Backyard poultry farming with improved germplasm: Sustainable food production and nutritional security in fragile ecosystem

Approximately 3 billion people were unable to afford a healthy diet in 2019 because of poverty and inequality. Most of these people live in Asia and Africa. Furthermore, 30% of the world population was affected by moderate to severe food insecurity in 2020, and most of this population lives in low- and middle-income countries. The world is at a critical juncture, and there is an urgent need for transformative food systems that ensure the empowerment of poor and vulnerable population groups, often smallholders with limited access to resources or those living in remote locations, as well as the empowerment of women, children, and youth (FAO, 2018). The backyard poultry production system (BPPS), as practiced by 80% of the world's rural population, can be that transformative change in low- and middle-income countries. Although the BPPS has low productivity, it still plays an important role in the food and nutritional security of rural people living in fragile ecosystems. Backyard poultry has been recognized as a tool for poverty alleviation and women empowerment besides ensuring food and nutritional security for rural poor. Poultry meat and eggs are the cheapest and best source of good quality protein, minerals, and vitamins. The introduction of improved backyard poultry germplasm has improved the productivity of this system in resource-poor settings and thereby improved the income and nutritional security of poor households. With these birds, the availability, access, utilization, and stability of food security have improved at household and national levels. Diseases, predation, non-availability of improved germplasm, lack of access to markets, and lack of skills are the major constraints to the adoption of improved backyard poultry. These constraints can be addressed by involving a network of community animal service providers. The improved backyard poultry germplasm will dominate the backyard poultry production system in the future and will be a tool for ensuring food and nutritional security on a sustainable basis, more particularly in low- and middle-income countries.

ECM-transmitted shear stress induces apoptotic cell extrusion in early breast gland development

Epithelial cells of human breast glands are exposed to various mechanical ECM stresses that regulate tissue development and homeostasis. Mechanoadaptation of breast gland tissue to ECM-transmitted shear stress remained poorly investigated due to the lack of valid experimental approaches. Therefore, we created a magnetic shear strain device that enabled, for the first time, to analyze the instant shear strain response of human breast gland cells. MCF10A-derived breast acini with basement membranes (BM) of defined maturation state and basoapical polarization were used to resemble breast gland morphogenesis in vitro. The novel biophysical tool was used to apply cyclic shear strain with defined amplitudes (≤15%, 0.2 Hz) over 22 h on living spheroids embedded in an ultrasoft matrix (<60 Pa). We demonstrated that breast spheroids gain resistance to shear strain, which increased with BM maturation and basoapical polarization. Most intriguingly, poorly developed spheroids were prone to cyclic strain-induced extrusion of apoptotic cells from the spheroid body. In contrast, matured spheroids were insensitive to this mechanoresponse—indicating changing mechanosensing or mechanotransduction mechanisms during breast tissue morphogenesis. Together, we introduced a versatile tool to study cyclic shear stress responses of 3D cell culture models. It can be used to strain, in principle, all kinds of cell clusters, even those that grow only in ultrasoft hydrogels. We believe that this approach opens new doors to gain new insights into dynamic shear strain-induced mechanobiological regulation circuits between cells and their ECM.

Responses of birds and mammals to long-established wind farms in India

Wind turbines have been recognised as an alternative and clean-energy source with a low environmental impact. The selection of sites for wind-farm often creates serious conservation concerns on biodiversity. Wind turbines have become a serious threat to migratory birds as they collide with the turbine blades in some regions across the globe, while the impact on terrestrial mammals is relatively less explored. In this context, we assessed the responses of birds and mammals to the wind turbines in central Karnataka, India from January 2016 to May 2018 using carcass searches to quantify animal collisions (i.e., birds and bats), fixed radius point count for bird population parameters, and an occupancy framework for assessing the factor that determines the spatial occurrence of terrestrial mammals. The mean annual animal fatality rate per wind turbine was 0.26/year. Species richness, abundance, and unique species of birds were relatively higher in control sites over wind turbine sites. Species and functional compositions of birds in control sites were different from wind turbine sites, explaining the varied patterns of bird assemblages of different feeding guilds. Blackbuck, Chinkara, Golden Jackal, and Jungle Cat were less likely to occupy sites with a high number of wind turbines. The study indicates that certain bird and mammal species avoided wind turbine-dominated sites, affecting their distribution pattern. This is of concern to the management of the forested areas with wind turbines. We raised conservation issues and mitigating measures to overcome the negative effects of wind turbines on animals.

