Disseminated malignant phyllodes: Presentation after a decade

Phyllodes tumors are rare biphasic fibroepithelial lesions of the breast and account for 0.3%-0.5% of primary breast tumors. Malignant phyllodes tumor has a 10%-26% risk of distant metastasis. The most common site of metastasis is lungs followed by bone and soft tissue. This is a rare case of a 42-year-old female with a previous history of malignant phyllodes tumor breast. She presented after 10 years with metastases to multiple sites including lung, abdominal wall, retroperitoneum, bone, and brain. These tumors have a poor overall survival. Accurate diagnosis and aggressive management of malignant phyllodes tumors can help in effective treatment at diagnosis and for close follow-up of the patients.

Efficacy of Mobile Phone Technology for Managing Side Effects Associated with Chemotherapy among Cancer Patients: A Systematic Review and Meta-Analysis

Background To establish the evidence related to the efficacy of mobile phone technology for managing side effects of chemotherapy and improved quality of life among patients with cancer.

Methods Articles published in peer-reviewed journals were included in this review. Randomized control trials (RCTs) and non-randomized control trials (non-RCTs) consisting of mobile-based interventions (mobile application, smart phone App-based interventions or guidelines to manage side-effects of chemotherapy or mobile health services), and adult cancer patients (aged 18 or above years) as participants who were undergoing chemotherapy and received mobile phone-based interventions as an interventional group versus control/comparator group who were getting routine or usual care were included in this systematic review. Databases such as Scopus, Science Direct, Cochrane library, PubMed, and Google Scholar were systematically searched between 2007 and 2020. Using the Cochrane risk of bias tool, the methodological quality of the included studies was evaluated by two independent authors.

Results We included 10 trials, involving 1467 cancer patients and the number of participants ranged from 50 to 457. All trials measured the side effects of chemotherapy as the main outcome and three trials measured the quality of life as the main outcome.

Ten trials included for narrative synthesis showed a significant decrease in chemotherapy side effects and considerable improvement in the quality of life in the interventional group than in the comparison group. Meta-analysis of four RCTs containing 803 subjects concluded a significant improvement (p < 0.0001) in the quality of life.

A significant improvement in the quality of life was revealed by random effects model (SMD = 0.31, 95% CI: 0.17, −0.46) and a significant difference (Z = 4.37, p < 0.001) was identified between experimental and control groups.

Conclusion Current review strengthens the evidence that utilizing mobile-phone based technology has favorable effects on improving the quality of life by minimizing side-effects associated with chemotherapy among cancer patients.

Herbal supplement usage among cancer patients: A questionnaire-based survey

Background

Herbal supplements (HS) are one of the most commonly used complementary and alternative medicines in cancer. Reduced therapeutic efficacy of prescription anticancer agents through unwarranted herb-drug interactions is a major efficacy/safety concern. In view of the rising cancer prevalence in India along with a high degree of reliance and cultural acceptability in favor of traditional medicine drugs, prevalence data exclusively of HS usage during cancer treatment are of considerable epidemiological significance.

Methodology

This questionnaire-based prospective observational study aimed at estimating the prevalence of HS among cancer patients during treatment at our tertiary care medical center. Taken on a population of 220 patients within a period of 9 months, data were generated by a customized validated questionnaire and the same processed by IBM SPSS Statistics for Windows, version XXIV, Armonk, NY: IBM Corp. Differences between HS use and nonuse with respect to demographic, disease, and treatment characteristics were assessed by Chi-square test. For examining the latter variables as possible predictors of HS usage, they were entered into bivariate logistic regression with odds ratio and confidence intervals calculated for each.

Results

Out of 220 patients, 57 (26%) were HS users and 163 (74%) were nonusers. Majority of the users (42.1%) were on self-prepared folklore herbal medicine postdiagnosis of cancer (57.9%), the most common reason cited being symptom palliation (35.1%) on the advice of friends and family (64.9%). Fear of disapproval was the most common reason cited (68.4%) for not disclosing HS usage to the physician.

Conclusion

Chemotherapy and unemployment are predictors of HS usage, and there is a significant association between occupation status and HS usage. This first study on HS prevalence among South Indian population proposes the need for a more robust evidence base for understanding all aspects of HS use in cancer.

Protocol for a Systematic Review of Mobile Phone Technology for Managing Side Effects of Chemotherapy in Cancer Patients:A Research Protocol

Introduction: Mobile phone technology is an evolving trend in the medical field for rendering health-related care services to the needy. Chemotherapy is one of the cancer treatments which leads to certain side effects. These side effects can be managed well with the help of mobile phones, which became an essential thing in our life in recent decades. Aim: To identify the efficacy of using mobile phone technology for managing side effects associated with chemotherapy and improvement in quality of life. Materials and Methods: A systematic review will be conducted on randomised control trials and non-randomised control trials. In this review, Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) will be followed and a literature search will be conducted in PubMed-Medline, CINHAL Cochrane Library, Scopus, Science Direct, Ovid, J-Gate, and Trip databases. The literature search for this systematic review will be done on studies published between 2007 and 2019. The quality of the study will be assessed by the JBI clinical appraisal checklist for Randomised Controlled Trials (RCTs) and Non-Randomised Controlled Trials (Non-RCTs). Studies will be included based on predetermined inclusive criteria like studies published in the English language, with keywords like cancer patients, smartphone/android applications, chemotherapy, quality of life. Results: A descriptive synthesis of the findings of the selected studies will be carried out which will be presented in a narrative summary with statistical findings incorporated. Conclusion: This review will provide up-to-date evidence to support or oppose the hypothesis that mobile phone technology plays an effective role in managing side effects associated with chemotherapy and improve the quality of life of cancer patients.

