bluuebunny/crossref_metadata_2025 huggingface dataset:
Loneliness, Social Support Networks, Mood, and Well-Being among the Community-Dwelling Elderly, Mysore
Authors: Narendran Meghana , Manjunath Renuka , Murthy M. R. Narayana
Published: January 2023

Background:

Humans are social beings. Older adults more commonly endorse social engagement than physical health when describing successful aging. Deficits in social support have been associated with a wide variety of adverse health outcomes in older age, ranging from physical health to depression and self-harm. In this study, we attempt to identify the relative contributions of subjective social isolation (loneliness) and objective social isolation, measured as support network type, to depression and well-being among the community-dwelling elderly. Therefore, the objective of the study was to estimate the prevalence of loneliness and depression and to know the relationship between social network type, loneliness, and depression among the community-dwelling elderly.

Subjects and Methods:

A cross-sectional study was done for a period of 6 months. Individuals aged 60 years and above were included and severely ill and bed-ridden patients were excluded from the study. Sampling method used was population proportion to size with sample size of 290. The participants were interviewed using a semistructured questionnaire, where demographic and personal data and social network pattern were collected. Depression was assessed using the Geriatric Depression Scale. Data were analyzed using Statistical Package for the Social Sciences Software, 22.0 version. Descriptive statistics like percentage, mean, and standard deviation were applied. Inferential statistical tests such as the Chi-square test were applied to find out the association and expressed it as statistically significant at a P value < 0.05.

Results:

Among the study participants, 44.3% were lonely, 19.4% felt hopeless, and only 38% felt satisfaction in life and happiness. "Suggestive Depression" was seen among 48.6% and "Persistent Depressive Mood" was seen in about 20.2% of participants. Loneliness explained the excess risk of depression in the widowed. Similarly, 38.2% had a nonintegrated social network and 32% had integrated social network who also reported being lonely.

Conclusion:

Loneliness and social networks both independently affect mood and well-being in the elderly, underlying a very significant proportion of depressed mood.
The golden spice curcumin in cancer
Authors: Karaboğa Arslan Ayşe Kübra , Uzunhisarcıklı Ebru , Yerer Mükerrem Betül , Bishayee Anupam
Published: January 2023

Curcumin, the key bioactive phytochemical present in turmeric (Curcuma longa L.), is the most studied natural compound in cancer. Preclinical studies (in vitro and in vitro) and clinical trials have demonstrated curcumin's effectiveness as an anti-inflammatory agent. The existing evidence supports that curcumin inhibits the proliferation of many types of cancer cells and can play an important role in cancer therapy. This study analyses the existing evidence in the literature on finalized clinical trials (2010–2020) related to the effect of curcumin and turmeric-derived products that focused on different types of cancers, such as chronic myeloid leukemia, multiple myeloma, prostate, colorectal and pancreatic cancer as well as cancer therapy-related complications, including oral mucositis and radiation dermatitis. Original English language articles and clinical trials published between 2010 and 2020 were searched using mainstream scholarly databases, such as PubMed, ScienceDirect, Google Scholar, and ClinicalTrials.gov. The keywords, such as “curcumin,” “turmeric,” “cancer,” “anti-inflammatory,” and “clinical trials,” were used in various combinations. A total of 21 clinical trials were selected, reviewed, and included in this study. Sixteen out of 21 clinical trials were associated with the effectiveness of curcumin or turmeric on various types of cancer, and the other five clinical trials were related to the evaluation of the efficacy of curcumin or turmeric in relieving the side effects of cancer chemotherapy and radiotherapy. The emerging data from the clinical trials confirm that curcumin has the potential for cancer prevention and intervention. However, it is not yet clear whether long-term curcumin supplementation has similar benefits.
Paroxysmal nocturnal hemoglobinuria clone in a patient with acute promyelocytic leukemia
Authors: Singh Balraj , Khan Nazia , Kaur Parminder , Maroules Michael
Published: January 2023

Acute promyelocytic leukemia (APL) is a unique subtype of acute myeloid leukemia (AML), which presents with a distinct coagulopathy. Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired hemolytic anemia which is clonal in nature due to somatic mutation. PNH may evolve to aplastic anemia, and more rarely, to a myelodysplastic syndrome or to AML. The literature review showed that AML is derived from the PNH clone as the leukemic cells lack the expression of glycosylphosphatidylinositol-linked proteins and PNH phenotype disappeared with the onset of acute leukemia. Herein, we report an unusual presentation of the coexistence of two clonal disorders PNH and APL. Our case contributes to the literature that AML in the setting of PNH is a separate disorder.
Stem gene expression in breast tumors during chemotherapy
Authors: Ibragimova Marina K. , Tsyganov Matvey M. , Deryusheva Irina V. , Slonimskaya Elena M. , Litviakov Nikolai V.
Published: January 2023

Introduction:

In this research, we studied how the expression of 14 stem genes (TERT; OCT3; SMO; MYC; SNAI2; MOB3B; KLF4; BMI1; VIM; FLT3; LAT; SMAD2; LMNB2; KLF1), as well as the TGF-β1 cytokine gene and its TGFBR1 receptor in breast tumors before and after NAC is associated with clinical and morphological parameters and the disease outcome.

Materials and Methods:

The study included 82 patients with the morphologically verified diagnosis of T1-4N0-3M0 breast cancer (stages IIA — IIIB). The material was paired biopsy samples of tumor and surgical material for each patient. The stem genes expression was analyzed via qPCR.

