RESUMEN
OBJECTIVE: This retrospective study was conducted to evaluate the behaviour of AIDS associated cancers treated with comprehensive cancer treatment along with highly active anti-retroviral therapy (HAART). METHODS: 172 AIDS-associated cancers were diagnosed and treated during 2003 to 2021. HIV status was evaluated by ELISA, viral load and CD4/CD8 counts. They were treated with different cancer treatment modalities for cancers, HAART for HIV infection and followed up periodically. RESULTS: Of 172 cases of AIDS associated cancers, AIDS-Defining Cancers (ADCs) were seen in 84 (48.84%) and non-AIDS-Defining Cancers (NADC) in 88 patients (51.16%). Non-Hodgkin Lymphoma was the commonest AIDS-defining cancer in 58 (69.05%) patients. Extranodal presentations of ARLs was seen in 28 cases (19.86%) followed by cervical cancers in 26 (30.95%) women with HIV infection. Kaposi's sarcoma was not found. Head and neck cancers were the most common cancers in NADCs, followed by breast cancers and other types of cancers. Only two patients had HIV-2 associated cancers. One patient had immune reconstitution syndrome (IRIS).Long-term non-progressor HIV infection with cancer was seen in one patient. 49 patients (28.49%) were receiving HAART. CONCLUSIONS: AIDS-associated cancers are seen in advanced stage of HIV infection. Concurrent chemotherapy and anti-retroviral therapy for ADCs show good control of both diseases. Non-AIDS-defining cancers do not show predictable response to anti-retroviral therapy. KS is not seen in our study.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Infecciones por VIH , Neoplasias , Sarcoma de Kaposi , Neoplasias del Cuello Uterino , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Terapia Antirretroviral Altamente Activa , Controladores de Élite , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Humanos , Neoplasias/complicaciones , Neoplasias/epidemiología , Estudios Retrospectivos , Sarcoma de Kaposi/tratamiento farmacológico , Sarcoma de Kaposi/epidemiologíaRESUMEN
With the inventions of faster cars and even more faster motorbikes there is a worldwide increase in road traffic accidents, which has increased the incidence of blunt abdominal trauma but still duodenal injury following a blunt abdominal trauma is uncommon and can pose a formidable challenge to the surgeon and failure to manage it properly can result in devastating results. It may typically occur in isolation or with pancreatic injury. Here, we report a case of an isolated transection of the third part of the duodenum with normal pancreas following a blunt abdominal trauma. The initial clinical changes in isolated duodenal injury may be extremely subtle before life-threatening, peritonitis develops. Hence, a high index of suspicion, on the basis of mechanism of injury and physical examination is the key in early detection of duodenal injury especially in a rural hospital like ours where the facilities for computed tomography scan are not available.
RESUMEN
OBJECTIVES: To study the incidence and effects of anti-retroviral therapy along with cancer chemotherapy on outcome of AIDS associated Cancers in Indian patients. METHOD: 3832 cancers patients were investigated over a period of 5 years. 46 AIDS-associated cancers were identified. HIV status was evaluated by ELISA, Western Blot, viral load and CD4/CD8 counts. Patients were treated with different modalities of cancer management and anti-retroviral therapy was discussed with the patient and relatives. Patients were followed up 6 monthly. RESULTS: Incidence of AIDS-associated cancers was 1.2 percent. AIDS-Defining Cancers (ADC) were seen in 26 (54.35%) while non-AIDS-Defining Cancers (NADC) were observed in 21 (45.65%). Non Hodgkin Lymphoma was the commonest form of AIDS-defining cancers in 21 (84%) patients, cervical cancers in 4 (16%) women while there was not a single case of Kaposi's Sarcoma. AIDS associated cancers were common in males. Mean age was 38.5 years. Only 33.5% patients received treatment for HIV and cancers. Development of immune reconstitution syndrome was observed in 9.09% patients. Hepatitis B infection was seen in only one patient (2.17%). CONCLUSIONS: AIDS-associated cancers are seen in advanced stage of HIV infection. Concurrent chemotherapy and anti-retroviral therapy for ARL is significantly effective. Cervical cancers and non-AIDS-defining cancers do not show predictable response to anti-retroviral therapy. Mortality in non-AIDS related cancers was significantly higher than AIDS related cancers.