Pharmacogenomics-assisted schizophrenia management: A hybrid type 2 effectiveness-implementation study protocol to compare the clinical utility, cost-effectiveness, and barriers

OBJECTIVES

The response to antipsychotic therapy is highly variable. Pharmacogenomic (PGx) factors play a major role in deciding the effectiveness and safety of antipsychotic drugs. A hybrid type 2 effectiveness-implementation research will be conducted to evaluate the clinical utility (safety and efficacy), cost-effectiveness, and facilitators and barriers in implementing PGx-assisted management compared to standard of care in patients with schizophrenia attending a tertiary care hospital in eastern India.

METHODS

In part 1, a randomized controlled trial will be conducted. Adult patients with schizophrenia will be randomized (2: 1) to receive PGx-assisted treatment (drug and regimen selection depending on the results of single-nucleotide polymorphisms in genes DRD2, HTR1A, HTR2C, ABCB1, CYP2D6, CYP3A5, and CYP1A2) or the standard of care. Serum drug levels will be measured. The patients will be followed up for 12 weeks. The primary endpoint is the difference in the Udvalg for Kliniske Undersøgelser Side-Effect Rating Scale score between the two arms. In part 2, the cost-effectiveness of PGx-assisted treatment will be evaluated. In part 3, the facilitators and barriers to implementing PGx-assisted treatment for schizophrenia will be explored using a qualitative design.

EXPECTED OUTCOME

The study findings will help in understanding whether PGx-assisted management has a clinical utility, whether it is cost-effective, and what are the facilitators and barriers to implementing it in the management of schizophrenia.

TRIAL REGISTRATION

The study has been registered with the Clinical Trials Registry-India (CTRI/2023/08/056210).

Subjective Global Assessment of Nutritional Status in Head and Neck Cancer Patients Treated with Radiotherapy - A Prospective Observational Study from North East India

Head and neck cancer (HNC) patients undergoing curative radiotherapy (RT) are at risk of malnutrition due to disease process as well as effects of therapy. Identifying the nutritional status of these patients at the earliest, helps to introduce adequate and timely interventions that can improve compliance and outcomes of treatment. Various tools for nutritional assessment in cancer patients have been proposed. In this prospective observational study we used the Subjective Global Assessment (SGA) questionnaire in a cohort of HNC patients receiving definitive RT at a regional cancer center of North East India. Recording of data was done at baseline, at two weekly intervals during treatment, at end of radiotherapy (EORT) and at follow-up upto 6 months. We observed that despite proper nutrition counseling, our patients suffered from malnutrition throughout their course of RT, which was at its peak by EORT but gradually improved over six months of follow-up. Pain on eating and swallowing were the most debilitating symptoms which caused significant decline of nutrient intake, body fat and muscle mass among patients together with deteriorating SGA ratings. Our results will hopefully help us design better strategies for nutrition management while delivering curative (chemo)radiotherapy for HNC patients of this region- which has one of the highest incidences of HNC in the world.

Influence of New FIGO 2018 Staging on Treatment Outcomes in Early-Stage Cervical Cancer: A Single-Center Study

Satinder KaurPurpose  The aim of this article was to study survival outcomes of early-stage cervical cancer patients and impact on survival after restaging them as per International Federation of Gynecology and Obstetrics (FIGO) 2018. Materials and Methods  A retrospective study was conducted from June 1, 2013 to May 31, 2018 in a tertiary care hospital in North India. One-hundred patients of early-stage cervical cancer (as per FIGO 2009 staging) who had been treated by surgery followed by risk based tailored adjuvant therapy in our hospital were evaluated. The clinicopathological features and survival outcomes of these patients were analyzed. These patients were then restaged as per new FIGO 2018 staging and survival outcomes between two FIGO classifications were compared. Results  The median age of the study population was 52.5 years with median follow-up of 62.1 months. Ninety percent of our patients had more than 2 years follow-up and 59% had more than 5 years follow-up. The overall survival and relapse-free survival were 87.5 and 91.4%, respectively. The study population was then reclassified according to new FIGO 2018 staging. It was seen that the patients with stage IB1and IB2 cervical cancer had overall survival of 91.1 and 90%, respectively. The overall survival of stage IB3 was 80% and the survival of stage IIIC1 was only 60%. Conclusion  The new FIGO 2018 classification has a significant effect on survival outcome and in prognostication of patients with cervical cancer.