Results:

As a result, we found that increased level of stem genes expression in breast tumors is associated with lymphogenic metastasis, young age, small tumor size, expression of estrogen and progesterone receptors, and the luminal B molecular subtype. NAC stimulates the expression of 7 out of 16 stem genes. Patients who further developed hematogenic metastases have twice as many hyperexpressed stem genes in their tumors before the treatment and after NAC than patients with no hematogenic metastases. The expression level of three genes - OCT3, LAT, and LMNB2 - in a residual tumor allows us to predict metastasis-free survival of patients with breast cancer of various molecular subtypes with a 79% accuracy.

Conclusion:

Thus, stem genes hyperexpression is associated with tumor progression.
Managing brain tumors in pregnancy
Authors: Goyal Shikha , Yadav Arun , Madan Renu , Chitkara Aarti , Singh Ranjit , Khosla Divya , Kumar Narendra
Published: January 2023

The diagnosis of malignancy, particularly brain tumors, in pregnancy is uncommon but poses a complex dilemma for the management of both the patient and her fetus, as the interplay of disease with the physiological state of pregnancy affects both outcomes. The routine evaluations (symptomatology, imaging, and hormonal assessments) and treatments (surgery, radiation therapy, and chemotherapy) that are commonplace in brain tumor management may need to be omitted or modified keeping in mind the risk to offspring. Multidisciplinary care and extensive prenatal and perinatal counseling and monitoring are essential. In this review, we discuss the available data addressing these issues and factors which may affect considerations of therapeutic abortions, changes in surgical or medical practices, and outcomes thereof.
Tumor control after palliative hypofractionated, “Quad-shot,” external beam radiotherapy followed by brachytherapy
Authors: kiattikul Chairat Lowanich , Narayan Kailash , Bernshaw David , Dyk Sylvia Van , Tzovaras Angelo , Lin Ming Yin
Published: January 2023

Context:

Cervix cancer is still a leading cause of death in developing countries. Concurrent chemoradiation (CCRT) over 5 weeks followed by brachytherapy is standard of care in locoregionally advanced cervix cancer. Such prolonged treatment may not be tolerated in medically compromised patients. High-dose interrupted hypofractionated Quad-Shot (QS) radiotherapy with brachytherapy treatment was well tolerated.

Aims:

This study aims to assess the locoregional tumor control in cervix cancer patients who were treated with QS regimen.

Settings and Design:

Retrospective.

Subjects and Methods:

Newly diagnosed histologically confirmed cervix cancer patients who were unfit for conventional CCRT and who were treated with QS protocol between 1999 and 2016 were analyzed. Tumor stage, treatment, and follow-up details were retrieved from an ethics-approved prospective departmental database.

Statistical Analysis Used:

Descriptive statistics and Kaplan–Meier method were used for estimating survival.

Results:

Thirty-six patients were available for analysis. The median age was 70.5 (32–92) years. Twenty-two of 36 (61.1%) patients had nodal disease while 33% of all patients had distant metastasis. Of 27 patients who died during follow-up, the local and pelvic control was 75% and 60%, respectively. The median overall survival and progression-free survival were 18.6 months. Grade 3–4 toxicity was observed (16%) in the bowel only.

Conclusions:

Hypofractionated QS radiotherapy with brachytherapy resulted in an overall 82.1% at least stable disease at the primary site. This treatment regimen was well tolerated and may be considered appropriate for patients who may not be suitable for conventional fully fractionated CCRT.
How prepared the radiotherapy centers are to deal with COVID-19 pandemic? A nationwide survey from 46 cancer centers across India
Authors: Barik Sandip Kumar , Behera Binod Kumar , Majumdar Saroj Kumar , Parida Dillip Kumar
Published: January 2023

Managing of radiotherapy department in many cancer centers in India has become very challenging during the COVID-19 pandemic. A radiotherapy center has to deal with multiple problems such as long treatment duration of each patient, high caseload on each radiotherapy machine, a limited number of qualified technical staff available, and equipment maintenance. For the department's smooth running, both the patient and healthcare worker must be safe from contacting COVID-19. A robust and planned strategy is required for prevention, screening, and awareness among all. To access our preparedness and evolve by gaining from other radiotherapy centers, a study was conducted using questionnaires and responses collected from different cancer centers in India.
Knowledge, attitude, and practice of radiation oncologists during COVID-19 pandemic
Authors: Ardha Aarathi , Prathyusha Nanuvala , Atreya Bijjal , Asha D. , Kumari Sanjeeva
Published: January 2023

Background:

Cancer care hospitals are taking measures to reduce the spread of COVID-19. Doctors and health-care workers might be suffering from burnout. Measures taken to reduce overcrowding in hospitals might be making access to essential cancer care difficult. The study aims to understand changes in practice, levels of burnout, and other psychological aspects in radiation oncologists working in a regional cancer center during the COVID-19 pandemic.

Methods:

Data were collected through online Google Forms. The participants who were included in the study were doctors working in the department of radiation oncology. A 25min survey consisting of multiplechoice questions related to the changes at work during COVID19, and standardized questionnaires assessing fear of Covid 19 and burnout. The Oldenburg Burnout Inventory (OLBI) was used in this study to assess burnout. The Fear of COVID-19 Scale was used to assess fear induced by the COVID-19 pandemic.

