EUREKA: Health Sciences

Prospective study on the effect of topical honey on radiation-induced mucositis induced by concurrent chemotherapy and radiation or radiation alone given as radical or adjuvant treatment in head and neck squamous cell malignancies

Nindra Armugam — 2023-03-31

Pain imparts additional morbidity and economic burden to patients by requiring parenteral analgesia, interruption of radiation therapy (RT) and/or hospitalization, and parenteral or tube feeding, all of which negatively impact patients' quality of life. There are various drugs tried to relieve pain associated with radiation-induced mucositis.

The aim: The aim of the study is to evaluate the effect of the topical application of pure natural honey on radiation-induced mucositis in patients undergoing concurrent chemo-radiation or radiation alone for radical or adjuvant treatment for head and neck squamous cell malignancies.

Materials and methods: It is a hospital-based prospective study enrolling patients with histopathologically proven head and neck cancers. All histopathologically proven patients of squamous cell carcinoma of Head & Neck cancer (carcinoma of the oral cavity, oropharynx) receiving chemotherapy and radiotherapy or radiotherapy alone in the definitive or adjuvant setting and who meet our inclusion and exclusion criteria will be taken up as study group.

Results: Mean age of patients was 49 years, most males 87 %. The oral cavity was the most common primary site (84 %), followed by the oropharynx (16 %). Most cases were locally advanced cancer stage IV (60 %). The set of mucositis is after 5 fractions in both study and control groups, but 89 % in the control group, compared to 33 % in the study group. On grade 3, mucositis is delayed in the study group compared to the control group, and no patients in the study group had grade 4 mucositis.

Conclusions: All patients in the study developed mucositis. On the set of grade 3, mucositis is delayed in the study group compared to the control group, and no patients in the study group had grade 4 mucositis. Honey is effective in preventing grade 3 and 4 mucositis. Honey showed no effect on weight loss and oral infections in this study.

A study of clinico etiological profile of children with cerebral palsy in a tertiary care centre

Chaitanya Jyothi Ravula — 2023-03-31

The clinical spectrum of Cerebral palsy (CP) can differ in various places depending upon the knowledge of the people and resources for prevention, diagnosis and management. Although studied extensively in high-resource countries, adequate data related to CP from resource-constraint settings are lacking.

The aim: The present study is a descriptive study done on clinical profiles, aetiology, and comorbidities.

Materials and methods: Present study is a hospital-based descriptive study of 80 children with Cerebral Palsy from January 2020 to June 2021 (18 months) admitted to Niloufer Hospital for Child Health, cases chosen as per inclusion criteria guided by "The Definition and classification of cerebral palsy, April 2006 International consensus". Clinical history and clinical examination and necessary investigations using a systematically designed proforma

Results: The most common types were spastic type (78.9 %) and hypotonic type (12.5 %). Spastic quadriparesis (55 %) was the most common among subtypes. Males were more affected than females, with more rural than urban distribution. 48.8 % belonged to the lower middle and 37.5 % to the upper lower class of socio-economic status. Consanguinity was observed in 33 %, and 3 % had a similar family history. A high incidence (65 %) was seen in firstborn children. Term gestation was commonest at 87 % and prematurity at 13 %. 91.3 % of the cases were institutional deliveries. For causes of cerebral palsy, 45 % required resuscitation at birth, 2.5 % had neonatal sepsis, 1.25 % had a cerebral malformation, 7.5 % had an intracranial bleed, 7.5 % had post-meaning encephalitic sequelae, 1.3 % had TORCH infection. Comorbidities Like mental retardation were seen in 90 %, seizure disorder in 87.5 %, visual problems in 24.8 %, hearing problems in 13.75 %, 56.25 % of cases were malnourished.

Conclusions: Comorbidities are significantly observed in cases of cerebral palsy. Appropriate screening and management of comorbidities, especially vision, hearing, speech, seizures, and nutrition, improve the overall prognosis in cases of Cerebral palsy.

Changing trends in the clinical profile of childhood in tuberculosis patients -at a tertiary centre

Vishnu Vardhan Reddy Yeredla — 2023-03-31

The aim: To study the clinical profile of childhood tuberculosis in the age group of 6 months to 12 years.