Pan-Asian adaptation of the EHNS-ESMO-ESTRO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with squamous cell carcinoma of the head and neck

The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of squamous cell carcinoma (SCC) of the oral cavity, larynx, oropharynx and hypopharynx was published in 2020. It was therefore decided by both the ESMO and the Korean Society of Medical Oncology (KSMO) to convene a special, virtual guidelines meeting in July 2021 to adapt the ESMO 2020 guidelines to consider the potential ethnic differences associated with the treatment of SCCs of the head and neck (SCCHN) in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with SCCHN (excluding nasopharyngeal carcinomas) representing the oncological societies of Korea (KSMO), China (CSCO), India (ISMPO), Japan (JSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence and was independent of the current treatment practices and drug access restrictions in the different Asian countries. The latter was discussed when appropriate. This manuscript provides a series of expert recommendations (Clinical Practice Guidelines) which can be used to provide guidance to health care providers and clinicians for the optimisation of the diagnosis, treatment and management of patients with SCC of the oral cavity, larynx, oropharynx and hypopharynx across Asia.

Evaluation of Antibiotic Sensitivity Test against Ophthalmic Pathogens

Ophthalmic infections can cause damage to the structure of the eye which can lead to vision loss and blindness if left untreated. Ophthalmic infection or eye infections are caused by exposure to bacterial, fungal viral and protozoan are common with frequently reported in Asian countries. In the present study, the external ocular infected samples collected from Thanjavur Medical College Hospital, Thanjavur. Seven strains were isolated from the external ocular infected samples and identified a standard manual of Determinative Bacteriology by Bergy’s manual 12th edition. The commercial antibiotics and eye drops tested against Bacillus cereus, B. subtilis, Escherichia coli, Klebsiella sp. Pseudomonas sp. Streptococcus sp. and Staphylococcus aureus. The majority of the isolates were sensitive to tobramycin followed by moxifloxacin, gatifloxacin and ofloxacin. The resistant antibiotics are ciprofloxin and sensitive antibiotic was ampicillin was recorded with respective bacteria.

Spin-up conversion, exchange-interactions, and tailored magnetic properties in core-shell La2NiMnO6of small crystallites

La₂NiMnO₆-a ferromagnetic (FM) insulator offers tunable charge carriers and spins useful to devise its multiple properties and applications. In this view, we studied a core-shell La₂NiMnO₆(2-3 nm shell on 65 - 80 nm core) of a Ni²⁺/Ni³⁺(d⁷) to Mn⁴⁺/Mn³⁺(d⁴) spin-up conversion- revived a new FM phase-2, raising a spin-densityσ_s = 0.7 s a^-1over the Ni^2+/Mn⁴⁺species (phase-1),σ_s = 0.5 s a^-1, i.e. 2.12μ_B/f.u. larger spin moment. HRTEM images studied with x-ray diffraction characterizing core-shell structure that plays a crucial role in tuning the high spin FM phase-2 of profound properties. Below 110 K, the dc magnetization and ac magnetic susceptibilityχ(ω,T) reveal a metastable magnetic behavior on an antiferromagnetic canting of a spin-glass nature. The results follow a Vogel-Fulcher type relaxation with a relaxation timeτ₀∼ 10^-13s, confirming a spin-glass freezing behavior. Uniquely, FM field of phase-1 controls magnetics of phase 2 of a coupled magnet, modulating joint features with small thermal magnetic hysteresis on heating-cooling cycles.

Guideline for the management of hip fractures 2020: Guideline by the Association of Anaesthetists

We convened a multidisciplinary Working Party on behalf of the Association of Anaesthetists to update the 2011 guidance on the peri-operative management of people with hip fracture. Importantly, these guidelines describe the core aims and principles of peri-operative management, recommending greater standardisation of anaesthetic practice as a component of multidisciplinary care. Although much of the 2011 guidance remains applicable to contemporary practice, new evidence and consensus inform the additional recommendations made in this document. Specific changes to the 2011 guidance relate to analgesia, medicolegal practice, risk assessment, bone cement implantation syndrome and regional review networks. Areas of controversy remain, and we discuss these in further detail, relating to the mode of anaesthesia, surgical delay, blood management and transfusion thresholds, echocardiography, anticoagulant and antiplatelet management and postoperative discharge destination. Finally, these guidelines provide links to supplemental online material that can be used at readers' institutions, key references and UK national guidance about the peri-operative care of people with hip and periprosthetic fractures during the COVID-19 pandemic.