Association of single nucleotide polymorphisms of adiponectin and leptin genes with breast cancer

Single nucleotide polymorphisms (SNPs) in adiponectin gene [rs1501299 (+276G/T) and rs266729 (-11377C/G)] and one SNP of leptin gene [rs7799039 (-2548G/A)] are known to influence plasma levels of adiponectin and leptin respectively. Literature is scarce on the association of adiponectin gene polymorphism rs266729 with breast cancer. The present study was taken up to study these polymorphisms and their association with breast cancer. Ninety-three patients diagnosed with malignant breast cancer were included as cases along with 186 age matched healthy controls. Adiponectin +276G/T, -11377C/G and leptin -2548G/A polymorphism were studied using polymerase chain reaction (PCR) based restriction fragment length polymorphism (RFLP). Adipokine levels in blood were measured using enzyme linked immunosorbent assay. Adiponectin +276G/T and leptin -2548G/A showed a significant increased risk for breast cancer even after adjusting for confounding variables like present age, age at menarche, age at first child birth and age at menopause. In the subset analysis, based on menopausal state, stronger association was observed between SNP in adiponectin gene +276G/T with the breast cancer in post-menopausal women after adjusting for all other variables. No association was found with adiponectin -11377C/G. No association of the gene polymorphisms with adipokine levels was observed. Also, no significant association was seen for the effect of gene-environment interaction i.e. presence of polymorphism with obesity and menopausal state for any of the SNPs studied. Adiponectin +276G/T is strongly associated with breast cancer in postmenopausal women while leptin -2548G/A polymorphisms is significantly associated with breast cancer irrespective of the menopausal state in south Indian subjects.

The Prognostic Role of Maximum Standardized Uptake Value of 18 F-FlouroDeoxy Glucose Positron Emission Tomography-Computed Tomography in Head and Neck Cancer Patients Undergoing Chemoradiotherapy

Aims and Objectives:

This retrospective study aims at correlating the pre- and post-therapy maximal standardized uptake values (SUV_max) of the whole-body 18-flourodeoxy glucose positron emission tomography (FDG-PET) scan with tumor response in patients with head and neck squamous cell cancer undergoing chemoradiotherapy.

Materials and Methods:

Data for this retrospective study were taken from the clinical records of 20 evaluable head and neck cancer patients who had availed treatment and evaluation at our institute during the previous year (March 2017–April 2018). All these above-mentioned patients had undergone chemoradiation at our center for locally advanced squamous cell carcinoma of the head and neck and had undergone pre- and post-therapy whole-body FDG PET scan. The posttherapy PET-computed tomography (CT) was advised after 8 weeks’ postcompletion of therapy. During the PET CT scan, images were acquired 1 h after injection of FDG. Pre- and post-therapy SUV_max were recorded and correlated with immediate treatment response.

Results:

The mean pretherapy SUV_Max of the primary tumor was 10.27 ranging from 4.5 to 26.17. The mean pretherapy SUV_Max of the node was 5.34 ranging from 0 to 17.9. The mean time of recording the posttherapy SUV_Max was 3 months (range 2–5 months). The mean posttherapy SUV_Max of the primary tumor was 1.05 ranging from complete metabolic response to 6.4. The mean posttherapy SUV_Max of the node was 0.7 ranging from complete metabolic response to 5.43. The statistical analysis based on Wilcoxon–Signed Rank test revealed a statistically significant difference in the pre- and post-therapy SUV_max values for both primary tumor (P < 0.001) and regional node (P = 0.001). Majority of patients (n = 15) showed clinical remission; however, five patients had progressive disease at the time of evaluation.

Conclusion:

Although the retrospective study revealed that complete responders had a statistically significant reduction in the posttherapy SUV_max in comparison to the pretherapy SUV_max it failed to identify a cutoff value for pretherapy SUV_max which could predict the probable outcome of therapy. In view of the same further prospective studies need to be conducted with larger patient numbers including various other tumor metabolic markers for greater clarity.

