Hi All,
The case summary of a patient admitted to the Regional Cancer Centre
Trivandrum, India is given below. Please give your advice to
save her
Case Summary
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Mrs ASHA LATHA - 40 year old female
Underwent total Abdominal Hysterctomy with Bilateral Salpingo
oophorectomy for malignant terractoma ovary on 11th June 1996,
followed by 4 courses of combination chemotherapy with eisplatin
hydrochloride, bleomycin and etoposide. Last chemotherapy on
24th September 1996. She was in Remission at the end of chemotherapy
Serum Beta HCG, AFP and CT scan chest were normal
After discharge from hospital she was affected with diarrhoea which
persisted for almost one month, and became very weak and dehydrated
So again admitted to Regional Cancer Centre on 20th December 1996
Relapsed on December 1996 with secondaries in Liver (Multiple
well defined hypocchoic areas are scattered in both lobes),
bilateral kidney enlargement (hydro nephrotic), irregular mass in the
region of uterus measuring 9.7 X 3.1 cms and another irregular
solid echotexture measuring 4.5 X 3.5 cms in the region of left ovary
No nymph nodes detected in paravertebral or lliac region (ultra sound
scan). Patient also has rectovaginal fistula. Vaginal discharge
of dark green colour sometimes contain motion. Chemotherapy given
with carboplatin (150 X 2 bottles) on 28th december, 1996. Now
she has urinary infection, with intermittent fever and shivering
(puss cells 30 - 35 per HPB, proteus grown, sensitivity ciproflxacin,
amioacin etc)
Plain RNAC Aspiration result on 26th December: Clinical Diagnosis -
Carcinonia ovary,
Site of aspiration (1) Pelvic mass, Report - shows only necrotic
material
Vaginal Swab Culture and Sensitivity Report on 3rd January 1997
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a) Klebsiella grown and b) stephylococcus aureus grown
c) Sensitivity of Klebsiella is reported
Sensitivity Pattern : Amioacin++, Brythromycin++, Netilmicin++
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Sensitivity of Staphylococcus is reported
Sensitivity Pattern: Netilmicin++, Pefloxacin++
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Proleinsteril KE 10%(intravenous aminoacids), Metrogyl 5mg/ml
Isotonic Metronidazole injection IP, pain killer TWC tablets etc are
being given. Average urine output 1400-1600 ml per 24 hours
Food intake: Horlicks, Vegetable soup with carrot, cabbage and beans
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rice soup, tea, tender coconut water and oats with milk
Patient is very week and the body condition is not improving
(Please rush your advice/suggestions to amar@giasmd01.vsnl.net.in)
Contact Phone numbers in India : (91) 471 541363
(91) 471 540155
If the above e-mail is not reachable please send a copy of your
e-mail to girish@crd.ge.com
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Girish Ramachandran
GE Corporate R&D
e-mail : girish@crd.ge.com
Phone : (518) 387 6546 (Office)
(518) 346 4701 (Home)
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