Results and Conclusion:

Out of 71 professionals who participated in this study, most of them belonged to the category of residents (84.5%) and the rest were consultants (15.5%). Rescheduling of the patients' radiation treatment to convenient time slots to avoid overcrowding, preferring hypofractionated radiotherapy, and the use of telephonic consultations to prioritize outpatient appointments were the most commonly used measures. The results have shown that 62% of the doctors have experienced symptoms of exhaustion and disengagement, indicating a presence of burnout. However, aspects related to fear of COVID have been revealed to be less prevalent among the participants.
Early detection of isolated pleural metastasis from carcinoma pyriform fossa
Authors: Vashistha Bhanu , Garg Palak , Negi Preety , Kingsley Pamela Alice
Published: January 2023

Isolated pleural metastasis from carcinoma of the pyriform fossa is a rare phenomenon. Literature search revealed pleural metastasis from head-and-neck cancer is in itself rare and carries a grave prognosis. Isolated pleural metastasis with local control in the primary and regional site with no other documented distant metastatic disease is again rarely encountered. We report this case as detection of pleural-based metastasis early in the course of disease and intervention can result in better outcome.
Can a signature molecular-profile define disparate survival in BRAF-positive Gliosarcoma and identify novel targets for therapeutic intervention?
Authors: Gandhi Puneet , Khare Richa , Garg Nitin , Mishra Jharna
Published: January 2023

Purpose:

Gliosarcoma (GS) has a low incidence but is aggressively invasive, with poor-survival. Even though GS is recognized as a different subgroup from glioblastoma (GB), there is no molecular panel available to define its clinical outcome. The objective was to identify the molecular imprint of GS in terms of expression of human telomerase reverse transcriptase (hTERT), high mobility group A1 (HMGA-1), kinesin superfamily protein-14 (KIF-14), epidermal growth factor receptor (EGFR) markers with reference to disparate prognosis and identify plausible targets for intervention.

Materials and Methods:

We retrieved 9-GS samples from a cohort of 57-GB patients during a 36 months study period and compared them with 10 molecularly typed GB-samples and 15 controls. Conventional-immunohistochemistry (IHC) was used for histopathology of GS and immunofluorescence-IHC was performed for quantification of identified marker-panel. Statistical tools for non-parametric data were used for inferring results.

Results:

GS was confirmed by reticulin-staining and positivity for glial fibrillary acidic protein, Vimentin, smooth muscle actin. Immune-reactivity for BRAF-V600Ewas present in both glial and sarcomatous cells and negative expression of isocitrate dehydrogenase, ATRX, TP53. Comparison between GS, GB, and control tissues showed that the expression of markers reached significance (P < 0.0001), without the influence of confounders. Significant correlation of EGFR was found with hTERT (r = 0.77), HMGA-1 (r = 0.72), KIF-14 (r = 0.82) suggesting that their combined analysis can define prognosis. To establish the diagnostic accuracy (threshold ≥80% specificity), AUC for EGFR was 0.78 (>3.95), KIF-14 0.97 (>7.45), hTERT 0.63 (>23.86), and HMGA-1 0.53 (>15.45).

Conclusion:

This is the first evidence-based investigation presenting differential expression of proliferation and stemness markers hTERT, HMGA-1, KIF-14 in-correlation with EGFR, indicating a plausible-association between survival and disease-progression in individual GS-cases. It can serve as a model for further studies in this glioma-subgroup and the designing of a target panel for personalized treatment.
Predictive significance of inflammatory indexes in metastatic nonsmall cell lung cancer patients treated with platinum-doublet chemotherapy
Authors: Yilmaz Mesut , Baran Ahmet , Yilmaz Merve Korkmaz
Published: January 2023

Introduction:

Lung cancer is the leading cause of cancer-related deaths, worldwide. Despite immune checkpoint inhibitors and targeted therapy have revolutionized the treatment of metastatic nonsmall cell lung cancer (NSCLC), a significant proportion of patients are still treated with platinum-based chemotherapy. It is widely noticed that systemic inflammation plays an important role in the development and progression of many solid tumors. In this study, we aimed to analyze the predictive role of the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and prognostic nutritional index (PNI) in patients with advanced NSCLC treated with first-line platinum-doublet chemotherapy.

Methods:

We retrospectively collected data of patients treated with first-line therapy for metastatic NSCLC. All patients were treated with first-line platinum-doublet chemotherapy. The patients were grouped based on the median values of SII, PNI, and NLR. The Mann–Whitney U test was used for comparisons between groups.

Results:

The chemotherapy response rate (RR) was 75% in all patients. RR is statistically significantly lower in high SII, low PNI, and high NLR groups.

Conclusions:

High inflammatory indexes in metastatic NSCLC patients who were treated with platinum-doublet chemotherapy are related to low chemotherapy RR.
Serum zinc status and the development of mucositis and dermatitis in head-and-neck cancer patients undergoing curative radiotherapy
Authors: Rao Suresh , Kalekhan Faizan , Hegde Sanath Kumar , Rao Pratima , Suresh Sucharita , Baliga Manjeshwar Shrinath
Published: January 2023

Background:

Radiation-induced mucositis and dermatitis are severe side effects and compromise the health of the head-and-neck cancer patient undergoing treatment. Zinc supplementation during the course of the treatment is shown to have protective effects against both radiation-induced mucositis and dermatitis. The aim of this study was to understand whether the level of serum zinc has an effect on the development of mucositis and dermatitis.