Significance of Pattern of Invasion in Tongue Squamous Cell Carcinoma—A Retrospective Study from a Regional Cancer Center of North-East India

Introduction Many multiparametric models and scoring systems had been proposed in oral tongue squamous cell carcinoma (OTSCC) to predict the survival and recurrence, out of which pattern of invasion (POI) is gaining focus recently.

Objective We conducted a retrospective study with the aim to see the prognostic significance of the POI and other parameters such as depth of invasion, perineural invasion (PNI), and lymph node status in OTSCC.

Materials and Methods The slides of already diagnosed OTSCC cases were prepared from January 2015 to December 2017 records and studied by two pathologists for different patterns using Brandwein-Gensler scoring system. The different clinicopathologic parameters were compared with different POI. Statistical analysis was performed to present cumulative survival outcomes and for comparison.

Results Most of our patients were > 40 years of age with male preponderance. Tumor differentiation pattern was assessed using Broders' system of grading that showed 85% of tumors were well, 12.5% tumors were moderately differentiated, and 2.5% tumors were poorly differentiated. The worst POI was predominantly pattern III (50%) followed by pattern II (32.5%) and pattern IV (13.8%). Most patients were in stage II (33.8%) followed by stage III (32.5%), stage IV (26.3%), and stage I (7.5%). There was an inverse relationship between POI with tumor stage and recurrence. A strong statistically significant association was found between POI with perineural infiltration and lymph node metastasis.

Conclusion We concluded from our study that worst POI is significantly associated with number of lymph nodes metastasis and perineural infiltration and hence can be used as an independent prognostic factor.

Influence of hormone receptors in breast cancer survival with correlation to place of residence

Introduction

Breast cancer is commonly diagnosed cancer in women. Tumor receptors estrogen receptor (ER) and progesterone receptor (PR) are well recognized prognostic factors for breast cancer.

Materials and Method

Data from the department of pathology for the 5-year period (2010 to 2014) is used for analysis for Kamrup district of Assam, India. Kaplan Meir method was used to evaluate survival rate.

Result

The overall 5-year survival is observed as 54.6%. There is a 10.6% improvement in survival was recorded among those who living in the urban areas. The risk of death was 40% higher for those who were resides in rural areas compared to urban areas (P = 0.070). There is a 6 fold variation in survival was observed according to their stage at presentation. Hormone receptors found to be play an important role in survival outcome. Patients with ER/PR+ (positive) status have 13.6% higher survival rate than those with ER/PR-. The overall survival for ER/PR positive is 72.1% compared to 58.5% of ER/PR negative.

Conclusion

From the study it is observed that population with positive hormone receptors (ER/PR +) and living in the urban areas is experiencing survival rate.

Homoeopathic Treatment as an Add-On for Minimizing After Effects of Conventionally Treated Cancer Patients: A Simple Randomized Pilot Study—Protocol from Northeast India Perspective

The north-eastern region of India accounts for a total of 37,448 cancer cases reported from 11 population-based cancer registries (PBCRs) from 2012 to 2014. Studies suggest that with the holistic approach adopted by homoeopathy, not only the symptoms like cancer pain are alleviated, but also the overall well-being of the patient. Homoeopathy can be beneficial to minimize the treatment-induced adverse effects like radiation-induced mucositis, skin reactions, postoperative seroma, bleeding, and complications associated with the use of surgery, chemotherapy, and radiation therapy. This study intends to provide homoeopathic services as an add-on to conventional treatment to the patients referred for homoeopathic treatment after their due consent. The primary objective is to study the usefulness of homoeopathic medicines for combating the suffering of cancer patients having complaints other than cancer. A sample size of 70 patients per group in two arms (Arm A: standard allopathic drug and Arm B: standard allopathic drug + homoeopathic treatment) will be recruited using simple random sampling without repetition. Cancer patients reporting complaints other than cancer itself and suffering from the after-effects of cancer treatment with chemotherapy and radiation therapy to any reputed cancer institute will be screened and will be recruited according to inclusion and exclusion criteria. After completion of the six months study duration, results will be able to predict the role of homoeopathic treatment as an add-on to conventionally treated cancer patients to minimize the suffering other than cancer and the after-effects of chemotherapy and radiation therapy. If found significant, this could prove to be a contribution in the health care system in handling cancer cases that are very difficult to treat. Further, the cost-effectiveness of homoeopathy will enable developing countries to manage such a disease effectively.

