Simple Oncoplastic Breast Conserving Surgery for Breast Cancer in a University Hospital.

Background The principle of oncoplastic surgery is the removal of tumors with negative margins as well as maintaining the contour of the breast. The goals are to achieve local control and best cosmesis. Objective The objective of this study was to assess patients' satisfaction with different techniques of simple oncoplastic breast conserving surgery (BCS) for early breast cancer. Method This was a retrospective study of early breast cancer cases operated during the period 2009 to 2017. All the patients were under regular follow up for at least five years after surgery. Original Harvard/NSABP/RTOG scale was used to evaluate cosmesis at one year after surgery. Result Median age of the patients was 43 years with median size of tumor being 2.5 cm. All of the patients had good to excellent cosmetic outcome. One patient (4.5%) had margin positivity. All patients were disease free and happy with the cosmesis at five years although one patient did not have whole breast radiotherapy. Conclusion Simple oncoplastic breast conserving surgery techniques in upper part of breast are simple, feasible and improve cosmetic outcome with low margin positivity and good disease-free five-year survival.

Displaced Intra-Articular Calcaneal Fractures: Evaluation of Clinical and Radiological Outcome Following Open Reduction and Internal Fixation with Locking Branched Calcaneal Plate.

Background An introduction of the World Health Organization Surgical Safety Checklist (WHO SSC) is essential to promote surgical safety. Objective To obtain country-specific information regarding the checklist in a leading medical institution in Nepal. Method The present research was a cross-sectional study with a survey conducted among healthcare professionals working in the operation theatre at the Tribhuvan University Teaching Hospital (TUTH) in Kathmandu, Nepal. A questionnaire was distributed to 150 healthcare professionals working in the operating theatre. Responses to the questionnaire were analysed descriptively and regression analyses used to identify factors associated with awareness of the checklist. Result In total, 127 healthcare professionals participated in the study, of whom 118 (92.9%) had been aware of the WHO SSC. A substantial proportion of participants (108, 91.5%) were not satisfied with the prevailing practice whereby the checklist was not routinely used during surgery. Lack of appropriate training was the most prevalent barrier to the checklist use (72, 67.9%), followed by unwillingness of staff to use the checklist (54, 50.9%), and lack of experience (42, 39.7%). The mean score on the survey was 6.0 out of 10. Regarding the results of the regression model on survey scores, surgeons had higher scores compared to nurses (unadjusted coefficient 0.80, 95% CI 0.20-1.40). Conclusion Most of the healthcare professionals were aware of the WHO SSC, however multiple barriers to the checklist use were identified. It is important to establish an effective use of WHO SSC in the operation theatre.

Effectiveness of convalescent plasma in Indian patients with COVID-19.

BACKGROUND: Convalescent plasma (CP) is being used as a treatment option in hospitalized patients with COVID-19. Till date, there is conflicting evidence on efficacy of CP in reducing COVID-19 related mortality. OBJECTIVE: To evaluate the effect of CP on 28-day mortality reduction in patients with COVID-19. METHODS: We did a multi-centre, retrospective case control observational study from 1st May 2020 to 31st August 2020. A total of 1079 adult patients with moderate and severe COVID-19 requiring oxygen, were reviewed. Of these, 694 patients were admitted to ICU. Out of these, 333 were given CP along with best supportive care and remaining 361 received best supportive care only. RESULTS: In the overall group of 1079 patients, mortality in plasma vs no plasma group was statistically not significant (22.4% vs 18.5%; p = 0.125; OR = 1.27, 95% CI: 0.94--1.72). However, in patients with COVID-19 admitted to ICU, mortality was significantly lower in plasma group (25.5% vs 33.2%; p = 0.026; OR = 0.69, 95%CI: 0.50-0.96). This benefit of reduced mortality was most seen in age group 60 to 74 years (26.7% vs 43.0%; p = 0.004; OR = 0.48, 95% CI: 0.29-0.80), driven mostly by females of this age group (23.1% vs 53.5%; p = 0.013; OR = 0.26, 95% CI: 0.09-0.78). Significant difference in mortality was observed in patients with one comorbidity (22.3% vs 36.5%; p = 0.004; OR = 0.50, 95% CI: 0.31-0.80). Moreover, patients on ventilator had significantly lower mortality in the plasma arm (37.2% vs 49.3%; p = 0.009; OR = 0.61, 95% CI: 0.42-0.89); particularly so for patients on invasive mechanical ventilation (63.9% vs 82.9%; p = 0.014; OR = 0.37, 95% CI: 0.16-0.83). CONCLUSION: The use of CP was associated with reduced mortality in COVID-19 elderly patients admitted in ICU, above 60 years of age, particularly females, those with comorbidities and especially those who required some form of ventilation.