Materials and Methods:

This was noninterventional study where the levels of serum zinc were ascertained before the start of treatment by spectrophotometric methods. The patients were treated every day with no more than one fraction of 2 Gy per day, five times a week without any intended gaps for a planned target dose of 60–70 Gy (6–7 consecutive weeks). The patients were assessed for radiation-induced dermatitis and mucositis in accordance with the standard guidelines. The association between the levels of serum zinc with the development of different grades of mucositis and dermatitis (on the day of development) was ascertained using the Pearson correlation coefficient (r). A statistical value of P < 0.05 was considered to be statistically significant.

Results:

A total of 52 consecutive patients satisfying the inclusion criteria were enrolled. The results indicate that serum zinc levels showed a significant correlation (r = 0.29; P < 0.038) for Grade 1, while it was insignificant for Grades 2 and 3. For dermatitis, a significant correlation for all the grades (Grade 1 [r = 0.28; P < 0.043]; Grade 2 [r = 0.39; P < 0.006]; and Grade 3 [r = 0.49; P < 0.047]) was observed.

Conclusions:

For the first time, the results of this pilot study indicate that the serum level of zinc had an inverse association with the early development of mucositis and dermatitis, with better effects seen in dermatitis where it was also effective in Grades 2 and 3.
Spectrum of pediatric kidney tumours with special references to WT1 immunostain at a tertiary care hospital
Authors: Das Chhanda , Mukhopadhyay Madhumita , Maity Namrata , Parvin Tamanna , Mukhopadhyay Biswanath , Mukhopadhyay Brati
Published: January 2023

Context or Background:

Pediatric renal tumours are the second most common solid tumours in children. The most common in this group is Wilms tumour with mesoblastic nephroma being the 2nd most common tumour in children, younger than 3 months.

Aims and Objectives:

The present study was conducted to study the epidemiological occurrence of pediatric renal tumours at a tertiary care hospital and to study the diagnostic efficacy of WT1 immunostaining in distinguishing Wilms tumour from other types of renal tumours.

Materials and Methods:

It was a single institution-based prospective and observational study conducted for 2 years (from October 2013 to September 2015) in the department of pathology in our hospital. A total of 50 cases were enrolled in this study all were below 15 years of age.

Results:

Nephroblastoma or Wilms tumour was found to be the most common type, occurring in 66% cases. Fourteen out of 33 cases of Wilms tumour showed triphasic components (blastemal, epithelial, and stromal) with Blastemal type Wilms being the second most common (11 cases). WT1 immunostaining was positive in 93.9% cases of nephroblastoma. The highest amount of nuclear positivity noted in blastemal cells followed by epithelial cells. Rhabdomyoblastic differentiation and regressive variant showed nonspecific cytoplasmic staining. Cystic partially differentiated nephroblastoma and diffuse anaplasia type Wilms tumour showed nuclear staining in blastemal cells.

Conclusion:

The expression of WT1 immunostain was found to be diagnostically significant in differentiating Wilms tumour from other renal tumours.
Choroidal metastasis in pancreatic adenocarcinoma
Authors: Singh Ashok , Malik Deepika , Singh Shikha , Vyas Virendra J.
Published: January 2023

Pancreatic adenocarcinoma is the seventh largest cause of death from cancer with a death rate of 3.8%. The 5-year survival rate is only 5%. We report A case 28 year old male presented with a 3 week history of pain in upper part of abdomen and dyspepsia of similar duration. After 2 cycles of palliative chemotherapy he presented with diminution of vision in right eye and watering of eye. USG showed retinal detachment with vitreous hemorrhage in the right eye and left eye was normal. On fundoscopy choroidal metastasis was detected as an accidental finding in the right eye. Though Ca Pancreas usually presents in as locally advanced or metastatic disease choroidal metastasis are extremely rare. Despite disappearance of ocular metastasis he had a progressive disease and died of intraparenchymal hemorrhage. Reports of pancreatic cancer with metastasis to the choroid and optic nerve have been rare. There were few reports that demonstrated the significance of a choroidal lesion as the initial clinical sign of pancreatic cancer. This aggressive behavior of the lesion may be an important feature to determine the origin of the tumor. Cancer of the tail of the pancreas is often not detected in the early stages before metastasizing.
Anorectal malignant amelanotic melanoma
Authors: Husain Musharraf , Rashid Tajamul , Ahmad Mir Mujtaba , Hassan Mohammad Jaseem
Published: January 2023