Cancer in patients of and above 90 years: A hospital-based retrospective study

Background and Objective

Cancers in a nonagenarian patient are rarely seen, and there is always a moral dilemma for the family members and patient of whether to opt for the treatment or not. The main objective was to identify the survival differences between treated and not treated nonagenarian cancer patients.

Materials and Methods

This was a retrospective study of Hospital-Based Cancer Registry data from 2010 to 2016. The data of all nonagenarian cancer patients were analyzed for gender distribution, leading sites of cancer, stage distribution, types of treatment received, and survival. The survival was calculated from the date of the first diagnosis. Kaplan-Meier analysis was done to present the survival.

Results

Of 60,087 patients, 146 (0.2%) patients were of 90 years and above. Hypopharynx in males (20.5%) and tongue (20.5%) in females were the top cancer sites, 60% patient data were in Stages III and IV, 37 (25.3%) patients received treatment, and 86% patients were treated by radiotherapy. The overall survival (OS) was 14.3%. OS in the treatment group was 21.3% versus 7.7% (P = 0.001) in the no treatment group. The unadjusted hazard ratio for no treatment group was 3.8 (P = 0.003, confidence interval = 1.5-9.7).

Conclusion

Selected nonagenarian cancer patients from our population with a good performance status should receive curative treatments in all possible ways.

Causes of Treatment Abandonment of Pediatric Cancer Patients – Experience in a Regional Cancer Centre in North East India

Introduction:

Refusal and abandonment of treatment is often considered as an important reason for poor survival of pediatric cancer patients in developing and underdeveloped countries. In this study we analyze the factors responsible for treatment abandonment and refusal in a Regional Cancer Centre (RCC) in North East India.

Material and Methods:

All histopathologically or cytologically confirmed cases of childhood cancer from below 15 years of age registered from 1st April, 2010 to 31st March, 2017 were included in this study. Parents or caregivers were interviewed thoroughly and a questionnaire was filled up for analysis of demographic and socio-economic factors. Modified Kuppuswamy scale was used to measure socioeconomic status.

Results:

Of 592 patients 161 (27.1%) abandoned therapy and 23 (3.9%) refused treatment. Factors associated with abandonment of treatment included: lower risk if residing in urban areas (Odds ratio [OR] = 0.8333, 95% CI 0.565-1.228; P=0.36) and higher risk with maternal education less than secondary school (OR = 1.357; 95%CI: 0.553-3.326; P=0.505). Low socioeconomic status and age >5yrs were also associated with abandonment of treatment. In a binary logistic regression analysis, male sex [Odds Ratio (OR) = 0.701; 95% CI 0.48-1.01; P=0.062] have lowest risk of abandoning treatment with trend to statistical significance.

Conclusion:

There is a need for proper definition of the problem of childhood cancer patients so that appropriate policy can be introduced to improve survival by improving treatment compliance.

A Survival Analysis of Hypopharyngeal Cancer Patients: A Hospital-Cancer registry Based Study

To study the survival in patients affected with hypopharyngeal cancer among treatment groups and different stages. Data of hypopharyngeal cancer patients diagnosed from 1st January 2010 to 31st December 2010 was used in the present study. The cases were analyzed for gender, age group distribution, sub-sites at presentation, stage at diagnosis and the type of treatments. Survival from the date of first diagnosis was estimated and hazard ratios were calculated. Survival probability and hazards ratios (HR) were calculated by Kaplan-Meier method and Cox-proportional regression analysis respectively. Censoring of patient who survived longer than 5 years was done. Active follow-up was done for the survival analysis. The study cohort included 217 patients and treatment compliance was observed in 46.9% of cases. The median age at diagnosis was 57 years (range 24-90), 86.2% of cases were locally advanced cases (stage III and IV), pyriform sinus was major sub-site (96%), radiotherapy was main treatment modality alone in 84.8% of cases, median survival was 31 months and 5-year overall survival was 36.9%, and HR for stage IV was 1.9 (P = 0.03, 95% CI - 1.04 to 3.7). In developing setting of North East India, radiotherapy was the main modality of treatment for hypopharyngeal cancer patients, and understanding the clinical parameters and survival of this group of cancers is crucial for its control.

