The impact of outpatient <i>versus</i> inpatient management on health-related quality of life outcomes for patients with malignant pleural effusion: the OPTIMUM randomised clinical trial

Background: The principal aim of malignant pleural effusion (MPE) management is to improve health-related quality of life (HRQoL) and symptoms.Methods: In this open-label randomised controlled trial, patients with symptomatic MPE were randomly assigned to either indwelling pleural catheter (IPC) insertion with the option of talc pleurodesis or chest drain and talc pleurodesis. The primary end-point was global health status, measured with the 30-item European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) at 30 days post-intervention. 142 participants were enrolled from July 2015 to December 2019.Results: Of participants randomly assigned to the IPC (n=70) and chest drain (n=72) groups, primary outcome data were available in 58 and 56 patients, respectively. Global health status improved in both groups at day 30 compared with baseline: IPC (mean difference 13.11; p=0.001) and chest drain (mean difference 10.11; p=0.001). However, there was no significant between-group difference at day 30 (mean intergroup difference in baseline-adjusted global health status 2.06, 95% CI −5.86–9.99; p=0.61), day 60 or day 90. No significant differences were identified between groups in breathlessness and chest pain scores. All chest drain arm patients were admitted (median length of stay 4 days); seven patients in the IPC arm required intervention-related hospitalisation.Conclusions: While HRQoL significantly improved in both groups, there were no differences in patient-reported global health status at 30 days. The outpatient pathway using an IPC was not superior to inpatient treatment with a chest drain

Australasian Malignant PLeural Effusion (AMPLE)-3 trial: Study protocol for a multi-centre randomised study comparing indwelling pleural catheter (±talc pleurodesis) versus video-assisted thoracoscopic surgery for management of malignant pleural effusion

Introduction: Malignant pleural effusions (MPEs) are common. MPE causes significant breathlessness and impairs quality of life. Indwelling pleural catheters (IPC) allow ambulatory drainage and reduce hospital days and re-intervention rates when compared to standard talc slurry pleurodesis. Daily drainage accelerates pleurodesis, and talc instillation via the IPC has been proven feasible and safe. Surgical pleurodesis via video-assisted thoracoscopic surgery (VATS) is considered a one-off intervention for MPE and is often recommended to patients who are fit for surgery. The AMPLE-3 trial is the first randomised trial to compare IPC (±talc pleurodesis) and VATS pleurodesis in those who are fit for surgery. Methods and analysis: A multi-centre, open-labelled randomised trial of patients with symptomatic MPE, expected survival of ≥ 6 months and good performance status randomised 1:1 to either IPC or VATS pleurodesis. Participant randomisation will be minimised for (i) cancer type (mesothelioma vs non-mesothelioma); (ii) previous pleurodesis (vs not); and (iii) trapped lung, if known (vs not). Primary outcome is the need for further ipsilateral pleural interventions over 12 months or until death, if sooner. Secondary outcomes include days in hospital, quality of life (QoL) measures, physical activity levels, safety profile, health economics, adverse events, and survival. The trial will recruit 158 participants who will be followed up for 12 months. Ethics and dissemination: Sir Charles Gairdner and Osborne Park Health Care Group (HREC) has approved the study (reference: RGS356). Results will be published in peer-reviewed journals and presented at scientific meetings. Discussion: Both IPC and VATS are commonly used procedures for MPE. The AMPLE-3 trial will provide data to help define the merits and shortcomings of these procedures and inform future clinical care algorithms. Trial registration: Australia New Zealand Clinical Trial Registry ACTRN12618001013257. Registered on 18 June 2018. Protocol version: Version 3.00/4.02.1

Traditional remedies of Kani tribes of Kottoor reserve forest, Agasthyavanam, Thiruvananthapuram, Kerala

589-594Agasthya Vanam is known for its floral diversity and is a part of Western Ghats. Kottoor Reserve forest is a rich source for medicinal plants that has long been utilized by the people, and hence this region is remarkable for rich medicinal folk knowledge. The paper provides information about 50 plant species used by Kani tribes to treat 39 ailments. In addition to the scientific names, vernacular names, family, habit, procedure for preparation of medicine, dosage and dietary control are given

