Metastatic Squamous Cell Carcinoma of the Anus: Time for a Shift in the Treatment Paradigm?

Anal cancers are rare tumours; however, the incidence is increasing in both men and women. Changing trends in sexual behaviour, smoking, and infection with the human papillomavirus are thought to be responsible for the increase. Patients with metastatic disease have a poor prognosis, with 5-year median overall survival rates of 10% in men and 20% in women. The standard systemic treatment of metastatic disease remains cisplatin and 5-fluorouracil, and aside from several non-randomised small phase II trials there has been no real progress over the past two decades. Based on the efficacy of cetuximab in squamous cell carcinomas from other primary sites, there appears to be clinical rationale for evaluation of anti-epidermal growth factor inhibitors in anal squamous cell carcinoma. In order to facilitate research and implement more effective treatment strategies international collaboration in clinical trials incorporating tissue collection for biomarkers is essential

Social Status of Hook and Line Fishermen in Visakhapatnam

This study aims to document the socio economic profile of the fisherfolk involved in hook and line fishing. The study was conducted among a sample of 100 fishermen involved in hook and line fishing in Pedajalaripeta village in Visakhapatnam district of Andhra Pradesh. Field survey method was adopted for data collection. Forty three percent of the fishermen were between the age group of 36- 45 years, and all of them belonged to Hindu religion and Jalari caste. Nearly 72% of the male population above the age of fifteen was also involved in hook and line fishing. The daily income of the fisherfolk was dependent on fish catch and it varied from Rs.150 to Rs.1000. Regarding the ownership pattern, 32% owned fibre catamaran and 9% owned wooden catamaran. The important types of hook and line operated in the area were long line and hand line. Only single day fishing trips were operated in the study area. In 28% of the families, the fisherwomen were involved in fish marketing and their monthly income ranged from Rs. 3 000 to Rs. 7 500. Poor implementation of regulations and excess fishing capacity were reported as major constraints. The study also suggests ways to improve the socio economic status of hook and line fishermen

मात्स्यिकी के क्षेत्रों में महिलाओं केलिए उपलब्ध रोज़ग़ार साध्यताएं

मात्स्यिकी के क्षेत्रों में महिलाओं केलिए उपलब्ध रोज़ग़ार साध्यताए

मात्स्यिकी प्रबंधन में महिलाओं की भूमिका

कृपया पूरा लेखा पढ

Twin pregnancy with a complete hydatidiform mole and coexisting foetus

Coexistence of a viable foetus with a complete hydatidiform mole is a rare entity. Traditionally, termination of pregnancy was recommended because of severe maternal and foetal complications. Here we report a case of a 30 year old G2A1 at 27 weeks with a twin pregnancy with a complete hydatidiform mole and coexisting normal foetus who took home a healthy baby without any persistent trophoblastic disease. This case is presented for the rarity of occurrence and good outcome

A successful obstetric outcome in pregnancy complicated with cor pulmonale, pulmonary hypertension secondary to pulmonary tuberculosis: a case report

Pregnancy in patients with pulmonary hypertension and cor pulmonale is associated with high morbidity and mortality. The timing of termination of pregnancy, mode of delivery, labour analgesia and anaesthesia and management during puerperium are challenging issues which need to be resolved. Authors report a case of a 30-year-old primigravida with cor pulmonale and severe pulmonary artery hypertension secondary to past pulmonary tuberculosis, who delivered a healthy baby vaginally, due to its rarity and good outcome. Early diagnosis, effective management of aggravating factors like anaemia and hypertension, informed choice by the couple regarding route of delivery and multidisciplinary approach are the keys to successful outcomes in patients with cor pulmonale

Unusual Occurrence of Peripheral Ossifying Fibroma in an Elderly Male

The present case is a scenario of occurrence of relatively common peripheral ossifying fibroma in an uncommon site of occurrence. It was noted in the maxillary posterior region incontrast to its usual occurrence in anterior maxillary region. The lesion was observed in elderly male subject aged 64 years, contradictory to its usual predilection for young females in thesecond or third decade of life. As this case contradicts the common norms of predilection of the lesion with regard to age, gender and site, it emphasizes the need for looking beyond theconventional norms for proper diagnosis and prompt treatment.&nbsp

Toward a New Approach to Evaluating Significance in Recent-Past Preservation Planning with a Case Study of 1960s Properties in Philadelphia County

