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Pathy S, Kumar L, Pandey R, Dadhwal V, Chander S, Madan R. Impact of treatment time on chemoradiotherapy in locally advanced cervical carcinoma. Gynecol Oncol 2014. [DOI: 10.1016/j.ygyno.2014.03.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sharma S, Manigandan D, Chander S, Subramani V, Julka P, Rath G. SU-E-T-199: How Number of Control Points Influences the Dynamic IMRT Plan Quality and Deliverability. Med Phys 2014. [DOI: 10.1118/1.4888529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Kandian S, Chander S, Bishop K. Management of sodium hypochlorite extrusion beyond the root apex during root canal treatment: a case report. Prim Dent J 2014; 3:72-75. [PMID: 25198335 DOI: 10.1308/205016814812135805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Sodium hypochlorite (NaOCl) is most commonly used as an irrigating solution in endodontic practice. This paper describes an incident of sodium hypochlorite extrusion past the apex (SHEPA) of the UR3. Management of the condition resulted in hospitalisation of the patient, and intravenous antibiotic and steroid therapy. This case report details the measures that can be employed to reduce the risk of SHEPA and management of its potentially serious complications. The reader should understand the various measures that can be adopted to reduce extrusion of endodontic irrigants beyond the root apex and management following SHEPA.
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Roshan V, Mallick S, Mondal D, Benson R, Bharti A, Bhaskar S, Chander S. EP-1108: Role of conformal radiotherapy in adenoid cystic carcinoma of Lacrymal gland. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31226-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Manigandan D, Sharma S, Biswas A, Mohanty B, Subramani V, Chander S, Julka P, Rath G. SU-E-T-636: Impact of Different Intensity Levels On Step and Shoot IMRT Plan Quality and Deliverability. Med Phys 2013. [DOI: 10.1118/1.4815064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Chander S, Hajela V. AB1305 Clinical utility of tuberculosis interferon gamma test (IGT) in patients due to start anti tnf treatment. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sharma S, Manigandan D, Biswas A, Mohanty B, Subramani V, Chander S, Julka P, Rath G. SU-E-T-638: Influence of Dose Rate On Step and Shoot IMRT Plan Quality and Deliverability. Med Phys 2013. [DOI: 10.1118/1.4815066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Nijhawan M, Gupta VK, Singh A, Chander S, Nijhawan S, Mathur A. Chemical cauterisation of bleeding spiders. TROPICAL GASTROENTEROLOGY : OFFICIAL JOURNAL OF THE DIGESTIVE DISEASES FOUNDATION 2012; 33:301. [PMID: 23923365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Gill S, Thomas J, Fox C, Kron T, Thompson A, Chander S, Williams S, Tai KH, Duchesne G, Foroudi F. Electronic portal imaging vs kilovoltage imaging in fiducial marker image-guided radiotherapy for prostate cancer: an analysis of set-up uncertainties. Br J Radiol 2011; 85:176-82. [PMID: 21976627 DOI: 10.1259/bjr/13553326] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES The purpose of this study was to compare interfraction prostate displacement data between electronic portal imaging (EPI) and kilovoltage imaging (KVI) treatment units and discuss the impact of any difference on margin calculations for prostate cancer image-guided radiotherapy (IGRT). METHODS Prostate interfraction displacement data was collected prospectively for the first 4 fractions in 333 patients treated with IGRT with daily pre-treatment EPI or KVI orthogonal imaging. Displacement was recorded in the anteroposterior (AP), left-right (LR) and superoinferior (SI) directions. The proportion of displacement <3 mm and the difference in median absolute displacements were calculated in all directions. RESULTS 1088 image pairs were analysed in total, 448 by EPI and 640 by KVI. There were 23% (95% confidence interval [CI] 18-28%) more displacements under 3 mm for EPI than for KVI in the AP direction, 14% (95% CI 10-19%) more in the LR direction and 10% (95% CI 5-15%) more in the SI direction. The differences in absolute median displacement (KVI>EPI) were AP 1 mm, LR 1 mm and SI 0.5 mm. Wilcoxon rank-sum test showed that distributions were significantly different for all three dimensions (p<0.0001 for AP and LR and p=0.02 for SI). CONCLUSION EPI has a statistically significant smaller set-up error distribution than KVI. We would expect that, because fiducial marker imaging is less clear for EPI, the clinical target volume to planning target volume margin would be greater when using IGRT; however, relying wholly on displacement data gives the opposite result. We postulate that this is owing to observer bias, which is not accounted for in margin calculation formulas.
