Concurrent radiotherapy and weekly gemcitabine treatment of locally advanced squamous cell carcinoma of head and neck

Head and neck cancers are not curable yet but survival and local control has been increased due to concurrent treatment approach. Study was conducted to assess the role of concurrent Gemcitabine (2'2' Difluro Deoxycytidine) along with radiotherapy in treatment of Head and Neck cancers and to assess local control as well as disease free survival achieved due to chemoradiation. 100 patients were enrolled in this study, 50 patients received Radiotherapy (Group A- Control group) alone and 50 patients received Concurrent Chemoradiotherapy (Group B- Study group). Patients in study group received Gemcitabine 200mg/m2 on weekly basis for 5-7 cycles over 30 mins. Radiation delivered after 2 hours of IV infusion. Conventional radiotherapy was given in dose ranging from 66-70Gy in 33-37# for 6-7weeks.In this study, Grade 3 mucositis and Grade 2 pharyngeal toxicity were common i.e, 56% and 54% respectively in study group and 30% and 38% respectively in control group. Hematological toxicity i.e., Grade 1 leucopenia was seen in 28%. Even though the toxicities were high in study group compare to control group but they were tolerable and acceptable. The response was better in concurrent group than radiotherapy alone (Control group) CR 52% vs 40%, PR 34% vs 36% and SD 14% vs 24%. Concurrent use of gemcitabine and radiotherapy is a effective modality in treatment of head and neck cancers with acceptable toxicity. Improved local control shows that Gemcitabine acts as a sensitizers and has synergistic action along with radiotherapy

Multi-Communication System for Physically Disabled PeopleUsing Raspberry Pi

Today to lead our life we needed to keep running with our quick materialistic world. We express our considerations, by speaking with various individuals in various languages and in various ways Therefore there effectively. In any case, it is troublesome for physically incapacitated individuals, for example, for example, dump, hard of hearing, visually impaired and deadened to express their considerations and thoughts. Is a need to develop such a concrete solution for physically disabled people which will results as a better communication media for them. The designed system resolves the said problems. (1) Dump people can express their thoughts by pressing keyboard buttons (2) When blind/deaf person speaks, Raspberry pi based device converts it into text and displays on screen. (3) The paralyzed people by wearing flex sensor glove can express their thoughts through feasible figure movement. All these activities are possible with a unique embedded system using raspberry pi and disabled people can lead their life peacefully and independently through smooth communication of their ideas and thoughts with their family members, friends and society

VACUUM AND THERMOPLASTIC MOULD-BASED IMMOBILIZATION SYSTEMS USED IN PATIENT UNDERGOING PELVIC RADIATION THERAPY: A COMPARATIVE STUDY

Introduction: The aim of the present study was to compare two immobilization systems for comparison of setup errors in targeted radiotherapy. Methods: Retrospective analysis was done for the patients undergoing radiotherapy from May 2012 to December 2018 at our institution. Immobilization was performed on 30 patients sessions (Vacuum cushion i.e., Vac-Lok™ = 15; Thermoplastic mould i.e., Pelvicast pelvic masks = 15). A total of 763 cone-beams were analysed. The target lesion location was verified by cone-beam computed tomography (CBCT) prior to each session, with displacements assessed by CBCT simulation prior to each treatment session. Systematic setup errors, random setup errors, isocenter deviations in the Medio-lateral (ML), Supero-inferior (SI), Antero-posterior (AP), Rotation (yaw) directions of the patient position was calculated. Results: On comparing the Vac-Lok™ and Pelvicast pelvic masks group with respect to Systematic and random error in the lateral, longitudinal, vertical and YAW direction, no statistically significant difference was seen except the random error in YAW direction (P=0.037, Unpaired t-test). There was no difference observed in comparing the isocentric deviation. Conclusion: It was inferred and concluded that using a vacuum cushion for pelvic radiotherapy provides no added benefit compared to using a thermoplastic mould. Thermoplastic mould is recommended for patients receiving pelvic radiotherapy to improve overall reproducibility.Keywords: Rotational therapy; Radiotherapy; Systematic, random error; Thermoplastic mould; Vacuum cushion

