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Burkholderia is a gram-negative bacillus causing infections in immunocompromised patients. It is commonly seen in the tropics and is known to mimic tuberculosis clinically. Six patients were reviewed who were admitted in our hospital between July 2018 to June 2019 after obtaining their consent. All the six patients were uncontrolled diabetics with HbA1c levels between 8.2-13.9% who presented with fever more than 2 weeks and had abdominal symptoms like vomiting, abdominal pain or loss of appetite. Some also had respiratory symptoms like cough, chest pain and breathlessness. All of them had leucocytosis (neutrophilic). Mild transaminitis was also observed. CT abdomen revealed presence of multiple hepatic and splenic abscesses in all the patients. Chest X-ray revealed bilateral pneumonia in five patients. Burkholderia cepacia was found in the blood of four patients, sputum of one patient and splenic pus aspirate of one patient. Four patients were treated with meropenem and rest with ceftazidime. All of them responded well to treatment and became asymptomatic. Ultrasonography abdomen at follow-up was negative for any intra-abdominal abscesses. They were also put on long term oral co-trimoxazole. The clinical presentation of Burkholderia closely mimics tuberculosis as it predominantly affects immunocompromised and causes a long-duration multi-systemic illness. There has been several case series of intra-abdominal abscesses caused by Burkholderia pseudomallei but infections by Burkholderia cepacia in the abdomen is a rare finding. The diagnosis of burkholderia is often delayed due to its inconspicuous nature, lack of clinical suspicion and often mimicking tuberculosis clinically.

Aim: In India, more than 70% patients present as locally advanced head-and-neck cancers (LAHNC), with poor performance status and are suitable candidates for palliative radiotherapy (RT) aimed at symptom relief. This prospective study aims to compare two different short course hypo-fractionated RT regimens in patients of LAHNC at a regional cancer centre of north-west India. Materials and Methods: A total of 70 patients of LAHNC were randomized to receive palliative RT in two groups of 35 each. Group A received 30 Gy/10# over 2 weeks and Group B received 20 Gy/5# over 1 week. Baseline symptoms of pain, dysphagia, insomnia, dysphonia, bleeding, fungation, and dyspnea were assessed before the start of study. The first assessment for toxicities, subjective and objective response was done at the conclusion of RT and then after 4–6 weeks. Results: Out of total 70 patients, 71% were males and 29% were females with a median age of 54 years. The most common sites were oropharynx (39%) followed by larynx (24%), oral cavity (20%), and hypopharynx (17%). Nearly 60% of the patients in both groups presented in stage IV and 40% in stage III. At conclusion of RT and at 4–6 weeks follow-up, both groups showed similar results in terms of symptom palliation, objective response, and acute toxicities. Group B showed higher incidence of Grade III and above mucositis (P = 0.027). Median overall survival was found to be 5.9 months (range 1–15 months) in group A and 6.1 months (range 1–18 months) in Group B. Conclusion: Hypo-fractionated RT promises to effectively relieve symptoms in LAHNC and reduces the need of analgesics and hospital visits. Furthermore, a shorter overall treatment time is beneficial at high volume centers and is also welcomed by patients with shorter life expectancy.

Background Older patients with cancer are more vulnerable to the effects of cognitive impairment affecting their functional status, quality of life, compliance to treatment and ultimately survival. Cancer-related cognitive impairment may be due to the cancer itself or due to the treatment of cancer. There are no data regarding the prevalence of cognitive impairment in older persons with cancer and brain metastasis. Methods This retrospective analysis was conducted on a prospectively collected data set of patients who attended the geriatric oncology clinic at a tertiary care comprehensive cancer centre in India from June 2018 to July 2021. Patients aged 60 years and above with malignancy were included. Cognition was assessed with the mini-mental status examination (MMSE); the Hindi MMSE was used for illiterate patients. A score of ≤23 on the MMSE was considered abnormal. Correlation between the presence of cognitive impairment and brain metastasis was tested using the chi-square test. Results A total of 597 patients were included, of which 462 (77.4%) were male. The median age was 69 years (range: 60–100 years). All patients had solid tumours; 244 (40.9%) had lung, 189 (31.7%) had gastrointestinal and 75 (12.6%) had head and neck malignancies. Forty-one (6.9%) patients had brain metastases, of which 10 (24.4%) had solitary, 30 (73.2%) had multiple lesions and 1 (2.4%) had leptomeningeal metastases. Cognitive impairment was noted in 11 (26.8%) of the 41 patients with brain metastases and 91 (16.4%) of the 556 patients without brain metastases. There was no significant correlation between the presence of brain metastases and cognitive impairment, p = 0.086. Conclusion Older persons with cancer and brain metastases were not found to have a higher occurrence of cognitive impairment than those without brain metastases in this study. The next step is to understand whether older persons with brain metastases are at a higher risk for cognitive decline as a result of therapeutic interventions such as cranial radiotherapy and chemotherapy.

Background: Pulmonary sarcomatoid carcinoma (PSC) constitutes a heterogeneous group of poorly differentiated non-small cell lung cancers. Since these are rare tumours, we sought to determine the characteristics and clinical outcomes of these patients treated at our centre. Methods:We did a retrospective evaluation of all patients diagnosed with PSC between