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Nqan S, McKendrick J, Bressel M, Leong T, Cooray P, Heriot A, Steel M, Chander S, McClure B, Michael M. 6050 POSTER A 12-week Regimen With Interdigitating FOLFOX Chemotherapy and Pelvic Chemoradiation for Simultaneous Primary and Metastatic Rectal Cancer. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71695-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kuet KP, Goepel J, Mudhar H, Bourne JT, Sykes MP, Riaz I, Borg FA, Everett C, Dasgupta B, Byng-Maddick R, Wincup C, Penn H, Jani M, Bukhari M, Halsey J, Chander S, Marsh J, Hughes R, Chu E, Little J, Bruce I, Soh C, Lee L, Ho P, Ntatsaki E, Vassiliou V, Youngstein T, Mohamed M, Lanham J, Haskard D, Lutalo PM, Scott IC, Sangle S, D'Cruz DP, Scott IC, Garrood T, Mackie SL, Backhouse O, Melsom R, Pease CT, Marzo-Ortega H, Al-Mossawi MH, Wathen CJ, Al-Balushi F, Mahto A, Humby F, Kelly C, Jawad A, Lee M, Haigh RC, Derrett-Smith EC, Nihtyanova S, Parker J, Bunn C, Burns A, Little M, Denton C, Tosounidou S, Harris S, Steventon D, Sheeran T, Baxter D, Field M, Lutalo PM, Sangle S, Davies R, Khamashta MA, D'Cruz D, Wajed J, Kiely P, Srikanth A, Lanyon P. Case reports: 1. IGG4 Related Fibrosis: A Treatable Disease. Four Cases in a District General Hospital. Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/ker025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chander S, Rees J. Strategies for the prevention of erosive tooth surface loss. SADJ : JOURNAL OF THE SOUTH AFRICAN DENTAL ASSOCIATION = TYDSKRIF VAN DIE SUID-AFRIKAANSE TANDHEELKUNDIGE VERENIGING 2010; 65:106-111. [PMID: 20496842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This article explores the available strategies for protection against erosive toothwear. As part of a preventive regime, the importance of dietary counselling is discussed. Risk factors that render patients susceptible to erosive toothwear need to be identified in early life, if possible, as it may improve their treatment outcome through the instigation of preventive measures. Practical advice and the importance of education regarding timing of toothbrushing following an acid challenge should be given to patients. Availability of fewer erosive beverages may prove acceptable alternatives for some patients, especially where poor compliance is an issue. Some patients may benefit from intra-oral appliances to improve and maintain delivery of fluoride. The importance of fluoride use and of products such as Pronamel/Tooth Mousse aimed at preventing erosive tooth surface loss are discussed.
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Chang JH, Gosling T, Larsen J, Powell S, Scanlon R, Chander S. Prophylactic gastrostomy tubes for patients receiving radical radiotherapy for head and neck cancers: a retrospective review. J Med Imaging Radiat Oncol 2010; 53:494-9. [PMID: 19788486 DOI: 10.1111/j.1754-9485.2009.02103.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Patients undergoing radical radiotherapy for head and neck cancers often experience significant complications. We sought to evaluate the impact of prophylactic gastrostomy tubes (PGTs) among these patients on four easily evaluable adverse outcomes, namely, absolute weight loss, percentage weight loss, admissions for nutritional reasons and treatment interruptions. A retrospective review was carried out on patients undergoing radical radiotherapy for primary head and neck cancers from September 1999 to October 2005 at the Wellington Blood and Cancer Centre (n = 71). PGTs were placed in 7 (10%) patients. Patients with PGTs were compared with the patients without PGTs (the control group) by univariate and multivariate analyses. By univariate analysis, there was no significant difference in absolute or percentage weight loss between those with PGTs and the control group. By multivariate analysis, those with PGTs lost 5.2% (P = 0.016) less weight than the control group. There were no significant differences between the two groups with regard to admissions for nutritional reasons or treatment interruptions. The use of PGTs can reduce weight loss in patients undergoing radical radiotherapy for head and neck cancers, and its use should be further evaluated in future studies.