Result and outcome of shorter fractionation schedule for post-operative cancer breast patients

Background:The purpose of this prospective study is to determine the effectiveness and cosmetic outcome of shorter fractionated radiotherapy in post-operative invasive breast cancer patients.Methods: Between July 2009 and June 2011, 216 post-operative cancer breast patients were treated with this regimen on cobalt60. The chest wall and supraclavicular area were treated using a tangential parallel pair, & direct supraclavicular portal with wedges as necessary, to a dose of 40 Gy / 15 fractions (study group) (133 cGy for tangential and 266 cGy for supraclavicular field each). (Control Group received 50 Gy / 25#) No additional boost was given. The median duration of follow-up surviving patients are 3 years.Results: From July 2009 to July 2011 (2 years), 216 histopathologically proven cases of Invasive ductal carcinoma of Breast were included in this study. All patients with early and locally advanced stage breast cancer were treated with hypofractionated and conventional schedule of radiotherapy. At baseline 80.19% in the study and 75.45% of patients in the control group were being rated as excellent or good. At 2 years, the percentages of patients with an excellent or good cosmetic outcome were 75.80% in the study and 73% in the control group. Grade II skin reactions were more in control (60%) as compared to study group (49%). A radiation schedule delivering 40 Gy / 15 # seems to offer control  rates of locoregional tumour relapse & late adverse effects at least as favourable as the standard schedule of 50 Gy / 25#.Conclusion:Shorter fractionation schedule is very much effective in preventing recurrent breast cancer and it provides a high level of patient satisfaction as well as reduce money and overall treatment time. Its shorter duration offers the added advantage of a more efficient use of resources and greater patient convenience.

VACUUM AND THERMOPLASTIC MOULD-BASED IMMOBILIZATION SYSTEMS USED IN PATIENT UNDERGOING PELVIC RADIATION THERAPY: A COMPARATIVE STUDY

Introduction: The aim of the present study was to compare two immobilization systems for comparison of setup errors in targeted radiotherapy. Methods: Retrospective analysis was done for the patients undergoing radiotherapy from May 2012 to December 2018 at our institution. Immobilization was performed on 30 patients sessions (Vacuum cushion i.e., Vac-Lok™ = 15; Thermoplastic mould i.e., Pelvicast pelvic masks = 15). A total of 763 cone-beams were analysed. The target lesion location was verified by cone-beam computed tomography (CBCT) prior to each session, with displacements assessed by CBCT simulation prior to each treatment session. Systematic setup errors, random setup errors, isocenter deviations in the Medio-lateral (ML), Supero-inferior (SI), Antero-posterior (AP), Rotation (yaw) directions of the patient position was calculated. Results: On comparing the Vac-Lok™ and Pelvicast pelvic masks group with respect to Systematic and random error in the lateral, longitudinal, vertical and YAW direction, no statistically significant difference was seen except the random error in YAW direction (P=0.037, Unpaired t-test). There was no difference observed in comparing the isocentric deviation. Conclusion: It was inferred and concluded that using a vacuum cushion for pelvic radiotherapy provides no added benefit compared to using a thermoplastic mould. Thermoplastic mould is recommended for patients receiving pelvic radiotherapy to improve overall reproducibility.Keywords: Rotational therapy; Radiotherapy; Systematic, random error; Thermoplastic mould; Vacuum cushion

The effect of induction chemotherapy followed by chemoradiotherapy in advanced head and neck cancer: a prospective study

