Browsing by Author "S. Pradhan"

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A comparative study of intratumoral chemotherapy in advanced childhood common solid tumors
(Medknow Publications and Media Pvt. Ltd, 2007) Rajeev Rahi; K. Vijyendra; S.P. Sharma; N.C. Aryya; R.C. Shukla; S. Pradhan; T.B. Singh; A.N. Gangopadhyay
Background: Advanced and inoperable solid tumors in children are great killer despite aggressive multimodality treatment. Intravenous chemotherapy, due to high dose of drug given systemically, at times leads to abandonment of therapy due to systemic toxicities. To overcome this problem lots of studies are going on to explore alternative modes of giving anticancer drugs so as to decrease the systemic toxicities of the drugs and increase their therapeutic index at the same time. Aim: The study was conducted to know the results of anterior intratumoral chemotherapy and its comparison to anterior intravenous chemotherapy. Materials and Methods: Forty patients of advanced inoperable solid tumors in children (Wilms′ tumor and neuroblastoma) between 2000-2004 were randomly allocated to two groups. Group A (20 patients) was given intratumoral chemotherapy while Group B (20 patients) was given intravenous chemotherapy. Both the groups were compared in terms of reduction in size and volume, resectability of tumor, histopathological changes and side-effects of chemotherapeutic drugs. The Institute′s ethics committee approved this study. Results: Males were predominant in both type of cases (Wilms′ tumor and neuroblastoma) in both the groups (Group A and Group B). Mean age in the study was 3.27 years. All cases in Group A had Stage III disease except three cases which had Stage IV disease (one case of Wilms′ tumor and two cases of neuroblastoma) while in Group B only two cases had Stage IV disease (one case of Wilms′ tumor and one case of neuroblastoma). Intratumoral chemotherapy was found to be superior over intravenous chemotherapy in terms of reduction of size and volume (63% in Group A vs. 22% in Group B). The resectability was 70% in the intratumoral group in comparison to 40% in the intravenous group. The overall good histopathological response was 71% in Group A as opposed to 0% in Group B. Moreover, the incidence and severity of side-effects of chemotherapy and morbidity was less in intratumoral chemotherapy. Mortality was also low in Group A (5%) in comparison to Group B (20%). Conclusion: In this study intratumoral chemotherapy was found to be superior over intravenous chemotherapy in terms of better and early tumor regression, minimal side-effects, better tumor resectability and well response on histopathological criteria. This study is still going on at our center where different drug combinations, different drug doses, their toxicities, their mechanisms of action, their serum levels and long-term results of intratumoral mode of chemotherapy are to be evaluated thoroughly in future.
Biotechnological potential of Microcystis sp. in Cu, Zn and Cd biosorption from single and multimetallic systems
(2001) S. Pradhan; L.C. Rai
This paper provides information on biosorption of Cu, Zn and Cd by Microcystis sp. in single, bi and trimetallic combination. Highest biosorption of Cu followed by Zn and Cd in single as well as in mixtures containing two or three metals was noticed. The order of inhibition of Cu, Zn and Cd biosorption in bi and trimetallic combinations was suggestive of screening or competition for the binding sites on the cell surface. This observation was reconfirmed by Freundlich adsorption isotherm. Kf values were maximum for Cu (Kf = 45.18), followed by Zn (Kf = 16.71), and Cd (Kf = 15.63) in single metallic system. The Kf values for each test metal was reduced in solution containing more than one metal. Further, the reduction in biosorption of each metal ion due to presence of other metal ion was of greater magnitude at relatively higher concentrations of interfering metal ion. The biosorption of Cu at saturation was less affected when secondary metal (Cd or Zn) was added in the medium. Above results suggest that Microcystis holds great potential for metal biosorption from mixture.
