Planned neck dissection following chemo-radiotherapy in advanced HNSCC

BACKGROUND: Neck dissection has traditionally played an important role in the management of patients with regionally advanced head and neck squamous cell carcinoma (HNSCC) treated with radical radiotherapy alone. However, with the incorporation of chemotherapy in the therapeutic strategy for advanced HNSCC and resultant improvement in outcome the routine use of post chemo-radiotherapy neck dissection is being questioned. METHODS: Published data for this review was identified by systematically searching MEDLINE, CANCERLIT & EMBASE databases from 1995 until date with restriction to the English language. RESULTS: There is lack of high quality evidence on the role of planned neck dissection in advanced HNSCC treated with chemo-radiotherapy. A systematic literature search could identify only one small randomized controlled trial (Level I evidence) addressing this issue, albeit with major limitations. Upfront neck dissection followed by chemo-radiotherapy resulted in better disease-specific survival as compared to chemoradiation only. Several single arm prospective and retrospective reports were also identified with significant heterogeneity and often-contradictory conclusions. CONCLUSIONS: Planned neck dissection after radical chemo-radiotherapy achieves a high level of regional control, but its ultimate benefit is limited to a small subset of patients only. Unless there are better non-invasive ways to identify residual viable disease, the role of such neck dissection shall remain debatable. A large randomized controlled trial addressing this issue is needed to clarify its role and provide evidence-based answers

Candiduria: its characterization, antifungal susceptibility pattern and biofilm formation

Background: Candida are the fourth most common species causing urinary tract infections. The last two decades has shown rapid increase in Candida associated UTI along with change in its distribution. The indiscriminate use of antifungal drugs, especially azole group have contributed in emergence of resistant strains of Candida. Biofilm producing property of Candida also contributes to antifungal resistance. Aims and objectives was to detect the occurrence of Candida as causative agent of UTI and a potent bio film producer. The susceptibility of Candida to antifungal drugs and their correlation with the production of bio film and presence of Foleys catheter was also determined.Methods: A total of 4192 urine specimens were analysed. Candida species isolated from urine samples were characterized using CHROM agar, sugar assimilation tests and micro morphology on corn meal agar. The antifungal susceptibility testing was performed by modified disc diffusion method on MHA with two drugs; fluconazole 25µg, and voriconazole 1µg discs. The biofilm production capability was tested according to the protocol proposed by Branchini et al.Results: Out of 113 Candida species isolated, 16.8% were Candida albicans as compared to 83.2% non albicans, with Candida tropicalis as the most common species. Antimicrobial sensitivity by modified Kirby Bauer disc diffusion method showed 74.3 % of Candida isolates to be fluconazole sensitive while sensitivity to voriconazole was 100%. 60.2% of Candida were biofilm producers out of which 48.5 % were from urine samples of catheterized patients. Similarly, 26.4 % of fluconazole resistant strains were also biofilm producers.Conclusions: The increased incidence of Non albicans candiduria which are also biofilm producers and resistant to commonly used drug fluconazole is a matter of concern. Therefore, the species identification of Candida isolates along with their antifungal susceptibility pattern should be routinely performed to help the clinicians in better treating the patients with candiduria

Pair excitation-deexcitation coherent states

A class of coherent states defined in terms of the excitation and deexcitation of pairs of photons is studied with reference to its nonclassical and other quantum-statistical properties. These states supplement the other well-known two-mode states such as Caves-Schumaker states and pair coherent states and can be produced by dissipative processes involving emission and absorption of photons in pairs

Binary Wavelet Transform Based Histogram Feature for Content Based Image Retrieval

In this paper a new visual feature, binary wavelet transform based histogram (BWTH) is proposed for content based image retrieval. BWTH is facilitated with the color as well as texture properties. BWTH exhibits the advantages of binary wavelet transform and histogram. The performance of CBIR system with proposed feature is observed on Corel 1000 (DB1) and Corel 2450 (DB2) natural image database in color as well as gray space. The results analysis of DB1 database illustrates the better average precision and average recall of proposed method in RGB space (73.82%, 44.29%) compared to color histogram (70.85%, 42.16%), auto correlogram (66.15%, 39.52%) and discrete wavelet transform (60.83%, 38.25%). In case of gray space also performance of proposed method (66.69%, 40.77%) is better compared to auto correlogram (57.20%, 35.31%), discrete wavelet transform (52.70%, 32.98%) and wavelet correlogram (64.3%, 38.0%). It is verified that in case of DB2 database also average precision, average recall and average retrieval rate of proposed method are significantly better

