Cancer related fatigue, effect of cancer treatment on fatigue and effect of fatigue on quality of life

BACKGROUND: Cancers in all forms are causing about 12 per cent of deaths throughout the world. In the developed countries cancer is the second leading cause of death accounting for 21% (2.5 million) of all mortality. In the developing countries cancer ranks third as a cause of death and accounts for 9.5% (3.8 million) of all deaths. Tobacco alcohol, infections and hormones contribute towards occurrence of common cancers all over the world. Cancer has become one of the ten leading causes of death in India. It is estimated that there are nearly 1.5-2 million cancer cases at any given point of time. Over 7 lakh new cases of cancer and 3 lakh deaths occur annually due to cancer. Nearly 15 lakh patients require facilities for diagnosis, treatment and follow up at a given time. Data from population-based registries under National Cancer Registry Programme indicate that the leading sites of cancer are oral cavity, lungs, oesophagus and stomach amongst men and cervix, breast and oral cavity amongst women. Cancers namely those of oral and lungs in males, and cervix and breast in females account for over 50% of all cancer deaths in India. AIMS AND OBJECTIVES: 1. To determine the magnitude of fatigue in Cancer Patients 2. To determine the effect of Cancer Treatment (Chemotherapy, Radiotherapy) on fatigue. 3. To determine the effect of Fatigue on Quality of Life. MATERIALS AND METHODS: This study was done purely in the Government hospital after obtaining the consent from the involved patients. The Tamil consent form is attached (appendix II). Ethical Committee clearance was obtained prior to the study.(appendix I). The license required to use the FACT-G in this study was obtained (appendix IV). The validity & reliability report for the FACT-G also obtained (appendix V). The study was periodically reviewed & presented in the department during the course. Estimation of Sample Size: The estimation of sample size is based on the study “Cancer-related fatigue: inevitable, unimportant and untreatable? Results of a multi-centre patient survey. Cancer Fatigue Forum.AU - Stone P et al”. The sample size is estimated based on 5% significance level and with an error of 0.6. The sample size required is 110. Sampling procedure: 120 patients with histologically proven cancer, receiving Cancer Treatment in the Radiation Oncology department of Madras Medical College February 2009 to September 2009 were the subjects of the study. Inclusion criteria: 1. Patients above 15 years. 2. Patient with histological documentation of Cancer. 3. Patients receiving External Beam Radiotherapy or Chemotherapy. 4. Patients with Karnofsky Performance Status(KPS) 70 and above. Exclusion criteria 1. Patients below 15 years. 2. Patients with KPS < 70. CONCLUSION: Fatigue prevalence – In this study 100% of the patients studied had fatigue be it either mild, moderate or severe. While other studies have had ranges from 65- 90%.One of the reasons for this variation could be that the patients in this study were all from low socio-economic group which makes it that much harder for them to have nutritious wholesome meal for 3/day. Cancer Related Fatigue affected all areas of patient’s life. Cancer related fatigue effected the time taken by the patients to attain normal productive life Cancer Related Fatigue peaked at 4-5 weeks of treatment. As observed in this study & review of the previous literature suggests that the Cancer related fatigue peaked during 4th- 5th week of the treatment .The reason for this needs to be further evaluated. Cancer Related Fatigue reduces the Quality of Life in patients .Cancer related fatigue effected every aspect of the patients life. It had a negative effect on the Emotional, Functional, Physical & social well being of the patients. Cancer related fatigue never reached pretreatment level scores. In this study none of the patients ever reported to reach the pre-treatment levels of fatigue even at 2 months of follow up

Potential drug-drug interactions among hospitalized cardiac patients

Background: Drug-drug interactions (DDIs) are a major cause for concern in patients with cardiovascular disorders due to multiple co-existing conditions and the wide class of drugs they receive. The objective of our study was to identify potential drug-drug interactions among hospitalized cardiac patients and to identify the risk factors associated with these interactions.Methods: After obtaining approval from Institutional Ethical Committee, a prospective observational study was carried out among 367 hospitalized cardiac patients in Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysuru. Cardiac patients prescribed at least 2 drugs and having hospital stay of more than 24 hour duration were enrolled into the study. The prescriptions were analysed for potential DDIs using MEDSCAPE multidrug interaction checker tool. Descriptive statistics, Student ‘t’ test, ANOVA and Pearson correlation coefficient were used to analyse the results.Results: The incidence of potential DDIs was 98% with 360 prescriptions having at least one potential DDI. A total of 38 potentially interacting drug pairs were identified among which majority were of significant grade while only 3 were serious. Majority of interactions were pharmacodynamic (76.3%) in nature. Aspirin/clopidogrel (71.1%) and pantoprazole/clopidogrel (69.8%) were the most common interacting pairs. Drugs most commonly involved were aspirin, clopidogrel, heparin, pantoprazole and ramipril. Age, female gender, polypharmacy, prolonged hospital stay, stay in ICU and diabetes mellitus were the risk factors found associated with the potential DDIs.Conclusions: Proper therapeutic planning, routine monitoring of cardiac in-patients and usage of online DDI database will avoid potentially hazardous consequences in cardiac in-patients

Expressão da plasticidade fenotípica em filhotes do lagarto Calotes versicolor (Squamata: Agamidae): influência da umidade do ninho.