Double cancer (A report on two cases)
(1990) A.K. Asthana; S. Pradhan; R.K. Jain; G.C. Pant; M. Kumar
[No abstract available]
Effect of prevailing local treatment options of breast cancer on survival outside controlled clinical trials: Experience of a specialist breast unit in north India
(2006) Mallika Tewari; S. Pradhan; M. Kumar; H.S. Shukla
Background: This study aimed at analyzing different treatments of breast cancer (BC) prevalent in the region, their effect on patients' survival, and discusses the most suitable method within available resources. Methods: The study was set up at a tertiary care hospital in north India. We retrospectively reviewed data of 473 female BC patients who attended the departments of Surgical Oncology and Radiotherapy from January 1997 to December 1999. Patients with cTNM stage IV and inoperable stage III were included; those who defaulted or were lost to follow-up were excluded. Out of 473 patients, 372 were selected. The selected patients were divided into groups on the basis of place and type of local treatment they received: (1) local excision only, (2) standard breast conservation therapy (BCT), (3) total mastectomy (TM) + axillary lymph node dissection + radiotherapy (RT), and (4) modified radical mastectomy (MRM) + RT. Data regarding recurrence and survival were analyzed in December 2005. Minimum follow-up was 6 years. Results: Overall recurrence rates were significantly higher in patients operated elsewhere (P <0.0001). Of 194 operated at our Breast Unit, 25 (14.6%) of 171 MRM patients and none of 23 BCT had recurrence. Of 178 patients operated elsewhere, 44 (100%), 6 (42.9%), 41 (41%), and 8 (40%) developed recurrence in groups 1, 2, 3, and 4 respectively. Overall survival was significantly better in patients with MRM at our unit versus TM outside (93.6% vs. 80%). Conclusions: Several types of treatment from improper local excision alone, BCT, TM, to a carefully done MRM are prevalent here. Properly done, MRM yields significant local control with survival benefit and appears to remain the gold standard in management of our BC patients. © 2006 Société Internationale de Chirurgie.
Estrogen and progesterone receptor status in breast cancer: Effect of oral contraceptive pills and hormone replacement therapy
(Churchill Livingstone, 2007) Mallika Tewari; S. Pradhan; Usha Singh; Hari S. Shukla
Background: Higher incidence of hormone receptor positive breast cancer (BC) in White women compared to Blacks and Asians is attributed to different inherent biology. Many of our patients have estrogen receptor (ER) and progesterone receptor (PR) negative tumors. We tried to explore if this is related to low frequency of oral contraceptive pills (OCP) and hormone replacement therapy (HRT) intake. Setting: Breast Unit, Department of Surgical Oncology, Tertiary Care Hospital, India. Methods: Records of female BC patients classified as 'Users' of OCP/HRT for minimum of 1 year and age, stage, histopathology matched 'Non-users' were reviewed retrospectively from January 1990 to October 2006. Results: Analysis of 150 evaluable 'Users' (58/122 premenopausal, 92/178 postmenopausal) and 150 matched 'Non-users' revealed 128 (42.67%) patients had ER and PR-negative, 157 (52.33%) ER and PR-positive, 12(4%) ER-positive/PR-negative, 3(1%) ER-negative/PR-positive tumor. Significantly more ER-positive tumor was found in both premenopausal [62.07% versus 39.06%, p=0.0184, odd's ratio (OR) 2.5527 and 95% confidence interval (CI) 1.2297-5.2993] and postmenopausal (63.04% versus 40.7%, p=0.0046, OR 2.4857 and 95% CI 1.3593-4.5455) 'Users' compared to 'Non-users', respectively. Grade III tumors were significantly less in premenopausal (p=0.0041) and postmenopausal (p=0.0012) 'Users'. Conclusions: These observations suggest that a low incidence of hormone receptor positivity in our patients could be partly due to low prevalence of OCP/HRT intake. © 2007 Elsevier Ltd. All rights reserved.
Leiomyosarcoma of kidney - A case report with long term result after radiotherapy and chemotherapy
(2007) D. Sharma; S. Pradhan; N.C. Aryya; V.K. Shukla
Leiomyosarcoma of the kidney is a rare entity with poor prognosis. Among renal sarcomas, it is the most common histologic subtype amounting to 50-60% of all cases. The tumors usually arise from either the renal capsule or smooth muscle tissue in the renal pelvic wall. We describe a case of renal leiomyosarcoma that presented with history of left flank pain. Physical examination was normal. Abdominal ultrasound showed a solid lesion of 38 × 36 mm arising from the left kidney. Intravenous urography showed cut off of both major and minor calyces of the left kidney from its pelvis with a normal right kidney. Exploratory laparotomy revealed a well-encapsulated mass confined to the renal parenchyma for which radical nephrectomy was performed. Histopathology showed a Grade I leiomyosarcoma arising from the renal capsule. Adjuvant chemotherapy and sandwich radiotherapy was given and he is disease free after six and half years of follow up. The rarity of this disease, its severity and poor prognosis, uncommon form of presentation, resulting delay in diagnosis and difficulty in management is highlighted and reported. © Springer Science+Business Media B.V. 2006.
