Therapy Related Chronic Myeloid Leukemia (trCML) or non-Therapy Related Second Malignancy Chronic Myeloid Leukemia (smCML) following Diffuse Large B-Cell Lymphoma(DLBCL): A Case Report and Review of Literature

  Introduction: Second malignancy could be either previous therapy related or non-therapy related like syndromic or shared etiologic exposure. It could be either a hematological/solid malignancy following tretment for previous solid tumour or prior hematological malignanacy.Review of literature regarding secondary Chronic Myeloid Leukemia (CML) following previous active treatment for primary cancer is listed out for further understanding.Presentation of Case: We describe a 71 year old elderly male who developed Chronic Myeloid Leukemia(CML) after a period of 6 years during follow up of Stage IV Diffuse Large B-Cell Lymphoma(DLBCL) for which he received 8 cycles of R-CHOP based Chemo-immunotherapy in 2008 .Whether it is therapy related Chronic Myeloid Leukemia (trCML) following prior cytotoxic treatment or simply a non-therapy related second malignancy hronic Myeloid Leukemia(smCML) is a matter of debate.However our patient responded dramatically like denova CML to imatinib therapy.Conclusion: Therapy related CML or non therapy related second malignancy CML following DLBCL treatment is rare but responds dramatically like denova CML to imatinib therapy.     

Antiangiogenic activity of zinc and zinc-sorafenib combination using the chick chorioallantoic membrane assay: a descriptive study

Background: Zinc, a trace element, is known for downregulating several proangiogenic growth factors and cytokines. However, its antiangiogenic activity is not adequately studied. The present study was aimed to evaluate the possible antiangiogenic activity of zinc via the chick chorioallantoic membrane (CAM) assay. Also, the antiangiogenic activity of the combination therapy of zinc with various doses of sorafenib, a tyrosine kinase inhibitor, was evaluated.Methods: A pilot study was initially conducted so as to select suitable doses of zinc and sorafenib. The antiangiogenic activity after combining zinc 2.5 μg/embryo with sorafenib 1, and 2 μg/embryo was also evaluated. The antiangiogenic activity was quantified in terms of total length of blood vessels, number of junctions, number of branching points, and mean length of the blood vessels.Results: Zinc 2.5 μg/embryo showed significant (p 0.05) to that of sorafenib 2 μg/embryo.Conclusions: Zinc caused significant antiangiogenic activity in the CAM assay. The lack of addition/synergism in the zinc-sorafenib combination could have been due to the variability in the dose/ratio selection. Addition of zinc to sorafenib therapy could improve treatment tolerability, reduce cost of therapy, and reduce the emergence of drug resistance. Future mechanistic studies could identify the exact pharmacodynamics of zinc as an angiogenesis inhibitor

Predicting Breast Cancer Response to Neoadjuvant Chemotherapy Using Pretreatment Diffuse Optical Spectroscopic-Texture Analysis

Purpose: Diffuse optical spectroscopy (DOS) has been demonstrated capable of monitoring response to neoadjuvant chemotherapy (NAC) in locally advanced breast cancer (LABC) patients. In this study, we evaluate texture features of pre-treatment DOS functional maps for predicting LABC response to NAC. Methods: LABC patients (n = 37) underwent DOS-breast imaging before starting neoadjuvant chemotherapy. Breast-tissue parametric maps were constructed and texture analyses were performed based on grey level co-occurrence matrices (GLCM) for feature extraction. Ground-truth labels as responders (R) or non-responders (NR) were assigned to patients based on Miller-Payne pathological response criteria. The capability of DOS-textural features computed on volumetric tumour data before the start of treatment (i.e. “pre-treatment”) to predict patient responses to NAC was evaluated using a leave-one-out validation scheme at subject level. Data were analysed using a logistic regression, naïve Bayes, and k-nearest neighbour (k-NN) classifiers. Results: Data indicated that textural characteristics of pre-treatment DOS parametric maps can differentiate between treatment response outcomes. The HbO2-homogeneity resulted in the highest accuracy amongst univariate parameters in predicting response to chemotherapy: sensitivity (%Sn) and specificity (%Sp) were 86.5 and 89.0%, respectively and accuracy was 87.8%. The highest predictors using multivariate (binary) combination features were the Hb-Contrast + HbO2-Homogeneity which resulted in a %Sn/%Sp = 78.0/81.0% and an accuracy of 79.5%. Conclusions: This study demonstrated that pre-treatment tumour DOS-texture features can predict breast cancer response to NAC and potentially guide treatments