International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2012-2017: Device-associated module

BACKGROUND

We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2012 to December 2017 in 523 intensive care units (ICUs) in 45 countries from Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific.

METHODS

During the 6-year study period, prospective data from 532,483 ICU patients hospitalized in 242 hospitals, for an aggregate of 2,197,304 patient days, were collected through the INICC Surveillance Online System (ISOS). The Centers for Disease Control and Prevention-National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI) were applied.

RESULTS

Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the medical-surgical ICUs, the pooled central line-associated bloodstream infection rate was higher (5.05 vs 0.8 per 1,000 central line-days); the ventilator-associated pneumonia rate was also higher (14.1 vs 0.9 per 1,000 ventilator-days,), as well as the rate of catheter-associated urinary tract infection (5.1 vs 1.7 per 1,000 catheter-days). From blood cultures samples, frequencies of resistance, such as of Pseudomonas aeruginosa to piperacillin-tazobactam (33.0% vs 18.3%), were also higher.

CONCLUSIONS

Despite a significant trend toward the reduction in INICC ICUs, DA-HAI rates are still much higher compared with CDC-NHSN's ICUs representing the developed world. It is INICC's main goal to provide basic and cost-effective resources, through the INICC Surveillance Online System to tackle the burden of DA-HAIs effectively.

Tuberculous lymphadenitis is associated with altered levels of circulating angiogenic factors

BACKGROUND

Angiogenic factors are important in granuloma formation and serve as biomarkers in pulmonary tuberculosis (PTB). The relationship between these markers and tuberculous lymphadenitis (TBL) is not known.

OBJECTIVE AND DESIGN

To examine the association of vascular endothelial growth factor (VEGF) and angiopoietin (Ang) family molecules in TBL, we measured systemic levels of VEGF-A, C, D, R1 (VEGF-receptor 1), R2, R3, Ang-1, Ang-2 and TIE2 (tyrosine kinase with immunoglobulin-like and epidermal growth factor-like domains 2) levels in TBL, latent tuberculous infection (LTBI) and lymph node culture supernatants (VEGF-A, C and Ang-2) of the same TBL patients.

RESULTS

Circulating levels of VEGF-A and VEGF-C were significantly diminished, whereas VEGF-R2, R3, Ang-2 and TIE2 levels were significantly increased, in TBL. Likewise, VEGF-A, C and Ang-2 levels were significantly increased in lymph node supernatants compared with plasma in individuals with TBL. Receiver operating characteristic curve analysis showed that VEGF-C and VEGF-R2 markers clearly distinguished TBL from LTBI. Following treatment, VEGF-C and Ang-1 levels were significantly altered. No association was observed between angiogenic factors and culture grade or lymph node size, except for VEGF-A. VEGF-A was also significantly decreased in multiple lymph nodes compared with single lymph nodes.

CONCLUSIONS

Our data suggest that altered levels of circulating angiogenic factors in TBL might reflect underlying vasculo-endothelial dysfunction. Reversal of angiogenic markers after anti-tuberculosis treatment suggests that these angiogenic markers may serve as biomarkers of disease severity or response to treatment in TBL.

Pulmonary Atresia with Ventricular Septal Defect: Rare Presentation with Coronary-to-Pulmonary Artery Collaterals from Both Right and Left Coronaries

Pulmonary atresia with ventricular septal defect and coronary-dependent pulmonary circulation arising from both major coronary arteries is rare. Dependence of pulmonary blood flow on the coronaries and the risk of early development of pulmonary vascular obstructive disease warrant early surgical repair in these patients. We report a case of a ten-month-old infant with pulmonary atresia with ventricular septal defect and coronary artery-to-main pulmonary artery connections who was successfully managed with ligation of the coronary fistulas and intracardiac repair.

Abstract P3-14-07: Evaluation of the effects of talazoparib on QT interval prolongation

Background: Talazoparib (TAL), an oral poly ADP-ribose polymerase inhibitor, is under investigation in multiple oncologic clinical trials and has been submitted to the US FDA for use in patients (pts) with germline BRCA-mutated, HER2-negative advanced breast cancer.

