Study on the role of primary systemic chemotherapy with anthracycline combination schedule in locally advanced breast cancer: long term follow up data

Background: Locally advanced breast cancer (LABC) refers to a heterogeneous group of locally advanced non metastatic group of breast cancer. Primary systemic chemotherapy (PST) which forms the prime modality in LABC management has several advantages. The objective of the study was to assess the response and survival of locally advanced breast cancer patients receiving PST with Anthracycline based combination chemotherapy in Indian setting.Methods: 75 LABC patients who were treated with PST were observed and finally analyzed for survival. Chemotherapy schedules were FAC (5-Fluorouracil 500 mg/m2, Doxorubicin 50 mg/m2 and Cyclophosphamide 500 mg/m2) and FEC (5-Fluorouracil 500 mg/m2, Epirubicin 100 mg/m2 and Cyclophosphamide 500 mg/m2).Clinical complete response (cCR), partial response (PR), stable disease (SD) and pathological complete response (pCR) were assessed. 5 year overall survival (O.S) & disease free survival (DFS) were analyzed using Kaplan Meier survival analysis.Results: 94% became operable after PST and 6% remained inoperable. MRM with axillary clearance was achieved in 70.4% while simple mastectomy with axillary dissection in 22.5%. Microscopic surgical clearance achieved in 85.9%. Objective clinical tumour response rate was 78.9% with cCR of 11.3%, PR of 67.6% & pCR of 7.5%. Five year O.S and DFS were 67.92% and 62.21% respectively.Conclusions: Anthracycline based chemotherapy is an excellent schedule in neoadjuvant setting in LABC in down staging disease. But to further improve the O.S, DFS and pCR addition of agents like Taxanes and their sequencing must be explored. RCTs addressing these issues are warranted especially in countries like India.

An Optimized Clogging Manage and Fault Executive System

In this paper, a new OCMFES congestion control mechanism is introduced in multi-homing mode. Congestion in each route can be avoided or can be controlled, based on an Active Queue Management (AQM) method. Also, routers compute probability of congestion for the sources on the paths and then notify them. Therefore, the sources can adjust their sending rates on each path effectively and if necessary, can switch to an alternate path to prevent congestion. Simulations have been conducted with Opnet linked with NS2. The simulation shows that the new method can decrease packet loss, increase the amount of transmissions and stabilize queue length, as compared with standard OCMFES. Keywords:  OCMFES; AQM; congestion control; sendin

Mining Event - Based Commonsense Knowledge from Web using NLP Techniques

The real life intelligent applications such as agents, expert systems, dialog understanding systems, weather forecasting systems, robotics etc. mainly focus on commonsense knowledge And basically these works on the knowledgebase which contains large amount of commonsense knowledge. The main intention of this work is to create a commonsense knowledge base by using an effective methodology to retrieve commonsense knowledge from large amount of web data. In order to achieve the best results, it makes use of different natural language processing techniques such as semantic role labeling, lexical and syntactic analysi. Keywords: Automatic statistical semantic role tagger (ASSERT), lexico - syntactic pattern matching, semantic role labeling (SRL

MEBCK from Web using NLP Techniques

The real life intelligent applications such as agents, expert systems, dialog understanding systems, weather forecasting systems, robotics etc. mainly focus on commonsense knowledge And basically these works on the knowledgebase which contains large amount of commonsense knowledge. The main intention of this work is to create a commonsense knowledge base by using an effective methodology to retrieve commonsense knowledge from large amount of web data. In order to achieve the best results, it makes use of different natural language processing techniques such as semantic role labeling, lexical and syntactic analysis. Keywords: Automatic statistical semantic role tagger (ASSERT), lexico - syntactic pattern matching, semantic role labeling (SRL

Incidence and spectrum of electrolyte disturbances in cisplatin based chemotherapy