Cancers With Bad and Good Survival Among Male Population of Northeast India

Background: The northeast region of India has an overall high incidence, mortality and lower survival rate of cancer in the country, an annual expected of around 40,000 were diagnosed with cancer every year in this region. Mortality rate due to cancer in northeastern India is increasing mainly because of difficulties in accessing the facilities for cancer diagnosis and treatment, socioeconomic conditions, lack of awareness, taboo, misconception and wide disparity in both diagnosis and treatment of cancers among the eight different states (regions) within northeast India. Furthermore, affordability of cancer care remains a major challenge in this part of India for effective cancer control. Aim: This study was conducted with a vision to provide an idea about the cancer survival pattern of 45 million of people living in the northeastern region of India with correlation to time at diagnosis and treatment competition status. Methods: All the cases registered with a history of cancer in between 2010-2014 calendar years. Five year observed survival was calculated based on all the followed up until 2017. Three categories were made for treatment-wise survival analysis, 1) those that have completed cancer treatment 2) those that did not completed treatment 3) those who have not taken any cancer directed treatment. The 5-year survival rates were generated by using the SPSS V19 software. Kaplan-Meier method was used to generate the statistics. Results: The five years overall survival for all cancers in men is 24.3% with earlier stage at diagnosis has a better survival (Stage I, 52.1%) than later stage (Stage IV, 18.8%) at diagnosis. Completed course of cancer directed treatment found to be playing a significant role in enhancing the survival among the patients. The five-year survival for completed cancer directed treatment is 27.5% followed by 12.5% for incomplete and 8.5% for those with no cancer directed treatment group. Inequality in survival was observed among different sites of cancer, as some cancers harm younger people more than others. The five year observed survival for all sites was ranges from 0% to 75.8%. Cancer of liver (0%), pancreas (0%), lung (2.4%), gallbladder (7.9%) and stomach (10.3%) is found as more lethal than other cancers as the five years survival was in-between the range 0%-10%. Cancer of Hodgkin lymphoma (75.8%) has the highest five year cancer survival rate followed by testis (60.1%), breast-male (55.3%), penis (49.7%) and skin cancer (49.1%). The prostate cancer (19.0%) rate is very low compared with other global parts of the world where it reaches around 100% in many countries. Advances in early detection and treatment can enhance the survival rate in these regions. Conclusion: The 5-year survival showed an increasing survival with decreasing in stage at the time of diagnosis and decreasing in number of decline treatment percentage among northeastern population.

Quality assessment and improvement of cancer registration system in Kamrup Urban District: A report

INTRODUCTION

The global burden of cancer incidence and mortality are rising continuously worldwide. As per the GLOBOCAN 2012 estimates, about 14.1 million cancer cases and 8.2 million cancer deaths occurred and 32.6 million people living with cancer (within 5 years of diagnosis) in 2012 worldwide. Reliable data on the magnitude and the pattern of cancer are essential for monitoring the health of the community, assessing the performance of the health care system. Cancer registries should pay great attention to quality of their data. The completeness of cancer registry data- the extent to which all of the incident cancers occurring in the population are included in the registry database- is an extremely important attribute of a cancer registry. There are mainly four aspects influencing the quality of data namely, comparability, completeness, validity and timeliness.

MATERIALS AND METHODS

Data regarding incidence and mortality with methods of diagnosis for individual years were obtained from the National Cancer Registry Program database of the Indian Council of Medical Research for 2009 to 2014 periods and recalculated for combined years (2009-2014).

