Browsing by Author "Pandey, M"
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Item Acute abdomen in patients receiving chemotherapy.(2001-06-21) Pandey, M; Mathew, A; Geetha, N; Sebastian, P; Ahamed, I M; Nair, M KOBJECTIVE: To assess the incidence of acute abdomen in patients receiving chemotherapy and to evaluate the factors affecting the clinical decision-making. MATERIAL AND METHODS: Retrospective analysis of surgical oncology references for the patients developing acute abdomen while receiving chemotherapy was carried out. A surgical oncologist reviewed each referral and a full work-up was carried out. Surgical interventions were carried out as and when deemed necessary. Response to treatment, whether surgical or conservative, was used as main outcome variable. RESULTS: Mean age of the patients was 37 years (7-58 years). Half of the patients were receiving chemotherapy for lymphoproliferative disorders, 13 for haematological malignancies and 3 for ovarian cancer. Clinical diagnosis was of acute appendicitis in 13, paralytic ileus in 9, typhilitis in 3 and intestinal perforation in 2, acute intestinal obstruction in 3, and obstructed hernia and intussception in one each. Six patients underwent surgery. Two patients expired postoperatively of progressive septicaemia and multi-system organ failure. CONCLUSION: Evaluation of cancer patients on chemotherapy is difficult. Tenderness, presence of peritoneal signs and absence of exaggerated bowel sounds are most important clinical signs, however they may be blunted by progressive neutropenia or corticosteroid administration. Decision to operate, should be made with extreme caution as mortality and morbidity after surgery is high.Item Attributing death to cancer: cause-specific survival estimation.(2002-10-07) Mathew, A; Pandey, MCancer survival estimation is an important part of assessing the overall strength of cancer care in a region. Generally, the death of a patient is taken as the end point in estimation of overall survival. When calculating the overall survival, the cause of death is not taken into account. With increasing demand for better survival of cancer patients it is important for clinicians and researchers to know about survival statistics due to disease of interest, i.e. net survival. It is also important to choose the best method for estimating net survival. Increase in the use of computer programmes has made it possible to carry out statistical analysis without guidance from a bio-statistician. This is of prime importance in third- world countries as there are a few trained bio-statisticians to guide clinicians and researchers. The present communication describes current methods used to estimate net survival such as cause-specific survival and relative survival. The limitation of estimation of cause-specific survival particularly in India and the usefulness of relative survival are discussed. The various sources for estimating cancer survival are also discussed. As survival-estimates are to be projected on to the population at large, it becomes important to measure the variation of the estimates, and thus confidence intervals are used. Rothman's confidence interval gives the most satisfactory result for survival estimate.Item Biological behavior and disease pattern of carcinoma gallbladder shown on 64-slice CT scanner: A hospital-based retrospective observational study and our experience.(2012-07) Dwivedi, A N D; Pandey, M; Shukla, R C; Shukla, V K; Gaharwar, S; Maurya, B NPurpose: The aim of this diagnostic observational study was to assess the spread and biological behavior of gallbladder cancer using 64-slice computerized tomography (CT) scanner in this particular geographic belt (eastern Uttar Pradesh, western Bihar, and northern Madhya Pradesh provinces of North India). Indians are ethnically and culturally different from their Western counterparts among whom the incidence of this disease is comparatively low. Subjects and Methods: After systemic examination, all patients (87) were subjected to ultrasonographic examination. All cases were histopathologically proven. Confirmed cases were subjected to volumetric CT examination of abdomen and pelvis, plain, post contrast and delayed phase. Results: Majority of the cases were adenocarcinoma. There was female preponderance with majority belonging to fifth and sixth decades. Commonest presentation was diffuse, irregular, enhancing wall thickening in 49.4%. Majority had invasion of liver parenchyma (74.7%). Cholelithiasis was seen in 48.3% cases. Invasion of biliary radicals was high (13.8-18.4%). Eleven cases had invasion of portal vein and tumor thrombus, with hepatic artery invasion in one case. In two cases, both hepatic artery and portal vein invasion was seen. Portal and peripancreatic nodal metastasis was seen in 58.5%. Distant metastasis was reported. Conclusion: Few studies involving the Indian population have attempted to use multi-row detector CT to define the biological behavior of carcinoma gallbladder. The opinion whether the pathology is operable or non-operable can reasonably be given. This large-scale, single-center study gives insight about the epidemiology and biological behavior of carcinoma gallbladder.Item Carcinoma of the ovary masqurading as gall bladder neoplasm.(1997-04-01) Shukla, V K; Arya, N C; Pandey, M; Gautam, AItem Carotid cavernous fistula.