International Conference on Harmonisation guidance recommends all new drugs be evaluated for effects on cardiac repolarization in a well-controlled clinical study. For drugs for which such evaluation cannot be conducted in healthy volunteers (eg, most anticancer agents), collection of robust corrected QT (QTc) interval data from a dedicated QTc study (hybrid thorough QT/QTc study) in pts is required in the registration dossier. The effect of steady-state (ss) TAL (1 mg once daily) on cardiac repolarization in pts with advanced solid tumors was evaluated in an open-label phase 1 study (NCT03042910).

Methods: Continuous 12-lead electrocardiogram (ECG) recordings were collected at baseline (Day -1); time-matched pharmacokinetic (PK) samples and continuous ECG recordings were obtained on Days 1, 2, and 22 (when TAL concentrations achieved ss). On Day -1, pts had continuous 12-lead ECG recording starting at Time 0 (Day 1 dosing time) for 6 hrs. On Days 1 and 22, ECG recording started 45 min before TAL administration and continued for 6 hrs post dose and blood samples for PK were collected before dose and at 1, 2, 4, and 6 hrs post dose. On Day 2, a 30-min ECG recording and a PK sample were obtained before dose at Time 0.

Continuous ECG recordings were submitted to a central laboratory; triplicate 10-sec ECGs were extracted from a 5-min extraction window beginning 15 min before each PK collection time. ECG measurements were reported via blinded manual adjudication process and included PR interval, QT interval, RR interval, and QRS complex. The QT interval was corrected for effect of heart rate using Fridericia's correction (QTcF) and Bazett's correction (QTcB).

The estimate of change from time-matched baseline and its 2-sided 90% confidence interval (CI) was calculated for each nominal time point using PROC MEANS. Additionally, a prespecified PK/pharmacodynamic (PD) model was used to describe the relationship between plasma TAL concentrations ([TAL]) and QTc. The prespecified linear mixed-effects model included [TAL], time (categorical), and treatment with random pt effects on [TAL] and the intercept. If the upper bounds (UB) of 1-sided 95% CIs of time-matched ΔQTc for all ECG time points were <20 msec and the UB of 1-sided 95% CIs of the predicted ΔQTc at the mean ss maximum [TAL] was <20 msec, the effect of TAL on QTc was not of clinical relevance.

Results: 37 of 38 pts enrolled received TAL and were included in the ECG and PK/PD analyses. No pts had a postbaseline absolute maximum QTcF or QTcB ≥500 msec or ΔQTc ≥60 msec. The UB of the 1-sided 95% CI for the time-matched ΔQTcF and ΔQTcB were <12 msec at all nominal ECG time points. In the PK/PD analysis, the slopes (95% CI) of QTcF-[TAL] and QTcB-[TAL] relationships were -0.14 (-0.78 to 0.50) msec/ng/mL and -0.24 (-0.88 to 0.41) msec/ng/mL, respectively, indicating that TAL did not have a concentration-dependent effect on QTcF or QTcB.

Conclusion: TAL does not have a clinically relevant effect on QTc.

Funding: Medivation LLC, acquired by Pfizer.

Citation Format: Hoffman J, Chakrabarti J, Wainberg ZA, Plotka A, Babu S, Milillo Naraine A, Kanamori D, Moroose R, Nguyen L, Wang D. Evaluation of the effects of talazoparib on QT interval prolongation [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-14-07.

The Significance of ERG and Androgen Receptor Expression in Adenocarcinoma Prostate

Background Fusions of transmembrane protease, serine 2 (TMPRSS2) with erythroblast transformation specific transcription factors have been found in prostate cancer. The v-etserythroblastosis virus E26 oncogene homologue (ERG) is a proto-oncogene of the erythroblast transformation specific transcription factor family. TMPRSS2-ERG fusion is the most common molecular alteration present in about 50% of prostatic adenocarcinomas. Androgen receptor (AR) plays a key role in prostate development and is involved in the progression of prostate cancer. Objective To evaluate the significance of combined ERG and AR expression in cases of prostatic adenocarcinoma. Method The study was conducted at Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India. Formalin fixed-paraffin embedded archival prostatic tissue specimens were obtained. A total of 10 cases of prostatic adenocarcinoma were included in the study. Immunohistochemistry for Androgen receptor was done by the standard protocol. Multiplex immunohistochemical staining was done for ERG+CK5 using a primary antibody cocktail of mouse and rabbit antibodies. Result Specific AR immunostaining was exclusively nuclear and was present in all 10 cases in varying intensity. Specific ERG immunostaining was nuclear and was present in seven cases (70%) and absent in three cases (30%). The three cases that were negative for ERG had a Gleason score of ≤ 6 and the AR staining was strong and present in about 90% of the cells. Gleason score was directly related to the ERG staining while AR staining was inversely related to the ERG staining. Conclusion The prognostic value of combined ERG and AR over-expression, its associated genes should be further investigated as potential therapeutic targets in prostate cancer progression. Preliminary data is being presented. Larger prospective studies with survival analysis are essential for prognostic significance.