RESULTS

In males in 2009-11, 77.1% were microscopically confirmed cases which are improved in the later years and for the year 2012-2014, it is 81.4%. In females also the percentage of microscopically confirmed cases were increased from 80.2% to 82.9%. An improvement in mortality to incidence ratio was observed over the years. MI ratio in males was improved to 32.9%. for the year 2012-14 as compared to 28.6% for the year 2009-11 while in female MI ratio is also increased from 18.8% to 21.8% over the period from 2009-11 to 2012-14. Whereas DCO was decreased from 12% to 10.7% in males and 7.3% to 6.6% in females respectively from the period 2009-11 to 2012-14.

CONCLUSION

Although there is a slight improvement in data quality till date, there is an enormous scope for population based cancer registry Guwahati to improve the data quality.

Patterns of tobacco use in patients with upper aero digestive tract cancers: A hospital-based study

Background

Tobacco use is a major risk factor for increasing the burden of upper aero digestive tract (UADT) cancer in the population of Northeast India.

Objective

The objective of this study was to investigate the pattern of tobacco use in different UADT cancer.

Materials and Methods

This was a retrospective study of electronically recorded data of the Hospital Cancer Registry for the period of May 2014 to December 2014. The UADT cancers were evaluated for gender and age-group distribution, their relative proportion, and association with tobacco use and tobacco-associated risk in males to develop UADT cancers. The type of tobacco usage was clustered as chewable, smoking, and both. Relative risk (RR) of UADT with tobacco usage was identified for males.

Results

A total of 1965 (n) UADT cancer patients were identified, male:female was 2.9, tobacco habits was in 1608 (81.8%) patients, both forms of tobacco use in 705 (43.8%), chewable tobacco use in 588 (36.6%) and smoking in 315 (19.6%) patients, tobacco habits in males ranges from 67.3% to 94.3% and in females range from 5.7% to 32.7%, RR of UADT cancer in males for tongue cancer was 1.5 (confidence interval [CI] =1.2-1.9), oropharynx was 1.4 (CI = 1.0-1.8), hypopharynx 1.4 (CI = 1.1-1.7), esophageal cancer was 1.4 (CI = 1.3-1.7), and for laryngeal cancer RR was 1.7 (CI = 1.0-3.0).

Conclusion

Consumption of chewable tobacco is the major form of tobacco use alone or in combination in UADT cancer patients of our population.

Epidemiology of gynecological cancers in Kamrup Urban District cancer registry

BACKGROUND

Cancers of the female reproductive system - namely cancer of the cervix, corpus uteri, ovarian, vulvar, vaginal, fallopian tube cancers and choriocarcinoma are an important cause of cancer morbidity and mortality among women worldwide. It is estimated to be the third most common group of malignancies in women. The comprehensive global cancer statistics from the International Agency for Research on Cancer indicate that gynaecological cancers accounted for 20% of the 14.1 million estimated new cancer cases and 8.2 million cancer deaths among women in the world in 2012. The estimation of cancer burden is necessary to set up priorities for disease control. Gynaecological cancers have increased in India and are estimated to be around 182,602 by the year 2020 constituting about 30% of the total cancers among women in India. Among these, cancer of the uterine cervix followed by ovary and corpus uteri are the major contributors.

METHODS AND MATERIALS

Cancer is not notifiable in India, so method of collecting information on cancer was active with voluntary participation of different sources including major hospitals, diagnostic centers, state referral board and birth and death registration centers within registry area.

RESULTS

A total of 3767 (44%) cases were registered in women out of the total number of 8561 cancer cases during the period from 2010-2014. In case of gynaecological cancers a total of 661 cases of cervical, ovarian and corpus uterine cancers were registered out of the total 3767 female cancer cases (17.5%) for the year 2010-2014.The annual average crude rate in women for all sites of cancer was 117.4 per 100000 population. The corresponding AARs was 166.6.

CONCLUSIONS

Women's health issues have attained high concern in recent decades. Utmost efforts should be made to educate women in early cancer detection by creating awareness on risk factors and symptoms.

