwent either radical or modified mastectomy, three underwent wide excisions, and one underwent quadrantectomy. Ten (52.6%) patients received postoperative adjuvant radiation. Two patients received chemotherapy. After a mean follow-up time of 34.5 months (median 25 months), eight patients failed. Failure was local in five, opposite breast in one, and both local and distant in two. The disease free survival at 3-year was 39%. In univariate analysis only the margin of first surgery was found to be a significant predictor of survival (P = 0.05). CONCLUSIONS: Primary sarcomas of the breast are aggressive tumors. Surgical treatment should consist of at least simple mastectomy. All attempts should be made to achieve a negative margin as this appears to be the only factor influencing survival in these patients.

Adult↗
PubMed2004

Actinomycosis of the parotid masquerading as malignant neoplasm.

BACKGROUND: Primary actinomycosis of the parotid gland is of rare occurrence and can mimic a malignant neoplasm both clinically as well as radiologically. CASE PRESENTATION: We present here a case of primary actinomycosis of the parotid gland presenting with a parotid mass lesion with erosion of skull bones. CONCLUSIONS: Clinical presentation of cervico-facial actinomycosis is characterized by the presence of a suppurative or indurative mass with discharging sinuses. The lesion demonstrates characteristic features on fine needle aspiration cytology and histology, however at times the findings are equivocal.

Actinomycosis↗
PubMed2004

Do younger women with non-metastatic and non-inflammatory breast carcinoma have poor prognosis?

BACKGROUND: Controversy abounds over whether breast cancer in younger women is more aggressive than those in older. The aim of the study was to assess the influence of age on long-term survival of women with breast carcinoma. MATERIALS AND METHODS: Patients with non-metastatic and non-inflammatory invasive breast carcinoma treated at the Regional Cancer Centre, Trivandrum, Kerala, India during 1990-93 were divided into 4 age groups as < 40 years, 40-49, 50-59, and > 60 years. The overall survival (OS) for each age group was estimated using the Kaplan-Meier method in relation to the primary tumor (T) and the axillary node status (N). The OS of the various age groups were compared using the log-rank test. Hazard ratio and 95% confidence interval for each age group was estimated using Cox-regression model after adjusting for T and N. RESULTS: Between 1990-1993, 1701 women (26%, <40 years) reported with non-metastatic and non-inflammatory invasive breast carcinoma. Overall survival (OS) of all the women was 52.6 % (standard error 1%) at 10 years. The OS for women with age < 40 years and with T3 and T4 disease status was 36.6% and 10.4% respectively and for those in 40-49 age group was 41.9% and 33.5%. The 10-year OS for women with node positive (N1) disease was 24.6% in < 40 years and 45.2% in the 40-49 age group (p = 0.0006). After adjusting for tumor and node stage the relative risk for death was 24% lower for women in 40-49 age group as compared to women <40 years of age. CONCLUSION: Women under 40 years with T3/ T4 breast lesions and/or positive axillary nodes were found to have a significantly poorer survival.

Journal Article↗
PubMed2004

Identifying and predicting behaviour outcomes in cancer patients undergoing curative treatment.

A lot of emphasis is now being placed in early identification of 'distress', a state that lies between the feelings of sadness and apprehension, and clinically defined syndromes. It is assumed that an intervention at this stage will check the progression along the continuum in cancer patients. We have been working in global distress in cancer patients undergoing multimodality treatment with curative intent, for over 5 years. It all started with the generation of a hypothesis which led to the development of the 'Distress Inventory for Cancer', its refinement, and finally to modelling distress. This article gives a brief overview of our work on distress as conceptualised by the National Comprehensive Cancer Network in 1998, adopted and modified by us using informal patient interviews, expert Delphi exercise and structured patient interviews.

Humans↗
PubMed2004

Quality of life of patients with cancer in India: challenges and hurdles in putting theory into practice.

Although well establish in west, quality of life is a relatively new concept in India. The success of treatment is still measured in term of number of years and not as number of quality years. We carried out a systematic review of the reports published from India on quality of life in cancer patients. Majority of the studies originated from the southern part of India, this was not surprising as this part has literacy rates and health indices at par with developed countries. The studies mainly dealt with translation of existing tools in local vernacular, development of new tools, cross-sectional studies, and studies on palliative care. This article reviews these studies and presents the results of what has been done so far and goes on to stipulate what more needs to be done.