Status of raptors in the Moyar River Valley, Western Ghats, India

This study examined the species composition and nest-tree characteristics of diurnal raptors in the tropical forests of Moyar Valley, Western Ghats between December 2012 and March 2013.  We recorded 28 species of raptors including three species of vultures.  Accipitridae was the dominant family comprising of 25 species followed by two from Falconidae and the monotypic Pandionidae.  Among them, eight species fall under various threatened category: three Critically Endangered, one Endangered, two Vulnerable and two Near Threatened.  The Critically Endangered Gyps bengalensis was frequently recorded during the survey (175 sightings) followed by Milvus migrans (39 sightings) and Haliastur indus (27 sightings).  We located 53 active nests of four species of raptors, viz., Gyps bengalensis (42 nests), Nisaetus cirrhatus (4 nests), Haliastur indus (4 nests), and Milvus migrans (3 nests).  A notable difference in the nest-tree characteristics among the sympatric raptors was observed.  These results would be important to identify priority areas for developing future conservation and management programs for the long-term conservation of raptorial birds in the Western Ghats.

Angiopoietins as biomarkers of disease severity and bacterial burden in pulmonary tuberculosis

BACKGROUND

Circulating angiogenic factors of the vascular endothelial growth factor family are important biomarkers of disease severity in pulmonary tuberculosis (PTB). However, the role of angiopoietins, which are also involved in angiogenesis, in PTB is not known.

OBJECTIVE AND DESIGN

To examine the association of circulating angiopoietins with TB disease or latent tuberculous infection (LTBI), we examined the systemic levels of angiopoietin (Ang) 1, Ang 2 and Tie-2 receptor in individuals with PTB (n = 44), LTBI (n = 44) or no tuberculous infection (NTBI) (n = 44).

RESULTS

Circulating levels of Ang-1, Ang-2 and Tie-2 were significantly higher in PTB than in individuals with LTBI or NTBI. Moreover, Ang-1, Ang-2 and Tie-2 levels were significantly higher in PTB with bilateral disease. The levels of these factors also exhibited a significant positive relationship with bacterial burdens in PTB. Receiver operating characteristics curve analysis revealed Ang-2 as a marker distinguishing PTB from LTBI or NTBI. Finally, the circulating levels of Ang-1, Ang-2 and Tie-2 were significantly reduced following anti-tuberculosis chemotherapy.

CONCLUSIONS

Our data demonstrate that PTB is associated with elevated levels of circulating angiopoietins, possibly reflecting endothelial dysfunction. In addition, Ang-2 could prove useful as a biomarker to monitor disease severity, bacterial burden and therapeutic responses.

Xanthogranulomatous Pyelonephritis: Intrahepatic and Intrathoracic Extension

A 32-year-old female presented to us with worsening cough and expectoration, low-grade fever, and malaise for 3 months. She gave a history of pregnancy loss secondary to urinary tract infection (UTI) a year back. At that time, she was told to have an obstructive right renal calculus. She also had a history of recurrent UTI in the past 1 year. She had no other comorbidities. Her clinical evaluation revealed an enlarged right kidney and reduced air entry in the right hemithorax. Radiological investigations revealed a large right kidney invading into the inferior surface of the right lobe of the liver and the right pleural space. A clinical diagnosis of xanthogranulomatous pyelonephritis was made, and she was advised nephrectomy. Intraoperatively, the right kidney was found to invade both the right lobe of the liver and the right pleural cavity through a right diaphragmatic defect. Histopathology of the kidney revealed the presence of foamy histiocytes suggestive of xanthogranulomatous pyelonephritis. Invasive xanthogranulomatous pyelonephritis is known, however, invasion into the extra-abdominal structures has not been reported in the literature. Our case is a rare manifestation of a rare clinical entity – xanthogranulomatous pyelonephritis.

