Case History :
A 75 years old lady had complaints of increased frequency of micturation since 1 and ½ month, whitish vaginal discharge and generalized weakness. She had taken local treatment but could not find relief. Hence she was referred to a Gynaecologist for further investigations.
The investigations revealed that she was suffering from Carcinoma of cervix.

Case History :
A 75 years old lady had complaints of increased frequency of micturation since 1 and ½ month, whitish vaginal discharge and generalized weakness. She had taken local treatment but could not find relief. Hence she was referred to a Gynaecologist for further investigations.
The investigations revealed that she was suffering from Carcinoma of cervix.The investigations carried out were as follows:

USG Abdomen and Pelvis (27/11/08)
Coarse hepatic echotexture.
Gall bladder calculus .No evidence of cholecystitis.
Significant fluid in the uterine cavity with internal echoes. The uterine wall show calcification.
The cervix appears hypoechic and bulky. This could represent neoplastic mass with heamatometra.
-Bilateral hydronephrosis (R>L) with bladder wall involvement.
Suggest CT scan abdomen for further evaluation.

Pap smear (27/11/08)
Smear is positive for malignancy.
CT Abdomen and Pelvis (30/11/08)
K/C/O Carcinoma of cervix. An ill-defined mass is seen in the cervix with bilateral perimetrial spread and enlarged obturator lymphnodes.Left moderate hydronephrosis is noted with mild hydronephrosis on right side. Calcified gall stones incidental findings.

Cystoscopy and Bilateral DJ stenting done on 12/12/08.
Electrolytes (13/12/08)
Sr. Sodium 132 mEq/L

Chemotherapy
The Chemotherapy schedule is as given below:
First Chemo was given during 13/12/2008 to 15/12/2008.The details of the treatment are, IV NS 2 Pints + Injection MVI, IV RL 1 pint, Tablet Cipril 5 mg 1 OD, Tablet Atorva 10 mg 1 HS.
Second Chemo was given on 18/12/2008.The treatment details are, Premedication Injection Nanoxel 250 mg, Injection Kemocarb 450 mg Hydration, Injection Calcium Gluconate, C-Pan D, Liquid Duphalac.

Cardiac Doppler (18/12/08)
Moderate concentric left ventricular hypertrophy.
Normal LV systolic function LVEF- 60 %.
Moderate mitral annular calcification .Trivial mitral regurgitation.
After chemotherapy patient had started complaining of uneasiness, weakness and vomiting. On 21/12/08, patient had complaint of chest pain, vomiting and excessive sweating. The patient was unconscious for 5 to 7 minutes. She has immediately admitted to hospital and treated for cardiac arrest.The investigations during hospitalization are given below:

Haemogram (22/12/08)
Hb 8.6 gm % (12.5-14.7 gm%)
WBC Count 3600 /cumm (4000-10000/cumm)


X- Ray Chest (22/12/08) -
Apparent cardiomegaly noted.

Cardiac colour Doppler (26/12/08)
Moderate concentric left ventricular hypertrophy.
Thinned hypokinetic distal 1/3 rd IVS and Apex.
Mild to moderate aortic stenosis, Mild to moderate aortic regurgitation Trivial tricuspid regurgitation.
Minimal pericardial effusion
Moderate sized layered soft apical thrombus.


Electrolytes (29/12/08)
Sr. Sodium 129 mEq/L          (135-150 mEq/L)
Sr. Potassium 2.55 mEq /L    (3.6-5.0 mEq/L)
Sr. Chlorides 95.6 mEq /L     (96-108 mEq/L)


X ray Chest (30/12/08)
Bilateral pulmonary opacities .Suggestive of pulomary edema.

Serum Electrolytes (30/12/08)
Sr. Sodium        134.6 mEq/L
Sr. Potassium    2.60 mEq/L


Haemogram (02/01/09)
Hb 9 gm %
Platelet Count 1.18 Lakh/cumm (1.5-4.5 Lakh/cumm)

Electrolytes (2/1/09)
Sr. Sodium        138 mEq/L
Sr. Potassium    4.9 mEq/L
Sr. Chlorides     99 mEq/L

Haemogram (09/01/09)
Hb                                     9 gm %
Platelet Count Adequate      3.58 Lakh/cumm
Total WBC Count                4800 /cumm

