Association between radiation dose to the pharyngeal constrictors and swallowing dysfunction and patients quality of life following radiotherapy or chemoradiotherapy for head and neck cancers

OBJECTIVE: To evaluate the correlation between the radiation dose to the pharyngeal constrictors and swallowing dysfunction using subjective and objective assessment, in patients with head and neck cancer undergoing radiation therapy alone or concurrent chemo radiation therapy. METHODS AND MATERIALS: Patients diagnosed to have head and neck cancers and planned for definitive or adjuvant radiation therapy (RT) with IMRT, with or without chemotherapy were screened and 14 patients were included in the study after meeting the inclusion and exclusion criteria. Subjective assessment to assess the Quality of Life (QoL) was done using MD Anderson Dysphagia Inventory (MDADI). Objective assessment of dysphagia was performed with Functional Endoscopic evaluation of Swallowing (FEES). Both assessments were performed before starting RT, midway during the course of treatment and at the end of treatment. The dose volume effects of the pharyngeal constrictors were correlated with FEES assessment and MDADI scores. RESULTS: Majority of the patients were male and majority had carcinoma of the buccal mucosa. No patient had complaints of dysphagia or radiological involvement of Pharyngeal constrictors before starting RT. Majority 64% (9/14) had impact on quality of life due to dysphagia at the end of RT, as assessed from MDADI score. 57% (8/14) had severe dysphagia with swallowing liquids and semisolids, as assessed by FEES. Patients with carcinoma of oropharynx, supraglottis and oral cavity received high mean doses and maximum doses to the pharyngeal constrictor muscles. Patients with severe dysphagia assessed by FEES had higher maximum doses to all the pharyngeal constrictors and higher mean dose to superior constrictor compared to those without dysphagia and this was statistically significant. High maximum and mean doses to pharyngeal constrictors were associated with poor quality of life as reflected from MDADI scores. CONCLUSION: Treatment of head and neck cancers with radiotherapy was associated with dysphagia that affects the quality of Quality of life. Severe dysphagia was common with patients who received high doses to pharyngeal constrictors, most significantly to the superior constrictor. Further studies are essential to assess severity of dysphagia in late setting

Patterns of Alcohol Consumption among Male Adults at a Slum in Kolkata, India

Globally, alcohol-abuse is a major cause of mortality and morbidity. Consumption of alcohol has increased in India in the recent decades. It is imperative to know the patterns of alcohol consumption among different types of consumers to launch a well-planned nationwide programme for the prevention and control of this devastating social pathology. This community-based, cross-sectional study was undertaken to identify the patterns of alcohol intake among different types of alcohol consumers and to assess the clinical signs of chronic harmful alcohol-use. A predesigned, pretested, semi-structured alcohol-use disorders identification test (AUDIT) questionnaire was used for interviewing males, aged >18 years, selected by random sampling from an updated household list of a randomly-selected sector of the service area of the Urban Health Centre in Chetla, Kolkata, West Bengal, India. Written informed consents were obtained from all the respondents. Relevant clinical examination for chronic harmful alcohol-use was done according to the AUDIT clinical screening procedures. The results revealed that 65.8% (150/228) were current consumers of alcohol; 14% were alcohol-dependents; 8% were hazardous or harmful consumers, and 78% were non-hazardous non-harmful consumers. The mean age of the respondents at the initiation of drinking alcohol was 20.8+5.9 years. Eighty-six percent of dependents (n=21) took both Indian-made foreign liquor and locally-made alcoholic beverages. The proportions of alcohol consumers who drank alone among alcohol-dependents, hazardous or harmful consumers, and non-hazardous non-harmful consumers were 71.4%, 50%, and 7.7% respectively, and the difference was significant (p<0.01). Forty-one percent of the consumers drank at public places and workplaces, which may be socially harmful. About 38% of the dependents purchased alcohol from unlicensed liquor shops. Only 16% expressed concerns for their drinking habit mainly to the past illness. The proportion of the concerned respondents was higher in the hazardous and harmful drinking patterns than in the non-hazardous non-harmful drinking pattern, and the difference was significant (p<0.05). About 62% of the dependents had clinical signs of chronic alcohol consumption. The presence of a considerable proportion of alcohol-dependents, the low mean age at initiation of drinking alcohol, and the habit of drinking in public places and workplaces are the main areas that need special emphasis by intervention programmes

Patterns of Alcohol Consumption among Male Adults at a Slum in Kolkata, India

Globally, alcohol-abuse is a major cause of mortality and morbidity. Consumption of alcohol has increased in India in the recent decades. It is imperative to know the patterns of alcohol consumption among different types of consumers to launch a well-planned nationwide programme for the prevention and control of this devastating social pathology. This community-based, cross-sectional study was undertaken to identify the patterns of alcohol intake among different types of alcohol consumers and to assess the clinical signs of chronic harmful alcohol-use. A predesigned, pretested, semi-structured alcohol-use disorders identification test (AUDIT) questionnaire was used for interviewing males, aged &gt;18 years, selected by random sampling from an updated household list of a randomly-selected sector of the service area of the Urban Health Centre in Chetla, Kolkata, West Bengal, India. Written informed consents were obtained from all the respondents. Relevant clinical examination for chronic harmful alcohol-use was done according to the AUDIT clinical screening procedures. The results revealed that 65.8% (150/228) were current consumers of alcohol; 14% were alcohol-dependents; 8% were hazardous or harmful consumers, and 78% were nonhazardous non-harmful consumers. The mean age of the respondents at the initiation of drinking alcohol was 20.8+5.9 years. Eighty-six percent of dependents (n=21) took both Indian-made foreign liquor and locally-made alcoholic beverages. The proportions of alcohol consumers who drank alone among alcoholdependents, hazardous or harmful consumers, and non-hazardous non-harmful consumers were 71.4%, 50%, and 7.7% respectively, and the difference was significant (p&lt;0.01). Forty-one percent of the consumers drank at public places and workplaces, which may be socially harmful. About 38% of the dependents purchased alcohol from unlicensed liquor shops. Only 16% expressed concerns for their drinking habit mainly to the past illness. The proportion of the concerned respondents was higher in the hazardous and harmful drinking patterns than in the non-hazardous non-harmful drinking pattern, and the difference was significant (p&lt;0.05). About 62% of the dependents had clinical signs of chronic alcohol consumption. The presence of a considerable proportion of alcohol-dependents, the low mean age at initiation of drinking alcohol, and the habit of drinking in public places and workplaces are the main areas that need special emphasis by intervention programmes