Evaluation of forewarning models for mustard aphids in different agro-climatic zones of India.

Mustard aphid, Lipaphis erysimi (Kaltenbach), is the most serious pest of Rapeseed-Mustard which is known to be responsible for a tremendous loss in yield and oil content, under various agro-climatic conditions of India. Information support on aphid occurrence and intensity is necessary for effective management by the farmers in the mustard-growing belt. In this study, an effort is made to develop forewarning model using the field data on aphid for 12 consecutive rabi seasons from 2003-2004 to 2014-2015 under different agro-climatic locations in India. Three main components of aphid-related stages were identified for which necessary forewarnings were needed to be issued: (1) severity, (2) the time of reaching the economic threshold level (ETL) for decision-making on pesticide application, and (3) time of occurrence of peak population. To address these, three different models were developed/used and validated using incident field dataset. Those field observations when the infestation level were below severe category (< 60) during rising phase of the aphid population were found to indicate highest R sqr. (0.82) for the model-I during validation. When model-II was used, 11 out of 14 locations (78.57%) stood validated. The assumptions made in model-III also got validated when humidity thermal ratio (HTR) of the week of peak population ranged between 1.5 and 4 (lowest among the weeks considered), and population reached severe category. The models showed better results during real-time validation in seasons 2016-2017 and 2017-2018, thus suggesting that these three models can be used to ascertain the severity, week of ETL, and week of peak aphid population for Brassica juncea varieties all over the mustard belt in India and can be operationalized spatially to forewarn against the aphid pest population in future under Gramin Krishi Mausam Sewa (GKMS) scheme.

Hemoadsorption by extracorporeal cytokine adsorption therapy (CytoSorb®) in the management of septic shock: A retrospective observational study.

INTRODUCTION: Sepsis results in immunologic disturbances with the release of various inflammatory mediators such as cytokines. Cytokines can damage the cells, and the continuous release of inflammatory mediators leads to severely impaired immunity. Therefore, the reduction in cytokine levels by hemoadsorption represents a new concept for blood purification. CytoSorb® as a hemoadsorption device is a detoxification system, which aims to decrease the cytokines levels. This study was conducted to understand any beneficial effects of CytoSorb® therapy in septic patients. METHODOLOGY: This was a retrospective and observational study, approved by the scientific and ethics committee of Max Super Specialty Hospital, Patparganj, Delhi, India and conducted in compliance with current International Council for Harmonization, Good Clinical Practice, Schedule Y, and Indian Council of Medical Research guidelines. Subjects of either gender (age > 18 year) were included in the study. The data were presented as mean ± standard deviation and categorical as frequency and percentage (%). A p value less than 0.05 (p < 0.05) was considered to be statistically significant. RESULTS: A total number of 36 patients were included in the study. Majority of the patients were male with mean age (56.36 ± 14.83). After therapy, procalcitonin and total leucocyte count levels decreased within 24 h. Post therapy, sepsis-related organ failure assessment (SOFA) score of Day (D)1, D2, and D3 reduced to 10.4 ± 3.63, 8.7 ± 4.02, and 7.8 ± 3.67, respectively. The Acute Physiology and Chronic Health Evaluation (APACHE) II score and predicted mortality were lower in the survivor group as compared to the non-survivor group. CONCLUSION: Hemoadsorption using the extracorporeal adsorption device (CytoSorb®) might be an effective rescue therapy in stabilizing septic shock patients.