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Turaka A, Mohanti BK, Chander S, Jena R, Deo SV. Acute and late effects of radical radiotherapy in elderly head and neck cancer patients. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.16515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
16515 Background: To evaluate the difference between acute and late effects of radical radiotherapy in elderly(above 60 years,Group A) head and neck cancer patients with young patients (below 50 years of age, Group B). Methods: The study was conducted on histologically proven head and neck cancer patients receiving radical radiotherapy (RT),49 patients were in group A and 40 in group B.The acute and late radiation morbidity was assessed using RTOG (phases I,II,&III- Pre RT, During RT & 1 month post RT respectively) and LENT-SOMA scoring systems (phases IV &V-3 & 6 months post RT). Results: In phase II, grade I dermatitis was commonly seen (83.7% in group A,72.5% in group B) and grade II dermatitis was 12.2 % vs 25% of patients.The difference in distribution over age was not significant (p= 0.12 & 0.18 in phase II and III).There was no significant difference in the incidence of late effects between two groups (p=0.91 in phase IV and p=0.99 in phase V).Grade II mucositits was seen in majority of patients in both groups,71.4% vs 72.5% in phase II.The late mucosal changes with worrisome subjective (pain) experiences were observed in 69.4% vs 75% of patients in group A and B, respectively.The difference in distribution over the age was significant (p<0.051) only in phase II.Dryness of mouth was the most common acute and late sequel of RT.The acute salivary gland morbidity was mostly moderate to complete dryness (grade II),seen in phases II and III in 24.5% & 73.5% of patients but the late sequel was seen in 83.37% of patients in group A and 85% in group B and the difference in late effects in both groups was statistically significant except in phase V (p= 0.02). Moderate dysphagia of grade II morbidity was seen in 75.5% vs. 65% in phase II. Grade III dysphagia was seen only 5 patients in group A and one in group B. In phase IV,66.7% patients in group A,72.5% in group B had persistent difficulty in swallowing. Conclusions: Grade I and II mucositis and dermatitis during the course of treatment led to increased morbidity, decreased nutritional intake and pain. Xerostomia is the most common and inevitable acute and late squeal of radical radiotherapy to head and neck cancer region resulting in difficulty in mastication and swallowing. There was no difference in the occurrence of acute and late effects between younger and elderly patients. No significant financial relationships to disclose.
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Subramani V, Rath GK, Chander S, Ganesh T, Joshi RC, Gopishankar N. SU-FF-T-178: Dosimetric Evaluation of Penumbra for Conformal and Intensity Modulated Radiotherapy. Med Phys 2007. [DOI: 10.1118/1.2760837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Subramani V, Rath GK, Chander S, Ganesh T, Joshi RC, Gopishankar N, JhothyBasu S. SU-FF-T-245: Impact of Volume Effect of Detectors in Multiple Points Absolute Dose and the Choice of Plane of Measurement in 2D Planar Dose Verification in Patient Specific IMRT QA. Med Phys 2007. [DOI: 10.1118/1.2760906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Loblaw DA, Holden L, Xenocostas A, Chen E, Chander S, Cooper P, Chan PC, Wong CS. Functional and Pharmacokinetic Outcomes after a Single Intravenous Infusion of Recombinant Human Erythropoietin in Patients with Malignant Extradural Spinal Cord Compression. Clin Oncol (R Coll Radiol) 2007; 19:63-70. [PMID: 17305256 DOI: 10.1016/j.clon.2006.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIMS To determine the cerebrospinal fluid concentrations and the functional and pain outcomes after a single intravenous infusion of erythropoietin at the start of a standard radiotherapy and steroid protocol. MATERIALS AND METHODS Ten paraparetic patients with malignant extradural spinal cord compression who were eligible for radiotherapy, lumbar puncture and intravenous epoetin alpha were enrolled. The patients received epoetin alpha 1500 IU/kg intravenously over 30 min followed by a standardised dexamethasone and radiotherapy protocol. A lumbar puncture and venipuncture were carried out 24-30 h after the epoetin alpha infusion. The patients were followed closely at defined intervals. RESULTS Erythropoietin was detectable in the cerebrospinal fluid in all eight patients sampled (median 92.5 mIU/ml, range 17.8-214.0 mIU/ml). Before treatment, eight patients were non-ambulatory and two patients were ambulatory with assistance. After treatment, eight (80%, 95% confidence interval [CI] 44-97%) improved at least one functional class and recovered or maintained ambulation. Five of seven patients (71%; 95% CI 29-96%) with objective sensory deficits and one of seven (14%; 95% CI 0-58%) catheter-dependent patients recovered. Overall, 78% (95% CI 40-97%) had a pain response. CONCLUSIONS After an intravenous infusion of epoetin alpha, radiotherapy and steroids, high concentrations of erythropoietin were detectable in the cerebrospinal fluid. Patients with malignant extradural spinal cord compression showed encouraging improvements in neurological function and pain.
