The Efficacy of Paxman Scalp Cooling System in Preventing Hair Loss in Breast Cancer Patients Receiving Chemotherapy in Western India - Multi-centre Retrospective Cohort Study.

Aim: Chemotherapy-induced alopecia (CIA) is the most common side effect of systemic treatment in breast cancer patients. Scalp cooling gained worldwide acceptance in preventing or mitigating CIA in patients undergoing chemotherapy. The objective of this study was to evaluate the efficacy and safety of the Paxman scalp cooling system (PSCS) in Indian breast cancer patients. Materials and Methods: This is a multi-centre, retrospective-observational study including patients registered from 1st March, 2019 to 30th April, 2021 undergoing chemotherapy for breast cancer by using PSCS. The primary end-point was the incidence of CIA after completing cycles of chemotherapy. Results: A total of 91 female patients were enrolled in the study, with a median age of 53 years (IQR: 44-62 years). The prevention of alopecia (grade 0 and grade I) was seen in 81%, while more than 50% hair loss (grade 2) was seen in 16.48% after completion of treatment. The univariate analysis results showed that CIA was significantly higher in patients who received anthracyclines (OR: 2.69; 95% CI: 1.04-6.958; P = 0.041) and in patients with a post-infusion cooling time of >150 minutes (OR: 8.409; 95% CI: 2.295-30.787; P = 0.001). The incidence of grade 2 (>50% hair loss) alopecia was 81.3% in patients <6 weeks and was 18.8% at >6 weeks of start of chemotherapy (P < 0.0001). No adverse events were reported in 71.4% of patients, and the most common adverse event was headache (18.7%). Conclusion: PSCS is an effective and well-tolerated treatment modality for preventing CIA among breast cancer patients undergoing chemotherapy.

A Real-World Molecular Epidemiological Study of Non-Small-Cell Lung Cancer (NSCLC) Patients from Western India.

Ashish JoshiBackground The molecular characterization of advanced non-small-cell lung cancer (NSCLC) has unveiled genomic alterations such as EGFR gene mutations, KRAS gene mutations, ROS1 gene rearrangements, EML4-ALK rearrangements, and altered MET signaling. The objective of this molecular epidemiological study was to report the clinical, pathological, and molecular profile of NSCLC patients from western India. Materials and Methods This real-world study of NSCLC patients was performed at a chemotherapy day-care center in western India. The clinical, pathological, and molecular data were collected from the patient's medical records after obtaining the Ethics Committee permission for the study. The study was conducted according to the ethical principles stated in the latest version of Helsinki Declaration, and the applicable guidelines for good clinical practice. Results A total of 182 (58.7%) men and 128 (41.3%) women with a median age of 63 years (range: 22-93 years) were included in the study. Of the total 310 patients, 195 (62.9%) were nonsmokers whereas 81 (26.1%) had a past history of smoking. EGFR , EML4-ALK Fusion Gene, KRAS , ROS1 gene rearrangement, and PD-L1 were positive in 42 (22.3%), 12 (9%), 2 (28.6%), 3 (12.5%), and 3 (25%) patients, respectively. One patient had concurrent EGFR mutation along with ROS1 gene rearrangement. Conclusion Oncogenic driver mutations are present in Indian NSCLC patients. Molecular testing should be performed for all patients of advanced NSCLC to identify those that can benefit from newer generation of targeted or immunotherapies.

Rapid review of factors influencing dietary behaviors in Fiji.

Introduction: In Fiji, multiple burdens of malnutrition including undernutrition, overweight/obesity, and micronutrient deficiencies coexist at the individual, household, and population levels. The diets of children, adolescents, and adults are generally unhealthy. The objective of this review was to understand how the dietary behaviors of children, adolescents, and women in Fiji are influenced by individual, social, and food environment factors. Methods: This rapid review was conducted to synthesize existing evidence, identify research gaps in the evidence base, and make recommendations for future research. The Cochrane Rapid Reviews Methods and the updated guideline for reporting systematic reviews were used. The search strategy for this rapid review was based on the Population Context Outcome [P(E)CO] framework, including search terms for population (children, adolescents, and adults), context (Fiji), and outcome (dietary behaviors). Searches were conducted in PubMed, Scopus, PsycINFO, and Google Scholar. Results: The 22 studies included in this review identified different factors influencing dietary behaviors in Fiji. Individual preferences for processed and imported foods, especially of younger generations, and social dynamics, especially gender norms and social pressure, to serve meat and overeat appeared to be prominent in driving dietary habits. The ongoing nutrition transition has led to increasing availability and affordability of ultra-processed and fast foods, especially in urban areas. Concerns about food safety and contamination and climate change and its effect on local food production also appear to influence dietary choices. Discussion: This review identified different dynamics influencing dietary behaviors, but also research gaps especially with regard to the food environment, calling for an integrated approach to address these factors more systemically.

