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Susheela S.P.,Healthcare Global | Revannasiddaiah S.,Government Medical College Haldwani
Annals of Translational Medicine | Year: 2016

The survival in patients with high grade gliomas (HGG) remains poor even after the adoption post-operative radiotherapy (RT) to magnetic resonance imaging (MRI) based volumes. Despite delivery of 'standardized' doses of radiation, recurrence is the norm, rather than the exception. Recurrences occur both within, and outside of the volume of irradiation, leading us to two questions-firstly concerning the adequacy of the dose of radiation used, and secondly about the current methods of treatment volume delineation. The emergence of newer radiopharmaceuticals for use in positron emission tomography (PET) have kindled the hope of more precise volume localizations for post-operative RT, and it is likely that these new radiopharmaceuticals can help us define accurate areas at highest risk of recurrence and thus allow us to use increased doses of radiation with confidence. © Annals of Translational Medicine.


Pant N.K.,Government Medical College Haldwani | Pandey K.C.,Government Medical College Haldwani | Madabhavi I.,Gujarat Cancer Research Institute | Pandey V.,Government Medical College Haldwani | Revannasiddaiah S.,Government Medical College Haldwani
Asian Pacific Journal of Cancer Prevention | Year: 2014

Background: Tobacco products continue to be used in large quantities in India despite the mandatory inclusion of pictorial health warnings (PHWs) on all tobacco packaging. The circumstances as to how people could continue the use of tobacco to the point of developing head and neck cancer despite enhanced awareness about the ill effects of tobacco is the main focus of this study. Materials and Methods: This study concerned patients with least 5-years history of tobacco use, having been diagnosed with histopathologically proven malignancies of the hypopharynx, larynx, oropharynx and oral cavity presenting at the Government Medical College-Haldwani, Nainital, India. A total of 183 patients were eligible for inclusion during July 1 2013- June 30 2014. Of these, 59 patients used smoked tobacco exclusively, 22 patients used smokeless tobacco exclusively, and 102 patients used both forms of tobacco. Among users of smoked forms, 75.2% (n=121) were beedi users, and 24.8% (n=40) were cigarette users. Patients were asked direct questions as to whether they had noticed the presence of PHWs upon tobacco products. The reasons as to why PHWs were not effective in stopping the patients from tobacco use were investigated. Results: Of the 183 patients, 146 reported being aware about the presence of PHWs, and when they were asked reasons as to why they continued tobacco despite being aware of ill-effects, the commonest reason chosen (by 53.4%) was that patients had not regarded themselves as using tobacco heavy enough to cause cancer. Among the 36 patients who reported as being oblivious to the presence of PHWs on tobacco products, 63.9% reported that the products they used never displayed any PHWs, and 36.1% reported never having paid attention to the packaging. The awareness about PHWs was higher among cigarette smokers in comparison to beedi smokers (100% vs 76.1%, p=0.0002). Conclusions: Locally produced and marketed tobacco products such as beedis and oral tobacco often fail to display PHWs. The presence of PHWs without doubt enhances awareness about the carcinogenic risks of tobacco. However, enhanced awareness alone may not be enough, and as elucidated by this study, some persons continue to use tobacco to the point of developing malignancies. The need of the hour is the implementation of legal and economic sanctions discouraging the use of tobacco products.


Pandey K.C.,Government Medical College Haldwani | Revannasiddaiah S.,Government Medical College Haldwani | Pant N.K.,Government Medical College Haldwani
Asian Pacific Journal of Cancer Prevention | Year: 2014