Generation of Hidden Optical-Polarization: Squeezing and Non-Classicality

A monochromatic double-mode coherent light endowed with orthogonally polarized photons propagating collinearly is studied in Degenerate Parametric Amplification. Generation of Hidden Optical- Polarized States is shown by non-zero values of Index of Hidden Optical-Polarization. Squeezing in HOPS is demonstrated by recognizing a Squeezing function. The Non-Classical feature of HOPS is observed by 'degree of Hidden Optical-Polarization' which attains non-classical value 'greater than unity'. The dynamical nature of Generation, Squeezing and Non-Classicality are numerically presented.Comment: 14 pages and 02 figure

REVIEW OF CHARACTERISTIC FEATURES OF ABHRAKA WSR TO PINAKA ABHRAKA

Rasashastra (Vedic chemistry) is the root branch of the Ayurveda (the science of life) that deals with herbomineral preparations. Abhraka (mica) is a mineral that classified in Maharasa group of Rasashastra. It contains several elements such as Si, Fe, Al, Mg, Na, and K as main ingredients. Four types of abhrakas are described in the Classics of Rasashastra including pinaka. Property of Pinaka is told that when it is heated on fire, the layers get separates. Intake of its bhasma causes severe constipation. The characteristic effect of pinak abhraka can be correlated with muscovite – paragonite micas. Because their perfect basal cleavage allows them to be split into thin, flexible sheets. Muscovite–paragonite series group of mica having hydrous potassium, sodium, aluminum, and silicate minerals. In this hydrous group, aluminum hydroxide causes constipation. In this paper, an attempt will be made to explain how does pinaka abhrak causes severe constipation

Clinical profile of heart failure in Beta-Thalassaemia Major (ß-TM): Case studies with current consideration and future perspectives

Background: Cardiac involvement is a major cause of mortality in Beta-Thalassaemia Major (ß-TM) patients. Despite many advances in therapeutic management of ß-TM, cardiac involvement remains the primary cause of mortality in ~70% of the cases. Chronic iron overloading results in thalassaemic cardiomyopathy, leading to diastolic dysfunction and overt heart failure (HF). Serial electrocardiography (ECG), 2D-echocardiography (2DECHO) and cardiovascular magnetic resonance (CMR) help in early detection and risk stratification of ß-TM patients, to prevent complications, such as arrhythmias and sudden cardiac death. An established network of care between thalassaemia centres and local health providers is essential for optimal management. Case presentation: We report 2 cases of HF in ß-TM of varied etiology, and different approaches undertaken for its early diagnosis and treatment. Conclusion: It is important to differentiate various phenotypes of cardiomyopathy in ß-TM. Since, the management of each varies accordingly. ß-TM patients require a multi-disciplinary approach that includes HF specialists, haematologist, hepatologist, endocrinologist, psychologist, transfusion experts and nursing personnel to maximise benefits from the application of the modern HF therapeutic strategies in evaluation, monitoring and treatment. SAHeart 2022;19:14-1

Effect of Uncomplicated Cataract Surgery on Central Macular Thickness in Diabetic and Non-diabetic Subjects

Purpose: To assess the quantitative changes of macula in diabetic and non-diabetic eyes after uncomplicated cataract surgery. Methods: In this prospective interventional study being performed in a tertiary healthcare hospital, a total of 660 eyes were divided into two groups. Group 1 included 330 eyes from healthy subjects and group 2 included 330 eyes from well-controlled diabetic subjects with no diabetic retinopathy planned for phacoemulsification with foldable IOL implantation by the same surgeon under similar settings. Optical Coherence Tomography (Heidelberg Spectralis SD-OCT) was used to assess preoperative and postoperative central macular thickness (CMT) at weeks 1 and 6. Results: The mean CMT in group 1 preoperatively, at postoperative week 1, and at post-operative week 6 was 257.03 ± 20.904, 262.82 ± 17.010, and 265.15 ± 20.078 μm, respectively. The corresponding values in group 2 were 255.36 ± 17.852, 259.15 ± 16.644, and 266.09 ± 18.844 μm, respectively. There was no significant difference in the mean CMT values between the two groups on any of the three occasions when the CMT was measured (P = 0.374 and P = 0.313 at weeks 1 and 6, respectively). Conclusion: There was no statistically significant difference in CMT between normal subjects and diabetic subjects without diabetic retinopathy preoperatively and in early postoperative period after uncomplicated phacoemulsification surgery