Oral glutamine: Is there a role in the amelioration of radiation-induced mucositis? A prospective case-control study at a tertiary care centre in North India.

BACKGROUND: The most frequently occurring painful and dose-limiting side effect of radiation therapy (RT) to the head and neck region is oral mucositis (OM). Several studies demonstrated that glutamine may reduce the severity and the duration of OM significantly during RT and chemo-radiotherapy in patients with head and neck cancer (HNC). MATERIALS AND METHODS: Between January 2021 and August 2022, a prospective single institutional case-control study compared the efficacy and safety of oral glutamine on radiation-induced mucositis in patients with HNC. Of 60 biopsy-proven patients with HNC, 30 patients in the study arm received oral glutamine suspension (10 g in 500 mL of water) orally once daily, 2 hours before RT, receiving definitive or adjuvant RT and chemo-radiotherapy, while as 30 patients in the control arm received placebo with the same dose and schedule (n = 30 in the study arm and n = 30 in the control arm). RESULTS AND ANALYSIS: A total of 27 (90%) in the glutamine arm and 28 (93.33%) patients in the control arm developed mucositis. Grade 3 mucositis (13.33%) and Grade 4 mucositis (6.66%), respectively, were significantly less ( P = .040 and P = .004) in the glutamine arm. The mean duration of grade 3 and grade 4 mucositis was significantly less in the glutamine arm (8.94 days in the study arm vs. 14.54 in the control arm; P = .0001). The mean time of onset of OM was significantly delayed in the glutamine arm in comparison to the control arm with P < .001. CONCLUSION: Glutamine delays the onset of OM and decreases the severity of OM in patients of HNC receiving RT with or without chemotherapy.

Improving the nutritional value and digestibility of wheat straw, rice straw, and corn cob through solid state fermentation using different Pleurotus species.

BACKGROUND: The growing food-feed-fuel competition, declining availability of traditional feeds, higher prices, and the urgent need to provide long-term sustainability for animal production have all triggered global research into the optimum extraction of energy and nutrients from lignin-rich plant biomass. Recent studies have shown that the Pleurotus species of white rot fungus can selectively degrade lignin in lignin-rich plant biomass; however, its effectiveness in selectively degrading lignin depends on the type of substrate and species of fungus. This study was therefore designed to treat wheat straw, rice straw, and corn cob, with Pleurotus eryngii, P. ostreatus, and P. florida for 30 days under solid-state fermentation, to identify a promising fungus-substrate combination for the selective degradation of lignin and optimal improvement in the nutritional value and digestibility of each substrate. RESULTS: The type of fungus strongly influenced (P < 0.01) selectivity in lignin degradation, and the level of improvement in crude protein (CP), in vitro dry matter digestibility (IVDMD), and in vitro gas production (IVGP), in wheat straw, rice straw, and corn cob. Fungus-substrate interaction data revealed that P. ostreatus caused maximum (P < 0.05) degradation of lignin, and greater (P < 0.05) improvement in CP, IVDMD, and IVGP in wheat straw and rice straw. The lowest (P < 0.05) degradation of lignin and improvement in CP, IVDMD, and IVGP was caused by P. eryngii in corn cob. Among the fungi, the maximum (P < 0.05) degradation of lignin, and greater (P < 0.05) improvement in CP, IVDMD, and IVGP were caused by P. florida as compared with those of P. ostreatus and P. eryngii. CONCLUSION: The results highlight significant influence of fungus-substrate combination for selective lignin degradability and the consequent improvement in the nutritional value of the substrates. Maximum selective lignin degradability and improvement in nutritional value and digestibility was caused by P. ostreatus in wheat straw and in rice straw, and by P. florida in corn cob. © 2021 Society of Chemical Industry.

Evaluation of the nutritional value of faba beans with high and low tannin content for use as feed for ruminants.

