Seven-year DOTS-Plus pilot experience in India: results, constraints and issues.

Background: India is initiating the DOTS-Plus strategy at the national level.

Objectives: To highlight the results, constraints and issues of a pilot DOTS-Plus experience in an urban setting in India.

Methods: Records of 126 patients with multidrug-resistant tuberculosis (MDR-TB) enrolled from January 2002 to December 2006, who received a daily fully supervised standardised treatment regimen under a pilot DOTS-Plus study in India, were analysed retrospectively.

Clinical considerations in developing dendritic cell vaccine based immunotherapy protocols in cancer.

Since the first reported clinical trial of Dendritic Cell Vaccine (DCV) in cancer in the mid nineties, few hundred clinical trials have been initiated and it was projected that over 3000 patients would be treated in DCV clinical trials by 2008. Despite extensive data to establish its safety, DCV remains an investigational approach, highlighting the need to undertake more meaningful proof of principle studies and more importantly, well designed and well conducted large efficacy trials. As opposed to phase I and II trials of new chemical entities where pharmacokinetics, maximum tolerated dose, toxicity profile and dose response effects are the primary concerns, for DCV the pertinent issues are quite different.

Prospective evaluation of radiotherapy with concurrent and adjuvant temozolomide in children with newly diagnosed diffuse intrinsic pontine glioma.

Purpose: To present outcome data in a prospective study of radiotherapy (RT) with concurrent and adjuvant temozolomide (TMZ) in children with diffuse intrinsic pontine gliomas (DIPGs).

Methods And Materials: Pediatric patients with newly diagnosed DIPGs were prospectively treated with focal RT to a dose of 54 Gy in 30 fractions along with concurrent daily TMZ (75 mg/m(2), Days 1-42). Four weeks after completing the initial RT-TMZ schedule, adjuvant TMZ (200 mg/m(2), Days 1-5) was given every 28 days to a maximum of 12 cycles.

Does a nanomolecule of Carboplatin injected periocularly help in attaining higher intravitreal concentrations?

Purpose: To compare intravitreal concentration (VC) of commercially available carboplatin (CAC) and the novel nanomolecule carboplatin (NMC), after periocular injection.

Methods: The study was a comparative animal study involving 24 white Sprague-Dawley rats, aged between 6 weeks and 3 months. CAC was bound with a nanoparticulate carrier by co-acervation with a biocompatible and biodegradable protein BSA (bovine serum albumin).

A pragmatic clinicopathobiological grouping/staging system for gliomas: proposal of the Indian TNM subcommittee on brain tumors.

Background: There is no universally accepted staging system for primary brain tumors wherein prognostication is mainly based on complex composite indices.

Aim: To develop a simple, pragmatic, and widely applicable grouping/staging system for gliomas, the most common primary brain tumor.

Materials And Methods: An expert neurooncology panel with representation from radiation oncology, neurosurgery, pathology, radiology, and medical oncology had several rounds of discussion on issues pertinent to brain tumor staging.

High-precision radiotherapy for craniospinal irradiation: evaluation of three-dimensional conformal radiotherapy, intensity-modulated radiation therapy and helical TomoTherapy.

This study aimed to establish the feasibility of intensity-modulated radiation therapy (IMRT) in craniospinal irradiation (CSI) using conventional linear accelerator (IMRT_LA) and compare it dosimetrically with helical TomoTherapy (IMRT_Tomo) and three-dimensional conformal radiotherapy (3DCRT). CT datasets of four previously treated patients with medulloblastoma were used to generate 3DCRT, IMRT_LA and IMRT_Tomo plans. A CSI dose of 35 Gy was prescribed to the planning target volume (PTV).

Prospective assessment of quality of life in adult patients with primary brain tumors in routine neurooncology practice.

The aim of this article is to evaluate and assess the impact of various factors on quality of life (QOL) in adult patients with primary brain tumors seen consecutively in routine neurooncology practice. Two hundred and fifty-seven adult patients, after undergoing surgical intervention and histologically proven primary brain neoplasms were registered in the NeuroOncology Clinic at our centre during 1 full calendar year. The study included detailed neurological assessment, evaluation of QOL using EORTC questionnaire (QLQ-30) and specific Brain Cancer module (BN 20).

Accelerated partial-breast irradiation vs conventional whole-breast radiotherapy in early breast cancer: a case-control study of disease control, cosmesis, and complications.

Context: Accelerated partial-breast irradiation (APBI) using various approaches is being increasingly employed for selected women with early breast cancer (EBC).

Aims: To conduct a case-control study comparing disease control, cosmesis, and complications in patients with EBC undergoing APBI using multicatheter interstitial brachytherapy vs those receiving conventional whole breast radiotherapy (WBRT).

Settings And Design: Women with EBC fulfilling the American Brachytherapy Society (ABS) criteria were selected as 'cases' if treated with APBI or as 'controls' if offered WBRT during the period from May 2000 to December 2004.

Do all patients of breast carcinoma need 3-dimensional CT-based planning? A dosimetric study comparing different breast sizes.

Evaluation of dose distribution in a single plane (i.e., 2-dimensional [2D] planning) is simple and less resource-intensive than CT-based 3-dimensional radiotherapy (3DCRT) planning or intensity modulated radiotherapy (IMRT).

Studies on Guizotia abyssinica L. oil: biodiesel synthesis and process optimization.

Guizotia abyssinica seeds, a common bird feedstock, have been explored for the potential of biodiesel synthesis. The oil was extracted from the seeds by solvent extraction and composition of G. abyssinica oil was examined.