Materials and methods: This сross-sectional study was conducted on patients of tuberculosis who were admitted for treatment. A total of 75 patients were enrolled in the study who are of age group: 6 months to 12 years and Stengen score>3.

Results: Approximately 50 % of the study population was under 5 years. 39 % belonged to the age group of 8–12 years. The male-to-female ratio was 1:1.02. 36 % of the study population belonged to the lower class. 33.33 % of the study population belonged to the middle class. One-quarter of the patients were not malnourished. Among the ones who were malnourished, 36 % belonged to Grade I, and 53.33 % had a Stengen score of 5–6. 46.66 % had a Stengen score of 46.66 %. Acid Fast Bacilli in 1.33 %, 18.66 % had tubercle present, 82.66 % had Mantoux positive, which was >10mm, and 62.66 % of them had suggestive radiology of tuberculosis, where the fever was present in 90 % of the study population. Fever with <2 weeks duration was present in 52 %, and the rest had a fever for more than two weeks. Cough was present in 77 % of the study population. Weight loss was present in 37.33 %. 22.66 % had pulmonary tuberculosis, and 77.33 % had extrapulmonary tuberculosis. Among extrapulmonary tuberculosis, lymphadenopathy was the common manifestation. It was present among 40 % of the study population. It includes cervical lymphadenopathy among 24 %, axillary lymph node involvement among 12 %, Sub mandibular lymph node among 2.66 % and supra clavicular in 1.33 %. The other manifestations of extrapulmonary tuberculosis include pleural effusion, the second most common one present among 29.33 % of the study population.

Conclusion: There is an urgent need for a systematic approach to determining the prevalence and incidence of M. tuberculosis infection among children. This has to become the cornerstone of TB control and of assessing the change in the trend of infection over time in the community until it reaches the required goal

Comparison of hemodynamic stability of propofol ketamine versus etomidate ketamine during induction in peritonitis cases posted for emergency surgery

Dadi Suneetha — 2023-03-31

The aim: The aim of the present study is to evaluate the hemodynamic stability of propofol ketamine versus etomidate ketamine during induction of anaesthesia in peritonitis cases posted for emergency surgery.

Methods: Sixty patients with peritonitis, posted for emergency surgery under general anaesthesia, were randomly allocated to two groups. Group propofol ketamine (P + K) comprised of 30 patients (n=30) were induced with propofol 1 mg/kg and ketamine 0.75 mg/kg IV. Group etomidate ketamine (E + K) comprised 30 patients induced with etomidate 0.3 mg/kg and ketamine 0.75 mg/kg. The hemodynamic effects of the combination of the drugs in both groups were compared before and after induction.

Results: The change in saturation (SPO₂) and Heartrate between the groups P+K & group E+K before induction and after intubation was similar in both groups. There was a statistically insignificant fall in systolic blood pressure (SBP) and diastolic blood pressure (DBP), and mean arterial pressure (MAP) in group P+K before and after induction when compared to group E+K.

Conclusions: The propofol ketamine and etomidate ketamine combinations have a similar haemodynamic profile and are equally effective in maintaining haemodynamic stability during induction and intubation.

Synchronous metastatic colon carcinoma presenting as ovarian metastasis: a case report

Mykhailo Kashtalian — 2023-03-31

The aim of the study was to discuss a rare case of synchronously metastatic colon cancer, which clinically manifested as intestinal obstruction due to the presence of ovarian metastasis.

Materials and methods. The clinical case of a 47-year-old patient with synchronously metastatic colorectal cancer with an affected disease, peritoneal carcinomatosis and metastatic ovarian lesions was analyzed.