BACKGROUND: Faba bean varieties with low or zero tannin content have been developed in Canada to overcome the negative effects of condensed tannins on the utilization by ruminants of crude protein (CP) and starch. However, their nutritional value has not been evaluated for incorporation in dairy rations. The objectives of this study were to investigate (i) the chemical profile; (ii) the Cornell Net Carbohydrate and Protein System (CNCPS) protein and carbohydrate subfractions; (iii) the energy values; (iv) the ruminal, intestinal, and total digestibility of CP; (v) the metabolizable protein (MP) supply to dairy cows; and (vi) the protein-inherent molecular spectral characteristics of brown-seeded (var. Fatima) faba beans with high tannin content and yellow-seeded (var. Snowbird) faba beans with low tannin content. RESULTS: The results revealed that Fatima beans had higher (P < 0.001) CP content than Snowbird (324 versus 295 g kg-1 dry matter (DM)), and lower (P < 0.01) starch content than Snowbird (411 g kg-1 DM versus 444 g kg-1 DM). Fatima had a lower (P = 0.001) soluble subfraction (201 g kg-1 DM versus 220 g kg-1 DM) and higher (P < 0.05) slowly degradable fiber-bounded (24.9 g kg-1 DM versus 14.7 g kg-1 DM) and non-degradable (3.24 g kg-1 DM versus 0 g kg-1 DM) CNCPS CP subfractions than Snowbird. Fatima had higher (P = 0.03) MP content (117 g kg-1 DM versus 111 g kg-1 DM) and metabolizable energy content (ME) 3.12 Mcal kg-1 versus 3.10 Mcal kg-1 ) than Snowbird. Molecular spectral intensities of amide I and II proteins (height and area) of Fatima were higher (P < 0.05) than those of Snowbird, reflecting their higher CP content. The ratio of protein spectral intensities, the amide I : amide II height ratio, and the α-helix : ß-sheet height ratio differed (P < 0.05) between the two types of bean, highlighting differences in their inherent protein molecular structures. CONCLUSION: The (Fatima) faba beans with high condensed tannin content had higher MP and ME content. On average, both Faba beans had higher ME and MP content than barley grains, highlighting their promising nutritional value for dairy rations. © 2021 Society of Chemical Industry.

Novel Use of Ultra-Resolution Synchrotron Vibrational Micropectroscopy (SR-FT/vIMS) to Assess Carinata and Canola oilseed tissues within Cellular and Subcellular Dimensions.

The study was conducted to: (1) apply advanced synchrotron radiation-based technique-SR-FT/vIMS to detect chemical profiles that are related to protein and carbohydrate biopolymers, (2) quantify the relationship between spectral features and nutrient utilization and bioavailability of newly developed carinata and canola seed lines. The molecular spectral features of these seed lines were analyzed using SR-FT/vIMS with both univariate and multivariate spectral analysis techniques. The results showed that the inherent structural characteristics of new carinata and new canola seeds could be detected by SR-FT/vIMS. The univariate molecular spectral analysis showed differences in absorption intensities (peak heights and areas) of functional groups related to protein and carbohydrate molecular structures, while multivariate molecular spectral analysis without any spectral parameterization results showed similar protein and carbohydrate structure between new carinata and new canola seeds. Based on both, univariate and multivariate analysis, there were some differences between carinata seeds and canola seeds in protein and Carbohydrate (CHO) structure spectral characteristics, but these differences were not distinguishable in CLA and PCA plots regardless the color seed coat when using original spectral without spectral parameterization. Protein and carbohydrate structural variables could be used as predictors of rumen protein degradation kinetics, protein intestinal digestion features and protein supply for dairy cows. The CHO molecular structure showed great correlation with rumen protein degradation, intestinal protein digestion and predicted true protein supply of the newly developed carinata and canola lines.

Relationship between protein molecular structural makeup and metabolizable protein supply to dairy cattle from new cool-season forage corn cultivars.

Protein solubility, ruminal degradation and intestinal digestibility are strongly related to their inherent molecular makeup. This study was designed to quantitatively evaluate protein digestion in the rumen and intestine of dairy cattle, and estimate the content of truly metabolizable protein (MP) in newly developed cool-season forage corn cultivars. The second objective was to quantify protein inherent molecular structural characteristics using advance molecular spectroscopic technique (FT/IR-ATR) and correlate it to protein metabolic characteristics. Six new cool-season corn cultivars, including 3 Pioneer (PNR) and 3 Hyland (HL), coded as PNR-7443R, PNR-P7213R, PNR-7535R, HL-SR06, HL-SR22, HL-BAXXOS-RR, were evaluated in the present study. The metabolic characteristics, MP supply to dairy cattle, and energy synchronization properties were modeled by two protein evaluation models, namely, the Dutch DVE/OEB system and the NRC-2001 model. Both models estimated significant (P<0.05) differences in contents of microbial protein (MCP) synthesis and truly absorbable rumen undegraded protein (ARUP) among the cultivars. The NRC-2001 model estimated significant (P<0.05) differences in MP content and degraded protein balance (DPB) among the cultivars. The contents MCP, ARUP and MP were higher (P<0.05) for cultivar HL-SR06, resulting in the lowest (P<0.05) DPB. However, none of the cultivars reached the optimal target hourly effective degradability ratio [25gNg/kg organic matter (OM)], demonstrating N deficiency in the rumen. There were non-significant differences among the cultivars in molecular-spectral intensities of protein. The amide I/II ratio had a significant correlation with ARUP (r=-0.469; P<0.001) and absorbable endogenous protein (AECPNRC) (P<0.001; r=0.612). Similarly, amide-II area had a weak but significant correlation (r=0.299; P<0.001) with RUP and ARUP, and with AECPNRC (P<0.001; r=0.411). Except total digestible nutrients and AECPNRC, the amide-I area did not show significant correlations with DVE/OEB and NRC predicted protein fractions. This study shows that molecular spectroscopy can be potentially used as a rapid tool to quantify protein molecular makeup and screen the protein nutritive value of forage corn.

