Carcinoma tonsillar region—five years survival with radiotherapy

Carcinoma tonsillar region is not a common malignancy in India (4% of all malignancy at our Hospital), and is t :eated by radiotherapy. This paper presents a retrospective analysis of 220 patients of carcinoma tonsillar region treated by Radiotherapy at the Gujarat cancer and research institute’ Ahmedabad (India) in the 3 years period between 1978–1980.     

The effect of Ramadan fasting on spirometry in healthy subjects

OBJECTIVES: Lung function tests are an important investigative tool in diagnosing respiratory diseases, judging their severity and assessing prognosis. The primary aim of the present study was to assess whether Ramadan fasting affected normal lung function values. METHODOLOGY: Forty-six non-smoking healthy males, with a mean age of 24.2 years (SD 6.4 years) were investigated. Spirometry was performed according to the recommendations of the American Thoracic Society. Days between the 15th and 25th of three Islamic months (pre-Ramadan, Ramadan and post-Ramadan) were selected for spirometry. On all three occasions, FVC, FEV(1), FEV(1)/FVC%, maximum voluntary ventilation (MVV(indirect)), PEF, FEF(25--75%) and body mass were measured. Pre- and post-Ramadan readings were compared with the readings during Ramadan fasting. The results were analysed by repeated measures analysis of variance. RESULTS: No significant change was seen in lung function during Ramadan as compared to the pre-Ramadan period. FVC was decreased significantly in the post-Ramadan period compared to Ramadan and this period was associated with a significant increase in body mass. CONCLUSION: Relative to pre-Ramadan baseline values, there was no change in spirometry during Ramadan fasting in these subjects.     

Effect of enalapril therapy on ventilatory pulmonary function tests in hypertensive patients

Fifty newly diagnosed nonsmoker patients suffering from mild to moderate hypertension (diastolic BP 90 to 114 mmHg), randomly selected and not having respiratory or other systemic diseases which may affect pulmonary functions were subjected to thorough interrogation and clinical examination. Twenty five normal age and sex matched healthy volunteers served as control. All patients and controls were subjected to ventilatory pulmonary function tests (VPFT), done by computerized spirometer. Hypertensive patients were put on oral enalapril, doses were titrated and maintained on 2.5 to 10 mg once daily. Twenty percent of the total hypertensive patients reported mild to moderate dry cough and was more frequently observed among females (27%). Significant decline was observed in MEF 50% and MEF 25% of vital capacity values (p 0.0204 and 0.0001) after 10 days of enalapril therapy. These two VPFT parameters showed significantly higher decline among patients who developed cough as compared to patients who did not develop cough. Decline in VPFT parameters were directly related to doses of enalapril.     

Coronaviruses: An overview with special emphasis on COVID-19 outbreak with musculoskeletal manifestations

An acute respiratory illness caused by a novel coronavirus, namely, severe acute respiratory syndrome coronavirus 2, the virus that causes coro-navirus disease 2019(COVID-19), began spreading across China in late December 2019. The disease gained global attention as it spread worldwide. Since the COVID-19 pandemic began, many studies have focused on the impact of the disease on conditions such as diabetes, cardiovascular disease, pulmonary disorders, and renal malfunction. However, few studies have focused on musculoskeletal disorders related to COVID-19 infection. In this review, we update the current knowledge on the coronavirus with special reference to its effects during and after the pandemic on musculoskeletal aliments, which may inform clinical practice.     

Educational Intervention among Barbers about Liver Cancer-Inducing Viruses: A Pilot Study from a Developing Country

Liver cancer is among the most prevalent cancers in the world and it is mainly related to the hepatitis B virus (HBV) and hepatitis C virus (HCV). This study evaluated the effectiveness of educational intervention on knowledge and practices regarding hepatitis B and hepatitis C among barbers. After completion of baseline interviews of 70 barbers in Karachi, Pakistan, a 30-min educational session was conducted. The same sessions were repeated twice for all barbers at an interval of 1 month each for reinforcement. Post-intervention interviews were conducted after 1 month of the last session. Before intervention, only 11.4% of the study participants had scored “good” about the knowledge of HBV, which improved to 74.3% after intervention (p < 0.001). Similarly, for HCV, significant improvement was observed after intervention. Regarding the safe practices to prevent HBV and HCV infections, <2% had scored to the level of “good” at baseline, which improved to 48.6% after intervention (p < 0.001). Educational interventions to prevent cancer-induced viruses are highly effective even in illiterate/low-educated people.     

A pro forma and review process for the assessment of standards of care in stillbirths

Stillbirth rates do not address deficiencies in care. We collected information on stillbirths from 2004 to 2009 using a standardised pro forma. A local panel used the pro forma to grade the level of care received by the Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI) categorisation. Comparison using kappa scores showed agreement between local and external multidisciplinary panels of similar referral patterns (n = 47, κ = 0.7), and that the categorisation was unaffected by the individual who fills out the pro forma (n = 17, κ = 0.5). There was less agreement between the local panel and adverse event review (n = 100, κ = 0.45). This report represents a validation of the pro forma and the review process for standard use in all units.     

Atrial arrhythmogenesis in wild-type and Scn5a+/Δ murine hearts modelling LQT3 syndrome

Long QT(3) (LQT3) syndrome is associated with abnormal repolarisation kinetics, prolonged action potential durations (APD) and QT intervals and may lead to life-threatening ventricular arrhythmias. However, there have been few physiological studies of its effects on atrial electrophysiology. Programmed electrical stimulation and burst pacing induced atrial arrhythmic episodes in 16 out of 16 (16/16) wild-type (WT) and 7/16 genetically modified Scn5a+/Δ (KPQ) Langendorff-perfused murine hearts modelling LQT3 (P < 0.001 for both), and in 14/16 WT and 1/16 KPQ hearts (P < 0.001 for both; Fisher’s exact test), respectively. The arrhythmogenic WT hearts had significantly larger positive critical intervals (CI), given by the difference between atrial effective refractory periods (AERPs) and action potential durations at 90% recovery (APD₉₀), compared to KPQ hearts (8.1 and 3.2 ms, respectively, P < 0.001). Flecainide prevented atrial arrhythmias in all arrhythmogenic WT (P < 0.001) and KPQ hearts (P < 0.05). It prolonged the AERP to a larger extent than it did the APD₉₀ in both WT and KPQ groups, giving negative CIs. Quinidine similarly exerted anti-arrhythmic effects, prolonged AERP over corresponding APD₉₀ in both WT and KPQ groups. These findings, thus, demonstrate, for the first time, inhibitory effects of the KPQ mutation on atrial arrhythmogenesis and its modification by flecainide and quinidine. They attribute these findings to differences in the CI between WT and mutant hearts, in the presence or absence of these drugs. Thus, prolongation of APD₉₀ over AERP gave positive CI values and increased atrial arrhythmogenicity whereas lengthening of AERP over APD₉₀ reduced such CI values and produced the opposite effect.