Case presentation. In July 2021, patient R., 47 years old, developed a clinic of sub-compensated intestinal obstruction. According to CT and MRI data, a volume formation of the small pelvis with a diameter of about 15 cm with compression of the surrounding soft tissues and metastases of the 6th and 4a segments of the liver were determined. According to a colonoscopy, a neoplasm of the sigmoid colon was verified as adenocarcinoma. The presence of peritoneal carcinomatosis was determined intraoperatively; the operation was performed in the following scope: SS-0 (complete cytoreduction) – right-sided ovariectomy with a tumour, resection of the sigmoid colon with a tumour, resection of the rectum with TME, extirpation of the cervical stump with the left ovary and pelvic peritonectomy en block resection and diathermocoagulation of foci of peritoneal carcinomatosis on the visceral peritoneum of the small intestine, omentectomy, radiofrequency ablation of a liver tumour under ultrasound guidance. According to histopathological examination: adenocarcinoma (G2) with foci of mucus production in the sigmoid colon, metastatic lesion of the right ovary, cervix, peritoneum, and liver.

Subsequently, from September 2021 to July 2022, the patient underwent 8 courses of adjuvant polychemotherapy according to the FOLFOX scheme and 2 courses according to the FOLFOX scheme and bevacizumab. In August 2022, due to signs of disease progression, the patient underwent SS-0 cytoreductive surgery: removal of tumour nodes of the parietal and visceral peritoneum, partial peritonectomy of the anterior abdominal wall, argon plasma coagulation of foci of peritoneal carcinomatosis of the parietal and visceral peritoneum, resection of the round ligament of the liver, NIRES. According to the results of the histological examination, metastases of mucinous adenocarcinoma of the intestinal type with the II-III degree of medical pathomorphosis were determined.

From September 2022, the patient received 2 courses according to the IRINOX + bevacizumab regimen and 6 courses according to the FOLFIRI + bevacizumab regimen.

According to the control MRI of the abdominal organs with intravenous contrast, metastases of the 7th and 8th segments of the liver were determined.

Performed percutaneous radiofrequency ablation of liver metastases under ultrasound control

Results. According to the results of the MRI of the OCP with intravenous contrast, there are currently no data on the progression of the disease. The patient's quality of life is satisfactory; the ESOG score is 0. It has been 22 months since the onset of the disease.

Conclusions. Cytoreductive surgical interventions for synchronously metastatic colorectal cancer can significantly improve patients' quality of life and their oncological outcomes rather than only symptomatic treatment.

Improvement of the scheme of preventive and treatment measures for associated respiratory infections in cats

Volodymyr Ruban — 2023-03-31

The aim of the research was to study the etiological structure of associated infectious rhinotracheitis in cats. It has been established that infectious rhinotracheitis is registered among cats in association with infectious diseases of bacterial aetiology.

Materials and methods. The research was conducted based on a private veterinary clinic in the city of Kharkiv in 2021–2023. A total of 48 cats with signs of respiratory tract damage were examined in the clinic. Samples for laboratory diagnosis were obtained by oropharyngeal swab and transnasal lavage. To confirm the laboratory diagnosis of infectious rhinotracheitis in cats, we used the PCR method (using the Rynovir test system), as well as rapid IXA tests (FHV Ag) manufactured by ASAN PHARM (China) or ZRbio (China). To detect specific antibodies, the method of serological (retrospective) ELISA diagnostics was used using the immunoComb Feline VacciCheck device-free ELISA test system manufactured by Biogal, Israel. Bacteriological studies were carried out according to well-known methods using special nutrient media for the selection and identification of associated bacterial microflora. The sensitivity of selected dominant cultures of bacteria to antibiotics was determined by diffusion in agar using discs containing antibiotics.

Results. It was investigated that Bordetella bronchiseptica was determined as the dominant pathogen in the bacterial association – 52.0 %. Isolated cultures of Bordetella bronchiseptica were sensitive to cefamycin. The proposed science-based scheme for the treatment of infectious rhinotracheitis in association with feline bordetelliosis ensures high therapeutic efficiency.

Conclusions. For the treatment of infectious respiratory diseases in cats, it is necessary to carry out individual complex etiotropic, pathogenetic and symptomatic therapy. Homoeopathic therapy relieves the symptoms of the disease, promotes faster recovery, and is an addition to the main methods of treatment. The main specific measure of disease prevention is timely vaccination (inoculation), the effectiveness of which, according to our research, ranges from 71 % to 100 %.