Background: Head and neck cancer without distant metastases is amenable to various modalities of treatment. However, the stage at presentation is a very important determinant for treatment success. The present study was conducted to determine the stage-wise presentation of non-metastatic head and neck cancer patients from the hilly regions in Kumaon division of Uttarakhand, India. Materials and Methods: The hospital records for non-metastatic head and neck cancer patients from the only functional cancer centre of the region for the period of two-years (January 2012- December 2013) were included. Nasopharyngeal carcinoma was excluded due to its staging system being different. Non-squamous histopathologies were also excluded. Patients hailing from nearby regions of Uttar Pradesh and Nepal were excluded, as were patients from non-hilly regions of Kumaon. Results: Of the 271 patients of head and neck cancer, 27 with distant metastases at diagnosis were excluded from the analysis. Of the 244 eligible patient records, 90.1% (n=222) were male, and 9.9% (n=22) were female. The proportions of patients with carcinoma of the larynx, oropharynx, oral cavity, hypopharynx and maxillary antrum were 31.9% (n=78), 27.9% (n=68), 20.5% (n=50), 12.7% (n=31) and 1.2% (n=3). A further 5.7% (n=14) were diagnosed as having secondary involvement of neck nodes with unknown primaries. The proportion of patients presenting in stages I, II, III, IVA and IVB were 0.8% (n=2), 2.5% (n=6), 9.4% (n=23), 51.6% (n=126) and 35.7% (n=87) respectively. Conclusions: An abysmally low proportion (3.3%) of non-metastatic head and neck cancer patients presented in the early stages (I and II). A vast majority of the patients (88.1%) presented with stages IVA and IVB. Not only does this reflect a poor therapeutic outlook, but also exposes the dire need for programmes focusing on cancer awareness and early detection in the region.


Jain G.,Government Medical College Haldwani | Palaria U.,Government Medical College Haldwani | Jha S.K.,Government Medical College
Journal of Obstetrics and Gynecology of India | Year: 2013

Objective: To compare effectiveness of intravenous iron-sucrose versus oral ferrous fumarate in postpartum anemia. Methods: In this study, 40 women with postpartum anemia with hemoglobin (Hb) less than 8 g/dl within 48 h postpartum were randomised into two groups. Group I consisted of 20 women who received 300-600 mg of intravenous iron-sucrose every alternate day for 3 days. Group II consisted of 20 women who were given 300 mg ferrous fumarate orally daily for 14 days. Results: On day 14, the increase in mean Hb level in group I was 2.4 g/dl in comparison to 1.2 g/dl in group II. Women in group I had significantly higher mean Hb values on days 7 and 14 (p < 0.001) than women in group II. Conclusion: These results suggest that intravenous iron-sucrose increases the Hb level more rapidly than oral ferrous fumarate in postpartum anemia without any serious side effects. © 2013 Federation of Obstetric & Gynecological Societies of India.


Kansal N.K.,Government Medical College Haldwani
European Journal of Pediatric Dermatology | Year: 2015

A 20-day-old newborn was first observed due to the presence of erythematous, papular and pustular lesions of the face: the identification of a "spaghetti and meatballs" finding on fresh mycological examination of the pus led to diagnose neonatal cephalic pustulosis. According to some Authors the latter is a disease in its own right, while others classify this disorder as neonatal acne.


Bisht V.,Government Medical College Haldwani | Rawat U.,Government Medical College Haldwani | Bhaisora C.P.,Government Medical College Haldwani | Singh P.,Government Medical College Haldwani
Journal of Indian Academy of Forensic Medicine | Year: 2012

Aim of this study was to evaluate the incidence, maternal morbidity & mortality, clinical features, management in cases of septic abortion in a tertiary centre. This study included 37 cases of septic abortion admitted during 5 years from January 2007 to January 2012 in the Department of obstetrics & Gynaecology in Government Medical College, Haldwani. All patients were evaluated with special reference to incidence, etiological factors, clinical features, surgery & maternal morbidity & mortality. The incidence of septic abortion was 1.08%. Common age group was between 26-30 years. Most of the cases were from lower socioeconomic status. Septic abortion following spontaneous abortion was present in 5 cases. Unwanted pregnancy was the indication for termination of pregnancy in 32 cases. 4 women were admitted in state of septic shock. 12 cases required lapratomy for drainage of pus, 3 had hysterectomy, 3 had resection anastomosis & uterus repair was done in 4 cases. Overall maternal mortality was 5 (13.5%).The incidence of illegal and septic abortion can be reduced by increasing awareness about family planning services and making legal abortion services easily available to the women and that too at a cheaper cost.


Sekhon J.,Desh Bhagat Dental College and Hospital | Singla R.,Government Medical College | Sharma T.,Punjab Institute of Medical science | Tayal I.,Government Medical College Haldwani | Singh A.,Desh Bhagat Dental College and Hospital
Journal of Indian Academy of Forensic Medicine | Year: 2013

The concept of identity is a set of physical characteristics, functional or psychic, normal or pathological-that define an individual. "Cheiloscopy" is a method of identification of a person based on the characteristic arrangement of lines on the lips. This study was conducted on 300 individuals of either sex (M: F: 100:200) to study the predominating pattern of lip prints in the North Indian Population. Materials used were dark colored lipstick, cellophane tape and white bond paper. The lips of the subject were thoroughly cleaned and lipstick was applied uniformly. Lip prints were taken on the glued portion of cellophane tape and then stuck on to a white bond paper. Then each of these lip prints were scanned using an image scanner set at a resolution of 300ppi. Type I, I'& II lip prints, when taken together found to be most predominant almost all the regions in both the sexes except in LUM region where type III replaced type II. In our study no two individuals or more than two individuals had similar types of lip prints patterns.