Accumulation of phytoene, a colorless carotenoid by inhibition of phytoene desaturase (PDS) gene in Dunaliella salina V-101

The aim of this work was to study the accumulation of phytoene in Dunaliella salina V-101 by down-regulating its phytoene desaturase (PDS) gene expression using RNA interference and Antisense technology. RNAi and antisense constructs were introduced into the Dunaliella cells by Agrobacterium-mediated transformation. Among thirty-two transformants, six showed positive down-regulation of PDS expression with RNAi construct and five positive transformants were obtained using antisense construct. Characterization of PDS suppression was carried out using semi-quantitative RT-PCR and quantitative determination of phytoene as well as other carotenoids by HPLC. Both the RNAi and antisense lines showed a significant decrease in the expression levels of phytoene desaturase and carotenoid content compared to wild type cells. The RNAi line #5 showed maximum Phytoene content (108.34±22.34µg/100mg DCW) compared to other transgenic lines. These phytoene-accumulating phenotypes exhibited slower growth rates and were found to be sensitive to high light conditions.

Concentration-dependent studies of Nd3+ -doped zinc phosphate glasses for NIR photoluminescence at 1.05 μm

Nd³⁺ -doped lead-free zinc phosphate glasses with the chemical compositions (60-x) NH₄ H₂ PO₄  + 20ZnO + 10BaF₂  + 10NaF + xNd₂ O₃ (where x = 0.5, 1.0, 1.5, 2.0 and 2.5 mol%) were prepared using a melt quenching technique. Vibrational bands were assigned and clearly elucidated by Raman spectral profiles for all the glass samples. Judd-Ofelt (J-O) intensity parameters (Ω_λ : λ = 2, 4, 6) were obtained from the spectral intensities of different absorption bands of Nd³⁺ ions. Radiative properties such as radiative transition probabilities (A_R ), radiative lifetimes (τ_R ) and branching ratios (β_R ) for different excited states were calculated using J-O parameters. The near infrared (NIR) photoluminescence spectra exhibited three emission bands (⁴ F_3/2 level to ⁴ I_13/2 , ⁴ I_11/2 and ⁴ I_9/2 states) for all the concentrations of Nd³⁺ ions. Various luminescence properties were studied by varying the Nd³⁺ concentration for the three spectral profiles. Fluorescence decay curves of the ⁴ F_3/2 level were recorded. The energy transfer mechanism that leads to quenching of the ⁴ F_3/2 state lifetimes was discussed at higher concentration of Nd³⁺ ions. These glasses are suggested as suitable hosts to produce efficient lasing action in NIR region at 1.05 μm.

An audit of cytoreductive surgeries in ovarian cancer from a rural based cancer center

BACKGROUND AND OBJECTIVE

Ovarian cancers are frequently seen at an advanced stage in our center. This audit was planned to see the morbidity and efficacy of different types of cytoreductive surgeries (radical vs. ultra-radical) done in such patients.

METHODS

This was a retrospective analysis of all ovarian cancer patients who underwent cytoreductive surgery at our center from January 2009 to August 2013. The case records of these patients were reviewed and the demographic, disease-related and treatment-related data were extracted.

RESULTS

Fifty-fivepatients were identified. Ten (18.2%) patients underwent primary cytoreduction while 45 patients had (81.8%) interval cytoreduction. The resections achieved were optimal in 50 patients (90.9%) and suboptimal in five patients (9.1%). The postoperative median blood loss was 400 (350-600) mL. The median time interval for surgery was 4.0 h (3-5 h). The type of resection achieved (optimal vs. suboptimal) was the only factor affecting the progression free survival (PFS) (Hazard ratio = 0.08 95% confidence interval 0.02-0.3). There was no significant difference in postoperative morbidity in patients undergoing the ultra-radical surgery as compared to those who underwent radical surgery.

CONCLUSION

Optimal cytoreduction may improve PFS in advanced ovarian cancer patients and needs to be done even if it mandates an ultra-radical surgery.