Quantum Transport through Organic Molecules

We explore electron transport properties for the model of benzene-1, 4-dithiolate (BDT) molecule and for some other geometric models of benzene molecule attached to two semi-infinite one-dimensional metallic electrodes using the Green's function formalism. An analytic approach, based on a simple tight-binding framework, is presented to describe electron transport through the molecular wires. Electronic transport in such molecular systems is strongly affected by the geometry of the molecules as well as their coupling to the side-attached electrodes. Conductance reveals resonant peaks associated with the molecular energy eigenstates providing several complex spectra. Current passing through the molecules shows staircase-like behavior with sharp steps in the weak molecule-to-electrode coupling limit, while it varies quite continuously with the applied bias voltage in the limit of strong molecular coupling. In the presence of transverse magnetic field, conductance exhibits oscillatory behavior with flux $\phi$, threaded by the molecular ring, showing $\phi_0$ ($=ch/e$) flux-quantum periodicity. Though, conductance changes in the presence of transverse magnetic field, but the current-voltage characteristics are not significantly affected by this field.Comment: 11 pages, 8 figure

Tuning of electron transport through a moebius strip: shot noise

We explore electron transport through a moebius strip attached to two metallic electrodes by the use of Green's function technique. A parametric approach is used based on the tight-binding model to characterize the electron transport through such a bridge system and it is observed that the transport properties are significantly affected by (a) the transverse hopping strength between the two channels and (b) the strip-to-electrode coupling strength. In this context we also describe the noise power of the current fluctuations that provides a key information about the electron correlation which is obtained by calculating the Fano factor ($F$). The knowledge of this current fluctuations gives important ideas for fabrication of efficient electronic devices.Comment: 9 pages, 8 figure

Role of the ribosome in protein folding

In all organisms, the ribosome synthesizes and folds full length polypeptide chains into active three-dimensional conformations. The nascent protein goes through two major interactions, first with the ribosome which synthesizes the polypeptide chain and holds it for a considerable length of time, and then with the chaperones. Some of the chaperones are found in solution as well as associated to the ribosome. A number of in vitro and in vivo experiments revealed that the nascent protein folds through specific interactions of some amino acids with the nucleotides in the peptidyl transferase center (PTC) in the large ribosomal subunit. The mechanism of this folding differs from self-folding. In this article, we highlight the folding of nascent proteins on the ribosome and the influence of chaperones etc. on protein folding

Barriers and Delays in Tuberculosis Diagnosis and Treatment Services: Does Gender Matter?

Background:. Tuberculosis (TB) remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation. Methods:. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences. Results:. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52%) and delays (42%), 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0%) and longer delays (presentation to diagnosis: 45% versus 0%) than men. Conclusions:. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men

Sedimentation patterns during the Precambrian : a unique record?

Although the similarities between depositional processes and products as well as the analogous controls on basin-filling and evolution appear to have enjoyed great uniformity throughout the sedimentary rock record, a noticeable distinction exists in the rates and intensities of a broad range of geological processes in the Precambrian epoch. This paper searches for distinctiveness in the Precambrian sedimentary record, both siliciclastic and carbonate, through an extensive, though not exhaustive, review of the relevant literature augmented by new observations. While differences in Precambrian deltaic, aeolian, glacial and possibly also lacustrine deposits and settings appear to have been small, their large-scale development was controlled largely by a combination of temporal and geodynamic influences, essentially of global compass. In this regard the onset of the supercontinent cycle and major perturbations in palaeo-atmospheric composition appear to have been significant. Marine environments provide a poor platform for PrecambrianePhanerozoic comparisons of sedimentation patterns, as those from the former period are preserved almost exclusively in epeiric settings, an environment essentially lacking on modern Earth. For the shallow marine carbonates, biological mediation of chemical sediment deposition changed radically from dominance by microbial biota in the Precambrian to a combination of metazons, protozoans and algae for the skeletal carbonates of the Phanerozoic. Despite it being widely recognized that Precambrian channel systems were braided in all environments (deltaic, tidal, alluvial, fluvial) as a consequence of the lack of vegetation and poor development of soils, the fluvial setting has some enigmatic aspects. Amongst these is evidence for ponding of muddy detritus in apparently sandstone bed-load dominated braided systems, with effects on local palaeoslopes which have resulted in unusual palaeohydraulic parameters for Precambrian fluvial systems. This is perhaps a field of research which holds greater promise when investigating sedimentation patterns prior to the Phanerozoic.SS acknowledges field grants from the CSIR, Government of India and the INSA-DFG for providing a fellowship to work with WA in Munich on molar tooth structure. PGE thanks both the University of Pretoria and the National Research Foundation of South Africa for funding.http://www.elsevier.com/locate/marpetgeonf201