Calotes versicolor se reproduz do final de maio ao início de outubro. A atividade de reprodução começa logo após a monção sul-oeste. Os ovos depositados no início da estação reprodutiva experimentam condições mais úmidas do que aqueles do final da estação. Nós estudamos a influência do nível de umidade do ninho sobre as características fenotípicas dos filhotes recém-eclodidos enterrando os ovos em ninhos de areia de 5 cm de profundidade com ~50% (ninho úmido) ou ~20% (ninho relativamente seco) de umidade para simularas condições de nidificação do início e do final da estação reprodutiva. Um grupo de ovos foi submetido a um  procedimento padronizado de incubação laboratorial em que os ovos são semienterrados na areia úmida enquanto a outra metade permanece exposta ao ar. O tempo de eclosão eo tamanho corporal dos filhotes recém-eclodidos variaram com o tratamento. Os ovos dos ninhos secos eclodiram mais tarde e os filhotes foram os maiores, mas possuíam menor quantidade de vitelo residual comparados com os grupos de ''ninhos úmidos'' e também de ''incubação laboratorial''.Nesses filhotes, os tamanhos da cabeça e dos membros foram significativamente maiores do que os dos outros dois grupos. Os resultados mostram: (1) uma plasticidade de desenvolvimento no lagarto, (2) que sob condições de baixa umidade um tamanho corporal maior é preferível e (3) que ocompromisso entre o crescimento somático dos embriões e as reservas energéticas futuras (vitelo residual) dos filhotes é influenciado pela umidade do solo em C. versicolor.Calotes versicolor breed from late May to early October. The breeding activity begins with the onset of the southwestmonsoon. The eggs laid in early breeding season experience more wet conditions than those of the late breeding season. We studied the influence of nest moisture levels on thephenotypic traits of hatchlings by burying the eggs in 5-cm-deep sand nests with ~50% (wet nest) or ~20% (relatively dry nest) moisture to simulate nesting conditions of early and late breeding seasons. A group of eggs were subjected to standard laboratory incubation procedure in which eggs are half-buried in the moist sand and the other half exposed to air. Hatching time and hatchling body size varied with the treatment. The eggs from dry nests hatched later and hatchlings were the biggest but possessed least amount of residual yolk compared to those of ''wet nest'' and also ''lab incubated'' groups. In these hatchlings head and limb sizes were significantly larger than that of the other two groups. The findings show: (1) a developmental plasticity in the lizard, (2) that under low moist conditions larger body size is preferred, and (3) that the trade-off between somatic growth of embryosand future energy reserves (residual yolk) of hatchlings is influenced by the soil moisture in C. versicolor

Iteration Complexity of Randomized Primal-Dual Methods for Convex-Concave Saddle Point Problems

In this paper we propose a class of randomized primal-dual methods to contend with large-scale saddle point problems defined by a convex-concave function $\mathcal{L}(\mathbf{x},y)\triangleq\sum_{i=1}^m f_i(x_i)+\Phi(\mathbf{x},y)-h(y)$. We analyze the convergence rate of the proposed method under the settings of mere convexity and strong convexity in $\mathbf{x}$-variable. In particular, assuming $\nabla_y\Phi(\cdot,\cdot)$ is Lipschitz and $\nabla_\mathbf{x}\Phi(\cdot,y)$ is coordinate-wise Lipschitz for any fixed $y$, the ergodic sequence generated by the algorithm achieves the convergence rate of $\mathcal{O}(m/k)$ in a suitable error metric where $m$ denotes the number of coordinates for the primal variable. Furthermore, assuming that $\mathcal{L}(\cdot,y)$ is uniformly strongly convex for any $y$, and that $\Phi(\cdot,y)$ is linear in $y$, the scheme displays convergence rate of $\mathcal{O}(m/k^2)$. We implemented the proposed algorithmic framework to solve kernel matrix learning problem, and tested it against other state-of-the-art solvers

Antifungal Activities of Selected Plant Extracts against Wood Rotting Fungi: A Challenge in Panel Wood Products