Role of environmental pollutants in liver physiology: special references to peoples living in the oil drilling sites of Assam

The populations residing near polluted sites are more prone to various types of diseases. The important causes of air pollution are the suspended particulate matter, respirable suspended particulate matter, sulfur dioxide and nitrogen dioxide. As limited information is available enumerating the effect of these pollutants on liver physiology of the population living near the polluted sites; in the present study, we tried to investigate their effect on liver of the population residing near the oil drilling sites since birth. In this study, a randomly selected 105 subjects (46 subjects from oil drilling site and 61 subjects from control site) aged above 30 years were taken under consideration. The particulate matter as well as the gaseous pollutants, sulfur dioxide and nitrogen dioxide, were analyzed through a respirable dust sampler. The level of alkaline phosphatase, alanine transaminase and aspartate transaminase enzymes in serum were measured by spectrophotometer. The generalized regression model studies suggests a higher concentration of respirable suspended particulate matter, suspended particulate matter and nitrogen dioxide lowers the alkaline phosphatase level (p<0.0001) by 3.5 times (95% CI 3.1-3.9), 1.5 times (95% CI 1.4 - 1.6) and 12 times (95% CI 10.74 -13.804), respectively in the exposed group. The higher concentration of respirable suspended particulate matter and nitrogen dioxide in air was associated with increase in alanine transaminase level (p<0.0001) by 0.8 times (95% CI 0.589-1.049) and by 2.8 times (95% CI 2.067-3.681) respectively in the exposed group. The increase in nitrogen dioxide level was also associated with increase in aspartate transaminase level (p<0.0001) by 2.5 times (95% CI 1.862 – 3.313) in the exposed group as compared to control group. Thus, the study reveals that long-term exposure to the environmental pollutants may lead to liver abnormality or injury of populations living in polluted sites.

Denominators: An attempt to adjust for cancer incidence and mortality rates and its role in cancer registries

Cancer is an important public health burden in India and around the Globe. Incident cases of cancer are reported continuously, and trends in incidence rates vary among five yearly age group. In India National census is carried out after every 10 years since 1951, the latest census is carried out in 2011. As Incident cases of cancer are reported continuously for 5 year age group and estimation of rates and trends for a given year of interest fall in-between two census period population estimation of five yearly age group, which serves as Denominator sense importance. Denominator serves as the most essential part of any cancer registry program as it used for calculation of various rates for five yearly age group such as age-standardized rate, crude rate, truncated rate, cumulative risk etc., Calculated by different registries and Individual Researchers, Government organizations, etc. Currently most of the registries used individual exponential growth rate and differential distribution method to estimate the growth rate. However, it is found that the calculated rates and risk be suffering from bias most of the time since some method over and underestimate the growth rate while some does not able to maintain consistency. Here, an attempt is made to adjust the world standard population with two census period to estimate the five yearly age group for a given year of interest of a geographical region falls in-between two census period. It is also shown here that how the proposed model “age-adjusted population growth model” maintain the overall growth as in exponential growth model and difference distribution method also maintains the estimated growth rate is as found in difference distribution method. Further, it is tried to highlight the points how these method overcomes the problems compared with other methods that are currently used by registries.

Community based intervention for tobacco cessation: a pilot study experience, north East India

BACKGROUND

North East India has a high prevalence of tobacco consumption, but only few individualsseek help for tobacco cessation. Impact of community based tobacco cessation intervention in this part needs more research.

MATERIALS AND METHODS

Retrospective analysis was done on the dataset from a community-based tobacco cessation intervention pilot project conducted in Guwahati metro during 2009-10. Subjects, both male and female tobacco users, age>15 years, permanent residents of these blocks giving consent were included in the study.

RESULTS

The sample was 800 tobacco users, of whom 25% visited any health care provider during last 12 months and 3% received tobacco cessation advice. An 18% quit rate was observed at six weeks follow up, more than the National average, with a 47% quit rate at eight months, while 52% of subjects reduced use.

CONCLUSIONS

Higher tobacco quit rate and reduced tobacco use, no loss to follow up and negligible relapse was observed with this community based intervention design. Such designs should be given more emphasis for implementation in specified communities with very high tobacco consumption rates, cultural acceptance of tobacco and less motivation towards quitting.