Background:Objective of current study was to observe the local control, progression free survival and organ preservation for locally advanced head and neck cancer by using induction Chemotherapy followed by concurrent chemoradiotherapy.Methods:102 patients enrolled in this study with stage III-IVB of head & neck cancer. Patients were assessed and treated by faculty of the department as per NCCN guidelines. Group A patients received three courses of cisplatin (100mg/m2) and paclitaxel (175mg/m2) at every 21 days interval followed by concurrent chemoradiothearpy with cisplatin 30mg/m2 on weekly basis while group B received only concurrent chemoradiothearpy. Radiotherapy consisted of total dose up to 66-70 Gy. by conventional fractionation schedule.Results:From August 2011 to July 2013, total 102 patients have completed 14 months of follow up after completing definitive treatment group A : 48 and group B: 54 patients. Response evaluation was done after one and half months of completion of chemoradiotherapy in both arms. Complete response rate was 60.42% and 38.88 % in study and control arm respectively while partial response was 72.92% and 55.56%. Most common grade III or IV toxicity was mucositis in group A and skin reaction in control arm. At a median follow-up 13 months the median progression free survival in group A was 11.5 months and 9 months in group B.Conclusion: Response to induction chemotherapy was useful as predictive factor for ultimate outcome and progression free survival. But our study shows statistically significant improvement in complete response rate in group A as compared to group B (p<0.05). Our induction chemotherapy with two-drug regimen followed by concurrent chemoradiotherapy was well tolerated with manageable toxicity and good locoregional control.

Effect of seasonal variations and different housing systems on physiological responses and hematological parameters of buffaloes

An experiment was conducted to study the effect of 2 housing systems and seasonal variations on physiological responses and haematological parameters of buffaloes. Twelve buffaloes were selected and randomly divided into 2 equal groups. Animals of group A were housed in shade with net and animals of group B in shade without net. The experiment was conducted for 2 seasons i.e. monsoon and winter. The physiological responses were recorded weekly. Blood samples were aseptically collected fortnightly and were analyzed for hematological studies. All the parameters of physiological responses viz. respiration rate, rectal temperature, heart rate, and pulse rate were non significantly higher in group B as compared to group A in monsoon and winter seasons. Highly significant increase in mean values of Hb, TEC, TLC and PCV was observed in group A than the group B values in monsoon and winter seasons. Significantly higher values of lymphocytes and neutrophils was observed in group A during monsoon and non-significantly lower values in group B during winter season. Eosinophils and monocytes were non significantly higher in group B during monsoon and winter season as compared to group A. The temperature humidity index (THI) showed significantly lower in group A as compared to group B in both the seasons

Symportin 1 chaperones 5S RNP assembly during ribosome biogenesis by occupying an essential rRNA-binding site

During 60S biogenesis, mature 5S RNP consisting of 5S RNA, RpL5 and RpL11, assembles into a pre-60S particle, where docking relies on RpL11 interacting with helix 84 (H84) of the 25S RNA. How 5S RNP is assembled for recruitment into the pre-60S is not known. Here we report the crystal structure of a ternary symportin Syo1–RpL5-N–RpL11 complex and provide biochemical and structural insights into 5S RNP assembly. Syo1 guards the 25S RNA-binding surface on RpL11 and competes with H84 for binding. Pull-down experiments show that H84 releases RpL11 from the ternary complex, but not in the presence of 5S RNA. Crosslinking mass spectrometry visualizes structural rearrangements on incorporation of 5S RNA into the Syo1–RpL5–RpL11 complex supporting the formation of a pre-5S RNP. Our data underline the dual role of Syo1 in ribosomal protein transport and as an assembly platform for 5S RNP

A puzzle of life: crafting ribosomal subunits

The biogenesis of eukaryotic ribosomes is a complicated process during which the transcription, modification, folding, and processing of the rRNA is coupled with the ordered assembly of ∼80 ribosomal proteins (r-proteins). Ribosome synthesis is catalyzed and coordinated by more than 200 biogenesis factors as the preribosomal subunits acquire maturity on their path from the nucleolus to the cytoplasm. Several biogenesis factors also interconnect the progression of ribosome assembly with quality control of important domains, ensuring that only functional subunits engage in translation. With the recent visualization of several assembly intermediates by cryoelectron microscopy (cryo-EM), a structural view of ribosome assembly begins to emerge. In this review we integrate these first structural insights into an updated overview of the consecutive ribosome assembly steps