Fungal infection to wood and panel product is a major economic concern for the building industry as it causes heavy losses of wood used in the construction. It is imperative to take the necessary steps to preserve the wood and the wood products. Due to growing concerns about the adverse effects of chemical preservatives on human health as well as environmental concerns had made the consumer look for alternatives. Hence an ideal compound for wood protection for interior applications which is non-toxic and able to provide long-term efficacy is increasingly being sought. As result, many plants are screened and their extractives were getting evaluated for their ability to inhibit fungal infection on wood. However, there is a lack of literature on the utilization of these bio based preservatives as the fungal inhibitor in wood composite panels. A study in this line is very important as challenges involved with of bio-based wood preservative for panel wood are totally different. Botanical preservative which is highly effective in wood may not be suitable for the panel wood products. Some modifications and incorporations are vital to use this bio-based preservative in the wood composite material. The objective of this paper is to investigate the fungal inhibitory effects of some natural plant extracts mixture, on wood panels and differences in their performances along with an obstacle faced in case of panel woods. For the purpose, extract of Lantana camara L., Ricinus communis L. Catharanthus roseus (L.) G. were prepared using water and petroleum ether as solvents by standard procedure. Amount of extractives obtained were quantified for each plant species. Extractives formed were range from 11-68-14.33 for different plant species. Extracts obtained from different plant were mixed to form a synergetic preservative and same was mixed in PF and UF resin at different concentrations (1%, 1.5%, 2%, 5% and 10%) and plywood samples were prepared using rubber wood veneers. Control panels were also prepared with PF and UF resins without extractives. From these panels experimental blocks were prepared and introduced in Kolle flask, containing test fungi Polyporous meliae and Trametes versicolor along with the control samples. Whole experimental setup was kept at room temperature (25±5o C) with 60-70% relative humidity. After the completion of an experiment, samples were removed from the Kolle flask and myceliums adhering to test samples were cleaned by taking care not to remove the splinters of the samples. Blocks were dried in an oven and final weight was taken. Mean percentage weight loss was calculated, which varied from 8-25% for different test samples. Result revealed that, Minimal fungal inhibitory effect was seen even at 1% concentration and as concentration increased resistance also increased. But at higher concentrations of extractives in glue line negatively affected the important physical and mechanical properties of panels. Hence it is important to determine an optimal extractive concentration to achieve the best possible result as the bio based preservative that too without affecting the bonding strength of the plywood. Thus we can conclude that incorporating with slight modifications effective eco-friendly wood preservatives can be prepared by utilizing these plant extractives.Keywords: Fungal wood decay, Bio-control, Plant extracts, PF and UF resin

ANTIBACTERIAL ACTIVITY OF SYNTHESIZED SILVER NANOPARTICLES BY SIMAROUBAGLAUCA AGAINST PATHOGENIC BACTERIA

Objective: The present study outline the plant-mediated synthesis of silver nanoparticles (AgNPs) using leaf extract Simaroubaglauca, which act as both reducing and stabilizing agent.Methods: Formation of silver nanoparticles was confirmed by primarily by Ultraviolet/visible spectroscopy. X-ray diffraction studies revealed the crystallinity of the nanoparticles. The scanning electron microscopy was carried out to determine the mean particle size, as well as the morphology of the NPs and the composition of elements, was studied with Energy Dispersive X-ray analysis (EDS).Results: The silver nanoparticles were spherical in shape with a mean size of 23 nm. The EDS showed strong optical absorption peak at 3keV and it was confirmed the formation of AgNPs. The synthesised AgNPs further utilized for the evaluation of antibacterial activity and shown significant antibacterial activity against Escherichia coli, Pseudomonas aeruginosa, Enterobacter and Klebsiella pneumonia at 50 µg/ml and 100µg/ml concentrations.Conclusion: The synthesised silver nanoparticles have been characterised by UV-vis, SEM-EDAX and XRD to determine the sizes and shapes of the silver nanoparticles

Metabolite and enzyme profiles of glycogen metabolism in Methanococcoides methylutens

When a buffered anaerobic cell suspension of Methanococcoides methylutens was maintained under methanol-limited conditions, intracellular glycogen and hexose phosphates were consumed rapidly and a very small amount of methane formed at 4 h of a starvation period. When methanol was supplemented after a total of 20 h of starvation, a reverse pattern was observed: the glycogen level and the hexose phosphate pool increased, and formation of methane took place after a lag period of 90 min. A considerable amount of methane was formed in 120 min after its detection with a rate of 0.18 µmol mg-1 protein min-1. When methane formation decreased after 270 min of incubation and finally came to a halt, probably due to complete assimilation of supplemented methanol, the levels of glycogen and hexose monophosphates decreased once again. However fructose 1,6-diphosphate levels showed a continuous increase even after exhaustion of methane formation. In contrast to the hexose phosphate pool, levels of other metabolites showed a small increase after addition of methanol. The enzyme profile of glycogen metabolism showed relatively high levels of triose phosphate isomerase. Glyceraldehyde 3-phosphate dehydrogenase reacted with NADPH with a three-fold higher activity as compared to that with NADH