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Epidemiology of lung cancer and approaches for its prediction: a systematic review and analysis

Abstract Background Owing to the use of tobacco and the consumption of alcohol and adulterated food, worldwide cancer incidence is increasing at an alarming and frightening rate. Since the last decade of the twentieth century, lung cancer has been the most common cancer type. This study aimed to determine the global status of lung cancer and to evaluate the use of computational methods in the early detection of lung cancer. Methods We used lung cancer data from the United Kingdom (UK), the United States (US), India, and Egypt. For statistical analysis, we used incidence and mortality as well as survival rates to better understand the critical state of lung cancer. Results In the UK and the US, we found a significant decrease in lung cancer mortalities in the period of 1990–2014, whereas, in India and Egypt, such a decrease was not much promising. Additionally, we observed that, in the UK and the US, the survival rates of women with lung cancer were higher than those of men. We observed that the data mining and evolutionary algorithms were efficient in lung cancer detection. Conclusions Our findings provide an inclusive understanding of the incidences, mortalities, and survival rates of lung cancer in the UK, the US, India, and Egypt. The combined use of data mining and evolutionary algorithm can be efficient in lung cancer detection

Quality of Life and Self-care Activities Among Type 2 Diabetes Mellitus Patients on Insulin

Context: Self-care activities play a crucial role in the management of diabetes. It can also improve quality of life in patients. Aims: The present study was carried out to understand the QoL and self-care activities among T2DM patients on insulin and find out the association between quality of life and self-care activities. Settings and Design: This study was conducted on 105 subjects (55 females and 45 males) between the ages of 40 and 60 years with more than 1 year of T2DM attending OPD in the endocrinology department of private hospitals in North-east and East Delhi. Materials and Methods: A general questionnaire along with validated self-care (SDSCA) and quality of life (QOLID) questionnaires were used to collect data. Statistical Analysis: Data analysis was done using SPSS version 21.0. For the categorical variable, frequencies and percentages were calculated and for the continuous variables mean and standard deviations were calculated. Results: Mean age of subjects being 51.3 ± 6.2 years and 55% of them were females. It was observed that diet (P = 0.016), exercise (P = 0.001), blood sugar testing (P = 0.017), and foot care (P = 0.018) were strong predictors of self-care that were affecting the QoL. Mean scores of various domains between males and females revealed better QoL in males than females in domains of physical health (3.65 ± 0.94), physical endurance (4.11 ± 0.67), general health (3.19 ± 0.71), treatment satisfaction (3.55 ± 0.44), and overall QoL (3.50 ± 0.39). Conclusions: The present study showed that self-care activities and QoL among T2DM patients were poor. Results showed that improving nutritional status of patients can be effective on their QoL improvement

Clustered Support Vector Machine for ATM Cash Repository Prediction

Prediction of ATM cash repository in an optimal way is a crucial task. This paper deals with the application of cash prediction of NN5 time series data using support vector machines. The main objective of this paper is time series prediction of NN5 data along with and without clustering at rst stage, support vector regression (SVR) is applied on NN5 data and root mean square error is computed. Further, the same study was conducted by clustering ATMs using hierarchical clustering technique on NN5 data before applying SVR. Discrete time wrapping is used as a distance measure for clustering. Root mean square error has been calculated for such clustered group of ATMs and the average is calculated. Root Mean Square error indicates applications of clustering before applying Neural Network. It is shown to increases precision in forecasting of ATM Cash Repository