Head and neck cancer is one of the ten most common cancers in the World constituting 15% of all malignancies. Head & Neck cancers rank 3rd in developing countries.In the prementioned context the current study is aimed at assessing patient compliance to concurrent chemo- radiation and also about the various factors influencing the outcome in the cases of head and neck cancers attending to Department of Radiotherapy, Government Medical College and General Hospital, Anantapuramu. Of a total number of 135 cases of head and neck tumours were treated with Radiation during the aforementioned period, 70 cases of locally advanced disease that are treated with Radical Radiation and concurrent chemotherapy were included in the study. In our study, we noticed complete response in 60 % of the patients. Response was significantly influenced by the site of the primary. Patients with primary in Nasopharynx and Larynx had better response, 80 % and 70 % respectively compared to. Tumor response was better in patients who completed treatment without breaks and with good performance status. Concurrent chemoradiation results in grade III reactions which have to be managed aggressively. Nutrition of the patient should be maintained with nasogastric or PEG tubes if needed along with parenteral nutrition. Weekly blood counts should be checked. Antifungals and antibiotics should be used whenever needed. Patients need counselling regarding diet and high protein diet should be advised.
Aim and Objective: To assess the distribution of various cytomorphological patters of clinically palpable breast lumps by Fine Needle Aspiration Cytology technique. Materials and Methods: A retrospective study over a period of 3 years 270 breast aspirates who attended the surgery out patient department in government medical college Anantapur from January 2012 to December 2014 were studied with clinical correlation and cytological analysis with FNAC. Smears were stained with H &E stain, and correlation with imaging studies, including mammography was done. Results and Analysis: Total of 270 cases were studied, out of these 191 (70.74%) were found benign and 50 (18.51%) were malignant. 20 (7.40%) cases given un- satisfactory results. Out of 270 cases of analysis, Fibroadenoma was the most common benign lesion found in 133 (49.25%) patients, followed by fibrocystic disease 28(10.37%) and mastitis/Breast abscess 8(2.96%) were common breast lesions on cytology. Malignant breast lesions constitute 50(18.51%) cases, among which Duct cell carcinoma 47(17.40%) cases were commonest type. Conclusion: Benign breast lesions are common than malignant lesions, fibroadenoma and fibrocystic disease are more common in benign disease. Maximum number of lesions (34%) was seen in age group of 20 to 30 years, whereas IDC accounts for the highest number of malignant lesions. Fine-needle aspiration cytology is a rapid and effective method for the primary categorization of palpable breast lumps into benign, malignant, atypical, suspicious, and unsatisfactory categories.
49 pags, 10 figs, 2 tabs. -- Supplementary data is available at the Publisher's web ; The goal of the Tropospheric Ozone Assessment Report (TOAR) is to provide the research community with an up-to-date scientific assessment of tropospheric ozone, from the surface to the tropopause. While a suite of observations provides significant information on the spatial and temporal distribution of tropospheric ozone, observational gaps make it necessary to use global atmospheric chemistry models to synthesize our understanding of the processes and variables that control tropospheric ozone abundance and its variability. Models facilitate the interpretation of the observations and allow us to make projections of future tropospheric ozone and trace gas distributions for different anthropogenic or natural perturbations. This paper assesses the skill of current-generation global atmospheric chemistry models in simulating the observed present-day tropospheric ozone distribution, variability, and trends. Drawing upon the results of recent international multi-model intercomparisons and using a range of model evaluation techniques, we demonstrate that global chemistry models are broadly skillful in capturing the spatio-temporal variations of tropospheric ozone over the seasonal cycle, for extreme pollution episodes, and changes over interannual to decadal periods. However, models are consistently biased high in the northern hemisphere and biased low in the southern hemisphere, throughout the depth of the troposphere, and are unable to replicate particular metrics that define the longer term trends in tropospheric ozone as derived from some background sites. When the models compare unfavorably against