Physiochemical Characteristics and Molecular Structures for Digestible Carbohydrates of Silages.

The main objectives of this study were (1) to assess the magnitude of differences among new barley silage varieties (BS) selected for varying rates of in vitro neutral detergent fiber (NDF) digestibility (ivNDFD; Cowboy BS with higher ivNDFD, Copeland BS with intermediate ivNDFD, and Xena BS with lower ivNDFD) with regard to their carbohydrate (CHO) molecular makeup, CHO chemical fractions, and rumen degradability in dairy cows in comparison with a new corn silage hybrid (Pioneer 7213R) and (2) to quantify the strength and pattern of association between the molecular structures and digestibility of carbohydrates. The carbohydrate-related molecular structure spectral data was measured using advanced vibrational molecular spectroscopy (FT/IR). In comparison to BS, corn silage showed a significantly (P < 0.05) higher level of starch and energy content and higher degradation of dry matter (DM). Cowboy BS had lower feeding value (higher indigestible fiber content and lower starch content) and lower DM degradation in the rumen compared to other BS varieties (P < 0.05). The spectral intensities of carbohydrates were significantly (P < 0.05) correlated with digestible carbohydrate content of the silages. In conclusion, the univariate approach with only one-factor consideration (ivNDFD) might not be a satisfactory method for evaluating and ranking BS quality. FT/IR molecular spectroscopy can be used to evaluate silage quality rapidly, particularly the digestible fiber content.

Uses of Various Grafting Techniques in External Approach Rhinoplasty: An Overview.

The surgeons performing rhinoplasty found Graft selection the greatest challenge. To avoid an immune response the preferred choice thus far for nasal reconstruction would be autograft compared to allograft due to its lower rate of rejection. We have evaluated 30 patients who underwent open rhinoplasty and We used conchal and septal cartilaginous grafts in various forms by the open approach to correct various nasal deformities compared our experience regarding the operative technique, graft availability, indications, and limitations. No bony graft material or synthetic materials were used. Preoperative extensive evaluation of the patient was done in order to determine the type of deformity and the type of graft to be used in order to correct the deformity. Preoperative and postoperative photographs were taken in four basic views: frontal, lateral, lateral-oblique and basal in order to assess the results of the surgery. The study was done on 30 patients (20 male and 10 females) using the external rhinoplasty approach using the septal and conchal cartilages in different forms. Autologous septal cartilage was used in most of the patients (25 out of 30) and conchal cartilage was used in 5 patients. Multiple grafting techniques were used in some patients. Three patients had traumatic etiology. Columellar strut graft along with TIG technique was used in 16 patients, spreader graft was used in 8 patients, and septal extension graft was used in 5 patient and shield graft in 1 patient. Septorhinoplasty continues to evolve through various new techniques and modifications with the main goal to improve functional nasal airway and to restore cosmetic harmony to the face. Optimum result is very much dependent on the surgeon's attention to functional, aesthetic, and reconstructive principles and graft selection.

Effects of canola meal pellet conditioning temperature and time on ruminal and intestinal digestion, hourly effective degradation ratio, and potential nitrogen to energy synchronization in dairy cows.