Adaptation, Psychological↗
PubMed2004

Squamous cell carcinoma in epidermolysis bullosa.

Epidermolysis bullosa (EB) is a group of inherited blistering disorders that are divided into three categories based on the plane of cleavage of the blister, mode of inheritance, and the presence or absence of scars. Squamous cell carcinoma developing in epidermolysis bullosa is rare and presents a therapeutic dilemma. The authors report a case of congenital epidermolysis bullosa with locally advanced squamous cell carcinoma.

Journal Article↗
PubMed2004

Burn injuries from radiation.

Accidental exposure to radiation leading to injury and illness occurs notwithstanding safety devices and protocols used for protection. The medical management of radiation casualties is a major concern. Radiation effects are principally thermal, similar to electrical burn injuries, but with some unique systemic expression. The pathological effects of radiation to the skin are known; it is often difficult to assess the level of severity, quickly and with accuracy, because of the delay between exposure and the appearance of lesions and obscured lesions. The severity depends mainly on the nature of the radiation.High-energy penetrating radiation causes more irreversible damage than low-energy radiation, which penetrates tissues less than the former. A thorough knowledge, high index of suspicion, and a team approach are keys to successful management.

Journal Article↗
PubMed2004

Squamous cell carcinoma in untreated psoriasis: a case report.

Skin cancer developing after treatment for psoriasis is seen more often than expected, however, there has been no report of cutaneous squamous cell carcinoma developing in a case of untreated psoriasis. Here, a case has been reported where an untreated psoriasis lesion progressed on to develop squamous cell carcinoma, with a brief review of literature.

Adult↗
PubMed2004

Reliability & validity of the Malayalam Functional Assessment of Cancer Therapy for Head & Neck Cancer.

BACKGROUND & OBJECTIVES: The need for quality over quantity in cancer survival is increasingly being recognised in the developing countries, and the efforts to monitor quality of life (QOL) are increasing. However, the non-availability of a valid and reliable tool in the local language is a common problem. Cross-culturally sensitive tools enable the researchers to compare different patient populations and identify cultural differences and variations. The present study was carried out to translate, validate and test for reliability a reliable QOL tool for the head and neck cancer patient population in a tertiary care hospital in south India. METHODS: The functional assessment of cancer therapy for head and neck cancer (FACT-H&N) was translated into the local language (Malayalam) and tested for reliability in 140 patients of head and neck cancer. RESULTS: The translated tool showed substantial psychometric sensitivity. The Cronbach's alpha for the total FACT-H&N was 0.94. The alpha scores for the five subscales ranged from 0.81-0.92. Significant correlations were observed amongst the total QOL and subscale scores and patient's demographic, disease and treatment variables. INTERPRETATION & CONCLUSION: The Malayalam translation of the FACT-H&N questionnaire was developed, tested and validated. It was found to satisfactorily measure QOL in head and neck cancer patients.

Adult↗
PubMed2003

Patterns of cervical metastasis from carcinoma of the oral tongue.

BACKGROUND: Cancer of the oral tongue is the second most common cancer among males in various parts of India. Despite advances in diagnosis and treatment the failure rates in cancer of the oral tongue are high and survival poor. Majority of these failures occur in untreated neck. METHOD: A retrospective review of the records of 75 patients undergoing surgery for the treatment of squamous cell carcinoma of the oral tongue was carried out to ascertain the pattern of metastasis in the neck and to evaluate the sensitivity of clinical examination in predicting nodal spread. RESULTS: All the patients underwent primary surgery. Cervical lymph node metastasis was found in 35.6% of T1 and T2 tumours and 62.35% of T3 and T4 tumours. Sensitivity of clinical examination was found to be 54.5% and specificity of 61.9%. Level II was the most commonly involved (63.6%). Isolated level IV involvement was never found in clinically negative neck. Tumour stage and node status were found to have a significant impact on disease free survival in both univariate and multivariate analysis. CONCLUSIONS: As the sensitivity and specificity of the clinical examination is low we suggest that methods like ultrasound or CT Scan of the neck should be regularly employed to improve the sensitivity and specificity of the examination. Furthermore as isolated level IV involvement is never found in our series, we suggest that a prophylactic supraomohyoid neck dissection should be carried out in all patients with a clinically node negative neck with cancer of oral tongue, to achieve a better disease free survival.

