Mallath M.K.,Tata Medical Center |
Taylor D.G.,University College London |
Badwe R.A.,Tata Memorial Center |
Rath G.K.,All India Institute of Medical Sciences |
And 20 more authors.
The Lancet Oncology | Year: 2014
Cancer can have profound social and economic consequences for people in India, often leading to family impoverishment and societal inequity. Reported age-adjusted incidence rates for cancer are still quite low in the demographically young country. Slightly more than 1 million new cases of cancer are diagnosed every year in a population of 1·2 billion. In age-adjusted terms this represents a combined male and female incidence of about a quarter of that recorded in western Europe. However, an estimated 600 000-700 000 deaths in India were caused by cancer in 2012. In age-standardised terms this figure is close to the mortality burden seen in high-income countries. Such figures are partly indicative of low rates of early-stage detection and poor treatment outcomes. Many cancer cases in India are associated with tobacco use, infections, and other avoidable causes. Social factors, especially inequalities, are major determinants of India's cancer burden, with poorer people more likely to die from cancer before the age of 70 years than those who are more affluent. In this first of three papers, we examine the complex epidemiology of cancer, the future burden, and the dominant sociopolitical themes relating to cancer in India. © 2014 Elsevier Ltd.
Saraiya H.A.,Gujarat Cancer and Research Institute |
Shah M.N.,GCS Medical College
Advances in Skin and Wound Care | Year: 2013
OBJECTIVE: Negative-pressure wound therapy (NPWT) is a well-known treatment modality for chronic, difficult, nonhealing wounds. Unfortunately, many commercially available negative-pressure therapy systems for wounds are expensive, require hospitalization, and may not be available throughout the world. The authors have designed a less expensive and effective NPWT system from components readily available in the hospital. DESIGN: The system is assembled from ethylene oxide sterilized polyurethane foam, transparent adhesive dressing, and a simple negative suction drain system, which is being routinely used in surgical cases. The multiple holes suction tube is inserted between 2 layers of polyurethane foam and is put on the wound, which is sealed by adhesive dressing. The negative pressure is created using a closed wound suction set. The dressing is changed every third day or as needed. MAIN RESULTS: The authors have used this system in 11 patients with diabetic foot. The mean time for preparation of wound for surgery with this system was 7 days (5-9 days). The raw areas were either secondarily closed or were covered with split-thickness skin graft. The mean hospital stay for debridement and definitive surgical procedure was 11 days (8-15 days). CONCLUSION: In the authors' experience, the NPWT system developed from off-the-shelf components reduces the length of hospital stays and therefore cost, without any compromise on quality. It leads to a quicker wound closure and reduces the need for multiple surgeries or flaps. This modification presents a simple, cheap, and effective alternative to commercially available NPWT machines. Copyright © 2013 Lippincott Williams & Wilkins.
Patel S.P.,Wayne State University |
Patel P.B.,Apollo Hospital |
Parekh B.B.,Gujarat Cancer and Research Institute
Journal of Cancer Research and Therapeutics | Year: 2014
Use of nanotechnology in medical science is a rapidly developing area. New opportunities of diagnosis, imaging and therapy have developed due to recent rapid advancement by nanotechnology. The most common areas to be affected are diagnostic, imaging and targeted drug delivery in gastroenterology, oncology, cardiovascular medicine, obstetrics and gynecology. Mass screening with inexpensive imaging might be possible in the near future with the help of nanotechnology. This review paper provides an overview of causes of cancer and the application of nanotechnology in cancer prevention, detection and treatment.
Jaju H.,Gujarat Cancer and Research Institute
Journal of Craniofacial Surgery | Year: 2014
Skull base tumors occur at an interface of multiple surgical specialties, which need to work in tandem to treat these cases. The number of estimated new cancer cases in India is approximately 1 million in a year, and skull base tumors are estimated to be 3500 a year. We present an overview of our experience of operating 550 patients with these tumors during a period of 15 years in a crosssection of society with varying economic background and with our limited resources. We have illustrated 5 patients who have been operated on by us. We have proposed how we could further our cause in treating these patients in our scenario. Copyright © 2014 by Mutaz B. Habal, MD.
Saraiya H.A.,Gujarat Cancer and Research Institute
Indian Journal of Plastic Surgery | Year: 2015
Introduction: Over centuries, virginity has been given social, religious and moral importance. It is widely believed as a state of a female who has never engaged in sexual intercourse, and her hymen is intact. Hymenoplasty for torn hymen is carried out not only for the sake of cultural and religious traditions but also for the social status and interpersonal relationships. Materials and Methods: 2.5 cm long and 1 cm wide four vaginal mucosal flaps were raised from the anterior vaginal wall just behind labia minora. Two flaps were based proximally, and their two opposing flaps were based distally. These flaps were overlapped in a crisscross fashion and were sutured with 5/0 Polyglactin (Vicryl®) sutures leaving no area raw. The donor area was closed primarily. When some remains of a torn hymen were found, one to three vaginal mucosal flaps were added to its remains as per the need for reconstruction. Results: We operated upon 11 patients. In nine cases, the hymen was reconstructed with four flaps. In remaining two, it was reconstructed from the remains using vaginal mucosal flaps. All flaps healed without any infection or disruption. Sutures got absorbed in 25-35 days. In all cases, this newly constructed barrier broke with only moderate pressure at the time of penetrative sex serving the purpose of the surgery completely. Conclusion: Erasing evidence of the sexual history simply by 'Surgical Revirgination' is extremely important to women contemplating marriage in cultures where a high value is placed on virginity. © 2015 Indian Journal of Plastic Surgery.