Monte carlo study of unflattened photon beams shaped by multileaf collimator
(Shiraz University of Medical Sciences, 2019) A. Kajaria; N. Sharma; Sh. Sharma; S. Pradhan; A. Mandal; L.M. Aggarwal
Introduction: This study investigates basic dosimetric properties of unflattened 6 MV photon beam shaped by multileaf collimator and compares them with those of flattened beams. Materials and Methods: Monte Carlo simulation model using BEAM code was developed for a 6MV photon beam based on Varian Clinic 600 unique performance linac operated with and without a flattening filter in beam line. Dosimetric features including lateral profiles, central axis depth dose, photon and electron spectra were calculated for flattened and unflattened cases, separately. Results: An increase in absolute depth dose with a factor of more than 2.4 was observed for unflattened beam which was dependent on depth. PDDs values were found to be lower for unflattened beam for all field sizes. Significant decrease in calculated mlc leakage was observed when the flattening filter was removed from the beam line. The total scatter factor, SCP was found to show less variation with field sizes for unflattened beam indicating a decrease in head scatter. The beam profiles for unflattened case are found to have lower relative dose value in comparison with flattened beam near the field edge, and it falls off faster with distance. Conclusion: Our study showed that increase in the dose rate and lower peripheral dose could be considered as realistic advantages for unflattened 6MV photon beams. © 2019, Shiraz University of Medical Sciences. All right reserved.
Optimization of flow rate, initial metal ion concentration and biomass density for maximum removal of Cu2+ by immobilized Microcystis
(2000) S. Pradhan; L.C. Rai
The potential of alginate-immobilized Microcystis packed in a column for maximum removal of Cu2+ at different flow rates, biomass, and initial metal ion concentration was assessed in a continuous flow system. Although Cu2+ removal did occur at all the flow rates tested, it was maximum (54%) at 0.75-ml min-1 flow rate, 30 μg ml-1 initial metal ion concentration and 0.016 g biomass. Cu2+ removal was influenced by inlet metal ion concentration and biomass density. An increase in the biomass concentration from 0.016 to 0.128 g resulted in an apparent increase in percentage removal but the Cu2+ adsorbed per unit dry wt. declined. When the flow rate (0.75 ml min-1) and biomass density (0.064 g) were kept constant and the inlet metal ion concentration was varied from 10 to 150 μg ml-1, a 68% removal of Cu2+ was obtained at 50 μg ml-1 initial concentration in a time duration of 15 min. The metal-laden columns were efficiently desorbed and regenerated following elution with double distilled water (DDW) (pH 2) (89%). This was followed by 1 mM EDTA > 1 mM NTA > 0.1 mM EDTA > 1 mM HCl > 1 mM HNO3 > 5 mM CaCl2 > DDW (pH 7.0) > 1 mM NaHCO3 > 1 mM CaCl2. Of the total (2.83 mg) adsorbed Cu2+, 1.89 mg (67%) was desorbed by DDW (pH 2) within the first 20 min of elution time. Thereafter the desorption rate slowed down and only 22% (0.632 mg) desorption was obtained in the last 20 min. In contrast to water pH 2, the desorption of Cu2+ by 1 mM EDTA was very slow, the maximum being 8% after 40 min of elution.
Radiation therapy for symptomatic vertebral haemangioma
(1990) A.K. Asthana; S.C. Tandon; G.C. Pant; A. Srivastava; S. Pradhan
Vertebral haemangiomas are slowly growing benign tumours and are usually asymptomatic. They rarely cause symptoms and signs related to cord compression. Larger lesions create significant problems during surgery because of haemorrhage and vascular supply crucial to spinal cord function. In such severely symptomatic vertebral haemangiomas, radiation therapy has been tried and good results obtained, especially in terms of good functional recovery. We have treated 17 patients (including nine paraplegic patients) with radiotherapy (Co-60). Treatment was given by single posterior field, encompassing the involved area with a dose of 35-40 Gy in 3 to 4 weeks (five fractions per week). All patients with pain and tenderness were relieved completely (87.5%) or partially (12.5%). Similarly patients with numbness and paresis showed either complete (66.7%) or partial response (33.3%) from symptoms on follow-up. Out of nine paraplegic patients six (66.6%) had recovered competely, one (11.2%) partially and two (22.2%) had no response. The two patients who did not show any marked relief, had paraplegia of longer duration (more than 6 months). Our study indicates that severely symptomatic vertebral haemangioma can be successfully treated by radiation therapy and it can be chosen as first line of treatment with an optimum dose of 35-40 Gy in 3 to 4 weeks. © 1990 The Royal College of Radiologists.
