Survey on medicinal spices of the nilgiris

A survey is made on the medicinal spices of the Nilgiris. Totally, there are 25 species available in various parts of the Nilgiris and they belong to 16 different families of angiosperms. Gudalur, Kothagiri, Kookalthorai, Aruvankadu, Coonoor, Burliar, Masinagudi and Ootacamund are some of the important places in the Nilgiris have a variety of medicinal properties that are put to use in homoeopathic and ayurvedic preparations.

Childhood thyroid cancer. Characteristics and long-term outcome in children irradiated for benign conditions of the head and neck

OBJECTIVE

To determine the characteristics and long-term outcome of radiation-induced thyroid cancer in children.

DESIGN

Retrospective review of a cohort of 4296 irradiated patients who received childhood radiation treatment to the head and neck area at the same hospital.

PATIENTS

Forty-one children who were younger than 20 years when thyroid cancer developed in them and 77 adults in whom thyroid cancer developed. All 118 cases were diagnosed before 1974 and were followed up for a median of 19.4 years.

RESULTS

Children presented with clinically palpable lymph nodes more often than adults (30.7% vs 15.1%, P = .05) and had more recurrences (39% vs 16%, P = .05). Despite these frequent recurrences, only one patient (an adult) died of thyroid cancer. Seventy percent of the recurrences occurred during the first 10 years of follow-up, but recurrences continued after 20 years. The adults had previously identified factors that predicted the risk of recurrences, but none could be identified in the children.

CONCLUSION

The presentation and relatively good outcome of radiation-induced thyroid cancer in children is similar to that in nonirradiated children. Frequent and late recurrences call for lifelong follow-up.

Physicians' and the public's attitudes on communication about death

We studied the preferences of physicians and the public as to how physicians should inform a family of a patient's unexpected death. When the family had to be reached by telephone, 72% of our 150 physician-respondents preferred telling the family that the patient was critically ill and asking the family to come to the hospital immediately (critical notification [CN]); 25% of the physicians preferred announcing the death over the telephone (death notification [DN]). When the news had to be announced in person, 58% of physicians preferred immediately announcing it (IA), and 33% preferred gradual announcement (GA). A Gallup poll commissioned by us showed that 64% of the adult population in the United States preferred CN, 26% DN, 79% IA, and 17% GA; CN and IA were preferred in all the demographic subgroups examined. We discuss our findings, the reasons for them, and their ethical and practical implications.