Head and Neck Cancers four year trend at the Nairobi Cancer Registry

Background: Data on head and neck cancers is scarce in the developing countries including Africa. These cancers are more common in the Western countries. In the USA for instance, over 50,000 new cases occur annually. Head and neck cancers subtypes include oral cancers, oral pharyngeal cancers, larynx and nasopharyngeal cancers. Some of the associated causes of head and neck cancers include oncogenic viruses, irradiation, dietary factors and genetic predisposition. These cancers present a major challenge in their management due to their occurrence near vital structures of the head and neck region. Diagnosis or screening is difficult in the early stages due to the hidden nature of the lesions often resulting in late clinical presentation. Treatment modalities include surgery, radiotherapy and chemotherapy alone or in combination. Study Design: This was a retrospective study. Materials and Methods: We reviewed data from the population based Nairobi Cancer Registry (NCR) for the occurrence of Head and Neck Cancers (HNC’s) in relation to the frequencies of all cancers registered within the period between 2000-2003. We also determined the demographical, clinical and the histological features of these cancers. Results: For the period 2000-2003, head and neck cancers comprised over 12.8% (697) of all the 5462 cancers reported from all cancer sites with a male to female ratio of 2:1. Among the head and neck sub-sites, oral cancers were the highest at 40.6%, followed by nasopharynx and laryngeal cancers with 20.8% and 13.8 % respectively. The commonest histology was squamous cell carcinoma. Conclusion: According to the cancer cases registered with the Nairobi Cancer Registry within the analysed period, Head and neck cancers comprised of a significant problem of all the cancers. They are characterised by high rates of oral and nasopharyngeal cancers

Sodium Stibogluconate (SSG) & Paromomycin Combination Compared to SSG for Visceral Leishmaniasis in East Africa: A Randomised Controlled Trial

Visceral leishmaniasis (VL) is a parasitic disease with about 500,000 new cases each year and is fatal if untreated. The current standard therapy involves long courses, has toxicity and there is evidence of increasing resistance. New and better treatment options are urgently needed. Recently, the antibiotic paromomycin (PM) was tested and registered in India to treat this disease, but the same dose of PM monotherapy evaluated and registered in India was not efficacious in Sudan. This article reports the results of a clinical trial to test the effectiveness of injectable PM either alone (in a higher dose) or in combination with sodium stibogluconate (SSG) against the standard SSG monotherapy treatment in four East African countries—Sudan, Kenya, Ethiopia and Uganda. The study showed that the combination of SSG &PM was as efficacious and safe as the standard SSG treatment, with the advantages of being cheaper and requiring only 17 days rather than 30 days of treatment. In March 2010, a WHO Expert Committee recommended the use of the SSG & PM combination as a first line treatment for VL in East Africa

Geographical Variation in the Response of Visceral Leishmaniasis to Paromomycin in East Africa: A Multicentre, Open-Label, Randomized Trial

Visceral leishmaniasis (VL) is a fatal parasitic disease with 500,000 new cases each year according to WHO estimates. New and better treatment options are urgently needed in disease endemic areas due to the long courses, toxicity and development of resistance to current treatments. Recently, the antibiotic paromomycin was tested and registered in India to treat this disease. The current study describes a clinical trial to test the effectiveness of injectable paromomycin, either alone or in combination with the standard drug sodium stibogluconate in three East African countries—Sudan, Kenya and Ethiopia. The study showed that at the same paromomycin dose that was successfully used and registered in India, a far poorer outcome was obtained, particularly in Sudan, suggesting that there are either differences in the patients ability to respond to the drug or in the susceptibility of parasites in East Africa compared with those in India. However, no major safety concerns were noted with the treatment. Further research was initiated to see if a higher dose of paromomycin would perform better, especially in Sudan. The results of this and the performance of the combination arm will be reported later. Our study highlights the importance of considering geographical differences to treatment responses

Quantum correlation measurements in interferometric gravitational-wave detectors

Quantum fluctuations in the phase and amplitude quadratures of light set limitations on the sensitivity of modern optical instruments. The sensitivity of the interferometric gravitational-wave detectors, such as the Advanced Laser Interferometer Gravitational-Wave Observatory (LIGO), is limited by quantum shot noise, quantum radiation pressure noise, and a set of classical noises. We show how the quantum properties of light can be used to distinguish these noises using correlation techniques. Particularly, in the first part of the paper we show estimations of the coating thermal noise and gas phase noise, hidden below the quantum shot noise in the Advanced LIGO sensitivity curve. We also make projections on the observatory sensitivity during the next science runs. In the second part of the paper we discuss the correlation technique that reveals the quantum radiation pressure noise from the background of classical noises and shot noise. We apply this technique to the Advanced LIGO data, collected during the first science run, and experimentally estimate the quantum correlations and quantum radiation pressure noise in the interferometer