Recurrence of carcinoma cervix in the scar of previous cesarean section: A case report
(2006) S. Pradhan; A.K. Asthana; G.K. Sharan; M. Kumar; O.P. Sharma
Although rare, reports of carcinoma cervix recurring in abdominal incision, episiotomy scars, laparoscopic port sites, and drain sites are available. However, recurrence in the scar of a previous cesarean section (CS) is unreported. A 49-year-old female with a diagnosis of keratinizing squamous cell carcinoma (SCC) of cervix, stage IIB, was treated by radical radiotherapy. She had undergone CS, through midline abdominal incision, for three previous deliveries. Twenty months later, she presented with a nodule of size 2.5 × 2 cm2 on the 26-year-old abdominal CS scar. Infiltration of the skin and extension into the deeper structures of the abdominal wall was present in an area of 5 × 4 cm2. There was no evidence of disease on the cervix. A fine-needle aspiration cytologic examination from the nodule revealed keratinizing SCC. Ultrasonography and computerized tomography scan revealed a mass lesion along the abdominal CS scar with subcutaneous nodule and peritoneal extension. Multiple metastatic lesions were present in the liver. She was treated with chemotherapy and radiotherapy. The patient has lived for more than 12.5 months. The first report of recurrence of carcinoma cervix in a CS scar is presented. Literature on surgical scar recurrence in carcinoma cervix is reviewed. © 2006 IGCS.
Sequential chemotherapy and radiotherapy in the treatment of head and neck cancers
(1990) S. Pradhan; A.K. Asthana; R.K. Jain; G.C. Pant; D.C.S. Reddy
The grim statistics of head and neck cancers calls for chemotherapy in addition to radiotherapy. Fortyfour patients with advanced cancers were treated with 4-6 injections of Methotrexate 50 mg iv weekly followed by radiotherapy (RT). Fortytwo control patients received only RT. With chemotherapy (CT) 13.64% complete (CR) and 43.18% partial response (PR) was obtained. Thirtyseven study patients and 38 control patients were assessable one month after treatment completion. 56.76% study and 42.11% control patients showed a final CR. Patients with stage III disease and oropharyngeal primary showed better response with little difference in response of laryngeal cancers between the two groups. Better response was seen in patients with good performance status. Initial responsiveness to CT was predictive of attainment of a final CR. Anterior chemotherapy did not accentuate subsequent radiation reactions. © 1990 Association of Otolaryngologists of India.
Sonographic and Colour Doppler morphology in carcinoma gallbladder
(2002) S. Pradhan; V.K. Shukla; S. Agrawal; V.K. Dixit; O.P. Sharma
Conventional radiography has limitations in accurate diagnosis of gallbladder cancer (GBC). Ultrasonography (USG) allows correct diagnosis in 70-80% advanced and 23% early GBC. Present study was initiated to identify morphology and flow characteristics in GBC using conventional USG and Colour Doppler USG (CD-USG). In 100 patients, USG assessed morphology of mass lesion/wall thickening together with associated features. Of these, 60 cases were studied using CD-USG for intralesional/perilesional vascularity, peak systolic flow velocity (V max), resistive index (RI) and pulsatility index (PI). USG identified GB with mass lesion in 44% cases (Group-I) and only mass in GB fossa in 56% cases (Group-II). Findings identified calculi (73%), Liver infiltration (74%), Intrahepatic ductal dilatation (IHDD) (52%), lymphadenopathy (19%) and ascites (5%). CD-USG revealed vascularity, mainly pulsatile flow, in 78.3% cases (in 91.3% Group-I cases). Mean Vmax was 0.3037 m/sec (0.109-0.646 m/sec.), mean RI was 0.6621 (0.526-1.000) and PI was 1.282 (0.772-2.140), Mean Vmax and PI were higher in Group-I compared to Group-II. Presence of calculus in 73% cases suggests a high association between calculus and malignancy. As flow signals were seen in 78% of all cases and 91.3% Group-I cases undergoing CD-USG, USG and CD-USG together can improve pickup rate of GBC.