Study of 2D ion chamber array for angular response and QA of dynamic MLC and pretreatment IMRT plans

AbstractAimTo study of 2 Dimensional ion chamber array for angular response and its utility for quality assurance of dynamic multileaf collimator and pretreatment intensity modulated radiotherapy plans.Materials and MethodsThe MLC QA test patterns and IMRT plans were executed on 2D ion chamber array having 1020 vented pixel ionization chambers. The dynamic MLC QA test patterns were chair test, x–wedge, pyramid, open swipe field, garden fence and picket fence. Performance of Dynamic wedges was compared with physical wedges. For IMRT verification, five patients with localized prostate carcinoma were planned using dynamic IMRT technique. Angular response of MatriXX was measured by exposing the system from different gantry angles.ResultsDynamic MLC QA tests such as chair, x-wedge, pyramid, and open swipe field were successfully verified. MatriXX was not able to recognize the bar pattern of picket test and garden fence test. The response of MatriXX gradually decreases from 0° to 180° angles and it was 7.7% less at 180° angle. The dynamic wedge profiles were matching with corresponding physical wedge profiles. For pretreatment IMRT QA, the average dose difference between planned and measured dose was 1.26% with standard deviation of 1.06.ConclusionI'mRT MatriXX can be used for routine dynamic MLC and IMRT pretreatment QA but care should be taken while taking measurements in penumbra region because of its limited spatial resolution

IMPORTANCE OF NANOCARRIERS AND PROBIOTICS IN THE TREATMENT OF ULCERATIVE COLITIS

Ulcerative colitis (UC) is an inflammatory chronic disease primarily affecting the colonic mucosa; the extent and severity of colon involvement are variable. Ulcerative colitis is identified by mucus diarrhea, tenesmus, bowel distension, and anemia. 5-aminosalicylic acid drugs, steroids, and immune suppressants are used for the therapy of ulcerative colitis. The mainchallenges in the management of thediseaseare drug-related side-effects and local targeting. To overcome these challengesprobiotics and micro and Nanoparticulate systemauspiciousapproaches to overcome drug-related adverse side effects and local targeting.Upon ingestion, the probiotics can result in beneficial health effects. Probiotics and micro and nanoparticulate approaches for suitable targeting and overcome the drug-associated side effect. Probiotics are mainly used as gut modulators but are also nowadays explored for their use in ulcerative colitis.The current therapeutic goals are to achieve clinical remission along with mucosal healing, avoidance of complications such as side effects of the drug and to improve the quality of life. The use of probiotics to increase the health of the intestine and used to block or manage intestinal disorders. They may prevent the induction of inflammatory reactions. Probiotics must be inspected for efficacy in the prevention and management of a wide spectrum of gastrointestinal diseases, like antibiotic-associated diarrhea.Micro and Nanoparticulate drug delivery system has been achieving huge importance for targeting of the drug to colon locally at a controlled and sustained rate

Oral Mucosal Immunization Recent Advancement and Exploit Dendritic Cell Targeting

Oral mucosal vaccine thrive significant interest in developing vaccines that evoke mucosal moreover systemic immune response i.e. induction of IgA. Oral immunization consistently preferred over conventional immunization because it provides strengthens inpatient acquiescence, needle-free delivery, cost-effective. Thereby strong antibody production at the mucosal site is not refreshing by parenteral administration of the vaccines. Antibodies produced on the mucosal surface instead of it also start common mucosal immune system (CMIS). Vaccines allow particulate delivery protection of antigen. Polylactic-co-glycolic acid, poly lactic acid loaded nanoparticles, liposomes, niosomes, dendrimers; proteosomes are some of the nanocarriers which protect the antigen from their degradation. Authentication concepts of various studies on the mucosal vaccine by using nanotechnology for targeting to dendritic cell presenting on Peyer's patch elicit antibody production. This review sums up current studies on mucosal vaccination by using nanocarrier. More of the studies have been done on mucosal for improvement in methodology. Keywords: Antigen, Nanotechnology, Dendritic cells, Peyer’s patch, Vaccin