The increase in bio-oil production in North America has resulted in millions of tonnes of co-products: canola meal and carinata meal. Little research has been conducted to determine the effect of pellet conditioning temperature, time, and their interaction on processing-induced changes in nutrient digestibility in the rumen and intestine (in vitro) of dairy cattle. The objectives of this study were to investigate the effects of conditioning temperature (70, 80, and 90°C), time (50 and 75 s), and their interaction (temperature × time) during the pelleting of canola meal on (1) rumen degradation kinetics and effective rumen degradability of dry matter, crude protein (CP), and neutral detergent fiber; (2) intestinal digestibility of rumen-undegradable protein (RUP); and (3) hourly effective rumen degradation ratio and potential N to energy synchronization in dairy cattle. The results showed that the temperature and duration of pellet conditioning significantly altered the degradation characteristics of nutrients in the rumen. Pelleting increased CP degradation in the rumen, and CP digestion site was shifted to the rumen rather than to the small intestine. When conditioning temperature was set 80°C, the rumen degradation of CP and neutral detergent fiber was highest, but postrumen digestion was lowest. With respect to intestinal digestion, the available CP for intestinal digestion became less because of reduced RUP supply to the small intestine. The pelleting process tended to significantly affect the intestinal digestibility of RUP. However, the total digestible CP content of canola meal was not affected. In conclusion, pelleting induced changes in rumen and intestinal digestion profiles, and altered the potential N to energy synchronization and hourly effective rumen degradation ratio of canola meal in dairy cattle.

Molecular basis of processing-induced changes in protein structure in relation to intestinal digestion in yellow and green type pea (Pisum sativum L.): A molecular spectroscopic analysis.

The objectives of this study were (1) to quantify the protein inherent molecular structural features of green cotyledon (CDC Striker) and yellow cotyledon (CDC Meadow) pea (Pisum sativum L.) seeds using molecular spectroscopic technique (FT/IR-ATR); (2) measure the denaturation of protein molecular makeup in the two types of pea during dry roasting (120°C for 60 min), autoclaving (120°C for 60 min) or microwaving (for 5 min); and (3) correlate the heat-induced changes in protein molecular makeup to the corresponding changes in protein digestibility determined using modified three-step in vitro procedure. Compared with yellow-type, the green-type peas had higher (P<0.05) ratios of amide I to II peak height (1.698 vs. 1.805) and area (1.843 vs. 2.017). A significant correlation was observed between the amide I and II peak height (r=0.48) and peak area (r=-0.42) ratio with protein content. Compared with yellow-type, the green-type peas had lower (P<0.05) α-helix:ß-sheet ratio (1.015 vs. 0.926), indicating varietal difference in protein secondary structure makeup. All processing applications increased α-helix:ß-sheet ratio, with the largest (P<0.05) increase being observed with roasting and microwaving. The heat-induced changes in α-helix:ß-sheet ratio was strongly correlated to intestinal digestibility of protein within the green (r=-0. 86) and yellow (r=0.81) pea-types. However, across the pea types the correlation was not significant. Principal component and hierarchical cluster analyses on the entire spectral data from the amide region (ca. 1727-1480 cm(-1)) were able to visualize and discriminate the structural difference between pea varieties and processing treatments. This study shows that the molecular spectroscopy can be used as a rapid tool to screen the protein value of raw and heat-treated peas.

Nutritive value of maize silage in relation to dairy cow performance and milk quality.

Maize silage has become the major forage component in the ration of dairy cows over the last few decades. This review provides information on the mean content and variability in chemical composition, fatty acid (FA) profile and ensiling quality of maize silages, and discusses the major factors which cause these variations. In addition, the effect of the broad range in chemical composition of maize silages on the total tract digestibility of dietary nutrients, milk production and milk composition of dairy cows is quantified and discussed. Finally, the optimum inclusion level of maize silage in the ration of dairy cows for milk production and composition is reviewed. The data showed that the nutritive value of maize silages is highly variable and that most of this variation is caused by large differences in maturity at harvest. Maize silages ensiled at a very early stage (dry matter (DM) < 250 g kg(-1)) were particularly low in starch content and starch/neutral detergent fibre (NDF) ratio, and resulted in a lower DM intake (DMI), milk yield and milk protein content. The DMI, milk yield and milk protein content increased with advancing maturity, reaching an optimum level for maize silages ensiled at DM contents of 300-350 g kg(-1), and then declined slightly at further maturity beyond 350 g kg(-1). The increases in milk (R(2) = 0.599) and protein (R(2) = 0.605) yields with maturity of maize silages were positively related to the increase in starch/NDF ratio of the maize silages. On average, the inclusion of maize silage in grass silage-based diets improved the forage DMI by 2 kg d(-1), milk yield by 1.9 kg d(-1) and milk protein content by 1.2 g kg(-1). Further comparisons showed that, in terms of milk and milk constituent yields, the optimum grass/maize silage ratio depends on the quality of both the grass and maize silages. Replacement of grass silage with maize silage in the ration, as well as an increasing maturity of the maize silages, altered the milk FA profile of the dairy cows, notably, the concentration of the cis-unsaturated FAs, C18:3n-3 and n-3/n-6 ratio decreased in milk fat. Despite variation in nutritive value, maize silage is rich in metabolizable energy and supports higher DMI and milk yield. Harvesting maize silages at a DM content between 300 and 350 g kg(-1) and feeding in combination with grass silage results in a higher milk yield of dairy cows.