HUGC - MS ANALYSIS OF LEAF AND STEM BARK OF CLEIDION NITIDUM (MUELL. – ARG.) THW. EX KURZ. (EUPHORBIACEAE)

Objective: GC-MS (Gas chromatography and mass spectroscopy) analysis of ethanol extracts of leaf and stem bark of Cleidion nitidum was carried out to detect the bioactive components. Methods:  The chemical compositions of the ethanolic extract of leaves and bark of Cleidion nitidum were investigated using Perkin – Elmer Gas Chromatography – Mass Spectra while mass spectra of the compounds found in the extract was matched with the National Institute of Standards of Technology (NIST) library.  Results:  Gas chromatography mass spectra (GC-MS) analysis revealed the presence of 16 compounds from leaves and 5 compounds from bark of the Cledion nitidum were identified. In GC-MS analysis , some of the phytocomponents screened were squalene, 3, 7, 11, 15-Tetramethyl-2, hexadecen-1-ol , Phytol and Vitamin E in leaves whereas, Thiophene-3-carbonitrite tetrahydro-4-oxo-, Dimethyl-2,6,10-dodecatrien-1-ol , D-Mannotetradecane-1,2,3,4,5-pentaol and Octanal 7-methoxy-3-7-dimethyl (5.13%) major compounds in the bark extract.  Conclusion: These results indicate the ethanol extract of leaf and stem bark of Cleidion nitidum possesses potent anti-tumor, anticancer, cancer preventive, anti-inflammatory antioxidant, antibacterial and pesticide effects so that it can be recommended as a plant of phytopharmaceutical importance.Keywords: Cleidion nitidum, GC-MS, Squalene, Phytol, vitamin-E and various application

Polycarbonate Glazing-Accelerated Wiper Testing, Surface Characterization and Comparison with On-Road Fleet Data

Exatec® PC glazing technology team, has developed advanced weathering and abrasion resistant coatings technology that can be applied to protect polycarbonate. It is of particular interest to quantify and understand the factors that determine the surface abrasion performance of coated PC in rear window and backlight applications that have a wiper system. In the present study we describe Exatec\u27s lab scale wiper testing equipment and test protocols. We also describe adaptation of optical imaging system to measure contrast and nano-profiling using nano-indenter, as post wiper surface characterization methods. These methods are more sensitive to fine scratches on glazing surface than standard haze measurement and mechanical profilometry. Three coating systems were investigated; Siloxane wetcoat (A), Siloxane wetcoat (B), and Siloxane wetcoat (B) plus plasma coat (Exatec® E900 coating). The performance comparisons were made using all these surface characterization methods. In one study, both wetcoat A and plasma coat show similar wiper abrasion performance with water only and performance is similar to glass after 500K cycle of wiper abrasion testing. Wetcoat systems alone may be enough to withstand environmental conditions where windows do not require a wiper. Exatec® plasma coatings, in another study using a slurry solution instead of water alone, shows superior performance compared to wetcoat and performance is comparable to glass. Hence the Exatec® E900 plasma coated glazing system can be a more suitable candidate for rear windows with wiper attached to it. Test results obtained with lab scale wiper tester have been correlated with on-road fleet vehicle data to help develop appropriate specifications of accelerated wiper abrasion testing for PC glazing

Effect of heat and nutritional stress on growth and testicular HSP70 expression in goats

A study was conducted to assess the combined effects of heat and nutritional stress on body weight changes and HSP70 gene expressionin Osmanabadi goats. Twenty four adult Osmanabadi bucks were divided into four groups of six animals each viz. C (control), HS (heat stress), NS (nutritional stress) and CS (combined stress). The C and HS bucks had ad libitum access to their feed while NS and CS bucks were subjected to restricted feed (30% intake of C bucks) to induce nutritional stress. The HS and CS bucks were exposed to heat stress in outside environment for six hours a day between 10:00 h to 16:00 h. Both C and HS groups showed significantly higher (P<0.01) body weight and body condition scoring as compared to NS and CS groups. The highest plasma growth hormone (P<0.01) was recorded in CS group and the lowest in all stress groups (C, HS and NS). The higher (P<0.05) expression of testicular Heat Shock Protein 70 (HSP70) mRNA was reported in HS groups. It can be concluded from this study that when nutrition is not compromised Osmanabadi goats were able to withstand heat stress without compromising production