In evaluating a stock of recent-past buildings, it is important to stay alert to the ways in which recent-past heritage is more difficult to assess, and what we might be prone to do to make it easier to assess. It is not enough to involve numerous people in the process and to articulate our method of analysis. We as preservation professionals must also consciously strive to avoid cognitive shortcuts. We must set evaluative standards and choose priorities, without simply dismissing a great portion of the built environment as “crap” or accepting self-evidence as a measure of significance. Complexity should not be a cause for despair. We must lead the public in a more self-reflexive view of built heritage, without getting stuck in never-ending philosophizing and debating. The field would benefit from a more systematic, methodical approach to championing pluralism in heritage and recognizing the polysemy in cultural objects, which nonetheless helps to uncover priorities of highest significance. In sum, prior to, and in addition to, preservation advocacy efforts to publicize and popularize buildings of the recent-past, preservation planning efforts must establish better methods for identifying resources and assessing their significance. In light of the issues and caveats just introduced, this study asks: what is an optimal inventory method for a municipal/county-level commission or nonprofit organization to identify priorities for preservation planning for the recent-past

Community Engagement, Co-Production or Citizen Action? Lessons from COVID-19 Responses in India and Bangladesh’s Informal Urban Settlements

Government COVID-19 disease control efforts in many contexts have been critiqued as simultaneously inadequate and authoritarian, causing widespread suffering. “Top-down,” bio-security focused approaches aimed at achieving behavioral change through information dissemination and legal measures have often been ineffective in informal urban settlements, for a range of reasons related to the nature of citizen-state relationships. Community engagement, participation, “co-production,” and citizen- and civil-society-led efforts have variously been identified as important to pandemic responses. However, to date, there have been few examinations of the ways in which social, political, and economic environments shape community actions during the COVID-19 pandemic, and the extent to which these have reached the most marginalized. Drawing on data and experiences of collaborative research and action from four cities in Bangladesh and India, we argue that citizen and community responses in informal settlements have often emerged from the necessity to survive in the absence of effective state interventions and support to guarantee the basic rights of citizens. They therefore represent neither engagement of the state with citizens nor genuine “co-production.” Community action emerging from inadequacies in state responses merely pushes the responsibilities of the state to poor and marginalized communities, many of which are fractured by axes of disadvantage such as length of residence, class, caste, religion, and gender. Effective community engagement or co-production requires the willingness of the state to recognize the rights of informal urban residents as urban citizens, trusting relationships within systems and structures built over time prior to a crisis, and the willingness of the state to share resources and cede power over decision making. Multi-sectoral, multi-scalar and multi-stakeholder collaborations that balance “top-down” public health policy implementation with community organization, through communication and accountability channels that privilege the perspectives of the marginalized, are required. Community engagement and co-production cannot be a standardized intervention but require ongoing processes of political, social, economic, and cultural negotiation and will play out in varied ways across different contexts

Functional imaging and circulating biomarkers of response to regorafenib in treatment-refractory metastatic colorectal cancer patients in a prospective phase II study

Objective: Regorafenib demonstrated efficacy in patients with metastatic colorectal cancer (mCRC). Lack of predictive biomarkers, potential toxicities and cost-effectiveness concerns highlight the unmet need for better patient selection. Design: Patients with RAS mutant mCRC with biopsiable metastases were enrolled in this phase II trial. Dynamic contrast-enhanced (DCE) MRI was acquired pretreatment and at day 15 post-treatment. Median values of volume transfer constant (Ktrans), enhancing fraction (EF) and their product KEF (summarised median values of Ktrans× EF) were generated. Circulating tumour (ct) DNA was collected monthly until progressive disease and tested for clonal RAS mutations by digital-droplet PCR. Tumour vasculature (CD-31) was scored by immunohistochemistry on 70 sequential tissue biopsies. Results: Twenty-seven patients with paired DCE-MRI scans were analysed. Median KEF decrease was 58.2%. Of the 23 patients with outcome data, >70% drop in KEF (6/23) was associated with higher disease control rate (p=0.048) measured by RECIST V. 1.1 at 2 months, improved progression-free survival (PFS) (HR 0.16 (95% CI 0.04 to 0.72), p=0.02), 4-month PFS (66.7% vs 23.5%) and overall survival (OS) (HR 0.08 (95% CI 0.01 to 0.63), p=0.02). KEF drop correlated with CD-31 reduction in sequential tissue biopsies (p=0.04). RAS mutant clones decay in ctDNA after 8 weeks of treatment was associated with better PFS (HR 0.21 (95% CI 0.06 to 0.71), p=0.01) and OS (HR 0.28 (95% CI 0.07–1.04), p=0.06). Conclusions: Combining DCE-MRI and ctDNA predicts duration of anti-angiogenic response to regorafenib and may improve patient management with potential health/economic implications