Malignant melanoma of the anorectal region is a very rare aggressive malignant neoplasm and it constitutes 1% of all malignant lesions of this area. About 70% of these lesions are pigmented, whereas 30% are amelanotic. Demonstration of immune markers of melanoma by immunohistochemistry (IHC) is required for confirming the diagnosis of amelanotic malignant melanoma. Here, we report a case of anorectal malignant amelanotic melanoma in a 65-year-old male with no medical comorbidities, who presented with chief complaints of bleeding per rectum associated with prolapsing mass per rectum of 7 months duration. On external examination and proctoscopy, three prolapsed pedunculated fungating masses were seen externally protruding out of the rectum approximately 4 cm from the anal verge. Contrast-enhanced computed tomography of the whole abdomen and pelvis was suggestive of moderately enhancing lobulated anorectal mass with large polypoidal intraluminal component arising from anorectal walls and extension into mid-lower rectum with liver and locoregional lymph nodes metastasis. The patient was taken up for palliative local excision. Per-operatively, three large irregular highly vascular pedunculated rectal growth was seen. The growth was excised and sent for histopathological examination. Microscopic examination of mass show spindle-to-ovoid tumor cells with hyperchromatic central to eccentric nuclei arranged in intersecting fascicles with a focal alveolar pattern. The large number of atypical mitotic figures (40-50/10 High Power Field (HPF)) was seen along with areas of necrosis and the presence of few bizarre binucleated and multinucleated giant cells. A differential diagnosis of malignant amelanotic melanoma was given along with undifferentiated carcinoma, gastrointestinal stromal tumor, and Non-Hodgkin's lymphoma. On IHC, the tumor cells were reactive for HMB45, S-100, and SOX-10. Thus a diagnosis of malignant amelanotic melanoma was confirmed. The patient had symptomatic improvement.
Challenging case of a re-irradiation in a dorsal spine primitive neuroectodermal tumor
Authors: Gaikwad Utpal , Biswas Satadru , Shamurailatpam Dayananda , Patro Kartikeshwar , Sawant Mayur , Jalali Rakesh
Published: January 2023

Extradural primary primitive neuroectodermal tumor (PNET) is a rare aggressive disease mostly occurring in young adults. We present a locally recurrent case of dorsal PNET in the fifth decade of life after a prolonged disease-free interval of 10 years. The patient received radiation therapy in fairly large fields twice in his lifetime and was planned for third-time radiation to a few overlapping paraspinal areas over a period of three decades. Keeping in mind previous irradiations, possible target volume in proximity to organs at risk (OARs) patient was planned for consolidtive radiation using the most conformal technique available, which is proton beam therapy with image guided pencil beam scanning technique. Special dose constraints for the spinal cord and other OARs were set, and proton therapy plan was generated at our institute. When compared with parallelly generated intensity-modulated radiation therapy plan with the same dose prescription and dose constraints using helical tomotherapy, intensity-modulated proton therapy plan showed superior dosimetric benefit in terms of coverage and significant sparing of OARs.
Highly aggressive gastric adenocarcinoma with multiple skin nodule and supraclavicular node in a 19-year-old patient
Authors: Sonkar Deepak Raj , Rathi Arun Kumar , Arora Savita , Azam Mohammad , Prabhat Kumar , Singh Kishore
Published: January 2023

Although gastric adenocarcinoma is common in middle- and old-aged population, it is rare in young people. Development of cutaneous metastasis during presentation is even rarer in any age group. We report the case of a 19-year young man with gastric adenocarcinoma who had multiple skin nodules over the trunk during presentation. Fine-needle aspiration cytology of the nodule revealed it to be metastasis from gastric adenocarcinoma. Cutaneous metastasis may be the first presentation of internal malignancies even with a short history of disease in young patients. Atypical presentation of a malignancy in atypical age group must be evaluated with prompt assessment, active intervention, and close follow-up.
Preparation and preclinical characterization of 111 In-DTPA-Anti-MUC1 as a radioimmunoconjugate for diagnosis of breast cancer by single-photon emission computed tomography
Authors: Alirezapour Behrouz , Ashkezari Mahmood Dehghani , Fini Mehdi Memari , Rasaee Mohammad Javad , Mohammadnejad Javad , Paknejad Malihe , Maadi Ehsan , Yousefnia Hassan , Zolghadri Samaneh
Published: January 2023

Context:

Targeting MUC1 antigens which are overexpressed in 80% of breast cancers can be widely used in the field of radioimmunoscintigraphy (RIS) of breast cancer.

Aims:

The aim of this study was to develop a new diagnostic labeled compound for breast cancer RIS.

Settings and Design:

In this study, an efficient indirect labeling method of PR81 with Indium-111 was developed and preliminary preclinical qualifications were reported.

Subjects and Methods:

111In-DTPA-PR81 was prepared and its radiochemical purity and stabilities in human serum and in phosphate-buffered saline (PBS) buffer were surveyed. Furthermore, cellular studies including complex reactivity, binding specificity, cell toxicity, etc., were examined. Finally, biodistribution and scintigraphy of the complex were studied in normal and tumoral animals.

Statistical Analysis Used:

Statistical analyses were performed using SPSS 10.0.

Results:

111In-DTPA-PR81 was prepared with a radiochemical purity of >99% at optimized conditions. Stability studies showed the radiochemical purity of >90% in PBS buffer after 96 h, while the stability in human serum showed decrement to 81% after 96 h. Reactivity of the complex with MUC1 was significantly (P < 0.005) higher than bovine serum albumin (BSA) (about 7–8 times), even though BSA concentration was about twice the MUC1. The binding specificity of the complex to the MUC1 antigen was confirmed by means of immunoreactivity assay. Cell toxicity examination showed no significant lethal effect of the radiolabeled compound on the cells. Biodistribution studies of the complex in normal rats were consistent with the biodistribution of antibodies and high accumulation was observed in the tissues expressing MUC1 antigen. The results of 111In-DTPA-PR81 scintigraphy in tumoral female BALB/c mice at 24 and 48 h after injection showed an increasement of the accumulation in the tumor site.

Conclusions:

111In-DTPA-PR81 can be considered as a potential agent for imaging of the MUC1 +breast tumors.
Tumor infiltrating lymphocytes in head and neck squamous cell carcinoma – Evaluation and clinical impact
Authors: Dasgupta Senjuti , Chakrabarti Sudipta , Deb Asit Ranjan
Published: January 2023

Background:

Head-and-neck squamous cell carcinomas (HNSCCs) are one of the most common malignancies worldwide. Emerging evidence reveals that tumor-infiltrating lymphocytes (TIL) provide valuable prognostic information in various malignancies, including HNSCC.