Study of 2D ion chamber array for angular response and QA of dynamic MLC and pretreatment IMRT plans

AimTo study of 2 Dimensional ion chamber array for angular response and its utility for quality assurance of dynamic multileaf collimator and pretreatment intensity modulated radiotherapy plans.Materials and MethodsThe MLC QA test patterns and IMRT plans were executed on 2D ion chamber array having 1020 vented pixel ionization chambers. The dynamic MLC QA test patterns were chair test, x–wedge, pyramid, open swipe field, garden fence and picket fence. Performance of Dynamic wedges was compared with physical wedges. For IMRT verification, five patients with localized prostate carcinoma were planned using dynamic IMRT technique. Angular response of MatriXX was measured by exposing the system from different gantry angles.ResultsDynamic MLC QA tests such as chair, x-wedge, pyramid, and open swipe field were successfully verified. MatriXX was not able to recognize the bar pattern of picket test and garden fence test. The response of MatriXX gradually decreases from 0° to 180° angles and it was 7.7% less at 180° angle. The dynamic wedge profiles were matching with corresponding physical wedge profiles. For pretreatment IMRT QA, the average dose difference between planned and measured dose was 1.26% with standard deviation of 1.06.ConclusionI'mRT MatriXX can be used for routine dynamic MLC and IMRT pretreatment QA but care should be taken while taking measurements in penumbra region because of its limited spatial resolution

Chromosome count, meiotic abnormalities and pollen sterility in Lahaul sweetvetch (Hedysarum astragaloides Benth. ex Baker, Fabaceae), an endemic and threatened species from India

Male meiotic studies were carried out on eight different accessions of Hedysarum astragaloides Benth. ex Baker (Fabaceae), an endemic and threatened species of northwest Himalaya, India. Although genetic factors such as meiosis, chromosome number, and ploidy level may be causative for the evolution, endemism, rare distribution or even extinction of the species, no detailed information exists. Keeping this in mind H. astragaloides has been studied cytologically. Male meiotic investigations revealed diploid level (2n=2x=14) for species and normal meiotic course in the accessions from the Manali Hills resulting in nearly 100% pollen fertility. However, the accessions scored from the Manimahesh Hills and Pangi Valley depicted inter-pollen mother cell transfer of chromatin material and structural heterozygosity for reciprocal translocations. Consequent upon these meiotic anomalies, some pollen sterility (21%) resulted. On account of this sweeping genetic outcome, the incidence of anomalies such as this in an endemic and threatened species warrants grave consideration. It is sensible to conclude that conservation measures should include the collection of germplasm from the localities where plants are meiotically stable with high gametic fertility, to ensure good germination and healthy plants for future use. Seeds from meiotically normal individuals should be given priority for inclusion in seed banks

Effect of natalizumab on disease progression in secondary progressive multiple sclerosis (ASCEND). a phase 3, randomised, double-blind, placebo-controlled trial with an open-label extension

