Pancreatic ductal adenocarcinoma (PDAC) is a lethal malignancy with limited treatment options. Communicating risks and benefits in detail related to each treatment option as a part of the informed consent process is crucial to actively engage patients in their care process. Older age and emotional distress after diagnosis may impair cognitive impairment and compromise their autonomy in making an informed decision. Involvement of a multi-disciplinary team in the care process and supplementing various treatment option discussions with visual illustrations may help in simplifying complex information and improving patient understanding.
Amyloidosis is a heterogeneous disorder resulting from the deposition of toxic insoluble beta-sheet fibrillar protein aggregates.Amyloidosis can be acquired or hereditary.The disease can be localized or systemic.Amyloid can accumulate in the liver, spleen, kidney, heart, nerves, and blood vessels, causing different clinical syndromes.The variation in presentation and rarity of amyloidosis makes it a challenging diagnosis to and one third of cases are not diagnosed up till until a year after presentation.Ultrastructural examination and chemical analysis reveal the complex nature of amyloid.It emerges that on the basis of morphology and physical characteristics, all forms of amyloid are similar in appearance, but they are chemically heterogeneous.Based on analysis, amyloid is composed of 2 main types of complex proteins: Fibril proteins comprise about 95% of amyloid and non-fibrillar components which include P-component predominantly and there are several other different proteins which together constitute the remaining 5% of amyloid.Although not common, amyloidosis is a serious disease that results in significant mortality and morbidity.The most challenging issue is significant delay in diagnosis, sometimes up to several years.Early suspicion and thorough investigation are critical to making a timely diagnosis and referral for treatment. Classification and terminologyIt was Rudolph Virchow in 1854 who adopted the term "amyloid,".Amyloid deposits were noted by Rokitansky to have a "waxy" or "lardaceous" appearance grossly and by Virchow to be amorphous and hyaline on light microscopy.Amyloidosis is a result of extracellular tissue deposition of fibrils composed of low molecular weight in the range of 5 to 25 kD, many of these proteins circulate as constituents of plasma.Genetic factors, point mutations, deletions, and premature stop codons may result in structural changes predisposing to fibril formation (fibrillogenesis) by these proteins and therefore development of amyloid.Depending upon the type of amyloidosis, the actors that affect protein folding which includes chaperones protein and failure of disaggregating pathways, may be functional.These mechanisms also depend upon non-fibrillar components found in all types of amyloid, including serum amyloid P component (SAP), apolipoprotein E, glycosaminoglycans, and proteoglycans.At least 30 different human and 10 different animal protein precursors of amyloid fibrils are now known.The different clinicopathological types of amyloidosis is shown in table 1. Amyloidosis may be localised amyloidosis where there is involvement of any one organ or systemic where there is involvement of two or more organs by amyloid protein deposits.Light chain amyloidosis (AL), or primary amyloidosis is the most prevalent type of amyloidosis in the developed countries which is due to plasma cell dyscrasia, is due to deposition of protein derived from immunoglobulin light chain fragments.In developing countries AA amyloidosis (secondary amyloidosis) related to chronic infection, is encountered more often.The nomenclature is based on amyloidogenic protein For eg:-AL (light chain), unmutated, Transthyretin (ATTR) in heart (age related senile amyloidosis) mutated forms of TTR, alpha chain of fibrinogen (Afib), Apolipoprotein AI, A II, (hereditary amyloidosis), AA amyloidosis (acute phase reactant
Aims: Aim of this study was to evaluate the toxicity profile and locoregional response rate comparing hypofractionated chemoradiation with conventional chemoradiation. Materials and Methodology:We conducted a prospective study done in 59 untreated patients of squamous cell carcinoma of cervix (FIGO stage II -IVA) with histologically confirmed diagnosis and no evidence of distant metastasis.They were randomized to Arm A (HRT) and Arm B (CRT), 29 patients in arm A and 30 patients in arm B. Arm A received EBRT 39Gy in 13#, while Arm B received 46Gy in 23# with standard pelvic field box technique.Both arm received concurrent cisplatin 100mg/m2 three weekly.EBRT was followed by 3 sessions of Intracavitory Brachytherepy (ICBT) at a week interval to a dose of 7Gy per session to point A by HDR.End point of the study were tumor response, acute (3 months) and late toxicities (1 year).Results: 29 patients in Arm A and 30 patients in Arm B were recruited over 18 months.All patients completed minimum follow up of 1 year.26 patients completed treatment in Arm A and 26 patients completed treatment in Arm B. Maximum acute toxicity in Arm A in term of skin reaction was grade I (57.6%) and proctitis is grade I (64.3%) with median time for completion of treatment 7-8 weeks.Maximum acute toxicity in Arm B in skin reaction was grade I (73%) and proctitis grade I (53.4%) with median time for completion of treatment 7-8 weeks.Complete response at 3 months is 100% in arm A and 92.3% in arm B. Overall Survival at 6 months was 80.7% equivalent in both arms.Progression free survival at 6 months was 65.3% and 76.9% in arm A and arm B respectively. Conclusion:Tumor response in patients treated with hypofractionated radiotherapy appears comparable to that of standard fractionation with manageable toxicity profile.