Electrolytes (9/1/09)
Sr. Sodium 138 mEq/L
Sr. Potassium      4.9 mEq/L
Sr. Chlorides       99 mEq/L

Considering the above episode,the patient and relatives confidence level was lost and the patient was reluctant to take chemotherapy because of it's many side effects. Hence, she opted for the clinic "Ayurveda". The patient came on 13/01/09 with complaints of nausea , loss of appetite and severe weakness .AMRT (Anti Malignant Rasayana Treatment) was started immediately. The treatment included Hirak Bhasma (10 mg ) along with honey in the morning and Suvarnasindoor (60 mg) along with honey at night .Other medicines included mixture of Kanchanar Guggul( 125 mg), Chandraprabha(125 mg ), Arogyawardhini (125 mg ), Ashok (125 mg ), Ashwgandha (125 mg ) , twice a day with lukewarm water.Rasayana treatment was given in three cycles (per cycle of 2 months) for a period of six months that constitutes one phase.The patient has already completed two phases of AMRT.She had shown good improvement in health within one month of starting the treatment . Her weakness has reduced and appetite has increased .She started feeling energetic after starting AMRT. Also the side effects of chemotherapy had reduced.

Her follow-up investigations showed remarkably following changes :

CT Abdomen and Pelvis (16/06/2009)
Follow up of Carcinoma of cervix showing a lobulated soft tissue mass arising from cervix with enlarged nodes in the pelvis As compared to previous CT of 29/11//08

1. Bialteral HN and HU is no more seen.
2. Dilated uterine cavity has return to normal.
3. Size of cervical mass is more or less the same
4. Pelvic adenopathy has regressed.

Colour Doppler (04/07/09)

• Ischemic heart disease
• Thinned , scarred, akinetic distal ½ of IVS , anterior wall, dyskinetic apex
• Global systolic function - moderate to severely depressed EF - 25- 30 %
• Dilated LA
• Moderate mitral regurgitation
• Mild aortic stenosis
• Moderate tricuspid regurgitation
• Severe pulmonary HTN

Follow Up: It was observed that the patient was absolutely fine and was feeling energetic .
DJ stent has replaced in the month of January 2010.
X- Ray KUB (06/01/2010)
Bilateral DJ stent in situ noted. Low left sided proximal end of DJ stent noted.Calcific density over left flank bone may represent? calicified lymphnode /haematoma. Both SI joints normal.Both renal and psos out lines are well defined.No evidence of abnormal gaseous distention of the abdomen.Intestinal gas patten is normal .There is evidence of early degenerative changes in lumbarspine in the form of lateral marginal sclerotic osteophytes.

Suggest -
clinical correlation
USG Abdomen and Pelvis (06/01/02010)
Findings are suggestive of
A large gall bladder calcus.
Bialteral D.J.stents in situ with low - set left stent as described.
Left adnexal cystic lesion with thick wall.
Mild bilateral pelvi-calyceal fullness with chronic cystitis.

Urine Examination (6/1/2010)
Proteins - present(+)
Pus cells - 60-80/hpf
RBC- Occasional

BUN                      13.4 mg/dl (6-20 mg/dl) (6/1/10)
Sr. Creatinine    1.2 mg/dl (0.8-1.5 mg/dl)

Urine Examination (15/1/2010)
Proteins       - present (+)
Pus cells      - 20-25/hpf
RBC             - 3-4/hpf
Occult blood - present (+)
Bacteria     - occasional

Urine for culture and sensitivity (02/02/2010)
Microscopic examination
Pus cells seen         - 6-8/hpf
Epithelial cells seen - 2-3 /hpf
Bacteria                 - +++

Gram stain - Gram negative bacilli seen
Culture - Organism isolated - Escherichia coli
She is still taking AMRT and is under observation and is leading almost NORMAL quality of life.

AMRT (Anti-malignant Rasayana treatment) has the following advantages:

1. Symptomatic relief by reduction in loss of appetite, nausea, increased frequency of micturation and weakness with increased energy levels and without any signs of toxicity.
2. AMRT directly acts on tumor and prevents it's further spread to other organs thereby decreasing the possibility of complications.The effects of AMRT had been seen in the patient consistently.Remarkable changes and significant tumour regression took place due to AMRT.It has been observed in this patient by regression of Adenopathy and stability of tumour with no further growth.