Saccharomyces: A Friend or Foe in ICU (A Case Report with Solution).

Saccharomyces cerevisiae or boulardii, also known as baker's yeast or brewer's yeast, is normally a nonpathogenic microbe. It is commonly used as a probiotic to prevent antibiotic-associated diarrhea. We present a case of a 77-year-old woman with uncontrolled diabetes who developed Saccharomyces fungemia with use of Saccharomyces containing probiotic after 5 days of treatment. The probiotic was immediately discontinued. The indwelling central line was removed, she was started on amphotericin B and the fungemia resolved. This case report highlights this peculiar complication of probiotic use. We also find it important to increase the awareness amongst the healthcare providers about this likely risk while prescribing probiotics, especially for critically ill patients. How to cite this article: Gupta P, Singh YP, Taneja A. Saccharomyces: A Friend or Foe in ICU (A Case Report with Solution). Indian J Crit Care Med 2019;23(9):430-431.

Round Block Technique in Management of Breast Lesions.

The basic tenets of oncoplastic surgery essentially includes volume displacement and volume replacement. The round block technique, so-called donut mastopexy or Benelli mastopexy, is frequently used as a volume displacement technique in breast conserving surgery for benign multicentric fibroadenomas and early breast cancers. Such techniques are still underused in Nepal. In this article we present on four cases managed with original round block technique and followed prospectively with their outcome.

Identification of mega-environments and rice genotypes for general and specific adaptation to saline and alkaline stresses in India.

In the present study, a total of 53 promising salt-tolerant genotypes were tested across 18 salt-affected diverse locations for three years. An attempt was made to identify ideal test locations and mega-environments using GGE biplot analysis. The CSSRI sodic environment was the most discriminating location in individual years as well as over the years and could be used to screen out unstable and salt-sensitive genotypes. Genotypes CSR36, CSR-2K-219, and CSR-2K-262 were found ideal across years. Overall, Genotypes CSR-2K-219, CSR-2K-262, and CSR-2K-242 were found superior and stable among all genotypes with higher mean yields. Different sets of genotypes emerged as winners in saline soils but not in sodic soils; however, Genotype CSR-2K-262 was the only genotype that was best under both saline and alkaline environments over the years. The lack of repeatable associations among locations and repeatable mega-environment groupings indicated the complexity of soil salinity. Hence, a multi-location and multi-year evaluation is indispensable for evaluating the test sites as well as identifying genotypes with consistently specific and wider adaptation to particular agro-climatic zones. The genotypes identified in the present study could be used for commercial cultivation across edaphically challenged areas for sustainable production.

Comparative and temporal transcriptome analysis of peste des petits ruminants virus infected goat peripheral blood mononuclear cells.

Peste des petits ruminanats virus (PPRV), a morbillivirus causes an acute, highly contagious disease - peste des petits ruminants (PPR), affecting goats and sheep. Sungri/96 vaccine strain is widely used for mass vaccination programs in India against PPR and is considered the most potent vaccine providing long-term immunity. However, occurrence of outbreaks due to emerging PPR viruses may be a challenge. In this study, the temporal dynamics of immune response in goat peripheral blood mononuclear cells (PBMCs) infected with Sungri/96 vaccine virus was investigated by transcriptome analysis. Infected goat PBMCs at 48h and 120h post infection revealed 2540 and 2000 differentially expressed genes (DEGs), respectively, on comparison with respective controls. Comparison of the infected samples revealed 1416 DEGs to be altered across time points. Functional analysis of DEGs reflected enrichment of TLR signaling pathways, innate immune response, inflammatory response, positive regulation of signal transduction and cytokine production. The upregulation of innate immune genes during early phase (between 2-5 days) viz. interferon regulatory factors (IRFs), tripartite motifs (TRIM) and several interferon stimulated genes (ISGs) in infected PBMCs and interactome analysis indicated induction of broad-spectrum anti-viral state. Several Transcription factors - IRF3, FOXO3 and SP1 that govern immune regulatory pathways were identified to co-regulate the DEGs. The results from this study, highlighted the involvement of both innate and adaptive immune systems with the enrichment of complement cascade observed at 120h p.i., suggestive of a link between innate and adaptive immune response. Based on the transcriptome analysis and qRT-PCR validation, an in vitro mechanism for the induction of ISGs by IRFs in an interferon independent manner to trigger a robust immune response was predicted in PPRV infection.