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Pearce A, Choo R, Danjoux C, Morton G, Deboer G, Szumacher E, Loblaw A, Cheung P, Chander S. 108 Quality of life after combined postoperative salvage radiotherapy and androgen suppression for recurrent adenocarcinoma of the prostate. Radiother Oncol 2006. [DOI: 10.1016/s0167-8140(06)80849-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Turaka A, Mohanti BK, Chander S, Deo SV, Jena R, Rath GK. Quality of life assessment in patients above 60, below 50 years of age during and after curative radiotherapy in head and neck cancers. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.5552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5552 Background: To evaluate the Quality of life in patients above 60 and below 50 years during and after curative radiotherapy in head and neck cancers. Methods: Head and Neck cancer patients who are to undergo curative radiotherapy (RT) were divided into two groups, 49 patients (Group A,above 60 years) and 40 patients (Group B,below 50). Quality of life assessment was done using EORTC QLQ C-30 version-2 at 4 phases;Pretreatment-Phase I,during RT-Phase II,1-month post RT-Phase III and 6 months post RT-Phase IV.Statistical analysis was done with mean scores using ’t’ test. Results: Physical functioning (PF)scores in both groups were highest in phase I (69.4;77.5, p < 0.035) and lowest in phase II (40; 50, p < 0.008) and the difference was statistically significant. Although PF scores declined in both groups in phase II, overall PF score remained higher in group B than in group A in all phases.Role functioning score remained low in both groups and the difference were not statistically significant at all phases. Emotional functioning score was highest in phase I (68.37; 69.15), but declined as treatment progressed, consequent to depression.The values improved over time, restored to near pretreatment values at phase IV. Cognitive functioning scores in both groups was also highest in phase I (70.07; 79.17). Social functioning of both groups declined during RT (42.52; 45)compared to pre RT values (73.47; 77.09). The mean Global Health Status score was higher in group B compared to group A at all phases, yet there was no statistical significance.The scores declined during RT (66.87 vs 35.62 & 64.79 vs 34.01), improved overtime but did not reach pre RT scores.The symptom scores were all higher for elderly patients compared with younger patients at all phases, implying elderly patients experienced more symptoms, with greater experience of symptoms during RT. Conclusions: Quality of Life of elderly patients was lower compared to younger patients at phase II in terms of physical functioning, social and emotional functioning. Global Health Status score was higher for younger patients than elderly at all phases, and declined in phase II. No significant financial relationships to disclose.
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Bahl A, Chander S, Julka PK, Rath GK, Sharma DN, Kumar A, Nair O. Micronuclei evaluation of reduction in neoadjuvant chemotherapy related acute toxicity in locally advanced lung cancer: an indian experience. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2006; 54:191-5. [PMID: 16800343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Lung cancer is the most common cancer in the world accounting for 17.6% cancers worldwide. The AAR i n I ndian population varies f r om 0.98-15.55. The aim of t he present study was to analyze areduction in neoadjuvant chemotherapy related acute toxicity in locally advanced lung cancer (stage IIIA and III B) using Wobe Mugos E and its evaluation using micronuclei as a cytogenetic marker. Micronuclei, which are cytoplasmic fragments of DNA, have been used as a biological dosimeter to assess DNA damage. MATERIAL AND METHODS Fourty patients of locally advanced NSCLC were randomized into two study groups between 2001-2003. One group received neoadjuvant chemotherapy using Cisplatin and Etoposide. The other group received neoadjuvant chemotherapy using Cisplatin and Etoposide along with Wobe Mugos E which is a proteolytic enzyme preparation. A study of micronuclei frequency was done pre and post chemotherapy in both groups. RESULTS Thirty eight patients were available for final evaluation. Anemia was the most common hematological toxicity observed. Nausea and vomiting were the most common non -hematological toxicity seen. Wobe Mugos E was found to reduce the incidence of leucopenia (p = 0.005), nausea (p=0.004), vomiting (p= 0.003), sensory neuropathy (p = 0.032) and treatment related depression (p= 0.005). A reduction in micronuclei was seen in patients in patients on Wobe Mugos E. (p =0.01). CONCLUSION Neo-adjuvant chemotherapy related acute toxicity is a major problem in patients with advanced lung cancer. A reduction in micronuclei frequency shows Wobe Mugos E to be effective in reducing chemotherapy related acute toxicity.
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Polat H, Polat M, Chander S. Kinetics of oil dispersion in the absence and presence of block copolymers. AIChE J 2006. [DOI: 10.1002/aic.690450904] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Pearce A, Choo R, Danjoux C, Morton G, Deboer G, Szumacher E, Loblaw A, Cheung P, Chander S. Quality of Life After Combined Postoperative Adjuvant Radiotherapy and Androgen Suppression for Adenocarcinoma of the Prostate. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Sis H, Kelbaliyev G, Chander S. Kinetics of Drop Breakage in Stirred Vessels under Turbulent Conditions. J DISPER SCI TECHNOL 2005. [DOI: 10.1081/dis-200057638] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pearce A, Choo R, Chander S, Danjoux C, Morton G, Deboer G, Szurmacher E, Loblaw A, Cheung P, Lee J. 205 Assessment of quality of life during combined, sequential radiation therapy and androgen suppression post radical prostatectomy for prostate cancer. Radiother Oncol 2005. [DOI: 10.1016/s0167-8140(05)80366-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sis H, Chander G, Chander S. Synergism in Sodium Oleate/Ethoxylated Nonylphenol Mixtures. J DISPER SCI TECHNOL 2005. [DOI: 10.1081/dis-200057666] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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