Journal Article↗
PubMed2003

Unusual metastasis of papillary thyroid carcinoma to larynx and hypopharynx a case report.

BACKGROUND: Although direct infiltration of papillary carcinoma of thyroid to larynx, trachea and esophagus is well recognized, lymphatic and vascular metastases to larynx and hypopharynx have rarely been reported. CASE REPORT: A case of loco-regionally advanced papillary carcinoma of thyroid metastasizing to the hypopharynx and aryepiglottic fold is presented CONCLUSIONS: Papillary thyroid carcinoma (PCT) is known for their indolent nature and erratic behavior. PCT commonly spreads through lymphatics and vascular spread is rare. However, when occurs it is usually to bone, brain, lungs and soft tissue. Therapeutic decisions in advanced thyroid malignancies are usually difficult especially when there is extra-nodal spread of the tumor. A judicious combination of surgical clearance combined with radioablation is the key to the management of such tumors

Journal Article↗
PubMed2003

Erythrocyte membrane fatty acid profile and saturation index in gallbladder carcinogenesis: a case-control study.

BACKGROUND: Gallbladder cancer is a common neoplasm of biliary tract, with an unknown etiology. PATIENTS AND METHODS: This study was carried out to evaluate the changes in the membrane fatty acid profile and saturation index in patients with gallbladder cancer. The study sample consisted of 50 newly diagnosed cases of gallbladder cancer and 50 patients undergoing cholecystectomy for cholelithiasis were recruited as controls. The fatty acid estimation was carried out by high performance liquid chromatography (HPLC). Statistical analysis was carried out by student 't' test and one-way ANOVA. Pearson's correlation coefficient was also obtained. RESULTS: A significant lowering of erythrocyte membrane stearic acid (p = 0.000), arachidonic acid (p = 0.001), and saturation index (p = 0.001) was observed in patients with gallbladder cancer compared to controls. A significant inverse relation was observed between stearic and oleic acid (r = -0.269 p = 0.007). CONCLUSION: Results of the present study suggest an increase in the delta 9 desaturation in cancer patients compared to controls however, a possible role of biliary stasis due to altered gallbladder motility or derangements of signal transduction secondary to altered membrane lipid bilayer cannot be ruled out.

Journal Article↗
PubMed2003

Unusual presentation of choriocarcinoma.

BACKGROUND: Choriocarcinoma is an aggressive neoplasm arising in the body of the uterus. The disease normally spreads to lung and brain. CASE REPORT: A case of malignant trophoblastic disease with brain metastasis, raised intra cranial pressure and small bowel metastasis presenting with acute abdomen is reported. CONCLUSIONS: Malignant transformation in a hydatidiform mole is rare event. Involvement of gastrointestinal tract is rarer even in presence of disseminated disease. Surgery is the treatment of choice for gastrointestinal complications.

Journal Article↗
PubMed2003

Tuberculosis and metastatic carcinoma coexistence in axillary lymph node: A case report.

BACKGROUND: Coexistence of cancer and tuberculosis in axillary lymph nodes is rare. Only seven cases have been reported in the literature. CASE REPORT: We report here a case of infiltrating ductal carcinoma breast metastasizing to the axillary lymph node along with tubercular granuloma in the same lymph node without primary mammary or pulmonary tuberculosis. CONCLUSION: Primary tuberculosis coexisting with carcinoma is of rare occurrence. A possibility should always be borne in mind especially in patients from endemic areas.

Journal Article↗
PubMed2003

Central Mucoepidermoid carcinoma of mandible - A case report and review of the literature.

BACKGROUND: Primary central mucoepidermoid carcinoma of jaws is a rare lesion comprising 2-3% of all mucoepidermoid carcinomas reported in literature. CASE PRESENTATION: The case presented here illustrates the hypothesis that its specific pathogenesis is unknown. CONCLUSIONS: Mucoepidermoid carcinoma of the jaw is a rare tumour of unknown aetiology. Although about a 100 cases has been reported in literature, the speculation on its aetiopathogenesis has mainly centred on the pluripotential capabilities of the epithelial lining of odontogenic cysts.

Journal Article↗