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Indian Journal of Medical and Paediatric Oncology
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   2000| March  | Volume 21 | Issue 1  
    Online since May 30, 2009

 
 
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Ceftazidime and netilimicin versus ceftazidime and amikacin for febrile neutropaenia.
DK Hawse, A Mukhopadhyaya, PM Parikh, R Gopal, TK Saikia, VR Pai, SS Menon, SH Advani
March 2000, 21(1):21-27
A total of 50 patients having high risk febrile neutropaenia were entered in the study, randomly and were assigned to receive either ceftazidime and netilmicin or ceftazidime and amikacin. Seventeen out of 25 (68 per cent) febrile episodes responded to ceftazidime and netilmicin while 12/25 (48 per cent) episodes responded to ceftazidime and amikacin. Total 26/50 (52 per cent) febrile episodes were diagnosed as FUO. Out of them, 15/16 (93.73 per cent) patients responded to ceftazidime and netilmicin and 4/10 (40 per cent) patients responded to ceftazidime and amikacin. The most common organisms grown were Gram-negative bacteria (26/29, 89.65 per cent) like E. coli, Pseudomonas, Klebsiella and Acinetobacter. Gram-positive bacteria were grown in 3/29 (11.35 per cent) episodes only. Though eight out of the 15 (16 per cent) episodes were associated with bacteremia. Of them, 1/13 (33.33 per cent) and 5/5 (100 per cent) episodes responded to ceftazidime and netilmicin and ceftazidime and amikacin, respectively. The median duration of therapy was 6 (4 to 12) days in the ceftazidime and netilmicin group and 8 (4 to 13) days in the ceftazidime and amikacin. A change in the antimicrobial was required in 8/25 (32 per cent) patients in the ceftazidime and netilmicin group, while in the ceftazidime and amikacin group a change in the antibiotics was required in 13/25 (52.5 per cent) cases. We conclude that combination of ceftazidime and netilmicin is found to be equally effective as the combination of ceftazidime and amikacin in febrile neutropaenic patients.
[ABSTRACT]   Full text not available   
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Soft tissue metastasis from glioblastoma multiforme : a case report.
R Jacob, P Kusumakumary
March 2000, 21(1):28-29
Metastatic paediatric glioblastomas are extremely rare, Involvement of leptomeninges is the most important factor in the development of metastases and most reported cases of metastatic glioblastomas occur after one or more craniotomies. In metastatic disease, lymphnodes are frequently involved and diagnosis is established with histology or cytology. The optimal management of these tumours is not known and current management is palliative. We report a case of metastatic glioblastoma multiforme in a five year old child with review of the relevant literature.
[ABSTRACT]   Full text not available   
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Drug review : topotecan.
N Somani
March 2000, 21(1):32-35
Topotecan is a semi synthetic topoisomerase -1 inhibitor. It acts by interfering with DNA repair and replication. It is mainly indicated for cancer of ovary, small cell cancer of lung (USA-FDA has approved it as the second line agent for this indication), myelodysplastic syndrome, refractory acute leukaemias, neuroblastoma, Ewing's sarcoma, retinoblastoma, hepatoblastoma, rhabdomyosarcoma, malignant glioma and other brain tumours. It is excreted by the kidneys and hence it needs dose modification for the impaired function. Neutropaenia is the dose limiting toxicity.
[ABSTRACT]   Full text not available   
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Febrile neutropaenia and role of bacterial surveillance cultures.
BM Hussain, KM Patel, SN Shukla, PM Shah, SA Shah, BJ Parikh, AA Anand, SS Talati, B Parekh, K Sajnanai, SV Nath, HP Panchal, V Vyas
March 2000, 21(1):9-20
Modern day cancer management is complicated by aggressive chemotherapy and suppressed immunity. Chemotherapy leads to neutropaenia and breaches in the mucosal barriers. Contamination of the external and internal milieu of such neutropaenic patients leads to febrile neutropaenic situations, which are often complicated by stomatitis. All of them ultimately lead to development of life threatening complications. Use of catheters and other intravascular tubings along with empirical antibiotic prophylaxis and antibiotic therapy also lead to emergence of a change in the microbial profile. Both the domestic and nosocomial infections affect the microbial flora hence the surveillance cultures are often advocated, which are at present possibly useful in scientific studies for determining hospital policy for empirical antibiotic therapy. Patients with non-regenerating marrow are at a higher risk and they require colony stimulating factors. Nonspecific hygienic precautions and antibiotic prophylaxis help avert many a crisis in these patients.
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Occurrence of high grade non-Hodgkin's lymphoma following renal transplant : a case report.
PS Sreedharan, NK Warrier, V Talwar, SG Ramanan, TG Sagar
March 2000, 21(1):30-31
We report a 33 year old made who presented with gastrointestinal lymphoma twenty seven months after renal transplantation. The patient was receiving triple immunosuppressive drugs after transplant
[ABSTRACT]   Full text not available   
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Issues related to the infections complications of chemotherapy.
N Shukla Shilin
March 2000, 21(1):1-8
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