Semwal V.,Government Medical College Haldwani | Jha S.K.,Government Medical College Haldwani | Rawat C.M.S.,Government Medical College Haldwani | Kumar S.,Government Medical College Haldwani | Kaur A.,Government Medical College Haldwani
Indian Journal of Community Health | Year: 2013

Background: The Village Health Sanitation and Nutrition Committee (VHSNC) is one of the major initiatives under National Rural Health Mission (NRHM) to decentralize and empower local people to achieve NRHM goal. Limited studies have been conducted to assess the VHSNC in India. Objective: To assess the composition of VHSNC and find out the deviations, if any, from the prescribed framework of guidelines, awareness of VHSNC members about their roles and to assess the functioning of VHSNC. Methodology: The cross-sectional study was carried out from July 2012 to June 2013 in two selected blocks (out of eight) in Nainital district of Uttarakhand. A total of 18 VHSNCs were studied, nine from Haldwani and nine from Bhimtal covering 48 revenue villages, 31 in Haldwani and 17 in Bhimtal block respectively. Out of 139 members in 18 VHSNC, 110 members were interviewed. Results: Mean age of the study subjects was 39.01 ± 8.5 years. Out of the 110 members studied maximum 73 (66.4 %) were female and 37 (33.6%) were males. Maximum subjects, 35 (32.8%) were qualified up to intermediate followed by 29 (26.4%) graduates. Maximum 78 (70.9%) participants belonged to Others (General) category, 30 (27.3%) belonged to scheduled caste and only two (1.8%) belonged to OBC category. There were no subjects belonging to scheduled tribe. Out of the 110 members interviewed there were 18 (16.4%) Gram Pradhans, 10 (9.1%) Female Health Workers, 20 (18.2%) ASHAs and 15(13.6%) Anganwadi Workers. There was very low awareness among the members about role of the committee. Maximum, 93 responses were for cleaning village environment which were given by all 18 Gram Pradhans, 16 ASHAs and ward members.


PubMed | Government Medical College Haldwani
Type: Journal Article | Journal: Asian Pacific journal of cancer prevention : APJCP | Year: 2014

Head and neck cancer without distant metastases is amenable to various modalities of treatment. However, the stage at presentation is a very important determinant for treatment success. The present study was conducted to determine the stage-wise presentation of non-metastatic head and neck cancer patients from the hilly regions in Kumaon division of Uttarakhand, India.The hospital records for non-metastatic head and neck cancer patients from the only functional cancer centre of the region for the period of two-years (January 2012- December 2013) were included. Nasopharyngeal carcinoma was excluded due to its staging system being different. Non-squamous histopathologies were also excluded. Patients hailing from nearby regions of Uttar Pradesh and Nepal were excluded, as were patients from non-hilly regions of Kumaon.Of the 271 patients of head and neck cancer, 27 with distant metastases at diagnosis were excluded from the analysis. Of the 244 eligible patient records, 90.1% (n=222) were male, and 9.9% (n=22) were female. The proportions of patients with carcinoma of the larynx, oropharynx, oral cavity, hypopharynx and maxillary antrum were 31.9% (n=78), 27.9% (n=68), 20.5% (n=50), 12.7% (n=31) and 1.2% (n=3). A further 5.7% (n=14) were diagnosed as having secondary involvement of neck nodes with unknown primaries. The proportion of patients presenting in stages I, II, III, IVA and IVB were 0.8% (n=2), 2.5% (n=6), 9.4% (n=23), 51.6% (n=126) and 35.7% (n=87) respectively.An abysmally low proportion (3.3%) of non-metastatic head and neck cancer patients presented in the early stages (I and II). A vast majority of the patients (88.1%) presented with stages IVA and IVB. Not only does this reflect a poor therapeutic outlook, but also exposes the dire need for programmes focusing on cancer awareness and early detection in the region.

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