observations, we discuss the potential causes of model biases and propose directions for future developments, including improved evaluations that may be able to better diagnose the root cause of the model-observation disparity. Overall, model results should be approached critically, including determining whether the model performance is acceptable for the problem being addressed, whether biases can be tolerated or corrected, whether the model is appropriately constituted, and whether there is a way to satisfactorily quantify the uncertainty. ; A portion of the work was carried out at the Jet Propulsion Laboratory, California Institute of Technology, under a contract with the NASA Aeronautics and Space Administration. A portion of the work was carried out the National Center for Atmospheric Research, which is operated by the University Corporation for Atmospheric Research under sponsorship of the National Science Foundation. PY acknowledges support from the Faculty of Science and Technology, Lancaster University. JB and UI acknowledge NordForsk under the Nordic Programme on Health and Welfare Project #75007: Understanding the link between air pollution and distribution of related health impacts and welfare in the Nordic countries (Nordic Welf Air); and the H2020-LCE project: Role of technologies in an energy efficient economy – model based analysis policy measures and transformation pathways to a sustainable energy system (REEEM), Grant agreement no.: 691739. GZ acknowledges the New Zealand Government's Strategic Science Investment Fund (SSIF) through the NIWA programme CACV. This work was supported by the Engineering and Physical Sciences Research Council [grant number EP/N027736/1] and the Natural Environment Research Council [grant number NE/N003411/1]. ; Peer reviewed
53 pags., 19 figs., 1 tab. ; Our understanding of the processes that control the burden and budget of tropospheric ozone has changed dramatically over the last 60 years. Models are the key tools used to understand these changes, and these underscore that there are many processes important in controlling the tropospheric ozone budget. In this critical review, we assess our evolving understanding of these processes, both physical and chemical. We review model simulations from the International Global Atmospheric Chemistry Atmospheric Chemistry and Climate Model Intercomparison Project and Chemistry Climate Modelling Initiative to assess the changes in the tropospheric ozone burden and its budget from 1850 to 2010. Analysis of these data indicates that there has been significant growth in the ozone burden from 1850 to 2000 (approximately 43 ± 9%) but smaller growth between 1960 and 2000 (approximately 16 ± 10%) and that the models simulate burdens of ozone well within recent satellite estimates. The Chemistry Climate Modelling Initiative model ozone budgets indicate that the net chemical production of ozone in the troposphere plateaued in the 1990s and has not changed since then inspite of increases in the burden. There has been a shift in net ozone production in the troposphere being greatest in the northern mid and high latitudes to the northern tropics, driven by the regional evolution of precursor emissions. An analysis of the evolution of tropospheric ozone through the 21st century, as simulated by Climate Model Intercomparison Project Phase 5 models, reveals a large source of uncertainty associated with models themselves (i.e., in the way that they simulate the chemical and physical processes that control tropospheric ozone). This structural uncertainty is greatest in the near term (two to three decades), but emissions scenarios dominate uncertainty in the longer term (2050¿2100) evolution of tropospheric ozone. This intrinsic model uncertainty prevents robust predictions of near-term changes in the tropospheric ozone burden, and we review how progress can be made to reduce this limitation. ; ATA and PTG would like to acknowledge support from National Centre for Atmospheric Science. YE would like to acknowledge support from the National Science Foundation Atmospheric and Geospace Sciences awards # 1900795 and 1929368. TW acknowledges support from the Hong Kong Research Grants Council (T24-504/17-N) and the National Natural Science Foundation of China (91844301). ASL thanks European Executive Agency under the European Union's Horizon 2020 Research Innovation programme (Project "ERC-2016-COG 726349 CLIMAHAL"). RH is supported by an NERC Independent Research Fellowship (NE/N014375/1). YMS is supported by an NERC PhD studentship. Part of this research was carried out at the Jet Propulsion Laboratory, California Institute of Technology, under a contract with the National Aeronautics and Space Administration.
