Treatment updates regarding anaplastic oligodendroglioma and anaplastic oligoastrocytoma

Anaplastic Oligodendroglioma / Anaplastic Oligoastrocytoma (AO/AOA) is a WHO Grade-III primary brain tumor. These tumors comprise about 5 - 10% of all gliomas, which make them the third most common primary brain tumors after glioblastoma multiforme and astrocytomas. For many years standard of treatment remained Maximum Safe Resection (MSR) followed by Radiotherapy (RT). These tumors have also been known to be sensitive to alkylator-based chemotherapy particularly the subset having 1p/19q co-deletion signature. There is robust data showing that these tumors are responsive to chemotherapy in recurrent or progressive setting. Recently, up front chemotherapy has been added to standard post-surgery RT. It has been found that subset of AO/AOA having 1p/19q co-deletion responded very well to the addition of chemotherapy. This substantial benefit in terms of median Overall Survival (OS) and median Progression Free Survival (PFS) have intrigued the personalized treatment of AO/AOA on the basis of molecular signature markers

Results of faculty evaluation at The Aga Khan University, Karachi, Pakistan

Objective: The aim of the retrospective correlational analysis was to identify the attributes valued most by students for assessing the overall effectiveness of a teacher. Methods: Responses of the students to the two versions of evaluation questionnaires, each attempting to assess 4 and 8 characteristics respectively on a scale of 1-5 were included in the analysis. The third and fourth year students, at the end of each course/module completed a total of 2110 evaluation forms, which were studied. Results: The over all effectiveness of the teacher showed statistically significant correlation of .914 and .895 with ability to communicate ideas effectively and clarity and organisation of the lectures. Whereas the knowledge of subject and the successful use of teaching aids showed a correlation of .658 and .637 with a statistical significance of PConclusion:Students need a basic outline of what they have to learn and guidance to plan their studies OPMA 49: 135, 1999)

Comparison of Sublingual Misoprostol and Manual Vacuum Aspiration for the Treatment of Incomplete Abortion in First Trimester in Terms of Frequency of Decreased Haemoglobin Levels

Background: To compare efficacy of manual vacuum aspiration with sublingual misoprostol for the treatment of incomplete abortion in terms of frequency of blood loss and decreased haemoglobin.Methods: In this randomized controlled trial, patients with incomplete abortion, open cervical os, vaginal bleeding, history of vaginal bleeding during this pregnancy and uterine size of less than or equal to 12wks menstrual period were included. Consenting women were randomized to either Group A who received a single dose of 600 microgram of sublingual misoprostol or Group B who underwent manual vacuum aspiration for evacuation of retained products of conception. Both groups comprised of 150 patients each. Pre and post (after 48 hours) treatment haemoglobin levels were measured.Results: Mean fall in haemoglobin level <1g/dl from baseline level was seen in misoprostol group while a mean fall of <0.5g/dl from baseline level was observed in MVA group (p<0.001, 95% CI, t=1.64, eta squared=0.006). A significant association was found with haemoglobin level, parity and age, with p=0.001, p= 0.05, p=0.02 respectivelyConclusion: The efficacy of manual vacuum aspiration (MVA) is indicated by lower level of blood loss (Hb<0.5g/dl from baseline) as compared to 600μg sublingual misoprostol. MVA is associated with less complications than misoprostol

Statistical analysis of the effect of machining parameters on fatigue life of aerospace grade aluminum alloy (AL 6082T6)

In this research work, aerospace grade aluminium alloy (Al 6082-T6) was analysed for the effect of cutting parameters on the fatigue life of the machined samples and optimization of cutting parameters for response factor. Different combinations of machining parameters were selected according to the ISO 3685 for sample preparation. Fatigue life of the samples was the response variable under investigation. Specimens for the rotating bending fatigue test were prepared according to the BS ISO 1143:2010 standards. The cutting inserts were selected from Sandvik Coromant catalogue recommended for machining of Al 6082-T6 alloy. A Designed of Experiment (DoE) with full factorial design was employed and a total of 81 experiments were performed for combination of cutting parameters. Fatigue life of the samples was observed to decreases with increasing feed rate, which is attributed to the compressive residual stresses at the surface of the samples. However, fatigue life increased with higher cutting speed and Depth of Cut (DoC)

