CLINICAL INSIGHT ON PATTERNS OF CARE AND PROGNOSTIC FACTORS IN ADULT HIGH GRADE GLIOMA: EXPERIENCE FROM A TERTIARY CANCER HOSPITAL FROM EASTERN INDIA

Objective: The Central Nervous System Tumors account for 2.4% of all malignancies in India, but are associated with high mortality in high-grade tumors which result in poor death-adjusted life years. This study focuses on patterns of care and prognostic factors of adult high-grade glioma to explore the unaddressed nuances in treating such patients. Methods: It was a retrospective single institutional study from June 2018 to July 2021 with an age group between 16 to 70 years. All histopathologically or clinicoradiologically proven cases of high-grade (World Health Organization Grades III and IV) gliomas were assessed. Defaulters and recurrent glioma at presentation were excluded from the analysis. Baseline characteristics were analyzed by Chi-square and unpaired t-test, and the Kaplan– Meir test was used for survival analysis. p<0.05 was considered significant. Results: 41 patients were accrued for final analysis with a median follow-up period of 18 months. The most common histology was Astrocytoma, followed by Glioblastoma with a female preponderance. The Frontal and Temporal lobe was the predominant site in the study population. A majority (82%) of the patients underwent maximal safe resection followed by chemoradiation therapy (63.4%). Median progression free survival was 24 months and 8 months for Grades III and IV gliomas, respectively. The median overall survival for Grade IV gliomas was 7 months. Conclusion: Resection status, Grade IV, IDH and 1p19q codeletion status were significant prognostic factors, while intensity modulated radiotherapy showed better dosimetry. More prospective randomized studies with larger sample sizes and longer follow-ups are required for validation and drafting an outcome nomogram

Neo-adjuvant chemotherapy and the recurrence of breast cancer in a tertiary care rural hospital of West Bengal, India

Background: Prior studies have shown long-term outcome of Neo-Adjuvant Chemotherapy (NACT) for locally advanced breast carcinoma. The purpose of the current study was to analyse the number and pattern of breast cancer recurrence at a rural hospital of West Bengal, India. The study also tried to evaluate the type of therapy received by the recurrent patients during their primary presentation and compare the disease free survival rate of the patients receiving NACT and Adjuvant Chemotherapy (ACT).Methods: A single institution (B.S. Medical College, Bankura) retrospective chart review in the year of 2011-2014 was performed. The Kaplan-Meier methods were used to calculate disease-free survival (DFS) from the date of initiation of NACT to the date of recurrence.Results: Of 776 patients in four years (2011-2014) total numbers of breast cancer recurrent patients were 30. The Kaplan Meier survival analysis showed disease free survival of 5 years (95% confidence interval) in case of early stage breast cancer (EBC) and 2.5 years (95% CI) in locally advanced breast CA (LABC). It was 29 months (95% confidence interval [CI] 26.74-33.253) for recurrence free survival in case of patients treated with NACT and 60 months (95% confidence interval [CI] 58.13-61.86) for recurrence free survival in case of patients not treated by NACT i.e. ACT cases.Conclusions: This study indicates multimodality Neo-Adjuvant chemotherapy helps to achieve complete pathological response in locally advance breast cancer. Despite the recurrence free survival in NACT patients is significantly low than the patients who received adjuvant chemothepapy

Respondent or non-respondent comparison post cardiac resynchronisation therapy implantation in patients with dilated cardiomyopathy

Background: Dilated cardiomyopathy can be treated using cardiac resynchronisation therapy (CRT) effectively. In our study, we compared the clinical and biochemical profile of responders and non-responders to CRT device (CRTD) implantation suffering from DCM. Methods: A cross-sectional observational study was performed in 47 patients with dilated cardiomyopathy for CRTD implantation for a period of 18 months. The tools used for the study include electrocardiography 12 lead, echocardiography: 2D, M mode, Doppler, strain echo, Holter monitoring, coronary angiography and CRTD implantation. Statistical analysis was performed using Epi Info (TM) 7.2.2.2. Results: The proportion of responders (68.1%) was significantly higher than non-responder (31.9%). Almost 60% of patients in non-responder group had smoking as a risk factor. Around 60% were suffering from hypertension and 33% from T2DM in non-respondent group. Parameters of dyssynchrony has significantly improved in responder group than in non-responder group. LVEDV, LVESV has shown an increase and EF has decreased considerably in DCM patients. Many patients in non-responder category have shown mitral and tricuspid regurgitation. Strain echocardiography parameters-GLS, GRS and GCS were significantly decreased. Post CRTD echocardiographic parameter has improved considerably and LVESV was reduced in more than 15% of responders. Conclusions: The CRTD implantation improves patients’ clinical and Echocardiographic data which can help in better patient management, improving quality of life and decreased healthcare cost. By this study we can improve patients’ selection and predict accordingly for CRT responders and non-responders and can take necessary measures for better patient’s management