Mid-infrared spectral characteristics of lipid molecular structures in Brassica carinata seeds: relationship to oil content, fatty acid and glucosinolate profiles, polyphenols, and condensed tannins.

The objectives of this study were to quantify lipid-related inherent molecular structures using a Fourier transform infrared spectroscopy (FT-IR) technique and determine their relationship to oil content, fatty acid and glucosinolate profile, total polyphenols, and condensed tannins in seeds from newly developed yellow-seeded and brown-seeded Brassica carinata lines. Canola seeds were used as a reference. The lipid-related molecular spectral band intensities were strongly correlated to the contents of oil, fatty acids, glucosinolates, and polyphenols. The regression equations gave relatively high predictive power for the estimation of oil (R² = 0.99); all measured fatty acids (R² > 0.80), except C14:0, C20:3n-3, C22:2n-9, and C22:2n-6; 3-butenyl, 2-OH-3-butenyl, 4-OH-3-CH3-indolyl, and total glucosinolates (R² > 0.686); and total polyphenols (R² = 0.935). However, further study is required to obtain predictive equations based on large numbers of samples from diverse sources to illustrate the general applicability of these regression equations.

Effect of thermal processing on estimated metabolizable protein supply to dairy cattle from camelina seeds: relationship with protein molecular structural changes.

This study evaluated the effect of thermal processing on the estimated metabolizable protein (MP) supply to dairy cattle from camelina seeds (Camelina sativa L. Crantz) and determined the relationship between heat-induced changes in protein molecular structural characteristics and the MP supply. Seeds from two camelina varieties were sampled in two consecutive years and were either kept raw or were heated in an autoclave (moist heating) or in an air-draft oven (dry heating) at 120 °C for 1 h. The MP supply to dairy cattle was modeled by three commonly used protein evaluation systems. The protein molecular structures were analyzed by Fourier transform/infrared-attenuated total reflectance molecular spectroscopy. The results showed that both the dry and moist heating increased the contents of truly absorbable rumen-undegraded protein (ARUP) and total MP and decreased the degraded protein balance (DPB). However, the moist-heated camelina seeds had a significantly higher (P < 0.05) content of ARUP and total MP and a significantly lower (P < 0.05) content of DPB than did the dry-heated camelina seeds. The regression equations showed that intensities of the protein molecular structural bands can be used to estimate the contents of ARUP, MP, and DPB with high accuracy (R(2) > 0.70). These results show that protein molecular structural characteristics can be used to rapidly assess the MP supply to dairy cattle from raw and heat-treated camelina seeds.

Microwave irradiation induced changes in protein molecular structures of barley grains: relationship to changes in protein chemical profile, protein subfractions, and digestion in dairy cows.

The objectives of this study were to evaluate microwave irradiation (MIR) induced changes in crude protein (CP) subfraction profiles, ruminal CP degradation characteristics and intestinal digestibility of rumen undegraded protein (RUP), and protein molecular structures in barley (Hordeum vulgare) grains. Samples from hulled (n = 1) and hulless cultivars (n = 2) of barley, harvested from four replicate plots in two consecutive years, were evaluated. The samples were either kept as raw or irradiated in a microwave for 3 min (MIR3) or 5 min (MIR5). Compared to raw grains, MIR5 decreased the contents of rapidly degradable CP subfraction (from 45.22 to 6.36% CP) and the ruminal degradation rate (from 8.16 to 3.53%/h) of potentially degradable subfraction. As a consequence, the effective ruminal degradability of CP decreased (from 55.70 to 34.08% CP) and RUP supply (from 43.31 to 65.92% CP) to the postruminal tract increased. The MIR decreased the spectral intensities of amide 1, amide II, α-helix, and ß-sheet and increased their ratios. The changes in protein spectral intensities were strongly correlated with the changes in CP subfractions and digestive kinetics. These results show that MIR for a short period (5 min) with a lower energy input can improve the nutritive value and utilization of CP in barely grains.

