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Glassy cell carcinoma (GCC) is a rare clinical entity involving uterine cervix with aggressive course and relatively poor prognosis. The most common presentation is abnormal bleeding or discharge per vaginum of recent origin. Histologically it is diagnosed by characteristic "Glassy" cells. All the three modalities (i.e. surgery, radiotherapy and chemotherapy) have been tried in various clinical settings, showing different clinical outcome. The common consensus regarding diagnosis and optimal treatment modalities is yet to emerge. The case presented here not only represents a rare histopathological diagnosis, but also reemphasizes the importance of Her2 neu immunostains as a bad prognostic marker. Key words: glassy cell carcinoma; radiotherapy; Her2 neu; cervix. DOI: http://dx.doi.org/10.4038/sljog.v33i2.4010 Sri Lanka Journal of Obstetrics and Gynaecology 2011; 33 : 65-67

Production Planning & Control would like to welcome Toshiya Kaihara, Milind Kumar Sharma and Manoj Kumar Tiwari to the Editorial Board.

Introduction: Discussion of bad news and resuscitation in terminal cancer is an important but difficult and often neglected issue in day-to-day oncology practice. Materials and Methods: We interviewed 35 radiation oncologists using an indigenous 15-item questionnaire on their beliefs about breaking bad news and resuscitation to terminal cancer patients. Results: Most responders had an oncology experience of three to seven years (20/35).Thirty-two were comfortable discussing cancer diagnosis, prognosis and life expectancy-related issues. A similar number believed all cancer-related information should be disclosed, while only four believed in imparting all information in one visit. All agreed that disclosing sensitive information did not affect survival. When requested by relatives to withhold truth from patients, 11 said they would not comply, 22 agreed to tell the truth only if asked and two agreed to avoid difficult questions. Twenty responders denied having been adequately trained in breaking bad news and were keen on dedicated classes or sessions in this area of practice. Most (33/35) believed that Indian patients were keen on knowing their diagnosis and prognosis. Although all agreed to the importance of discussing resuscitation, only 17 believed patients should be involved. Majority (20/35) agreed that the issue needs to be discussed while the patient was conscious. Patients with unsalvageable disease were deemed unsuitable for aggressive resuscitation by 30 responders while the rest believed it should be offered to all. Most (21/35) admitted to feeling depressed after breaking bad news though only seven felt disclosure was more stressful than untruthful statements. Only four knew of a law regarding resuscitation in cancer. Conclusion: Observing the widely varied beliefs and practices for disclosing bad news, it is recommended that such training be a regular part of medicine curriculum, especially in the Oncology setting.

Background: In upper abdominal malignancies (UAM), due to the presence of multiple inhomogeneous tissues, a wedge-based conformal treatment planning results in high-dose regions inside the target volume. Aim: This study was designed to explore the feasibility of using a field-in-field (FIF) technique in different UAM and its efficacy in reducing the high-dose regions. Materials and Methods: Twelve patients of UAM (which included malignancies of the gastroesophageal junction, stomach, gall bladder, and pancreas) were selected for this study. Computed tomography (CT) scans were performed and three-dimensional conformal wedge plans were generated for all the cases. The same plan was copied with the wedges removed and a FIF plan was generated. The two plans were compared for mean, maximum, and median doses; dose received by 2% (D2) and 98% (D98) of the target volume; volume receiving >107% (V > 107%) and 107%, and CI; there was a statistically significant reduction in monitor units. With regard to doses to critical structures, there was marginal dose reduction for the kidneys and spinal cord with FIF as compared to wedge-based planning. Conclusion: The FIF technique can be employed for UAM in place of wedge-based conformal treatment plans.

Cylindric cell carcinomas (transitional cell carcinomas) are a rare and distinct histopathological entity presenting in the head and neck region. They have been known by myriads of nomenclature like cylindric carcinomas, nonkeratinizing sinonasal carcinoma, papillary carcinoma, cylindrical or columnar cell carcinoma, intermediate cell carcinoma, Schneiderian carcinoma, and Ringertz carcinoma. They are considered a variant of nonkeratinizing squamous cell carcinoma. Cylindric carcinomas are usually described in the sinus and nasal cavity and rarely said to involve nasopharynx and larynx. Only passing references have been made for its presentation in oropharynx including tonsils and the base of the tongue. We report here a rare case of transitional cell carcinoma presenting in the base of the tongue. There are no separate treatment recommendations in the literature, and the management is on the lines of treatment of squamous cell carcinoma. We report here a case of cylindric cell carcinoma presenting in the base of the tongue. The patient was staged as having cT2 N3 M0 (Stage IV B) disease. The patient received palliative radiotherapy of 20 Gy in five fractions followed by chemotherapy with injection paclitaxel and carboplatin. A partial response to treatment was achieved at the time of writing this report.