The architectural network for protein secondary structure prediction

Over the past 25 years, the accuracy of proteins secondary structure prediction has improved substantially. Recently evolutionary information taken from the deviation of proteins in some structural family have again enhance prediction accuracy for all these residues predicted correctly is in one of the three sates helix, strands and others . The new methods developed over the past few years may be interesting in context of improvements which is achieved through combination of the existing methods. Evolutionary divergences profile posses’ adequate information to improve protein secondary structure prediction accuracy. These profiles can also able to correctly predict long stretches of identical residues in other secondary structure. This sequence structure relationship may help to help to developed tool which can efficiently predict the protein secondary structure from its amino acid sequence

Size class homogeneity of repeat lengths and evolutionary divergence of ribosomal RNA genes in fishes as studied by restriction fragment length analysis

Fish ribosomal RNA genes (rDNA) have been compared by restriction endonuclease digestion followed by Southern hybridization using rRNA or cloned rRNA genes as labelled probes. In several species belonging to the orders Cypriniformes and Perciformes, the simple restriction patterns revealed a high degree of size class homogeneity among the rDNA repeats and similar restriction map within a species. Different species have different restriction patterns and fragment lengths arising mostly out of different length of the nontranscribed spacer. Polymorphic restriction sites are present in some species. The species-specific differences in fragment lengths produced in rDNA by some restriction enzymes can thus be used to study interspecific fish hybrids

Dosimetric feasibility and clinical outcome of image guided interstitial brachytherapy using two different fractionation schedule in carcinoma cervix

Background: In advanced cervical cancer, external beam radiotherapy along with concurrent chemotherapy followed by brachytherapy is the treatment of choice. There are various dose fractionation regimes for template-based high dose rate (HDR) interstitial brachytherapy (ISBT) following external beam radiotherapy (EBRT) for cancer cervix with consideration of the normal-tissue EQD23Gy dose limits and recommended D90 goal between 85 and 95 Gy EQD210Gy for the high risk clinical target volume (HR-CTV). Materials and methods: 60 patients were accrued between 2014–2017 and treated with ISBT using Syed–Neblett Template by iridium 192 with Gamma Med plus HDR after loader unit. They were allotted in 2 arms (n = 30) and received 9 Gy ×2# and 7 Gy ×3 #, respectively. All patients received 50 Gy/25# whole pelvis EBRT by Theratron 780C. Coverage index (CI), dose homogeneity index (DHI), overdose index (OI), dose non-uniformity ratio (DNR), D90 Target and 2 cc EQD2 of OARs were calculated and correlated with toxicity, locoregional control and survival. Unpaired t-test and χ2 test were used. Progression-free survival (PFS) and overall survival (OS) were calculated and a log-rank test was used for comparison. Results: Mean equivalent dose in 2 Gy fractions (EQD2) for the bladder (77.33 vs. 80.24 Gy) and rectum (69.12 vs. 69.87) along with D90 (9.12 Gy vs. 7.20 Gy) were comparable. With a median follow up period of 38 months, 3-year local control rate was 56.6% vs. 46.60% (p = 0.72) and 3-year OS was also similar: 83% vs. 80% (p = 0.8). Conclusions: In a developing country like India, 9 Gy ×2 # is a reasonably good alternative for treating locally advanced carcinoma cervix, keeping the patient compliance and convenience in mind

Spectrum of vaginal foreign body in children: A report of two cases

An extraordinary type of foreign body (FB) may be found in the female external genitalia, especially in children. Intravaginal FB, retained for long duration, can produce diagnostic dilemma. Vaginal bleeding as the result of a leech bite is extremely rare although reported. We report two cases of vaginal FB (intravaginal Scotch-Brite in a 5-year-old girl and leech in the vagina in a 7-year-old girl)