Optical properties and spectroscopic study of different modifier based Pr(3+):LiFB glasses as optical amplifiers

In this paper, we report the preparation and optical characterization of Pr(3+) doped lithium fluoro borate (LiFB) glasses for six different chemical compositions of Li2B4O7-BaF2-NaF-MO (where M=Mg, Ca, Cd and Pb), Li2B4O7-BaF2-NaF-MgO-CaO and Li2B4O7-BaF2-NaF-CdO-PbO. The structural and optical properties of these glasses were characterized by X-ray powder diffraction (XRD), scanning electron microscope (SEM), Fourier transform infrared spectroscopy (FTIR), optical absorption and photoluminescence techniques. The optical absorption spectra of Pr(3+) ions in LiFB glasses have been recorded in the UV-VIS-NIR region. The optical absorption data are used to calculate various spectroscopic parameters such as Racah (E(1), E(2), E(3)) and spin-orbit interaction (ξ4f) parameters. Judd-Ofelt (J-O) (Ωλ where λ=2, 4 and 6) intensity parameters were determined by applying J-O theory, which in turn used to calculate the radiative properties such as radiative transition probabilities (A), radiative lifetimes (τR), integrated absorption cross-sections (Σ) and branching ratios (βr) for all emission levels of Pr(3+) ion in different LiFB glass matrices. By using the J-O theory and luminescence parameters, stimulated emission cross sections (σp) of prominent transitions, (3)P0→(3)H4 and (1)D2→(3)H4 of Pr(3+) ion in all LiFB glasses were calculated. (3)P0→(3)H4 possesses higher branching ratios and stimulated emission cross-sections for the Pr(3+):LiFB(Mg-Ca) glass, which can be used as a best laser excitation. The optical gain parameter (σpxτR) was noticed higher in Pr(3+):LiFB(Mg-Ca) and Pr(3+):LiFB(Cd-Pb) glasses for the transition (3)P0→(3)H4 transition, and these glasses have potential for optical amplification at 488 nm wavelength.

Patterns of care in geriatric cancer patients - An audit from a rural based hospital cancer registry in Kerala

BACKGROUND

There is deficit of data from India on elderly patients with cancer. Comprehensive geriatric assessment may lead to a better decision making capacity in this population. However, routine implementation of such assessment is resource consuming.

AIM

The aim of this study was to determine the patterns of care in elderly patients treated at a tertiary rural cancer center in India.

MATERIALS AND METHODS

All patients with age 70 or above with solid tumors without any definitive treatment prior to the registration at our center and registered between 01/01/2010 and 31/12/2011 were selected for this study. The baseline demographic pattern and the pattern of care of treatment were analyzed. SPSS version 16 (IBM Inc, Armonk, New York, U.S.) was used for analysis. Descriptive data are provided.

RESULTS

A total of 761 patients were evaluable subject to the aforementioned inclusion criteria. The median age of this cohort was 75 years (70-95 years). The most frequent primary sites of malignancies in 451 males were head neck (32.4%), lung (23.3%) and gastrointestinal (23.3%). In 310 females, the most common sites were head neck (31.6%), gynecological (18.4%) and gastrointestinal (24.5%). 228 (30%) of the patients had localized disease, 376 (49.4%) had loco-regionally advanced disease and 145 (19.1%) had distant metastases at presentation. 334 (46.32%) of patients were treated with curative intent. On logistic regression analysis the factors that predicted use of curative intent treatment were age <75 years, performance status 0-1, primary site and clinical extent of disease.

CONCLUSION

Routine comprehensive geriatric assessment needs to be implemented in our setting as almost 50% of our geriatric patients undergo curative intent treatment.

Association of Anaesthetists of Great Britain and Ireland: Safe vascular access 2016

Safe vascular access is integral to anaesthetic and critical care practice, but procedures are a frequent source of patient adverse events. Ensuring safe and effective approaches to vascular catheter insertion should be a priority for all practitioners. New technology such as ultrasound and other imaging has increased the number of tools available. This guidance was created using review of current practice and literature, as well as expert opinion. The result is a consensus document which provides practical advice on the safe insertion and removal of vascular access devices.

Idiopathic nodular glomerulosclerosis: Report of two cases and review of literature

Nodular glomerulosclerosis, a pathological finding characterized by areas of marked mesangial expansion with accentuated glomerular nodularity can be seen in a number of conditions including diabetic nephropathy, amyloidosis, light chain deposition disease, fibrillary and immunotactoid glomerulopathy, collagen type III disease, nodular membranoproliferative glomerulonephritis, and Takayasu's arteritis. Idiopathic nodular glomerulosclerosis is a diagnosis of exclusion and is reported in patients with hypertension, smoking, chronic obstructive pulmonary disease, obesity, metabolic syndrome, etc. We report two cases of idiopathic nodular glomerulosclerosis, one in obese hypertensive male and the other in nonhypertensive, nonobese female patient.