Monitoring and verifying network behavior using data-plane state

Modern computer networks are complex, incorporating hundreds or thousands of network devices from multiple vendors performing diverse functions such as routing, switching, and access control across physical and virtual networks (VPNs and VLANs). As in any complex computer system, these networks are prone to a wide range of errors such as misconfigurations, software bugs, or unexpected interactions across protocols. Previous tools to assist operators in debugging network anomalies primarily focus on analyzing control plane configuration. Configuration analysis is limited in that it cannot find bugs in router software, and is harder to generalize across protocols since it must model complex configuration languages and dynamic protocol behavior. This thesis studies an alternate approach: diagnosing problems through static analysis of a network's data-plane state. We call it data-plane verification. This approach can catch bugs that are invisible at the level of configuration files, and simplifies unified analysis of a network across many protocols and implementations. To prove the applicability and usefulness of data-plane verification, we designed and implemented two tools to rigorously check important network invariants, such as absence of routing loops, routing consistency of replicated devices, and other reachability properties. Our first tool, called Anteater, translates a network's data-plane state and invariants into boolean satisfiability problems, and checks them using a SAT solver. Our second tool, called VeriFlow, creates a device independent graph model of the network state, and uses standard graph traversal algorithms to detect invariant violations. We tested our tools with real world network data-plane traces, and with large emulated networks. Both of our tools were able to detect real bugs that went unnoticed to network operators for more than a month. Our tools helped them to narrow down the faulty configurations, and resolve those quickly. Results from emulated larger networks showed that the running time performance of our tools, especially that of VeriFlow, is good enough to detect bugs quickly before they can be exploited by outside attackers. Due to the fast response time of VeriFlow, it can be used in the emerging Software-Defined Networking (SDN) setting as a proactive tool to detect and filter out faulty configurations before they reach network devices

Plan dose evaluation of three dimensional conformal radiotherapy planning (3D-CRT) of nasopharyngeal carcinoma (NPC): experience of a tertiary care University Hospital in Pakistan

Background: Radiation therapy is the mainstay of treatment for nasopharyngeal carcinoma. Importance of tumor coverage and challenges posed by its unique and critical location are well evident. Therefore we aimed to evaluate our radiation treatment plan through dose volume histograms (DVHs) to find planning target volume (PTV) dose coverage and factors affecting it.MATERIALS AND Methods: This retrospective study covered 45 histologically proven nasopharyngeal cancer patients who were treated with definitive 3D-CRT and chemotherapy between Feb 2006 to March 2013 at the Department of Oncology, Section Radiation Oncology ,Aga Khan University Hospital, Karachi, Pakistan. DVH was evaluated to find numbers of shrinking field (phases), PTV volume in different phases and its coverage by the 95% isodose lines, along with influencing factors.Results: There were 36 males (80%) and 9 females (20%) in the age range of 12-84 years. Stage IVA (46.7%) was the most common stage followed by stage III (31.1). Eighty six point six-percent received induction, 95.5% received concurrent and 22.2% received adjuvant chemotherapy. The prescribed median radiation dose was 70Gy to primary, 60Gy to clinically positive neck nodes and 50Gy to clinically negative neck regions. Mean dose to spinal cord was 44.2Gy and to optic chiasma was 52Gy. Thirty seven point eight-percent patients completed their treatment in three phases while 62.2% required four to five phases. Mean volume for PTV3 was 247.8 cm3 (50-644.3), PTV4 173.8 cm3 (26.5-345.1) and PTV5 119.6 cm3 (18.9-246.1) and PTV volume coverage by 95% isodose lines were 74.4%, 85.7% and 100% respectively. Advanced T stage, intracranial extension and tumor volume \u3e200 cm3 were found to be important factors associated with decreased PTV coverage by 95% isodose line.CONCLUSIONS: 3D CRT results in adequate PTV dose coverage by 95% isodose line. However advanced T stage, intracranial extension and large target volume require more advanced techniques like IMRT for appropriate PTV coverage

Exploring Emotional and Psychological Impacts of Mammography in Women

Introduction: Mammography is a diagnostic tool that is routinely used to test women for breast cancer. While it has been shown to be beneficial in detecting early-stage malignancies, it can also have emotional and psychological consequences for patients. The goal of this study is to dive into the emotional and psychological experiences of mammography patients. We hope to obtain a better understanding of the potential complications and problems faced by women during the screening process by investigating these elements. Materials and Methods: The Psychological Consequences Questionnaire (PCQ) and a self-administered questionnaire were used to collect data. SPSS was used for statistical analysis. All participants were given information about mammography technology and safety, and their participation was based on informed consent. Results: The study included 60 women ranging in age from 40 to 67 years old, with a mean age of 50.22. The PCQ results revealed a high prevalence of symptoms such as difficulty sleeping, changes in appetite, depression or unhappy feelings, fear and panic, nervousness or tension, feeling under pressure, withholding items, venting frustrations on others, withdrawal from relationships, difficulty with daily tasks, and difficulties fulfilling obligations. These findings shed light on the psychological repercussions that people face and point to the necessity for support networks or therapy to address these concerns. Conclusion:  This research focuses on the emotional and psychological effects of mammography on women. The data suggest that anxiety is a common feeling for women undergoing mammography, which could be exacerbated by previous negative experiences or fear of breast cancer. In order to provide holistic and comprehensive care, healthcare providers must recognize and meet patients\u27 emotional and psychological needs