Background: Global burden of cancer is expected to be 28.4 million cases in 2040 with a 47% rise as compared to 2020.An estimated 19.3 million new cancer cases and almost 10 million cancer deaths occurred in 2020 worldwide (GLOBOCAN 2020).Nowadays Female Breast cancer is the most common cancer with an estimated 2.3 million new cases.National Cancer Registry Programme report shown cancer incidence is seven times higher in Aizwal district than Osmanabad district.Rising cancer incidence creates a tremendous burden on people economic condition and health condition.Cancer registries are helpful to estimate the cancer burden and prepare the health system to make programme and policies for awareness, prevention, and treatment of cancer. Material and Method:Our Institute is situated in Patna (Bihar).We have registered every case prospectively in Hospital Based Cancer Registry.The demographic profile of each patient is registered since 2014 to 2021. Result:We analysed data of 15 common cancer a total of 32057 cases.8-year data was compiled which were registered since Jan 2014 to Dec 2021.A total of 32057 cases were registered in which 16232 (50.78%) were males and 15825 (49.37%) were females.Overall, the most common cancer was Carcinoma Gall Bladder (4204) 13% in these years with common age of diagnosis was 50-60 years (Median age is 55 years) which comprises 1748 cases (41.5%) male: female ratio is 0.55.
Liver cancer ranks among the leading global causes of death.The process of detecting liver tumours from computerized tomography (CT) images is crucial for the detection and management of liver cancer.It takes a significant amount of time and effort to physically identify cancer tissue.So, in order to accurately identify the right therapy, a computer-aided diagnostic is utilised in the decisionmaking process.As a result, the primary goal of this work is to properly identify and categorise liver cancer using deep learning technique.The volumetric data of 1800 Computerized Tomography images were taken for processing.The proposed method involves pre-processing, segmentation, classification, and feature extraction.The segmentation is processed by the Spatial Fuzzy C-means clustering algorithm to detect the affected liver region.Then the feature extraction is carried out by the Bat Optimization (BO) algorithm.The classifiers of the CNN are employed to categorize the affected and unaffected regions in the liver CT images.The findings demonstrate that the Convolutional Neural Network method performs better than competing approaches and provides possibilities for liver tumour detection and classification.The proposed methods performance criteria, including accuracy, recall, precision, and F1-Score, are assessed, and then its superiority to various existing systems is clearly shown.According to simulation results, the overall rates for accuracy, recall, precision, and F1-Score were roughly 99.80%, 100%, 99.99%, and 99.10% compared to a number of previous studies.
Atypical blue naevus is a controversial entity with histologic features that can be similar to both benign blue naevi and melanoma.Evaluated were 30 blue naevi for atypical histologic features that conventionally include increased lesion size, increased cellularity, polymorphous spindle and epithelioid cells, vesicular nuclei and prominent nucleoli, intense pigmentation, and infiltrative growth with 'dumbell'-shaped nesting.It was found that when present together, atypical histologic features of fatty infiltration, polymorphous population of spindle and epithelioid cells with prominent nucleoli, perineural infiltration and deep 'dumbell-shaped' lesional cell nesting were associated with sentinel lymph node metastasis.In select cases, these histologic features, when present together, may impart higher clinical risk and may warrant adequate complete lesional excision and sentinel lymph node sampling.
