Translation of Goswami Harirai's Jarasandhavadha Mahakavyam from Sanskrit to English with a Critical Introduction

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Anticancer Drugs Induced Chromosomal Rearrangements in Lymphocytes of Breast Cancer Patients

 Breast cancer is one of the most commonly diagnosed malignancies in women around the world. Chromosomal rearrangements are known to play important role in the pathogenesis of many diseases including cancer. In case of breast cancer, chromosomal changes are detectable at all stages of tumour development providing excellent opportunity for prognosis and therapy. Present work aimed to study the frequency of chromosomal aberrations and satellite associations in human peripheral blood lymphocyte culture of freshly diagnosed breast cancer patients after in vitro exposure to combination of anticancer drug treatment. The present study reveals that, combination of anticancer drugs significantly increases chromosomal aberrations without altering the frequency of satellite associations

Cutaneous manifestations of anti retroviral therapy used for post-exposure prophylaxis

Health care workers are at increased risk of needle stick injuries. Blood borne diseases that could be transmitted by such an injury include HIV, Hepatitis B, HCV and many others. Post exposure prophylaxis should be immediately started within 72 hours and should be continued for 28 days. Currently two Nucleoside Reverse Transcriptase Inhibitors (NRTIs) are given along with one NNRTI (Non- Nucleoside reverse Transcriptase Inhibitor) including Efavirenz or Nevirapine. Multiple adverse effects have been reported with all the Anti- Retroviral Therapies including various cutaneous manifestations. A 22-year-old intern doctor studying in tertiary hospital of Ahmedabad had a needle stick injury with a needle contaminated with blood of HIV positive patient. Post Exposure prophylaxis was started within 72 hours consisting of fixed dose regimen of Tenofovir disprodoxil sulphate, Efavirenz and lamivudine. He was started with the drug within 2 hours and was prescribed one drug per day for next 27 days. On 22nd day he started having rash on his body which started on palms and soles. On 23rd day he saw severe facial edema along with edema on lips and rash spreading to other parts of the body. He was diagnosed with Hypersensitivity reaction and angioedema due to ART drug therapy. He was instructed to stop ART medications and was given antihistaminic for the symptoms. Patient's angioedema was relieved in 2-3 days and rash disappeared after 4-5 days. As he had already finished 23 days of therapy he was instructed to discontinue the drugs. No recurrence of rash or angioedema was noted. This case points out the severity of side effects in the normal healthy people taking ART as Post Exposure Prophylaxis. Apart from cutaneous manifestations, angioedema is a very grievous condition which doctors should always have lower threshold for diagnosis. Early diagnosis can prevent further complications. ART drugs have many complications and these patients should have intensive regular monitoring while on treatment. Also, proper education is required for needle cut injuries in health care workers

The Practice of Interventional Gastrointestinal Endoscopy at a Tertiary Referral Hospital

Background: Interventional endoscopy enables one time diagnosis and treatment of gastrointestinal diseases with minimally invasive therapy and improved disease outcome. Local use has remained low with minimal reporting. Knowledge of current practice at a tertiary level may promote utilization of interventional gastrointestinal endoscopy. Objective: To describe the practice of interventional gastro intestinal endoscopy at Kenyatta National Hospital. Methods: In a prospective descriptive study consecutive sampling was used. Main variables were interventional procedure offered, sedation mode and immediate outcome of the procedure. Results: There were 211 cases and interventional endoscopy accounted for 21.7% of these.The male: female ratio was 1:0.9. The median age group was 41-50 years. Variceal band ligation, ERCP and esophageal stenting were the three most common procedures. No mortalities were recorded during the period of study. Conclusion: Our report describes application of interventional endoscopy in a variety of gastrointestinal diseases with acceptable immediate outcome.Key words: Interventional, Endoscopy, Varices, Bandin

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Multi-Sensor Based State Prediction for Personal Mobility Vehicles.

This paper presents a study on multi-modal human emotional state detection while riding a powered wheelchair (PMV; Personal Mobility Vehicle) in an indoor labyrinth-like environment. The study reports findings on the habituation of human stress response during self-driving. In addition, the effects of "loss of controllability", change in the role of the driver to a passenger, are investigated via an autonomous driving modality. The multi-modal emotional state detector sensing framework consists of four sensing devices: electroencephalograph (EEG), heart inter-beat interval (IBI), galvanic skin response (GSR) and stressor level lever (in the case of autonomous riding). Physiological emotional state measurement characteristics are organized by time-scale, in terms of capturing slower changes (long-term) and quicker changes from moment-to-moment. Experimental results with fifteen participants regarding subjective emotional state reports and commercial software measurements validated the proposed emotional state detector. Short-term GSR and heart signal characterizations captured moment-to-moment emotional state during autonomous riding (Spearman correlation; ρ = 0.6, p < 0.001). Short-term GSR and EEG characterizations reliably captured moment-to-moment emotional state during self-driving (Classification accuracy; 69.7). Finally, long-term GSR and heart characterizations were confirmed to reliably capture slow changes during autonomous riding and also of emotional state during participant resting state. The purpose of this study and the exploration of various algorithms and sensors in a structured framework is to provide a comprehensive background for multi-modal emotional state prediction experiments and/or applications. Additional discussion regarding the feasibility and utility of the possibilities of these concepts are given