Background:Cisplatin, one of the most commonly used chemotherapeutic agents, has electrolyte imbalances as one of its most important adverse effects. We conducted this study to characterize the spectrum of its electrolyte abnormalities.Methods: In this observational study, all patients who received chemotherapy containing cisplatin either as single agent or in combination of not more than 2 drugs were included. After baseline investigations, serum electrolytes were recorded, before each cycle of chemotherapy. The incidence and grade of electrolyte abnormalities were analyzed Median dose and cycle at which each of the electrolyte abnormality first occurred was analyzed with Kaplan Meir survival analysis.Results: The most common individual abnormality was hypomagnesaemia, which was seen in 91.8% of patients, followed by hyponatremia 88.2%. Hypocalcaemia 70.6% and hypokalemia 27.1%. The median dose of Cisplatin at which half of the patients had hyponatremia (critical dose) was 195mg and occurred in cycle 2  while the critical dose for potassium was 560mg which occurred in cycle 7. Similarly critical dose and cycle for calcium and magnesium were 240mg at cycle 3 and 160mg at cycle 2 respectively. Majority of electrolyte abnormalities were grade 1 for all the four electrolytes. Grade 3 (15.3%) and Grade 4 (2.4%) was seen predominantly for sodium. There were no grade 3 or 4 hypomagnesaemia.Conclusions: Cisplatin chemotherapy is associated with hypomagnesaemia in a highly significant percentage of patients. Incidence increases with increase in cumulative dose of cisplatin.  Frank clinical manifestations associated with this abnormality are rare.

Heart Rate Variability in Cirrhosis Liver.

INTRODUCTION : Hyperdynamic circulatory state is a common and long-recognized feature of patients with decompensated chronic liver disease. It is characterized by elevated cardiac rate and output and reduced peripheral vascular resistance, with pooling of blood in the splanchnic and peripheral circulation and effective central hypovolemia. The autonomic nervous system plays a central role in modulating cardiac performance and the vasomotor activity in the hyperdynamic circulatory state. The presence of an autonomic dysfunction (AD) in cirrhosis has been clearly shown through different experimental approaches, including the evaluation of the cardiovascular and sudomotor responses to physiological and pharmacological stimulation), and by showing a hyperproduction of weak adrenergic neurotransmitters. It has also been reported that the severity of AD is proportional to the severity of cirrhosis, and its presence is an indicator of poor prognosis in patients with both early and advanced liver disease. In an earlier study from our department, the presence of AD correlated with the occurrence of variceal bleed . Heart rate variability implies variations in the interval between consecutive heart beats as well as between consecutive instantaneous heart rate, ie, it describes the variations of both instantaneous heart rate and RR intervals. It is a simple test to assess the function of the autonomic nervous system and its modulation on the heart rate. Measurement of AD in chronic liver disease, using Heart rate variability (HRV), has been shown to correlate with the underlying severity of the liver disease. But, there are no studies from India, on the impact of Heart rate variability in predicting the severity, prognosis and bleed pattern in patients with cirrhosis liver. AIM OF THE STUDY : To assess Heart rate variability (HRV) as a test for Autonomic nervous system (ANS) function in patients with liver cirrhosis, comparing it with healthy controls. To correlate HRV results with the severity of the underlying liver disease To compare HRV outcome between – Bleeders and non-bleeders – Survivors and non-survivors. CONCLUSION : HRV analysis is a simple, noninvasive test to assess the cardiovascular autonomic function in patients with chronic liver disease. Patients with liver cirrhosis have significantly reduced heart rate variability (decreased parasympathetic activity) and an increased sympathetic tone in supine posture. Cirrhotics have an abnormal homeostatic response to standing with no increase in sympathetic tone in the upright posture. With worsening Child Pugh class (A vs B/C), there is an increase in autonomic dysfunction, with an increased activity of the sympathetic component. There were no significant differences in HRV parameters between bleeders versus non-bleeders and survivors versus non-survivors

Magnetic Properties of Gadolinium-Doped ZnO Films and Nanostructures

The magnetic properties of Gd-doped ZnO films and nanostructures are important to the development of next-generation spintronic devices. Here, we elucidate the significant role played by Gd-oxygen-deficiency defects in mediating/inducing ferromagnetic coupling in in situ Gd-doped ZnO thin films deposited at low oxygen pressure by pulsed laser deposition (PLD). Samples deposited at higher oxygen pressures exhibited diamagnetic responses. Vacuum annealing was used on these diamagnetic samples (grown at a relatively high oxygen pressures) to create oxygen-deficiency defects with the aim of demonstrating reproducibility of room-temperature ferromagnetism (RTFM). Samples annealed at oxygen environment exhibited superparamagnetism and blocking-temperature effects. The samples possessed secondary phases; Gd segregation led to superparamagnetism. Theoretical studies showed a shift of the 4f level of Gd to the conduction band minimum (CBM) in Gd-doped ZnO nanowires, which led to an overlap with the Fermi level, resulting in strong exchange coupling and consequently RTFM