Pleomorphic adenoma of hard palate: an experience.

INTRODUCTION: Pleomorphic adenoma of minor salivary glands of hard palate is a rare benign tumour. It usually presents as slow growing submucosal mass on hard palate. The purpose of this study was to collect observational data regarding age, size, symptoms, CT findings and treatment of pleomorphic adenoma of hard palate. MATERIAL AND METHODS: The prospective observational study was done in the Department of ENT, Department of Oral and maxillofacial surgery at SKIMS Medical College and at Peoples Care Polyclinic for a period of 2 years. Twenty cases were enrolled in the study. After clinical suspicion, computed tomography, FNAC and core needle biopsy was done in all twenty cases before any surgical intervention was done. RESULTS: Most common age group seen to be involved was 16-30 years. Most common symptom was submucosal slow growing mass. Core biopsy was diagnostic with 100 % efficacy. On CT scan twelve patients (60 %) were seen to have intact hard palate even without minor erosions while four patients had full thickness erosion of hard palate. Surgical wide excision was done in all cases and one patient needed total maxillectomy. All treated patients were followed for one year and none showed signs of recurrence. CONCLUSION: Pleomorphic adenoma of hard palate is usually seen in adults. Definitive diagnosis lies on histopathological examination. CT is necessary for ruling out any bony erosion. Treatment is by wide local excision.

Moist and dry heating-induced changes in protein molecular structure, protein subfractions, and nutrient profiles in camelina seeds.

The objectives of the present study were to investigate the nutritive value of camelina seeds (Camelina sativa L. Crantz) in ruminant nutrition and to use molecular spectroscopy as a novel technique to quantify the heat-induced changes in protein molecular structures in relation to protein digestive behavior in the rumen and intestine of dairy cattle. In this study, camelina seeds were used as a model for feed protein. The seeds were kept as raw (control) or heated in an autoclave (moist heating) or in an air-draft oven (dry heating) at 120°C for 60 min. The parameters evaluated were (1) chemical profiles, (2) Cornell Net Protein and Carbohydrate System protein subfractions, (3) nutrient digestibilities and estimated energy values, (4) in situ rumen degradation and intestinal digestibility, and (5) protein molecular structures. Compared with raw seeds, moist heating markedly decreased (52.73 to 20.41%) the content of soluble protein and increased (2.00 to 9.01%) the content of neutral detergent insoluble protein in total crude protein (CP). Subsequently, the rapidly degradable Cornell Net Protein and Carbohydrate System CP fraction markedly decreased (45.06 to 16.69% CP), with a concomitant increase in the intermediately degradable (45.28 to 74.02% CP) and slowly degradable (1.13 to 8.02% CP) fractions, demonstrating a decrease in overall protein degradability in the rumen. The in situ rumen incubation study revealed that moist heating decreased (75.45 to 57.92%) rumen-degradable protein and increased (43.90 to 82.95%) intestinal digestibility of rumen-undegradable protein. The molecular spectroscopy study revealed that moist heating increased the amide I-to-amide II ratio and decreased α-helix and α-helix-to-ß-sheet ratio. In contrast, dry heating did not significantly change CP solubility, rumen degradability, intestinal digestibility, and protein molecular structures compared with the raw seeds. Our results indicated that, compared with dry heating, moist heating markedly changed protein chemical profiles, protein subfractions, rumen protein degradability, and intestinal digestibility, which were associated with changes in protein molecular structures (amide I-to-amid II ratio and α-helix-to-ß-sheet ratio). Moist heating improved the nutritive value and utilization of protein in camelina seeds compared with dry heating.

Cost analysis of in-patient cancer chemotherapy at a tertiary care hospital.