Productivity of sodic soils can be enhanced through the use of salt tolerant rice varieties and proper agronomic practices.

Regaining the agricultural potential of sodic soils in the Indo-Gangetic plains necessitates the development of suitable salt tolerant rice varieties to provide an entry for other affordable agronomic and soil manipulation measures. Thus selection of high yielding rice varieties across a range of sodic soils is central. Evaluation of breeding lines through on-station and on-farm farmers' participatory varietal selection (FPVS) resulted in the identification of a short duration (110-115 days), high yielding and disease resistant salt-tolerant rice genotype 'CSR-89IR-8', which was later released as 'CSR43' in 2011. Several agronomic traits coupled with good grain quality and market value contributed to commercialization and quick adoption of this variety in the sodic areas of the Indo-Gangetic plains of eastern India. Management practices required for rice production in salt affected soils are evidently different from those in normal soils and practices for a short duration salt tolerant variety differ from those for medium to long duration varieties. Experiments were conducted at the Indian Council of Agricultural Research-Central Soil Salinity Research Institute (ICAR-CSSRI), Regional Research Station, Lucknow, Uttar Pradesh, India during 2011 and 2013 wet seasons, to test the hypothesis that combining matching management practices (Mmp) with an improved genotype would enhance productivity and profitability of rice in sodic soils. Mmp were developed on-station by optimizing existing best management practices (Bmp) recommended for the region to match the requirements of CSR43. The results revealed that transplanting 4 seedlings hill-1 at a spacing of 15 × 20 cm produced significantly higher yield over other treatments. The highest additional net gain was US$ 3.3 at 90 kg ha-1 N, and the lowest was US$ 0.4 at 150 kg ha-1 N. Above 150 kg ha-1, the additional net gain became negative, indicating decreasing returns from additional N. Hence, 150 kg N ha-1 was considered the economic optimum N application rate for CSR43 in these sodic soils. Using 150-60-40-25 kg N-P2O5-K2O-ZnSO4·7H2O ha-1 in farmers' fields grown to CSR43 produced an average of 5.5 t ha-1 grain. The results of on-farm evaluation trials of CSR43 showed that matching management practices (Mmp) increased yield by 8% over existing best management practices (Bmp) recommended by ICAR-CSSRI for sodic soils and by 16% over framers' management practices; however, combining Mmp with CSR43 resulted in 35% higher yields over farmers' current varieties and management. This approach of combining cost effective crop and nutrient management options and a salt-tolerant variety can maximize the productivity and profitability of sodic soils in the alluvial Indo-Gangetic plains and in neighboring salt-affected areas of the Ganges mega delta in South Asia.

Morphological and comparative genomic analyses of pathogenic and non-pathogenic Fusarium solani isolated from Dalbergia sissoo.