Nasit J.G.,P.A. College |
Trivedi P.,Gujarat Cancer and Research Institute
Fetal and Pediatric Pathology | Year: 2013
Astroblastoma is a rare primary glial tumor of children and young adults. Radiologically astroblastoma presents as a large well-circumscribed supratentorial, solid-cystic heterogeneous mass. Histology shows perivascular pseudorosettes with hyalinization. Only a single case has been reported with signet-ring-like cell morphology. Signet-ring morphology in primary central nervous system tumors is exceedingly rare. Complete surgical resection is the recommended treatment. Prognosis of astroblastoma depends on the extent of resection and histology. The proliferative index may be a useful tool to define prognosis. We present a case of 10-year-old girl having recurrent low-grade astroblastoma with signet ring-like cells and high proliferative index. © 2013 Informa Healthcare USA, Inc.
Patel S.M.,Gujarat Cancer and Research Institute |
Desai A.,Gujarat Cancer and Research Institute
Journal of Reproductive Medicine for the Obstetrician and Gynecologist | Year: 2010
OBJECTIVE: To determine the outcome of secondary management in drug-resistant gestational trophoblastic neoplasia (GTN). STUDY DESIGN: Sixteen of 60 patients with GTN (8 low-risk and 8 high-risk) who developed resistance to primary chemotherapy were studied retrospectively. Primary chemotherapy was methotrexate-folinic acid rescue (MTX-FA) for low risk and etoposide/methotrexate/ actinomycin D/cyclophosphamide/vincristine (EMA-CO) for high risk. Secondary chemotherapy for the low-risk group was either actinomycin D or EMACO, depending on serum beta human chorionic gonadotropin (hCG) levels at resistance. For the high-risk group, etoposide/methotrexate/actinomycin D/cisplatinum (EMA-EP) or bleomycin/etoposide/cisplatin (BEP) was given. Third-line chemotherapy was vincristine/actinomycin D/cyclophosphamide (VAC) or vincristine/ iphosphamide/cisplatin (VIP). Surgery and radiotherapy were used in selected patients. RESULTS: Survival after salvage therapy in low-risk patients was 100%: 2 with EMA-CO and 6 with actinomycin D. Of high-risk cases 75% were cured with EMAEP or BEP. Third-line chemotherapy was given in 2 patients: 1 was lost to follow-up and the other died. Survival was significantly influenced by both hCG level at the start of secondary therapy and site of metastasis. CONCLUSION: Prognosis in GTN is excellent. Optimization of treatment strategies for those who develop drug resistance remains a key challenge. © Journal of Reproductive Medicine®, Inc.
Jaju H.,Gujarat Cancer and Research Institute
Indian Journal of Plastic Surgery | Year: 2013
Treatment of skull base tumors involves multiple specialities. The lesions are usually advanced and the treatment is often associated with unfavorable results, which may be functional and/or aesthetic. Here we have done an analysis for the complications and unfavorable results of 546 cases treated surgically by a single craniofacial surgeon over a period of 14 years. The major morbidity ranges from death to permanent impairment of vital organ functions (brain, eye, nose), infections, tissue losses, flap failures, treatment associated complications, psychosocial issues, and aesthesis besides others. This article is aimed at bringing forth these unfavorable results and how to avoid them.
Shah S.A.,Gujarat Cancer and Research Institute
Indian Journal of Medical and Paediatric Oncology | Year: 2013
Gujarat Cancer and Research Institute, Ahmedabad presented data of total 840 patients, out of which 775 (90%) were in chronic phase. Complete hematological response (CHR) was seen in 96% of patients and median time to achieve (CHR) was 2 months. Complete cytogenetic response was seen in 36%.
Dhawan D.,Patel Pharmaceutical Education and Research Development Center |
Panchal H.,Gujarat Cancer and Research Institute |
Shukla S.,Gujarat Cancer and Research Institute |
Padh H.,Patel Pharmaceutical Education and Research Development Center
Indian Journal of Medical Research | Year: 2013
Background & objectives: The efficacy and toxicity of a given chemotherapy regimen varies widely among patients due to the inherited variability of genes that are involved in drug metabolism. There are several crucial enzymes identified involving metabolism of 5-fluorouracil (5-FU) and cisplatin, which are polymorphic. We studied head and neck cancer patients (n=23) on 5-FU and cisplatin combination therapy attending a tertiary care cancer research institute in Gujarat, India, to understand the effect of a particular genotype on toxicity. Methods: The patients were genotyped for dihydropyrimidine (DPYD) (85T>C, IVS14+1G>A, 2846A>T, 2194G>A), thymidylate synthase (TYMS) [28bp tandem repeat in the promoter enhancer region (TSER)], methylenetetrahydrofolate reductase (MTHFR) (677C>T, 1298A>C), glutathione S-transferase P1(GSTP1) (Ile105Val), glutathione S-transferase T1 (GSTT1) (null allele) and glutathione S-transferase M1 (GSTM1) (null allele) by multiplex allele-specific PCR and long range PCR. Results: Of the 23 (19 males 4 females, age range 18-16 yr) patients, two had grade 3 and 4 toxicity while the remaining 21 had 0 to 2 grade toxicity after treatment with 5-FU and cisplatin combination therapy. An association between the genotype of GSTM1 (+/- and -/-) and the toxicity of cisplatin (P=0.043) was observed. Interpretation & conclusions: The findings of this preliminary study suggested an association between the variants of GSTM1 and toxicity observed due to cisplatin. Well planned studies on a large sample of head and neck cancer patients need to be conducted to understand the effects of these genetic variants on toxicity and efficacy of anticancer drugs.