Response and Survival Estimates of Patients With Plasma Cell Myeloma in a Resource-Constrained Setting Using Protocols From High-Income Countries:A Single-Center Experience From Sri Lanka

There is a significant disparity in global cancer care and outcome between countries. Progress in the treatment of symptomatic plasma cell myeloma (PCM) in high-income countries is not seen in low- and middle-income countries. MATERIALS AND METHODS: This is was a retrospective cohort study of all patients diagnosed with PCM between May 1, 2013, and September 30, 2021, at the first hemato-oncology center in Sri Lanka. We aimed to provide data on clinicopathologic characteristics, response, and survival estimates. RESULTS: A total of 79 patients with PCM received first-line therapy during the study period. The median age was 64 years, and approximately one third (33%) of patients were older than 70 years. There were 42 (53%) males and 37 females. Hypercalcemia, renal impairment, anemia, and bone disease were detected in 36.7%, 38%, 72.1%, and 81%, respectively. Thirty-nine, 34, and six patients received a combination of cyclophosphamide, thalidomide, and dexamethasone; bortezomib, thalidomide, and dexamethasone; and other treatments, respectively. The overall response rate (≥ partial response) was approximately 97% for both cyclophosphamide, thalidomide, and dexamethasone and bortezomib, thalidomide, and dexamethasone. Twenty-three (29%) of these patients died during the study period, but only 14 (18%) died due to PCM or associated sepsis. After a median follow-up of 40.6 months (range, 35.2-59.07 months), the median overall survival was 84.2 months (95% CI, 60.87 to not available). The 5-year estimated overall survival was 65%. CONCLUSION: To our knowledge, this is the only well-characterized study on long-term survival of patients with PCM in Sri Lanka. We have shown that it is possible to successfully apply Western treatment and supportive care protocols to the local population. These published data will help to benchmark and improve the treatment and develop blood cancer care in the local setting

A Range-Based Algorithm for Autonomous Navigation of an Aerial Drone to Approach and Follow a Herd of Cattle

This paper proposes an algorithm that will allow an autonomous aerial drone to approach and follow a steady or moving herd of cattle using only range measurements. The algorithm is also insensitive to the complexity of the herd’s movement and the measurement noise. Once arrived at the herd of cattle, the aerial drone can follow it to a desired destination. The primary motivation for the development of this algorithm is to use simple, inexpensive and robust sensing hence range sensors. The algorithm does not depend on the accuracy of the range measurements, rather the rate of change of range measurements. The proposed method is based on sliding mode control which provides robustness. A mathematical analysis, simulations and experimental results with a real aerial drone are presented to demonstrate the effectiveness of the proposed method

Development of a Conductive Polymer Based Novel 1-DOF Tactile Sensor with Cylindrical Arch Spring Structure Using 3D Printing Technology

Under this research, a novel tactile sensor has been developed using a conductive polymer-based sensing element. The incorporated sensing element is manufactured by polymer press moulding, where the compound is based on silicone rubber and has enhancements by silica and carbon black, with Silane-69 as the coupling agent. Characteristics of the sensing element have been observed using its sensitivity and range, where its results pose an inherent nonlinearity of conductive polymers. For the force scaling purpose, a novel 3D printed cylindrical arch spring structure was developed for this highly customizable tactile sensor by adopting commonly available ABSplus material in 3D printing technology. By considering critical dimensions of the structure, finite element analysis was carried out to achieve nearly optimized results. A special electrical routing arrangement was also designed to reduce the routing complexities. The optimized structure was fabricated using the 3D printing technology. A microcontroller-based signal conditioning circuit was introduced to the system for the purpose of acquiring data. The sensor has been tested up to the maximum load condition using a force indenter. This sensor has a maximum applicable range of 90 N with a maximum structural deflection of 4 mm. The sensor assembly weighs 155 g and the outer dimensions are 85 mm in diameter and 83 mm in height

Star fruit nephrotoxicity: a case series and literature review

Abstract Background Star fruit is a popular medicinal fruit in the tropics. Its hypoglycaemic properties are considered useful in achieving glycaemic control in diabetes. Star fruit induced nephrotoxicity is a rare cause of acute kidney injury in individuals with both normal and reduced baseline renal function. We present three cases of acute kidney injury due to star fruit nephrotoxicity from Sri Lanka, and discuss the published literature on this topic. Case presentation Three Sri Lankan patients, all with a background of diabetes, presented to us with acute nausea and anorexia following recent consumption of star fruit. Two patients complained of diarrhoea and one patient complained of intractable hiccoughs. They all had elevated serum creatinine on admission. Two were known to have normal baseline serum creatinine levels. On renal biopsy two had evidence of oxalate crystal deposition. One did not show crystal deposition but had acute interstitial nephritis for which no alternate cause could be identified. Two were treated with short courses of prednisolone and two required acute haemodialysis. All recovered renal function, with both patients with known baselines approaching their premorbid serum creatinine levels. Conclusion Consumption of star fruit, especially on an empty stomach or in a state of dehydration may precipitate acute kidney injury. A history of star fruit ingestion must be actively looked for in patients presenting with unexplained acute kidney injury. The use of star fruit as a therapy for diabetes should be discouraged

Honey Mediated Green Synthesis of Nanoparticles: New Era of Safe Nanotechnology

With the advent of nanotechnology, many related industries rapidly developed over the recent past. Generally, top-down and bottom-up approaches are the two major processes used to synthesize nanoparticles; most of these require high temperatures, vacuum conditions, and harsh/toxic chemicals. As a consequence, adverse effects impacted organisms including humans. Some synthesis methods are expensive and time-consuming. As a corollary, the concept of “green nanotechnology” emerged with the green synthesis of nanoparticles commencing a new epoch in nanotechnology. This involves the synthesis of nanomaterial from microorganisms, macroorganisms, and other biological materials. Honey is documented as the world’s oldest food source with exceptional medical, chemical, physical, and pharmaceutical values. Honey mediated green synthesis is a relatively novel concept used during the past few years to synthesize gold, silver, carbon, platinum, and palladium nanoparticles. Honey acts as both a stabilizing and a reducing agent and importantly functions as a precursor in nanoparticle synthesis. This method usually requires room temperature and does not produce toxic byproducts. In conclusion, honey mediated green synthesis of nanoparticles provides a simple, cost effective, biocompatible, reproducible, rapid, and safe method. The special activity of honey functionalized nanoparticles may provide valuable end products with numerous applications in diverse fields

Applicability of Western protocols in resource‐limited setting: Real‐world data of long‐term outcome of intensive treatment of adult acute myeloid leukaemia in Sri Lanka

Abstract There are no published data on long‐term survival and applicability of treatment protocols from developed countries in acute myeloid leukaemia (AML) in Sri Lanka. Eighty‐seven AML patients were reviewed; there were 56 newly diagnosed patients between 18 and 65 years. Thirty‐one out of 33 who started treatment achieved complete remission after first cycle of treatment. The induction mortality was one of 33. Twelve out of 20 patients who completed treatment are alive at the time of analysis. The estimated 5‐year overall survival rate is 0.629. Strict infection control and treatment and superior clinical experience may have contributed towards better outcome