Background: Although several disease-modifying treatments are available for relapsing multiple sclerosis, treatment effects have been more modest in progressive multiple sclerosis and have been observed particularly in actively relapsing subgroups or those with lesion activity on imaging. We sought to assess whether natalizumab slows disease progression in secondary progressive multiple sclerosis, independent of relapses. Methods: ASCEND was a phase 3, randomised, double-blind, placebo-controlled trial (part 1) with an optional 2 year open-label extension (part 2). Enrolled patients aged 18–58 years were natalizumab-naive and had secondary progressive multiple sclerosis for 2 years or more, disability progression unrelated to relapses in the previous year, and Expanded Disability Status Scale (EDSS) scores of 3·0–6·5. In part 1, patients from 163 sites in 17 countries were randomly assigned (1:1) to receive 300 mg intravenous natalizumab or placebo every 4 weeks for 2 years. Patients were stratified by site and by EDSS score (3·0–5·5 vs 6·0–6·5). Patients completing part 1 could enrol in part 2, in which all patients received natalizumab every 4 weeks until the end of the study. Throughout both parts, patients and staff were masked to the treatment received in part 1. The primary outcome in part 1 was the proportion of patients with sustained disability progression, assessed by one or more of three measures: the EDSS, Timed 25-Foot Walk (T25FW), and 9-Hole Peg Test (9HPT). The primary outcome in part 2 was the incidence of adverse events and serious adverse events. Efficacy and safety analyses were done in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT01416181. Findings: Between Sept 13, 2011, and July 16, 2015, 889 patients were randomly assigned (n=440 to the natalizumab group, n=449 to the placebo group). In part 1, 195 (44%) of 439 natalizumab-treated patients and 214 (48%) of 448 placebo-treated patients had confirmed disability progression (odds ratio [OR] 0·86; 95% CI 0·66–1·13; p=0·287). No treatment effect was observed on the EDSS (OR 1·06, 95% CI 0·74–1·53; nominal p=0·753) or the T25FW (0·98, 0·74–1·30; nominal p=0·914) components of the primary outcome. However, natalizumab treatment reduced 9HPT progression (OR 0·56, 95% CI 0·40–0·80; nominal p=0·001). In part 1, 100 (22%) placebo-treated and 90 (20%) natalizumab-treated patients had serious adverse events. In part 2, 291 natalizumab-continuing patients and 274 natalizumab-naive patients received natalizumab (median follow-up 160 weeks [range 108–221]). Serious adverse events occurred in 39 (13%) patients continuing natalizumab and in 24 (9%) patients initiating natalizumab. Two deaths occurred in part 1, neither of which was considered related to study treatment. No progressive multifocal leukoencephalopathy occurred. Interpretation: Natalizumab treatment for secondary progressive multiple sclerosis did not reduce progression on the primary multicomponent disability endpoint in part 1, but it did reduce progression on its upper-limb component. Longer-term trials are needed to assess whether treatment of secondary progressive multiple sclerosis might produce benefits on additional disability components. Funding: Biogen

Utility of C4D deposits in native renal diseases and relation with disease progression

INTRODUCTION: C4D is a well-known biomarker of complement cascade. The utility of C4D in identification of antibody-mediated rejection has been known since its incorporation in Banff classification in 2003. Recently, many researchers have turned their attention to C4D deposition in native renal diseases. The present study was done at our tertiary care center to adjudge the significance of C4D deposits in native renal diseases across Indian cohort of patients. MATERIALS AND METHODS: A retrospective study was done on fifty cases of native renal diseases and followed up at 6 months. C4D immunohistochemical analysis was performed on formalin-fixed paraffin-embedded renal tissue sections with antibody against C4D (polyclonal rabbit immunoglobulin G antihuman C4D antibody). RESULTS: All cases of membranous nephropathy, immunoglobulin A nephropathy, and hypertensive nephropathy showed glomerular C4D positivity ranging from 2+ to 3+. Nearly 50%, 50%, 43%, and 40% cases of diabetic nephropathy, membranoproliferative glomerulonephritis, lupus nephritis, and postinfectious glomerulonephritis, respectively, demonstrated positive glomerular C4D deposits. Increased intensity expression of glomerular C4D deposits was in significant concordance with presenting 24 h urinary protein level at the time of biopsy and in follow-up trends; C4D positive cases were noted to have slowed recovery process as evidenced by delay in returning to normal range proteinuria. Higher histological grades in respective native diseases' classification correlated with increased glomerular C4D intensity expression. C4D positivity in other renal compartments did not yield any significant results. CONCLUSION: C4D positivity can be explored as a diagnostic and prognostic tool in native renal diseases as well, apart from transplant biopsies' evaluatio