Aims and Objectives:

The present study aimed to evaluate a simple yet accurate method of counting TILs in HNSCCs. It was also done to determine if there is any correlation between different clinicopathological parameters of HNSCC and TIL counts.

Materials and Methods:

A retrospective institutional-based, observational study was undertaken for 1 year. Patients with histologically proven HNSCCs were included. All clinicopathological parameters were noted, and evaluation of TIL was meticulously done both in the stromal and intratumoral regions for each case. Standard statistical methods were employed for data analysis.

Results:

The present study included 81 patients, among which 51 (63%) were male and the rest (30, 37%) were female. The mean age of the patients was 55.3 ± 10.5 years. Most tumors were located in the oral cavity (73, 90.1%). The most common histologic type was moderately differentiated (MD) squamous cell carcinoma (SCC) (50 cases, 61.7%). Stromal TIL score was high in 45 cases (55.6%). In 69 cases (85.2%), the intratumoral TIL level was low. A statistically significant correlation was found between TIL levels (both stromal and intratumoral TIL) and tumor differentiation, pT stage, and lymphovascular invasion. The correlation between intratumoral TIL level, age of patients, and pN stage was also statistically significant.

Conclusion:

TIL evaluation is an inexpensive, simple, and reproducible method, which furnishes relevant prognostic data. It has the potential for consideration of its inclusion in routine histopathological reports of HNSCCs.
Monte Carlo simulation for assessing absorbed dose effects of low-dose β-radiation (90 Sr/90 Y) on cytotoxicity and apoptotic death in K562 cells
Authors: Alizadeh Zeynab , Khodabakhsh Rasoul , Mohammadzadeh Mehdi , Pazhang Yaghub , Mohammadi Seyed Mostafa
Published: January 2023

Objective:

Most studies suggest that dose-specific radiation regimens are essential for optimal induction of cancer cell response. This study focused on determining β-radiation-absorbed dose (rad) effects on the cell viability, cytotoxicity, hypersensitivity, and cell death of K562 cells using experimental methods and Monte Carlo simulation (MCS).

Materials and Methods:

The K562 cells were cultured and irradiated with β-particles emitted from a strontium source in vitro, with the estimated daily activity of 1.238 μCi. The treated cells were radiated at least three times every day for 3 consecutive days. The cell viability and apoptosis were investigated in treated cells by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, DNA electrophoresis, Hoechst dye, and inverted microscope. The average absorbed doses were obtained by MCS (MCNPX code). To verify simulation and experimental results, we used a Geiger–Muller counter and estimated a scaling factor.

Results:

The cytotoxic effects and cell death were induced in the treated groups via rad in a time-dependent manner. The highest apoptotic and cytotoxic effects were observed in cells after irradiation with β-particles for 120 min per day in 3 consecutive days. rads were determined using MCNPX code and cell survival rates were significantly reduced during irradiation periods. No significant hyper-radiosensitivity was found based on experimental and theoretical results.

Conclusion:

Despite the difficult calculation of the rad in the target cells and the scant information in this field, fortunately we have achieved significant theoretical data consistent with the experimental results. Our findings also introduced MCS as a better choice for evaluating of rad effects under different cellular conditions with high accuracy.
Comparison of albumin adjusted ischemia-modified albumin and total antioxidant status in patients with locally advanced head and neck cancer
Authors: Madhumita R. , Nanda Nivedita , Sethi Pooja , Rani Jasmine M. , Natarajan Chandramouli
Published: January 2023

Background:

Among all types of cancers in India, head and neck cancer (HNC) accounts for 30%. Oxidative stress (OS) is one of the aetiologies for cancer. However, it is not evaluated for these patients scheduled for anticancer therapy. Therefore, in the present study, we have compared two biochemical markers in HNC patients before therapy to assess their suitability as a marker for ongoing OS in the locally advanced stage of HNC.

Materials and Methods:

We measured the body mass index (BMI), waist-hip ratio (WHR), blood pressure (BP), albumin, total antioxidant status (TAS), ischemia modified albumin (IMA), and albumin adjusted IMA (AdjIMA) in forty locally advanced squamous cell carcinoma HNC patients and compared with forty healthy individuals of similar age and gender. AdjIMA and TAS were compared by the receiver operating curve.

Results:

BMI and WHR were significantly lower in HNC patients with no difference in BP parameters. Both IMA and AdjIMA were higher and TAS was lower in HNC patients. TAS was positively associated with BMI and negatively with AdjIMA. Between AdjIMA and TAS, AdjIMA at an optimal cutoff value of 0.23 absorbance unit had higher sensitivity (71%), specificity (65%), and area under the curve (0.710 vs. 0.365).