Sissoo or shisham (Dalbergia sissoo Roxb.) is one of the finest wood of South Asia. Fusarium solani is a causal organism of sissoo wilt, decline, or dieback. It is also a potential causal organism associated with other valuable tree species. Thirty-eight Fusarium isolates including 24 F. solani and 14 Fusarium sp., were obtained in 2005 from different geographical locations in India. All 38 (18 pathogenic and 20 non-pathogenic) isolates were characterized for genomic analysis, growth behaviour, pigmentation and sensitivity to carbendazim. Based on growth pattern, growth rate, pigmentation and sensitivity to carbendazim, all 38 isolates showed a wide range of variability, but no correlation with pathogenicity or geographical distribution. Three techniques were used for comparative genomic analysis: random amplified polymorphic DNA (RAPD); inter simple sequence repeats (ISSR); and simple sequence repeats (SSR). A total of 90 primers targeting different genome regions resulted a total of 1159 loci with an average of 12.88 loci per primer. These primers showed high genomic variability among the isolates. The maximum loci (14.64) per primer were obtained with RAPD. The total variation of the first five principal components for RAPD, ISSR, SSR and combined analysis were estimated as 47.42, 48.21, 46.30 and 46.78 %, respectively. Among the molecular markers, highest Pearson correlation value (r = 0.957) was recorded with combination of RAPD and SSR followed by RAPD and ISSR (r = 0.952), and SSR and ISSR (r = 0.942). The combination of these markers would be similarly effective as single marker system i.e. RAPD, ISSR and SSR. Based on polymorphic information content (PIC = 0.619) and highest coefficient (r = 0.995), RAPD was found to be the most efficient marker system compared to ISSR and SSR. This study will assist in understanding the population biology of wilt causing phytopathogen, F. solani, and in assisting with integrated disease management measures.

Genetic analysis of reproductive performance of Frieswal cattle at Military Farm, Ambala.

AIM: This study was carried out to investigate the genetic analysis of reproductive performance of Frieswal cattle at Military Farm, Ambala. MATERIALS AND METHODS: A total number of 3005 lactation records of 1147 Frieswal cows over a period of 15 years extending from 1993 to 2007 were used to study at Military Dairy Farm, Ambala. The study period was divided into 5 period of 3 years each. The average performances of reproduction traits, effect of genetic and non-genetic factors were analyzed, and estimation of genetic and phenotypic parameters of reproduction traits was undertaken. RESULTS: The age at first calving (AFC) differed significantly across the periods of calving. The AFC was lowest during the third period (1999-2001) and longest in the first period (1993-95). The effect of season and period of calving, lactation order and regression of AFC on dry period, calving interval and service period was highly significant. The effect of sire was non-significant. The heritability estimates were low for almost all the traits under study. The service period had a high genetic correlation with dry period and calving interval. The dry period also found to have a low genetic correlation with calving interval in Frieswal cows. Service period had a high phenotypic correlation with dry period and very high with a calving interval. The phenotypic correlation between the dry period and calving interval was recognized high. CONCLUSIONS: Low heritability estimate for the reproduction traits indicates that there is a very little additive genetic variance in these traits, and individual selection will not be helpful for improving them. Improvement may be brought through better feeding and management of cows by reducing the environmental variability.

Post operative diagnosis of early gastric cancer in a low risk population and the possibility of risk stratified screening.

BACKGROUND: Gastric cancer is the second commonest cause of cancer related mortality worldwide. Though its incidence is more in Eastern Asia, it is increasing in the South Asian subcontinent. The diagnosis of early gastric cancer (EGC) confined to the mucosa or submucosa, is an important concern due to a better outcome at this stage where five year survival rates could increase by 90 percent. Though mass screening is done in few countries, it has not been applied in developing countries like Nepal. Preoperative diagnosis of EGC is rare in Nepal. The aim of this study is to analyze the clinicopathological features of postoperative cases of gastric cancer managed in a tertiary care university hospital of Nepal. METHODS: All patients with histological diagnosis of gastric cancer admitted in the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal during the three year period (September 2010 to August 2013) were analyzed retrospectively. RESULTS: Ninety two patients with endoscopic diagnosis of gastric cancers were admitted during the past three years. The mean age was 60 years ranging from 28 years to 85 years with the male to female ratio of 2.8:1. Five patients were younger than 40 years and all were in advanced stage. Thirty five percent of the patients belonged to Janajatis (Hill) community though they comprise only 23% of the population and about 65% of them belonged to an area involving 25% of the country. Seventy six cases were operated. Out of 92 patients, 4 patients were diagnosed as early gastric cancer postoperatively. All patients with early gastric cancer were above 50 years with CT Scan abdomen revealing focal thickening without lymphadenopathy. CONCLUSION: Over the years, the incidence of gastric cancer is increasing in Nepal. Though 92% are advance gastric cancers, few have been diagnosed and treated early. A screening program in a country like Nepal with diverse ethnicity and difficult terrain might be helpful if it targets high risk people in high risk areas.