Primary rhabdoid tumor of lung is a rare histological and clinical entity. Lung tumors with rhabdoid features have been included as variants of large-cell carcinoma in the 1999 World Health Organization (WHO) classification of lung tumors. A large-cell carcinoma with a rhabdoid phenotype (LCCRP) is unusual, with only 38 cases reported till date. We report the clinical details of one such case that was treated with pneumonectomy and adjuvant chemotherapy. We also present a review of the literature. To identify relevant articles, we searched PubMed, Ovid, and IngentaConnect databases using the key words ′rhabdoid,′ ′lung cancer,′ and ′primary rhabdoid tumor of lung.′

Sarcomatoid squamous cell carcinoma of the cervix is a rare tumor. Only 16 cases have so far been reported in literature. We report here one such tumor occurring in a 54-year-old postmenopausal woman. Our case report describes the clinical, pathological, and PET scan characteristics of this tumor. The patient was treated with concurrent chemoradiotherapy and is disease free at 6-months follow-up.

Although Indian Small and Medium Enterprises (SMEs) are competent enough to produce and supply internationally acceptable quality goods and services but these are not yet to get sufficient exposure and economic returns in the absence of proper information system architecture. Mediators and brokers take undue economic benefits in the absence of proper information system architecture for which the Indian SMEs are the deserving candidates. This issue is addressed in this paper by proposing information system architecture for Indian SMEs that can help them to take first step towards supply chain management to avoid mediators and provide right kind of information at right time.

Performance Measurement System (PMS) is underdeveloped and underresearched in Small and Medium Enterprises (SMEs). It has emerged as a vital decision support tool at the strategic management level in SMEs in the developing nations. This research explores and examines the PMS development through four select case studies in India. Another purpose of this study is to provide some preliminary insights on why SMEs adopt the PMS. It also aims to identify critical issues that would contribute to the effective performance measurement function in Indian SMEs. This research is exploratory in nature; a case study methodology is used for the research. Based on four case studies from diverse SMEs from three different states of western India, the paper presents four important issues PMS strategy, competitive priorities, benefits observed/perceived by effective management of PMS function and barriers observed in implementing PMS practices. Based on the analysis of the case studies, several propositions as recommendations for effective PMS development in Indian SMEs are proposed.

To improve overall business performance and the more and more use of Information Technology (IT) have forced Small- and Medium-Sized Enterprises (SMEs) to design and deploy effective strategy for management of Information system (IS) function and follow proper IS-related practices. SMEs with limited resources may be able to deploy IS for their normal operations, but may not be able to manage the IS functions or follow IS practices properly. This study aims to identify critical issues that would contribute to effective performance of the IS management in Indian SMEs sector. On the basis of the four case studies from diverse SMEs from three different states of western India, this paper presents the four important issues in IS management – IS strategy, competitive priorities, benefits observed/perceived by effective management of IS function and barriers observed in implementing IS management practices. On the basis of the analysis of the case studies, several propositions as recommendations such as the role of top management, use of IT tools, investment in IT, supply chain linkages and work culture for an effective IS management in Indian SMEs have been discussed.

The findings in the paper are reported on the basis of the outcome of sponsored research project on Small and Medium Enterprises (SMEs). Effective Performance Measurement System (PMS) for organisation is a key factor for success in today's competitive globalised market. In the era of globalisation and outsourcing, SMEs understand and acknowledge the importance of the performance measurement system in day-to-day business operations but may not able to pay serious attention to it. This paper presents results of a survey of Indian SMEs whilst addressing this issue. The study included SMEs from three western states of India covering the manufacturing, high tech engineering, finance, packaging, and distribution sector. Responses from 147 SMEs are analysed for various issues related to performance measurement system.