Conclusion:

Antioxidant levels are grossly altered in HNC patients. AdjIMA can be considered a better marker for assessing OS in HNC patients than TAS.
Acute myeloid leukemia presenting in a human immunodeficiency virus-positive patient
Authors: Naseem Shano , Murgai Pooja , Varma Neelam , Varma Subhash
Published: January 2023

We report a case of AML in a 29-year-old HIV-positive female on anti-retroviral therapy. She presented with bicytopenia, fever and easy fatiquability. Bone marrow examination revealed 77% blasts, which on flow cytometric immunophenotyping showed positivity for myeloid lineage markers and were negative for monocytic and lymphoid lineage markers. Although rare, AML is seen in HIV patients, therefore, in presence of persistent cytopenias, detailed hematological evaluation should be done so as to not miss/delay the AML diagnosis.
Expression of Poly(Adenosine Diphosphate-Ribose) Polymerase Protein in Breast Cancer
Authors: Akanksha  , Mishra Shashi Prakash , Kar Amrita Ghosh , Karthik J. S. , Srivastava Aviral , Khanna Rahul , Meena Ram Niwas
Published: January 2023

Background:

The use of poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitors for breast cancer (BC) therapy is the subject of debate, and there is an urgent need to understand much the expression and prognostic role of the PARP1 protein. In this study, we have compared the expression of PARP between BC and benign breast disease (BBD) patients and also analyzed the association of PARP expression with clinicopathological parameters in BC.

Methods:

The study consists of 30 patients with newly diagnosed operable BC who were planned for surgery without neoadjuvant chemotherapy and 15 patients of BBD as a control between 2019 and 2021. Immunohistochemical analyses were performed prospectively on tissue samples. Anti-human PARP1 rabbit polyclonal antibody gives strong nuclear positivity. Internal control was the adipose tissue and the BBD acted as the external control. PARP1 expression was evaluated using the multiplicative quickscore method.

Results:

The mean age for BC patients was 51.30 ± 10.694 years (range: 25–75 years) while BBD was below 30 years. Overexpression of PARP was present in 25 (83.3%) and weak expression in 5 (16.7%) of BC patients compared to BBD, only 2 (13.3%) patients demonstrated an overexpression of PARP, and 13 (86.6%) patients showed weak expression which showed significant association (P < 0.001). In BC, nuclear PARP (nPARP) overexpression was seen in 22 (73.3%) patients and weak expression of nPARP in 8 (26.7%), whereas 5 (16.7%) patients showed cytoplasmic overexpression. On comparing expression of PARP with clinicopathological parameters, PARP overexpression was significantly associated with older population (age >50 years) (P = 0.002), postmenopausal women (P = 0.029), higher TNM stage (Stage II and III) (P = 0.014), higher histological grade (grade 2) (P = 0.043), and presence of lymphovascular invasion (P = 0.015). Enhanced PARP1 expression is closely correlated with positive estrogen receptor status (P = 0.001) and PR status (P = 0.001). Overall PARP and nPARP overexpression was significantly associated with ER- (P = 0.006 and P = 0.008) and PR-positive (P = 0.006 and P = 0.008) patients. The PARP and nPARP overexpression was significantly associated with nontriple-negative BC patients (P = 0.001 and P = 0.001).

Conclusion:

We have not come across any study in the literature to compare PARP expression in BC and BBD patients. On the basis of our observations, we concluded that PARP overexpression is a poor prognostic marker in BC.
Synchronous Primary Endometrial and Fallopian Tube Carcinoma with Metchronous Renal Pelvis Carcinoma in One Patient
Authors: Gulati Anchana , Sharma Reetika , Sharma Sudershan K.
Published: January 2023

Triple primary cancers in one patient are a very rare finding and occur in only 0.5% of patients with cancers. Here, we report the case of triple malignancy in a 62-year-old woman who developed synchronous primary endometrial endometroid type and serous type of fallopian tube carcinoma, which is again a rare finding after 4 years of diagnosis of transitional cell carcinoma of the right renal pelvis.
Lymphocytic Hypophysitis
Authors: Patil Amruta Ashok , Patil Purwa , Walke Vaishali
Published: January 2023

Lymphocytic hypophysitis (LYH) is a rare inflammatory disease in which lymphoplasmacytic infiltration of the pituitary gland can potentially lead to panhypopituitarism. This entity was first recognized in 1962 by Goudie and Pinkerton. We report the case of a 36-year-old nonpregnant female operated for a presumed nonsecreting pituitary adenoma. On intraoperative squash cytology and histology of excision biopsy confirmed the diagnosis of LYH. Review of the literature shows that most reported cases have occurred in women during pregnancy or during postpartum period. Many were accurately diagnosed only after biopsy or at necropsy. It is suspected to be an autoimmune endocrinopathy as concomitant lymphocytic infiltration of the thyroid and pituitary glands has been noted and antipituitary antibodies have been found in some instances. Clinically and radiologically, LYH may mimic a nonsecretory pituitary adenoma. Intraoperative diagnosis may prevent unnecessary excision of potentially functioning pituitary.
Feasibility of Pectoralis Major Myocutaneous Flap for Primary Reconstruction of Near-Total Glossectomy Defects
Authors: Mathews Jency , Subash Shali , Prathiba P. M. , Seviar Prince
Published: January 2023