Reliable screening technique for evaluation of wild crucifers against mustard aphid Lipaphis erysimi (Kalt.).

Wild crucifers namely Arabidopsis thaliana, Brassica fruticulosa, B. rugosa, B. spinescens, B. tournefortii, Camelina sativa, Capsella bursa-pastoris, Crambe abysinnica, Cronopus didymus, Diplotaxis assurgens, D. gomez-campoi, D. muralis, D. siettiana, D. tenuisiliqua, Enatharocarpus lyratus, Lepidium sativum and Sinapis alba along with five cultivated Brassica species including B. rapa (BSH-1), B. juncea (Rohini), B. napus (GSC-6), B. carinata (DLSC-2) and Eruca sativa (T-27) were screened against mustard aphid Lipaphis erysimi (Kalt.) with a standardized technique under definite level of aphid pressure developed using specially designed cages. Observations have revealed that B. fruticulosa, B. spinescens, Camelina sativa, Crambe abysinnica and Lepidium sativum were resistant to mustard aphid L. erysimi with aphid infestation index (AII) ≤ 1. Capsella bursa-pastoris was highly susceptible to bean aphid, Aphis fabae during its vegetative stage (with 100% mortality). Other genotypes were found in the range of 'susceptible' to 'highly susceptible' with AII ranging 3-5.

Pregabalin premedication - A new treatment option for hemodynamic stability during general anesthesia: A prospective study.

BACKGROUND: Hemodynamic responses of laryngoscopy, intubation, and pain are powerful noxious stimulus which should be attenuated by the appropriate premedication, smooth induction, and rapid intubation. CONTEXT: The oral pregabalin may attenuate the hemodynamic pressor response with intraoperative hemodynamic stability. AIMS: The present study was designed to evaluate the clinical efficacy and safety of oral pregabalin for hemodynamic stability. SETTINGS AND DESIGN: This is a prospective blind randomized controlled cohort observation study. MATERIALS AND METHODS: The 80 adult consented patients of ASA grade I and II of either gender aged 24-54 years who met the inclusion criteria were randomized to receive oral pregabalin 150 mg or placebo capsule, given 60-75 min before surgery. Patients were premedicated with metoclopramide (10 mg), glycopyrrolate (0.2 mg), and fentanyl (1 µg/kg). Anesthesia was induced with propofol and rocuronium and maintained with isoflurane, nitrous oxide, and oxygen. Both groups were assessed for preoperative sedation and changes in heart rate and mean arterial blood pressure before and after the induction and 1, 3, 5, and 10 min after laryngoscopy and intubation, then at 5 min intervals till end of surgery along with postoperative complications. STATISTICAL ANALYSIS: The hemodynamic variables were analyzed by using analysis of variance (ANOVA), Student's t test, and chi square test as appropriate. RESULTS: Preoperative sedation was higher with pregabalin with no significant change in heart rate. The mean arterial pressure was attenuated with oral pregabalin to statistically significant value (P<0.007). The requirement of analgesic drug was reduced with no postoperative respiratory depression, nausea, or vomiting and hemodynamic parameters remained stabilized perioperatively. CONCLUSIONS: Oral pregabalin premedication effectively leads to sedation and analgesia with successful attenuation of the adverse and deleterious hemodynamic pressor response.