(1989-07-01) Mishra, G K; Jindal, V; Vernekar, J; Pandey, MItem A case of human thelaziasis from Himachal Pradesh.(2006-01-01) Sharma, A; Pandey, M; Sharma, V; Kanga, A; Gupta, M LSmall, chalky-white, threadlike, motile worms were isolated from the conjunctival sac of a 32 year-old woman residing in the Himalaya mountains. They were identified as both male and female worms of Thelazia callipaeda. To the best of our knowledge, this is the second case report of human thelaziasis from India.Item Caveats and pitfall in medical research.(1998-05-26) Pandey, MItem Development of a distress inventory for cancer: preliminary results.(2002-01-26) Thomas, B C; Mohan, V N; Thomas, I; Pandey, MCONTEXT: Advances in cancer treatment have led to cure and prolongation of patients' lives; however associated psychosocial problems, including distress, can detrimentally affect patients' compliance with treatment and ultimately, their outcome. Symptom distress has been well addressed in many studies; however, psychological distress has only been quantified by using depression or anxiety scales/checklists or quality of life scales containing a distress sub scale/component or by the use of scales that are not psychological distress-specific. AIMS: The present study is an attempt to construct a psychological distress inventory for specific use with cancer patients. SETTINGS AND DESIGN: The standardisation sample consisted of 63 randomly selected patients with head and neck cancer who had undergone/ were undergoing curative treatment at the Regional Cancer Centre, Trivandrum. PATIENTS AND METHODS: The Distress Inventory for Cancer contained 57 positively and negatively toned items. An item analysis was conducted, followed by a factor analysis, thereby identifying the domains influencing distress. RESULTS: The final questionnaire contained 26 items subdivided into four domains viz. the personal, spiritual, physical, and the family domains, with each domain providing a sub score. The reliability coefficient (Cronbach's alpha) of the scale was found to be 0.85. CONCLUSIONS: These are the preliminary results of an ongoing study on global distress and tool development process. Reported here is the first step towards development of such tool.Item Endotracheal intubation related massive subcutaneous emphysema and tension pneumomediastinum resulting in cardiac arrest.(2003-04-18) Pandey, M; Jain, A; Mehta, A; Sharma, MItem Energy and Protein Intake During Pregnancy in Relation to Preterm Birth: A Case Control Study.(2015-06) Awasthi, Shally; Chauhan, M; Pandey, M; Singh, S; Singh, UObjective: To find the association of maternal energy and protein intake with preterm birth. Design: Case-control study. Setting: Two hospitals at Lucknow in Northern India. Participants: Cases (n=350) were defined as mothers (age 18-40 y) of singleton live preterm (<37 wks) neonates. Controls (n=350) were mothers who delivered a singleton neonate, consecutive to enrolled case, after completing 37 weeks of gestation. Results: There was a statistically significant lower mean (SD) energy intake [cases 1624 (249) Kcal vs. controls 1911 (341) Kcal; P<0.001] and protein intake [cases 32.1 (6.1) vs. controls 37.2 (7.0); P<0.001] among women who delivered preterm neonates. Maternal energy and protein intake had significant positive correlation with neonatal weight, length, foot length, head circumference and chest circumference. Conclusion: Lower energy and protein intake during pregnancy is possibly associated with preterm birth.Item Fatty diarrhoea due to spontaneous cholecystocolonic fistula.(1988-02-01) Mishra, G K; Vernekar, J; Pandey, M; Gupta, AItem Fermentation of starch to ethanol by an amylolytic yeast Saccharomyces diastaticus SM-10.(2002-03-15) Sharma, S; Pandey, M; Saharan, BA total of fifteen yeast strains were isolated from natural sources including fruits, soil, molasses, honey and a variety of indigeneous fermented foods. Screening of these strains for growth, ethanol production and glucoamylase activity led to selection of a yeast strain SM-10 identified as S. diastaticus having maximum glucoamylase activity (80 units ml(-1)) and ethanol production from starch (3.5%). Ethanol production from wheat flour was found to be 1.75% which could be increased to 5.2% after treatment of wheat flour with pepsin, diastase and glucoamylase.Item Hepatic duct stones masquerading as Klatskin tumour.(1999-02-22) Dixit, V K; Chaturvedi, P; Pandey, M; Agarwal, A K; Shukla, V KWe report woman who presented with painless progressive jaundice following cholecystectomy. Radiological investigations indicated proximal bile duct obstruction suggestive of hilar malignancy. Exploratory laparatomy revealed bilateral hepatic duct stone causing obstruction.Item Intra- and interspecies variations in pupation height in Drosophila.(1991-10-01) Singh, B N; Pandey, MIn order to study the pupation site preference which is an important component of larval behaviour, pupation height was scored in Drosophila ananassae, D. bipectinata and D. malerkotliana by using a large number of strains of these species. The mean pupation height of different strains ranged from 1.1 to 8.7 mm in D. ananassae, from 0.41 to 0.75 mm in D. bipectinata and from 1.0 to 1.3 mm in D. malerkotliana. The analysis of variance and t-test were performed to test intre- and interspecies variations in pupation height. These tests revealed significant variation among three species. Significant variations among different strains of the same species were also found in D. ananassae and D. bipectinata. These observations provide evidence for intra- and interspecies variations in pupation height in Drosophila. Variations among different strains of the same species in pupation height are attributable to genetic heterogeneity among the strains.Item Lipoma of the nasopharynx.