Drug-Eluting Bead, Irinotecan (DEBIRI) Therapy for Refractory Colorectal Liver Metastasis:A Systematic Review

Colorectal cancer and related mortality present a profound challenge in its management, even in this modern age. Even today, colorectal cancer-related deaths rank third in the world. Despite having multiple lines of chemotherapy, combined with radiotherapy and chemoembolization techniques, after or before surgical resection, the five-year survival rate is approximately 20%. Drug-eluting bead, irinotecan (DEBIRI) is a new technique that involves embolization of the feeding vessels to the tumour and delivering irinotecan for its chemotherapeutic effects. A significant amount of literature compares DEBIRI as an adjunct to various lines of chemotherapy. However, so far, not much data are available on DEBIRI as a singular treatment for those patients who have had multiple chemotherapies and still progressing and are not fit for liver resection. In this systematic review, we aim to highlight and bring together the results of those studies that focused on this specific patient group. A systematic search of the literature involving three large databases (published between January 2017 and July 2022), excluding languages other than English, was conducted to identify articles documenting patients who had disease progression despite chemotherapy and were not fit for surgical resection. The level of evidence and the quality check were assessed by two independent reviewers, and consensus with the senior author resolved disagreements. Out of seven studies that met the final criteria, we found a pooled cohort of 302 patients. The mean age of the patients was 61.2 years, ranging from 40.7 to 84 years. The most commonly used DEBIRI beads were M1 (70-150 um) and M2 (100-300 um), but two studies reported the use of 40 um as well. The total number of DEBIRI treatments performed in our pooled cohort was 904. The majority of the studies reported only G1/G2 toxicities among the patients, with maximal toxicity of G4 in a few selected patients. The median overall survival in our pooled cohort was 19.52 months. The median progression-free survival in our data was 5.76 months. Our systematic review concludes that DEBIRI is undoubtedly a useful treatment modality with an acceptable toxicity profile. This treatment offers a good overall survival benefit for refractory colorectal liver metastasis.</p

Secure Authentication and Key Management Protocol in Cloud Computing

Cloud computing has brought revolution in IT (Information Technology) sector. It has transform the way organizations and individuals  process, store and access applications and data ,  by offering scalable and on-demand access to computing resources including networks, servers, storage  and applications.  It is a flexible service that  allows users to dynamically scale up and down  their resources based on demand which enhances  efficiency and optimizes resource utilization .Cloud computing offers number of benefits and saves cost. It  eliminates the need for investing  in hardware and software. Cloud computing allows users to work from anywhere over internet connection which enhances productivity .However, cloud computing has some challenges such as Security concerns that include unauthorized access and data breach. To provide security in cloud computing environment various authentication and authorization protocols exist but they also suffers from various security attacks. Nowadays three factor MAKA (Mutual Authentication and Key Management) protocol  has gained popularity but they also lacked as they don’t have dynamic revocation mechanism .To address these issues we have proposed a system  based on id , password and biometric based authentication that has  dynamic revocation mechanism and can resist various known attacks

A Review Article on Authentication Protocols in Cloud Computing

Cloud computing  technology   provides on demand computing resources like software, hardware and storage in pay-per-use model. Cloud computing is very beneficial for today’s organizations, as there is no need to maintain physical infrastructure. These services and resources can be accessed from anywhere anytime over the internet. It is cost effective as users only need to pay for resources they use. Many individuals and organizations have shifted themselves over cloud environment as it is cheaper and convenient. As huge amount of sensitive data is being stored and processing in cloud computing environment so there is major concern of security. Lack of security may cause several issues. It may result in loss of organisation’s data and may even leak confidential data of user and organisation to unwanted access. To implement security in cloud computing various authentication and encryption protocol exists. This aim of this paper is to review various authentication protocols given by various researchers all over the world

Correlation between glycosylated haemoglobin and serum lipid profile in patients with type 2 diabetes mellitus in a Tertiary Care Hospital

Type 2 diabetes mellitus (T2DM) is a chronic disease that develops due to defective insulin secretion and is frequently associated with insulin resistance. T2DM patients are prone to diabetic dyslipidemia, which puts them at risk of developing macrovascular (stroke, peripheral vascular disease and coronary artery disease) and microvascular (nephropathy, neuropathy and retinopathy) diseases. This is a cross sectional study conducted at Tertiary care Teaching Hospital over a period of 1 year. Total 70 patients of Type 2 diabetes mellitus were taken for the study after applying inclusion and exclusion criteria, and after obtaining written and informed consent from them. HbA1c and Fasting Lipid profile: Total cholesterol, Triglycerides, HDL and VLDL cholesterol were measured. In our study, among 70 Type 2 diabetic individuals included in this study, 41 were male and 29 were female. Distribution of Glucose Triad results of FBS, PPBS and HbA1c levels of patients presented as Mean±SD, mean FBS was 173.59±39.64, mean PPBS was 234.59±94.59 and mean HbA1c was 7.78±0.83. Our study accomplished that HbA1c has a direct, significant correlation with total cholesterol, triglyceride, VLDL, and LDL among the lipid profile