Patterns of upper aero-digestive tract cancers in Kamrup Urban District of Assam: a retrospective study

BACKGROUND

The incidence of upper aero-digestive tract (UADT) cancers, including C00-C14, C30-C32, C15 and C16, is increasing rapidly in Kamrup Urban District (KUD) of Assam, North East (NE) India. According to the NCRP (2013) report 37.6% of all cancers in both sexes are UADT cancers in the NE region, accounting for 53.3% in males and about 27.5% in females of the total cases

MATERIALS AND METHODS

A retrospective study was conducted for patient information from the period of 2008-2011. Age-standardized or age-adjusted rates (ASR or AAR) (per 100,000 person-years) were calculated using the World Standard Population as proposed by Segi and modified by Doll et al. The registry population area at risk was estimated using the 1991 and 2001 census population by sex, as well as the growth rate during that interval using the difference distribution method.

RESULTS

There were 5,638 cases registered during the last four years of the study (2008-2011) accounting for 56.7% (3,198/5,638) of the total in males and 43.3% (2,440/5,638) in females. The male: female ratio was 1.31: 1.00. The overall age adjusted rates (AAR) were 179.4 and 153.8 per 100 000 males and females respectively. Cancer of the oesophagus was most common in both sexes, with most appreciable gender variation for tongue and hypopharynx, presumably reflecting differential exposure to risk factors.

Descriptive report on pattern of variation in cancer cases within selected ethnic groups in Kamrup Urban District of Assam, 2009-2011

BACKGROUND

The global burden of cancer is continuously increasing. According to recent report of the National Cancer Registry Programme (NCRP) on time trends it is estimated that future burden of cancer cases for India in 2020 will be 1,320,928. It is well known that knowledge of the incidence of cancer is a fundamental requirement of rational planning and monitoring of cancer control programs. It would help health planners to formulate public health policy if relevant ethnic groups were considered. North East-India alone contains over 160 Scheduled Tribes and 400 other sub-tribal communities and groups, whose cancer incidence rates are high compared to mainland India. As since no previous study was done focusing on ethnicity, the present investigation was performed.

MATERIALS AND METHODS

In this paper PBCR-Guwahati data on all cancer registrations from January 2009 to December 2011 for residents of the Kamrup Urban District, comprising an area of 261.8 sq. km with a total population of 900,518, including individual records with information on sex, age, ethnicity and cancer site are provided. Descriptive statistics including age adjusted rates (AARs) were taken as provided by NCRP. For comparison of proportional incidence ratios (PIR) the Student's t test was used, with p<0.05 considered as statistically significant.

RESULTS AND CONCLUSIONS

Differences in leading sites of Kamrup Urban District since from the beginning of the PBCR-Guwahati were revealed among different ethnic groups by this study. The results should help policy makers to formulate different strategies to control the level of burden as well as for treatment planning. This study also suggests that age is an important factor of cancer among different ethnic populations as well as for overall population of Kamrup District of Assam.

Role of glutathione S transferase polymorphism in COPD with special reference to peoples living in the vicinity of the open cast coal mine of Assam

BACKGROUND

COPD may develop due to variation in the functioning of antioxidants along with smoking and environmental factors in genetically susceptible individuals. Since there are different views about the antioxidants responsible for detoxifying xenobiotic compound in the human body whose functional variation may lead to obstructive disease, this associative study has been taken up between GST gene polymorphism and COPD in populations exposed to coal dusts.

METHODS

Genotypes of the 70 COPD patients and 85 non COPD patients were determined by PCR based methods followed by multiplex PCR of GSTT1 and GSTM1 genes taking albumin gene as a control. Suspended particulate analyses were determined through the Respirable Dust sampler along with the FTIR analysis of the dust samples from the glass microfiber filters.

RESULTS

Dust sampling analysis reveals higher level of respirable suspended particulate matter, non respirable particulate matter, SO2 and NO2 present in air of the study site. FTIR analysis also suggests a higher concentration of organic silicone and aliphatic C-F compounds present in air of the study site and when spirometry was done, low lung function was observed among most of the subjects. GSTM1 null type was significantly associated with low lung function in smoker groups and the presence of at least one active allele (either GSTM1/GSTT1) seemed to have a protective role in the development of COPD.

CONCLUSIONS

GSTM1 (null genotype) appeared to be a risk factor for lower lung function in smokers living in the vicinity of coal mines. Apart from polluted environment and genetic susceptibility, mixed coal dust exposure rich in organic silicone and aliphatic C-F compounds also appears to be a factor for the low lung function.