(1998-09-05) Pandey, MItem Malignant tumours of the minor salivary glands: a survival analysis of 17 years from a tertiary referral cancer centre.(2003-01-17) Pandey, M; Thomas, S; Mathew, A; Nair, M KBACKGROUND: Malignant tumours of the minor salivary glands are rare and constitute less than 0.5% of all malignant neoplasms. AIM: This study was carried out to evaluate the clinical presentation, site distribution, treatment, survival and predictors of survival in malignant minor salivary gland tumours. SETTING: A tertiary care, superspeciality referral hospital. DESIGN: Retrospective analysis. PATIENTS AND METHOD: Forty-two cases of minor salivary gland tumours treated over a period of 17 years were reviewed for clinical presentation, histopathology, stage distribution, treatment and treatment outcome. STATISTICAL ANALYSIS: Survival by Kaplan Meier Method and the outcomes were compared using log-rank test. RESULTS: The mean age of the patients was 46.9 years with a male to female ratio of 1.4:1. Majority of the patients presented with a painless progressive swelling, with 13 (31%) of them in T2 stage. About one-third of the patients had palpable lymph nodes at presentation, while none had distant metastasis. Palate was the commonest site and mucoepidermoid carcinoma was the commonest hispathological type. About 1/3 of the patients were treated with primary surgery and were followed up by adjuvant radiotherapy. Seven patients underwent palliative treatment alone. Over a mean follow-up of 30 months, 5 patients failed. The disease free survival was 72% at 5-year, none of the factors studied were found to significantly influence survival. CONCLUSIONS: Results of the present study suggest that minor salivary gland tumours should be treated with primary surgery irrespective of site and histological type to achieve best loco-regional control and survival.Item Necrotising histiocytic lymphadenitis.(2002-01-26) Pandey, M; Abraham, E K; Somanathan, T; Sebastian, PItem Oral cancer among patients under the age of 35 years.(2001-07-08) Iype, E M; Pandey, M; Mathew, A; Thomas, G; Sebastian, P; Nair, M KBACKGROUND: Cancer of the oral cavity is one of the commonest cancers among males. AIMS: To assess the aetiological factors, patient characteristics, treatment and the outcome in young patients with oral cancer. SETTINGS AND DESIGN: A retrospective descriptive study of patients under the age of 35 years with cancer of the oral cavity treated between 1982-1996, with the last follow-up till 2001, using the tumour registry data of Regional Cancer Centre (RCC), Trivandrum, Kerala, India. SUBJECT AND METHOD: The detailed clinical, treatment and follow-up data were obtained from the computerised records of RCC and recorded on a preset proforma. This was analysed with emphasis on age, sex, risk factors, site, histology, clinical extent and treatment methods and survival in the study group. STATISTICAL ANALYSIS: The survival analysis was carried by Kaplan-Meier method and the difference in survival was analysed using log-rank test. RESULTS: Out of 264 patients analysed, tongue was the commonest site identified in 136 (52%) patients followed by buccal mucosa in 69 (26%) patients. A male female ratio of 2.3:1 was observed with a significantly higher male preponderance in buccal mucosa (4.3:1). Prior exposure to tobacco or alcohol was noted in 59.4% patients, with more habitués in buccal mucosa cancer. Histological confirmation was present only in 83.7% patients and among them most were squamous cell carcinoma (85.9%). Radiotherapy, surgery or combined modalities of treatment were employed for majority of patients. The 5-year survival was 57.3%. T stage of the tumour was found to be significant in predicting disease free survival (P=0.03). CONCLUSIONS: The importance of early detection for clinical down staging is stressed. There is a need to investigate the aetiology of intra oral cancers in younger patients since a significant proportion (almost 40%) of these patients do not have associated risk factors for cancer.Item Primary malignant chest wall tumours.(2001-11-23) Pandey, M; Ahmed, I M; Ramdas, K; Mathew, ANeoplasms of the chest wall are not uncommon. Majority of the tumours occurring in the chest wall are benign. The tumours may arise from the soft tissues,connective tissues or bone. Metastatic tumours can arise as a result of direct infiltration or haematogenous spread. The management of these tumours is challenging. Resection of the chest wall with or without the excision of ribs, require reconstruction not only for aesthetic reasons but also for providing the stability to the chest wall which is of prime importance in maintaining the respiratory functions. In this article, 46 cases of the primary malignant chest wall tumours seen over a period of 5 years are reviewed.Item Recurrent trichobezoar: first reported case.(1996-03-01) Kumar, V; Khatri, A K; Pandey, M; Shukla, V K; Gangopadhyay, A N