Radiofrequency tissue ablation: an early Indian experience.

INTRODUCTION: Radiofrequency (RF) tissue ablation has been tried safely and effectively in the West as percutaneous local tissue ablation therapy. We present our experience with this technique in malignant lesions. METHODS: RF tumor ablation was done using an RF generator (Berchtold; Germany) generating 35-50 RF watts of power output. The RF needle was placed in the tumor under image guidance (n = 22) or at open surgery (n = 1). Around 1500 watts/cm3 RF energy was delivered to the tumor. Over 21 months, 23 patients underwent the procedure for 73 lesions, including metastatic liver lesions (n = 21) and locally advanced inoperable carcinoma of pancreas (n = 2). RESULTS: All lesions less than 3 cm in size (n = 15) and 39% of lesions 3-4 cm in size (17/44) had complete necrosis. Residual tumor was seen in 27/44 lesions (61%) 3-4 cm in size and in all 14 lesions more than 4 cm in size. There was no mortality or major morbidity. There were two minor complications (ascites 1, pleural effusion 1). Of 21 patients treated for liver metastases, 10 are still alive (6-month survival 19/21 [90%] and 12-month survival 11/17 [64.7%]). Only 2 of 32 (6.2%) lesions with complete necrosis had local recurrence. CONCLUSION: RF tumor ablation is a safe and effective local tissue ablative method in Indian patients.     

Validity of a modified Born approximation for a pulsed plane wave in acoustic scattering problems

The validity domain of a modified Born approximation (MBA) has been examined for the scattering of a pulsed plane wave (PPW). This new approximation has been compared with exact results and also with the conventional Born approximation (BA). Comparisons have been made for the scattering by a homogeneous sphere. Error charts have been presented for various scatterer sizes and acoustic properties for forward as well as back scattering. The pulse width has also been varied. Our study shows that the modified Born approximation is generally preferable to the conventional Born approximation in the forward direction. In the backward direction both approximations have a similar kind of validity domain. These observations are important in view of the fact that the Born approximation has been widely used in acoustic scattering problems.     

Clinicopathological patterns of bladder carcinoma over 1 year: experience from University Hospital of Nepal

Purpose

To define the clinical and pathological patterns of urinary bladder carcinoma from the University Hospital of Nepal.

Methods

This is a retrospective analytical study. Patients with bladder mass who underwent surgery over 1 year and who had data record were included in the study. Demographic profile, type of surgery, findings on clinical examination, cystoscopy findings, histopathological report, tumor stage, and post-surgery adjuvant therapy were analyzed.

Results

Out of 86 patients who underwent transurethral resection of bladder tumor, 77 patients had biopsy-proven malignant bladder tumor. Urothelial cancer was present in 96.1%. Male were 78.6%. The mean age of diagnosis was 65.5?±?11.8 years. Non-muscle-invasive bladder cancer (NMIBC) was 3.7 times more common than muscle-invasive bladder cancer (MIBC). High-grade tumors (58.6%) were more common than low grade (41.4%). The detrusor muscle was present inthe biopsy specimen of 48 patients (64%). Re-TURBT within 2–6 weeks was considered based on histopathology reports for about half of the patients (45.3%). Upstaging and upgrading of the tumor was present in 5.8 and 5.8% of the patients, respectively. Residual tumor without upstaging and upgrading was present in 23.5%. One patient (1.3%) had Clavien–Dindo grade 1, three (4%) patients had grade 2 and two patients (2.7%) had grade 3b.

Conclusion

In the present study, patients with bladder cancer are younger than reported in other studies. Smokers are strongly predisposed. The histological pattern is similar to the Western and Asian populations. NMIBC and MIBC occur in proportion to that described as in other studies. We had a lower rate of recurrence, upstaging and upgrading. We had a lesser rate of acceptance for radical cystectomy in our patients.