Biodiesel surrogates: achieving performance demands.

Synthesis of surrogate molecules is particularly useful for generating in sight of structural-activity relationships, understanding processes and improving the performance. In order to improve upon the physico-chemical properties of biodiesel, methyl, ethyl, isopropyl and n-butyl esters of beta-branched fatty acid have been synthesized, initiating from beta-branched alcohols. Beta-branched alcohols upon oxidation gave corresponding acids, which were converted to their esters.

Planning and delivery of whole brain radiation therapy with simultaneous integrated boost to brain metastases and synchronous limited-field thoracic radiotherapy using helical tomotherapy: a preliminary experience.

Lung cancer is the commonest source of brain metastases, which has been traditionally treated with Whole Brain Radiation Therapy (WBRT) with or without focal boost. We herein report our preliminary experience of the planning and delivery of WBRT with Simultaneous Integrated Boost (SIB) to brain metastases along with synchronous limited-field thoracic radiotherapy using Helical TomoTherapy in four patients with lung cancer. All plans were iteratively optimized for maximal target volume coverage and organ-at-risk (OAR) sparing.

Zinc as a marker in viscera of suspected metal phosphide poisoning: a study by neutron activation analysis.

Zinc as a marker element in the viscera of suspected metal phosphide poisoning has been studied during the present work. Neutron activation analysis (NAA) has been employed to detect and quantify the concentration of zinc in the viscera/stomach portion. The methodology has been developed on simulated and real life viscera samples to quantify the amount of zinc using NAA.

Case-control study and meta-analysis of SULT1A1 Arg213His polymorphism for gene, ethnicity and environment interaction for cancer risk.

Cytosolic sulphotransferase SULT1A1 plays a dual role in the activation of some carcinogens and inactivation of others. A functional polymorphism leading to Arg(213)His substitution (SULT1A1*2) affects its catalytic activity and thermostability. To study the association of SULT1A1*2 polymorphism with tobacco-related cancers (TRCs), a case-control study comprising 132 patients with multiple primary neoplasm (MPN) involving TRC and 198 cancer-free controls was carried out.

Prospective assessment of activities of daily living using modified Barthel's Index in children and young adults with low-grade gliomas treated with stereotactic conformal radiotherapy.

Purpose: To report prospective evaluations of activities of daily living (ADL) in young patients with low-grade gliomas treated with stereotactic conformal radiotherapy (SCRT).

Materials And Methods: Between April 2001 and February 2008, 38 children and young adults (age 5-25 years, median 12.5 years) with low-grade gliomas with residual/progressive disease and treated with SCRT were accrued in a prospective protocol.

Specific 50'CpG island methylation signatures of FHIT and p16 genes and their potential diagnostic relevance in Indian breast cancer patients.

Even after tremendous molecular studies, early detection,more accurate and sensitive diagnosis, and prognosis of breast cancer appear to be a riddle so far. To stab the enigma, this study is designed to envisage DNA methylation signatures as cancer-specific and stage-specific biomarkers in Indian patients. Rigorous review of scattered scientific reports on aberrant DNA methylation helped us to select and analyze a potential tumor suppressor gene pair (FHIT and p16 genes) in breast cancer patients.

Hypermethylation analysis of mismatch repair genes (hmlh1 and hmsh2) in locally advanced breast cancers in Indian women.

Alterations in protooncogenes and tumor-suppressor genes at the DNA and/or protein level, which indicate the biological properties of individual breast cancers, led us to design a study encompassing the dilemma of "epigenetic silencing-driven genomic instabilities." In this study, we analyzed the promoter methylation of potent mismatch repair genes (hmlh1 and hmsh2) for the first time in 232 Indian patients with primary breast cancer (using methylation-specific polymerase chain reaction and expressional analysis). The study evaluates the gamut of epigenetic aberrations as well as genomic instabilities (microsatellite instabilities and loss of heterozygosity) and includes analysis of BAT-25, BAT-26, D2S123, D5S346, and D17S250.

Radiotherapy-induced depigmentation in a patient with breast cancer.

Vitiligo is a common dermatological disorder. A middle-aged woman with preexisting vitiligo was diagnosed with breast carcinoma. After surgery and chemotherapy she received regional radiotherapy.

Primary lymphoma of the breast: a clinicopathological study.

3 cases of primary non Hodgkins lymphoma of the breast are described, seen over a period of 2 years among 199 cases of breast malignancies. All were diffuse large B cell type. Application of immunohistochemistry greatly aids in differentiating lymphoma from anaplastic carcinoma, with which it can easily be confused.

A novel method for CT-scan-based localization of the internal mammary chain by internal mammary catheterization: an aid in breast cancer radiation therapy planning.

The purpose of the study was to evaluate the localization of the internal mammary lymph node chain (IMC) using CT scan data acquired after intraoperative placement of a catheter into the internal mammary vessel (IMV). CT data sets comprising 58 suitable patients with breast carcinoma undergoing placement of a catheter into the IMV during breast conservative surgery were evaluated for the study. CT was performed with a radio-opaque dummy wire placed into the IMC catheter.

The DOTS strategy for treatment of paediatric pulmonary tuberculosis in South Delhi, India.

Setting: Paediatric Pulmonology Department, TB Institute, New Delhi, India.

Objective: To evaluate the outcome of the DOTS strategy for paediatric pulmonary tuberculosis (TB).

Design: Retrospective analysis of 1098 children.