AIM: Cancer remains a major health problem in all communities worldwide. Rising healthcare costs associated with treating advanced cancers present a significant economic challenge. It is a need of the hour that the health sector should devise cost-effective measures to be put in place for better affordability of treatments. To achieve this objective, information generation through indigenous hospital data on unit cost of in-patient cancer chemotherapy in medical oncology became imperative and thus hallmark of this study. DESIGN AND SETTING: The present prospective hospital based study was conducted in Medical Oncology Department of tertiary care teaching hospital. MATERIALS AND METHODS: After permission from the Ethical Committee, a prospective study of 6 months duration was carried out to study the cost of treatment provided to in-patients in Medical Oncology. Direct costs that include the cost of material, labor and laboratory investigations, along with indirect costs were calculated, and data analyzed to compute unit cost of treatment. RESULTS: The major cost components of in-patient cancer chemotherapy are cost of drugs and materials as 46.88% and labor as 48.45%. The average unit cost per patient per bed day for in-patient chemotherapy is Rs. 5725.12 ($125.96). This includes expenditure incurred both by the hospital and the patient (out of pocket). CONCLUSION: The economic burden of cancer treatment is quite high both for the patient and the healthcare provider. Modalities in the form of health insurance coverage need to be established and strengthened for pooling of resources for the treatment and transfer of risks of these patients.

Pseudocyst of pinna and its treatment with surgical deroofing: an experience at tertiary hospitals.

INTRODUCTION: Pseudocyst of pinna is an uncommon condition hardly encountered in routine ENT practice. The involvement is usually seen in scaphoid, triangular fossa, and antihelix. Medical treatment is ineffective. Various treatments are suggested in the literature. The aims of the paper were to study the clinical characteristic of patients with pseudocysts and to share our experience with surgical deroofing and buttoning as a definitive treatment. MATERIALS AND METHODS: Twenty-six patients were diagnosed with pseudocyst of the auricle between April 2011 and 2013 in two medical college hospitals. Clinical characteristics were noted. All patients underwent incision and drainage with removal of anterior cartilage leaflet followed by buttoning for 12 days. RESULTS AND OBSERVATIONS: Out of 26 patients, only two were females. Involvement of left side was seen more than right one. None had bilateral involvement. Adults in the age group of 31-40 were commonly affected. Most common site of involvement was scaphoid and triangular fossa. The success rate with primary I and D and buttoning was 96%. CONCLUSIONS: Pseudocyst of the pinna is a benign condition of unknown etiology affecting the pinna, commonly encountered in middle-aged men. Many modalities of treatment have been recommended in the literature with varied recurrence and failure rates. The best form of treatment with minimum recurrence is incision and drainage with removal of anterior cartilage leaflet with buttoning.

Quality of life assessment in survivors of breast cancer.

AIM: The aim was to assess the health-related quality of life (HRQOL) and its temporal variation at first visit and subsequent visits among breast cancer patients. DESIGN AND SETTING: The prospective study was carried out in Outpatient Department of Radiation Oncology, University Teaching and Tertiary Referral Hospital. MATERIAL AND METHODS: After clearance from the ethical committee and EORTC group, 81 surgically treated female breast cancer patients referred to the Outpatient Department of Radiation Oncology for chemoradiation and hormonal therapy were included in the study after informed written consent, irrespective of the age and stage of disease. The patients were interviewed as per the EORTC QLQ-C30 Questionnaire module at four levels at the first visit and at subsequent follow-up visits at 6, 12, and 24 months, respectively, and are still on follow-up. STATISTICAL ANALYSIS: The data collected were expressed as mean/raw score (RS), standard deviation (SD), and percent mean/scale score expressed on the linear transformation scale, derived as per the calculations and equations of the EORTC QLQ-C30 Scoring Manual. Intragroup comparison (IGC) was done at four levels/visits, a, b, c and d. A P-value of <0.05 was considered significant. RESULTS: The mean age at presentation was 46.6 ± 10.2 years. The study showed that the physical functioning, role functioning, cognitive functioning, emotional functioning, social functioning, global health status, and symptomatology showed statistically significant improvement over time (P < 0.001). CONCLUSION: The survivors of female breast cancer over the long-term follow-up showed significant improvement and coping mechanisms involved in a majority of HRQOL parameters.

Gorham's disease of femur.

Gorham's disease is a rare condition of bones characterized by spontaneous massive and progressive osteolysis. Less than 200 cases have been reported so far. Femur is an uncommon site of Gorham disease. We report a young female, presenting as pathological fracture of the femur, wherein rapid osteolysis of femur occurred. The clinical, pathological, and radiological picture suggested a diagnosis of Gorham's disease. The patient was subjected to radiotherapy (40 Gys) and put on bisphosphonates. At a follow-up of 2 years, the disease process had stopped and partial recalcification of the bone had occurred.