The aim of tongue cancer surgery is to restore speech and swallowing. Smaller defects have a plethora of options, including local and distant flaps to restore volume and function may not be compromised. Large tumours of the tongue require extensive resection - near total or total glossectomy, which creates large volume defects. Free flaps using microvascular reconstruction techniques are the ideal method of reconstruction in such defects. Regional flaps like pectoralis major myocutaneous (PMMC) flaps are used only as salvage flaps when the free flaps fail and they are not used as the primary method of reconstruction. The disadvantage with free flaps is that it requires a team of surgeons with microvascular expertise, which may not be feasible in low-resource settings. Hence, the workhorse flap of head–neck reconstruction, the PMMC flap, has a lot to offer in the primary reconstruction of large tongue defects. There is always a risk of lifelong dependence on feeding tubes and tracheostomy tubes following these surgeries despite free flap reconstruction. The outcomes of the reconstruction methods are validated by the absence of dependence on these tubes. We report 2 cases of near glossectomy defects reconstructed primarily by PMMC flap and the functional outcomes of speech and swallowing and the absence of dependence on tubes for feeding and breathing.
Quality of Life in Patients Undergoing Endovenous Laser Ablation and Saphenofemoral Ligation and Stripping
Authors: Madhu Deepesh D. , Saji M. T. , Manilal P. K.
Published: January 2023

Introduction:

Surgery for varicose veins was the treatment of choice before the advent of minimally invasive procedures.

Aim:

This study was done to compare the utility of endovenous laser ablation (EVLA) as an effective alternative to surgery to treat varicose veins.

Materials and Methods:

The study was conducted in a tertiary care hospital between October 2019 and March 2021. One hundred and six patients with varicose veins of the long saphenous system were included in the study, 53 in the laser surgery group and 53 in the open surgery group. European Quality of life 5 dimensions questionnaire, the WHO VAS score and clinical aetiological, anatomical and pathological classification for varicose veins scores of the affected limb of the patients were recorded preoperatively and postoperatively at day 90. Data were statistically analysed using SPSS.

Results:

Patients treated by EVLA enjoyed a better quality of life than the ligation and stripping group. They experience significant reduction in the post-operative pain, the absence of wound infection and a significant reduction in the clinical severity scores.

Conclusion:

EVLA is a safer and effective means for treating varicose veins.
Intraoperative Parathyroid Hormone Assay to Guide Completion of Parathyroid Surgery
Authors: Shaju S. , Varghese Melvin , Saran N. , Safwam A Mohamad
Published: January 2023

Introduction:

Primary hyperparathyroidism (pHPT) is characterised by an autonomous production of parathyroid hormone (PTH), which causes hypercalcemia. It is classified into adenoma, glandular hyperplasia and carcinoma. The standard treatment for the pHPT has been bilateral neck exploration (BNE) and the visualisation of all parathyroid glands. However, the increasing sensitivity of pre-operative localisation methods such as 99Tc-sestamibi scanning and ultrasound in combination with intra-operative PTH monitoring (ioPTH) assay can be utilised to decrease the need of BNE and subsequent complications. The aim of the study was to determine the effectiveness of ioPTH during parathyroidectomy and to assess the effectiveness of ioPTH in surgery for pHPT.

Materials and Methods:

Thirty-one patients admitted to the general surgery department in our tertiary care centre with hyper-parathyroidism and underwent parathyroidectomy, whose ioPTH evaluation was done were considered for the study. Their pre-operative and post-excision (10 min after excision of suspicious gland) values of PTH were as noted. Reduction in ioPTH value, based on MIAMI criteria was considered as the eradication of hyper-functioning tissues and its effectiveness in confirming the success of pHPT-surgery in terms of post-operative serum calcium level, thereby evaluating MIAMI criteria.

Results:

Twenty-nine (90.6%) patients showed a reduction of more than 50% in PTH following excision of suspicious glands from pre-operative PTH which is statistically significant, whereas only 21 (65.6%) patient shows normal PTH value following excision of suspicious gland. However, all 31 patients showed decline in PTH value as compared to pre-excision value.

Conclusion:

When the abnormal parathyroid gland is excised, there will be the reduction of PTH more than 50% from their pre-excisional value. Hence, by utilising ioPTH assay to confirm the excision of pathological gland, we can reduce BNE.
Incidence and Role of Large Vessel Disease in Diabetic Foot
Authors: Sasidharan Akash , Khan Shafy S. L. Ali , Khan Firoz M. H. , Namita U.
Published: January 2023

Introduction:

Diabetic patients are at risk for considerable morbidity as a result of chronic foot ulceration and infection, including limb loss. Diabetic foot infections are usually a consequence of skin ulceration from ischaemia or trauma to a neuropathic foot. The accurate diagnosis of the underlying cause is very important in planning the treatment. The aim of the study was to study the incidence and role of large vessel disease in patients with diabetic foot.

Materials and Methods:

Seventy-five patients admitted with features of diabetic foot and its complications were included in the study after excluding patients of comorbid medical illness. The presence of macrovasculopathy was assessed by examination for peripheral pulses, followed by assessment using arterial Doppler amongst patients with macrovasculopathy, those with gangrene or non-healing ulcers and those who underwent amputations or disarticulations were analysed.

Results:

Clinically, dorsalis pedis artery pulses were absent in 81.3% and posterior tibial artery pulses were absent in 54.7%. In arterial Doppler, involvement is 66.7% for dorsalis pedis and 68% for posterior tibial. Fifty-six percentage of patients ended up having poor outcomes in the form of amputations or disarticulations. There is a significant incidence of large vessel disease, especially in elderly patients who were diabetic for more than 10 years. Large vessel disease seems to have a significant role in the final outcome of diabetic foot complications.

Conclusions:

Vasculopathy is a strong risk factor in the development of diabetic foot lesions. An arterial Doppler will help detect involvement early in cases presenting with diabetic foot complications. The presence of diabetic microvascular disease imparts an even greater importance on the early detection and treatment of significant macrovascular disease.