     

In vitro and in vivo characterization of erythrosin B and derivatives against Zika virus

Zika virus (ZIKV) causes significant human diseases without specific therapy. Previously we found erythrosin B, an FDA-approved food additive, inhibited viral NS2B−NS3 interactions, leading to inhibition of ZIKV infection in cell culture. In this study, we performed pharmacokinetic and in vivo studies to demonstrate the efficacy of erythrosin B against ZIKV in 3D mini-brain organoid and mouse models. Our results showed that erythrosin B is very effective in abolishing ZIKV replication in the 3D organoid model. Although pharmacokinetics studies indicated that erythrosin B had a low absorption profile, mice challenged by a lethal dose of ZIKV showed a significantly improved survival rate upon oral administration of erythrosin B, compared to vehicle control. Limited structure−activity relationship studies indicated that most analogs of erythrosin B with modifications on the xanthene ring led to loss or reduction of inhibitory activities towards viral NS2B−NS3 interactions, protease activity and antiviral efficacy. In contrast, introducing chlorine substitutions on the isobenzofuran ring led to slightly increased activities, suggesting that the isobenzofuran ring is well tolerated for modifications. Cytotoxicity studies indicated that all derivatives are nontoxic to human cells. Overall, our studies demonstrated erythrosin B is an effective antiviral against ZIKV both in vitro and in vivo.KEY WORDS: Flavivirus, Zika virus, Dengue virus, Antiviral, Protease inhibitor, Erythrosin B     

Improving Trauma Care in India: the Potential Role of the Rural Trauma Team Development Course (RTTDC)

The Rural Trauma Team Development Course (RTTDC) was devised to optimize trauma resuscitation training in under-resourced rural institutions. This program appears ideal for India because of its dense traffic, large population, and high frequency of rural trauma. We report on the feasibility and desirability of introducing RTTDC in India. An instructor course for 20 faculties and a provider course for 23 were conducted in New Delhi, India. The courses were evaluated by multiple choice question (MCQ) performance, by rating the modules on a three-point scale (1 = very relevant, 2 = relevant, and 3 = not relevant) for communication skills, principles of performance improvement and patient safety (PIPS), and clinical scenarios. Evaluation questionnaires including desirability of promulgation in India were completed using a five-point Likert Scale (1 = strongly agree, 2 = agree, 3 = neutral, 4 = disagree, and 5 = strongly disagree). Overall written comments were also provided. Both faculty and providers improved post-course MCQ scores (p?<?0.05) with lower scores in the provider group. Seventy-eight percent faculty and 74 % providers rated the communication module very relevant. PIPS was rated very relevant by 72 % faculty and 65 % providers. There were over 150 comments, generally positive with over 90 % of both faculty and providers rating strongly agree to agree that the course be promulgated widely in India. The RTTDC including plans for promulgation was enthusiastically received in India, and its potential for improving trauma care including communication skills and PIPS appears excellent.     

The endocannabinoid system and cardiometabolic risk

Worldwide, the rates of obesity are rapidly rising. Abdominal obesity in particular is associated with increased cardiovascular risk factors, namely increased triglycerides, low high-density lipoprotein (HDL) cholesterol, elevated blood pressure and increased plasma glucose. The cluster of these obesity-related metabolic disorders identifies individuals with the cardiometabolic syndrome, who are at particular risk for cardiovascular disease and type 2 diabetes. The accumulation of intra-abdominal fat and the subsequent development of visceral obesity rely on the body's mechanisms to store energy and to stimulate appetite. The endocannabinoid system has been implicated in the regulation of energy balance and has emerged as a critical target for the modulation of visceral obesity and insulin resistance. Its overactivity appears to be associated with the development of obesity. The current review examines the role of the endocannabinoid system in cardiometabolic disease and its basis as a target for modulating cardiovascular risk.     

Biomarker System for Genetic Analysis of Stored Grain Pests Callosobruchus maculatus and Callosobruchus chinensis

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - Random amplified polymorphic DNA-PCR (RAPD-PCR) analysis was used in combination with morphological...