Late results of multistage polysegmental lung resection for tuberculosis at many sites

The late outcomes of surgical treatment of 124 patients operated on for pulmonary tuberculosis at many sites were analyzed. Surgery was made in the anatomic variant of typical polysegmental resections involving 3 to 7 bronchopulmonary segments in combination with a number of additional elements. The stable cure rates were 77.7, 71.2, and 64.3% at 3-, 5- and 10-year follow-ups, respectively. The maximum relapse rates at 2- and 3-year follow-up were 9.5 and 9.2%, respectively with variations in some subgroups according to the type of resection, the clinical forms of tuberculosis, the bacteriological activity of the process by surgery and the drug resistance of Mycobacteria. The cumulative adjusted survival rates in the same periods were 92.1, 85.1, and 70%, respectively, with the maximum mortality rate (6.8%) at 3-year follow-up, they being ranged under the influence of the above risk factors. No systematic controlled preventive chemotherapy regimens are a cause of relapses and death in the late periods of follow-ups.     

Psychological morbidity,sources of stress and coping strategies among undergraduate medical students of Nepal

Background  

In recent years there has been a growing appreciation of the issues of quality of life and stresses involved medical training as this may affect their learning and academic performance. However, such studies are lacking in medical schools of Nepal. Therefore, we carried out this study to assess the prevalence of psychological morbidity, sources and severity of stress and coping strategies among medical students in our integrated problem-stimulated undergraduate medical curriculum.     

Classical and anaplastic seminoma: difference in survival

Classical and anaplastic seminoma are traditionally treated with radiation therapy and are said to have the same prognosis. A retrospective study was undertaken of 90 seminoma patients treated with radiation therapy between 1961 and 1985. The classical group consisted of 71 patients of whom 50 had stage I and 21 had stage II disease. The anaplastic group consisted of 19 patients of whom ten had stage I and nine had stage II disease. The median follow-up time was 64 months for the entire group. The 10-year relapse-free survival rate for the classical group was 94% and for the anaplastic group was 70% (P less than .05). For patients with classical stage I disease, the relapse-free actuarial survival rate was 98%; for patients with anaplastic stage I disease, it was 64% (P less than .02). For the classical stage II disease group, the relapse-free actuarial survival rate was 84% and for the anaplastic stage II disease group, 75% (P less than .70). Four patients in the classical group (6%) had relapses; of these, one patient had local recurrence of tumor, and three had distant metastases. In the anaplastic group, four patients (21%) had relapses; two patients had local recurrence of tumor, and two had distant metastases. Therefore the data suggest a difference in survival and relapse rates between classical and anaplastic seminoma.