Estrogen-related receptors (ERRs) are a group of nuclear receptors that share sequence homology with ER whereas do not bind to Estrogen.In this article, studies were conducted with ERRβ, which is considered to have antiproliferative capabilities, to summarize its effects upon overexpression and knockdown.Clonogenic assay, and vivo zebra fish model tumour xenograft assay was used to detect the tumour growth and suppression.Wound healing and trans well migration as well as invasion assays were used to detect the metastasis in breast cancer.In this study, we established ERRβ as a possible tumour suppressor.Furthermore, epithelial-mesenchymal transition (EMT) pathway was checked with respective markers and it was observed that ERRβ overexpression in MCF7 and MDAMB -231 cells reduced the expression of mesenchymal markers where in promoting an upregulation of epithelial markers.Using triple negative MDAMB 231 cell lines, the zebra fish model was also utilized to check for tumor growth and migration.It was discovered that overexpression of the ERRβ resulted in a considerable reduction in the size of the tumor and its metastasis.Overall, our research showed that ERRβ interferes with breast cancer cell ability to proliferate and metastasize.Therefore, emphasizing on the function of ERRβ and, in turn, the process of EMT, may prevent the oncogenesis and metastasis in breast cancer cells.
Introduction: Cancer of the uterine cervix is the fourth most common cancer among women worldwide, with a higher burden in the low-and middle-income countries.Human Papilloma Virus (HPV) is the foremost aetiological factor which integrates into the genome of the epithelial cells at the cervical transformation zone leading to neoplasia.Aim: This study was undertaken to demonstrate overexpression of p16INK4a as a biomarker for HPV infection in cervical biopsies; to know its frequency of occurrence in cases of cervicitis, low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL) and invasive cancer; to establish marker's specificity and the ability to differentiate between cervical dysplasia from benign morphological mimickers. Materials and Methods:Totally 75 cervical biopsies were studied between 2014 to 2016, and categorized as inflammatory, precancerous and cancerous lesions.Routine histopathological examination was combined with Immunohistochemistry (IHC) using p16INK4a antibody.Grading of immuno-positivity was made depending on the number of cells exhibiting strong nuclear and/or cytoplasmic positivity.Results: Age of the patients ranged between 24 to 80years and the commonest clinical complaint was vaginal discharge.Of the 75 biopsies studied, 32% were diagnosed as cervicitis, 12% as LSIL and 16% as HSIL.Totally 30(40%) cases of invasive cancers were studied which included 26 cases procured from a cancer hospital to conduct a pilot study.p16INK4a was positive in all invasive cancers (100%) and negative in all cases of cervicitis.Statistically significant results were noted between histopathological diagnoses and the grades of immunopositivity with p16INK4a. Conclusion:This study reiterates the usefulness of p16INK4a as a reliable biomarker for HPV induced cervical lesions and unnecessary follow-up can be avoided in immune-negative cases.The fact that all cervical cancers were positive for HPV is alarming, signifying that developing nations have to give utmost importance to the primary prevention of cervical cancer with vaccination for HPV.
Cancer is one of the leading causes of death among patient in United States after death due to heart diseases.According to traditional Chinese medicine's reasoning, cancer comes from energy deficiency and formation of interna Fire (that is another energy imbalances that comes when the patient has energy deficiency or excessive energy).The purpose of this article is to show that the increase incidence of cancer is not only related to advanced age of the population but has an energy alteration in the entire population nowadays caused by the influences of the electromagnectic radiation from the use of cell phones and computers characterizing a new global immunodeficiency.Methods: I am medical doctor working in Western and in traditional Chinese medicine in my own clinic in Brazil.In a research made by myself in my clinic in Brazil (2015Brazil ( -2020)), I showed that 90% of all my patients were in the lowest level of energy, rated one out of eight.If I analyze the energy of the population today (2023-2024), I would say that it is affecting 100% of all my patients independently on the type of diagnosis or the age group.The use of any kind of highly concentrated medication or highly concentrated vacines or the use of metalic implants inside the body can reduce even more this energy and can increase the chance to have cancer.