A Singular Perturbation Based Midcourse Guidance Law for Realistic Air-to-Air Engagement

In this study, a singular perturbation based technique is used for synthesis and analysis of a near optimal midcourse guidance law for realistic air-to-air engagement. After designing the proposed midcourse guidance law using three dimensional point mass formulation it has been validated through detailed realistic six degrees of freedom simulation. During terminal phase only proportional navigation guidance have been used. The calculation of optimal altitude in present guidance law has been carried out using Newton’s method, which needs generally one iteration for convergence and suitable for real-time implementation. Extended Kalman filter based estimator has been used for obtaining evader kinetic information from both radar and seeker noisy measurements available during midcourse and terminal guidance. The data link look angle constraint due to hardware limitation which affects the performance of midcourse guidance has also been incorporated in guidance law design. Robustness of complete simulation has been carried out through Monte Carlo studies. Extension of launch boundary due to singular perturbation over proportional navigation guidance at a given altitude for a typical engagement has also been reported.<br />

Enhanced Singular Value Decomposition based Fusion for Super Resolution Image Reconstruction

<p>The singular value decomposition (SVD) plays a very important role in the field of image processing for applications such as feature extraction, image compression, etc. The main objective is to enhance the resolution of the image based on Singular Value Decomposition. The original image and the subsequent sub-pixel shifted image, subjected to image registration is transferred to SVD domain. An enhanced method of choosing the singular values from the SVD domain images to reconstruct a high resolution image using fusion techniques is proposesed. This technique is called as enhanced SVD based fusion. Significant improvement in the performance is observed by applying enhanced SVD method preceding the various interpolation methods which are incorporated. The technique has high advantage and computationally fast which is most needed for satellite imaging, high definition television broadcasting, medical imaging diagnosis, military surveillance, remote sensing etc.</p>

Biogenic silver nanoparticles for cancer treatment: an experimental report

A generation of nanoparticles research has discussed recently. It is mandatory to elaborate the applications of biogenic nanoparticles in general and anticancereous property in particular. The present study was aimed to investigate the in vitro cytotoxicity effect of biogenic silver nanoparticles (AgNPs) against human breast cancer (MCF-7) cells towards the development of anticancer agent. Biogenic AgNPs were achieved by employing Sesbania grandiflora leaf extract as a novel reducing agent. It was well characterized by FESEM, EDAX and spectral studies showed spherical shaped nanoparticles in the size of 22 nm in slightly agglomerated form. It was surprising that biogenic AgNPs showed cytotoxic effect against MCF-7 cell lines were confirmed by MTT, AO-EB, Hochest and COMET assays. There was an immediate induction of cellular damage in terms of loss of cell membrane integrity, oxidative stress and apoptosis were found in the cell which treated with AgNPs. This may be a first report on anti-MCF-7 property of biogenic AgNPs in the fourth generation of nanoparticles research. It is necessary to study the formulation and clinical trials to establish the nano drug to treat cancer cells.

Agrobacterium-mediated genetic transformation and development of herbicide-resistant sugarcane (Saccharum species hybrids) using axillary buds

Direct regeneration from explants without an intervening callus phase has several advantages, including production of true type progenies. Axillary bud explants from 6-month-old sugarcane cultivars Co92061 and Co671 were co-cultivated with Agrobacterium strains LBA4404 and EHA105 that harboured a binary vector pGA492 carrying neomycin phosphotransferase II, phosphinothricin acetyltransferase (bar) and an intron containing beta-glucuronidase (gus-intron) genes in the T-DNA region. A comparison of kanamycin, geneticin and phosphinothricin (PPT) selection showed that PPT (5.0 mg l(-1)) was the most effective selection agent for axillary bud transformation. Repeated proliferation of shoots in the selection medium eliminated chimeric transformants. Transgenic plants were generated in three different steps: (1) production of putative primary transgenic shoots in Murashige-Skoog (MS) liquid medium with 3.0 mg l(-1) 6-benzyladenine (BA) and 5.0 mg l(-1) PPT, (2) production of secondary transgenic shoots from the primary transgenic shoots by growing them in MS liquid medium with 2.0 mg l(-1) BA, 1.0 mg l(-1) kinetin (Kin), 0.5 mg l(-1) alpha-napthaleneacetic acid (NAA) and 5.0 mg l(-1) PPT for 3 weeks, followed by five more cycles of shoot proliferation and selection under same conditions, and (3) rooting of transgenic shoots on half-strength MS liquid medium with 0.5 mg l(-1) NAA and 5.0 mg l(-1) PPT. About 90% of the regenerated shoots rooted and 80% of them survived during acclimatisation in greenhouse. Transformation was confirmed by a histochemical beta-glucuronidase (GUS) assay and PCR amplification of the bar gene. Southern blot analysis indicated integration of the bar gene in two genomic locations in the majority of transformants. Transformation efficiency was influenced by the co-cultivation period, addition of the phenolic compound acetosyringone and the Agrobacterium strain. A 3-day co-cultivation with 50 micro M acetosyringone considerably increased the transformation efficiency. Agrobacterium strain EHA105 was more effective, producing twice the number of transgenic shoots than strain LBA4404 in both Co92061 and Co671 cultivars. Depending on the variety, 50-60% of the transgenic plants sprayed with BASTA (60 g l(-1) glufosinate) grew without any herbicide damage under greenhouse conditions. These results show that, with this protocol, generation and multiplication of transgenic shoots can be achieved in about 5 months with transformation efficiencies as high as 50%.