Management of breast cancer in Nepal.

Breast cancer is the second most common malignancy among women in Nepal. It is more common in young premenopausal women. Breast cancer continues to increase in incidence due to lifestyle changes in Nepalese women despite constant remarkable development in the management of this disease over the past three decades. Breast cancer was diagnosed solely clinically and surgery was the only treatment option until fifty years ago. Multidisciplinary approach has been adopted for diagnosis and treatment of breast cancer in Nepal. Imaging is required for the diagnosis, appropriate treatment decision and proper follow up. Treatment modality depends upon the extent of the disease and tumor biology. However, there is a strong need for standard guidelines for the proper management of breast cancer in Nepal so that surgeries, chemotherapy, hormone therapy and radiotherapy are standardized in the country. Palliative care has been initiated to provide to some patients with metastatic breast cancer recently. The breast cancer management in Nepal is a little different when compared with the centers in the developed countries. The reasons are socioeconomic status, lack of education and lack of facilities. Although cancer care is on the rise in Nepal, the optimal facility for centers managing breast cancer has to be improved significantly.Cancer education, screening and early detection are the key elements to influence the diagnosis, treatment and prognosis of breast cancer in Nepal. Breast cancer awareness and clinical breast examination are important tools for early detection in our resource limited context. Breast cancer can be cured in majority of the cases if diagnosed in early stages. This review will focus on relevant patient data along with future recommendation regarding breast cancer treatment in Nepal.

Observation of photon-assisted tunneling in optical lattices.

We have observed tunneling suppression and photon-assisted tunneling of Bose-Einstein condensates in an optical lattice subjected to a constant force plus a sinusoidal shaking. For a sufficiently large constant force, the ground energy levels of the lattice are shifted out of resonance and tunneling is suppressed; when the shaking is switched on, the levels are coupled by low-frequency photons and tunneling resumes. Our results agree well with theoretical predictions and demonstrate the usefulness of optical lattices for studying solid-state phenomena.

Blood glutathione levels in head and neck malignancies.

Blood glutathione was estimated in fifty patients of head and neck cancer in the age group of 18-76 years and the results were compared with a group of normal healthy controls. Mean blood glutathione level was found to be significantly lowered in patients than the controls. Irrespective of the site, TNM classification, histopathology, and character of lesion, fall in blood glutathione was nearly same in all the patients. The mean level was significantly increased after radiotherapy when compared with the levels before radiotherapy. The decreased levels of GSH in-patients with head and neck cancer, observed in the present study, may be due to its increased utilization by the cells. The results suggest that patients with head and neck cancer have increased oxidative stress.

Biogas production from plant biomass used for phytoremediation of industrial wastes.

In present study, potentials of water hyacinth (Eichhornia crassipes) and water chestnut (Trapa bispinnosa) employed for phytoremediation of toxic metal rich brass and electroplating industry effluent, were examined in terms of biogas generation. Inability of the plants to grow in undiluted effluent directed to select 20%, 40% and 60% effluent concentrations (with deionized water) for phytoremediation experiments. Slurry of both the plants used for phytoremediation produced significantly more biogas than that by the control plants grown in unpolluted water; the effect being more pronounced with plants used for phytoremediation of 20% effluent. Maximum cumulative production of biogas (2430c.c./100gdm of water hyacinth and 1940c.c./100gdm of water chest nut) and per cent methane content (63.82% for water hyacinth and 57.04% for water chestnut) was observed at 5mm particle size and 1:1 substrate/inoculum ratio, after twenty days incubation. Biogas production was quicker (maximum from 8-12days) in water hyacinth than in water chestnut (maximum from 12-16days). The qualitative and quantitative variations in biogas production were correlated with COD, C, N, C/N ratio and toxic metal contents of the slurry used.