Introduction: Any person of age 60 and above and a citizen of India is categorized as senior citizen according to maintenance and welfare of parents and senior Citizen Act 2007.According to 2014 report by Help age India (Non-Profit Organization), in 2050 elderly population will be 20% of population addressed as a senior citizen.Cancer gradually peaks at the age of 70-80 years and there is a sharp increase reported after the age of 80 years.This article provides an overview of profile of elderly patients undergoing Radiotherapy in State Cancer Institute of Bihar. Material and Method:This is a retrospective study of all cancer patients of 60 year and above at our department who received Radiotherapy from August 2021 to April 2023.Result: A total of 1738 patients have received Radiotherapy during this period in which 432 (24.85%) cases were elderly patients from age 60 and above.246 (57%) patients were males and 186 (43%) patients were females.The most common cases reported in our study was of Head and Neck cancer -186 (43%) cases.15.2% patients of Carcinoma Cervix.10.4% patients presented with carcinoma Breast.Discussion: 432 Patients were included and analysed in this study about 24.35% of all total cases received Radiotherapy during period.HBCR data from 5 Indian hospitals also shown 20.3% of all malignancies in 65 years of age and above (17).In our study common site was carcinoma Head and Neck was commonest about 43.1% followed by carcinoma cervix, Carcinoma gastrointestinal cancer urogenital cancers. Conclusion:A significant number of patients can be treated with curative intent with Suppurative care There should be some patients protocol regarding nutritional status and for these patients treatment according to their need.
Colon cancer is the second leading dreadful disease-causing death.The challenge in the colon cancer detection is the accurate identification of the lesion at the early stage such that mortality and morbidity can be reduced.In this work, a colon cancer classification is done by recurrent neural network and CNN.Initially, the input cancer images subjected to carry a pre-processing, in which outer artifacts are removed.The pre-processed image is forwarded for segmentation.The obtained segments are forwarded for attribute selection module.Finally, the Comparison is done for CNN and RNN Results.
Cancer remains a significant global health concern, and while strides have been made in various medical domains, its potential correlation with dental curing lights warrants thorough investigation.This comprehensive review explores the evolution and utilization of photo-curable resin composite (RC) restorations, a cornerstone of modern dental practice, and the pivotal role of light-curing units (LCUs) in their application.The enhanced mechanical properties and superior esthetic outcomes of RC restorations have led to their widespread adoption, reflecting evolving patient preferences towards minimally invasive and cosmetic appealing dental treatments.However, the efficacy of RC restorations is intrinsically linked to the proper usage of LCUs, highlighting the critical importance of understanding their characteristics and correct application.Despite advancements in curing light technology, discrepancies in output descriptions and usage persist, potentially compromising the quality and longevity of dental restorations.The meeting of key opinion leaders and manufacturers in 2014 yielded invaluable recommendations for selecting and utilizing curing lights, emphasizing factors such as regulatory compliance and the adoption of standardized output metrics.The historical progression of curing light technology, from UV radiation-based devices to modern LED-based units, underscores a continual pursuit of safer, more efficient solutions for dental procedures.Nevertheless, concerns regarding potential health risks, including cancer, persist, particularly concerning prolonged exposure to blue light and the generation of free radicals during the curing process.While current evidence suggests that curing lights are generally safe for clinical use, ongoing research is necessary to elucidate any long-term implications and mitigate potential risks.
Squamous cell carcinoma is the most common malignant tumor of oral cavity generally seen in people above 50yrs of age, rarely under 40yrs of age, case report describes a case of pt aged 50 with history of tobacco use/drinking habit And describing the Aetiology, Management of Oral Squamous Cell Carcinoma.
Introduction: Globally head and neck cancer is 7th most common cancer with more than 66,000 new cases and about 50% deaths annually.In India, head and neck cancer incidence is higher as compared to western world due to risk factors like oral tobacco, betel nut chewing, Pan masala, poor oral hygiene, and smoking habits. Material and Method:We included 120 Patients.All patients were treated with radical intent.All the patients were histologically proven advanced head and neck carcinoma from stage II, III & IV in 8-month duration from -Sept 22 to April 23, patients were divided into two arms. Conclusion:Weekly paclitaxel with the dose of 75 mg/nm2 with radiotherapy can be considered as a promising and feasible alternative for the treatment of locally advanced Head and Neck Carcinoma.Haematological toxicities mucositis and skin reaction was higher but manageable.xerostomia and the loss of taste was reported more in cisplatin arm.
