The 60 patients of gastrointestinal cancer comprising this study were in the age range of 29--70 years with 39 males and 21 females. The primary sites of cancer were: gallbladder 19, colon 13, stomach 12, anorectum 8, and liver 8. The stage of tumor spread was localized in 32 and metastatic in 28 cases. Round cell infiltration scores were classified semiquantitatively from O-V. Cellular immunity as expressed by the blood lymphocyte count and DNCB reactivity was also studied. Round cell infiltration was dense in the localized group (P less than 0.0005). The mean lymphocyte counts in all the primary sites of gastrointestinal cancer were significantly higher in the localized group as compared to metastatic group. The DNCB reactivity showed anergy in six cases and poor response in the remaining 22 cases of metastatic group. There was a statistically significant correlation between lymphoreticular infiltration, peripheral blood lymphocyte count, and the DNCB reactivity. Diminished round cell infiltration, lymphopenia, and depressed DNCB response indicate an advanced stage of gastrointestinal cancer.
Objective: To assess maternal mortality ratio (MMR), trends and causes of maternal mortality in rural Uttar Pradesh, India, and suggest ways to reduce it. Materials and methods: Retrospective review of all maternal deaths that occurred at a tertiary care hospital in rural India for a time period of 2008 to 2013. Results: Extremely high MMR of 1,083.09 per 100,000 live births was observed in this period. Out of total maternal deaths, 95.36% were from rural areas, 98.1% were unbooked for delivery, and 66.88% were in 21-to 30-year age group. Hemorrhage (26.14%) was the commonest direct cause followed by eclampsia (13.9%), and anemia (24.83%) was the most common indirect cause of death. Conclusion: There is a scope for reducing the MMR as majority of the causes are preventable and curable.
Clear cell carcinoma of endometrium is a rare (1-6%) but aggressive malignancy with high propensity of early extra-uterine spread. The usual presentation is postmenopausal bleeding and discharge as with other endometrial cancers but it does not have preceding hyperplastic stage, instead it develops from thin atrophic endometrium, therefore impossible to identify by the screening measures like Pap smear and transvaginal sonography. First step for early diagnosis of such unfavorable endometrial cancer should be endometrial biopsy. Histopathological diagnosis is mandatory to confirm the clear cells present in the endometrial sample before planning the management. Clinical staging is highly erroneous in clear cell endometrial cancer and should not be taken into consideration in management plan. Being a rare cancer, there is lack of true evidence on its management protocol. Here, we had tried to provide the review about the clear cell endometrial (CCE) cancer diagnosis and management along with a case report for clinical perspective.
How to cite this article
Seth S, Rawat R, Kanti V, Mishra P, Vishwakarma S. Clear Cell Carcinoma of Endometrium: A Clinical Review. J South Asian Feder Menopause Soc 2014;2(1):15-19.
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