Extra nodal Rosai Dorfman disease masquerading as metastatic soft tissue sarcoma- A case report.

Rosai Dorfman disease is rare benign disease of phagocytic histiocytosis usually present as painless massive lymphadenopathy. Extra nodal presentation of Rosai Dorfman disease is rare but also described. We hereby describe an unusual presentation of the extra nodal Rosai Dorfman disease with rapidly growing soft tissue lesion in the left thigh with associated osseous lesions in the right distal femur, left distal femur, left proximal tibia and presence of solitary pulmonary nodule. This case is unique as clinical presentation highly suspicious of soft tissue sarcoma but excision biopsy of thigh lesion showed Rosai Dorfman disease.Though RDD in extremities has been described in limited number of cases, to the best of our knowledge this is first case of lower extremity RDD associated with osseous lesions and pulmonary nodule but without lymphadenopathy.

Fabrication and Characterization of Bioblocks from Agricultural Waste Using Fungal Mycelium for Renewable and Sustainable Applications.

Recent advances in the field of biomaterials and an ever-growing need to curb the alarming rate of pollution levels have led to the utilization of biodegradable waste to fabricate sustainable materials with tunable properties. The current study investigated the growth kinetics and morphology of Pleurotus ostreatus (P. ostreatus) mycelium grown on different agricultural wastes such as wheat bran, sugarcane, sawdust, and the mixture of these substrates. Further, it delineated the fabrication process of biodegradable "bioblocks" from such agricultural waste using a green synthesis approach and mycelium P. ostreatus as a natural adhesive material. The fabricated bioblocks showed excellent thermal stability, hydrophobic properties, and mechanical strength. The compressive strength of these bioblocks was approximately 6.0-7.5 N/mm2, which is 5-6 times higher than that of the routinely used polystyrene packaging material. These properties of the bioblocks render them fit to replace the non-biodegradable materials that are commonly used in packaging applications, wall paneling, and filtration of toxic wastes.

Solitary Plasmacytoma of Bone Involving Spine in a 12-year-old Boy: Report of a Rare Case and Review of Literature.

Solitary plasmacytoma of the bone (SPB) is a rare plasma cell neoplasm representing only about 5% of plasma cell neoplasia. It usually presents as a lytic lesion mainly localized within the axial skeleton. SPB is exceedingly rare in young individuals, and only few cases have been reported so far in patients younger than 20 years of age. In view of rarity of disease, definitive treatment guidelines have not been established. We hereby report a case of SPB involving of lumbar vertebra (L5) in a 12-year-old boy. He was initially treated with antilymphoma therapy and curative radiotherapy considering as primary bone lymphoma. However, he had local recurrence with paraparesis after 9 months which was diagnosed as solitary bone plasmacytoma for which he was treated with decompressive laminectomy and chemotherapy (bortezomib, lenalidomide, and dexamethasone). The purpose of this article is to report a rare case of SPB in a pediatric patient and to review the available literature and treatment options. SPB should be considered in the differential diagnosis of osteolytic bone lesions even in young patients.

Hepatosplenic Gamma Delta T-Cell Lymphoma (HSGDTCL): Two Rare Case Reports from Western India.

Peripheral T cell lymphomas are a heterogeneous group of post-thymic, mature lymphoid malignancies, accounting for approximately 10-15% of all non-Hodgkin's lymphomas. Hepatosplenic T-cell lymphoma (HSGDTCL) is a rare entity, which is characterized by primary extra nodal disease with typical sinusoidal or sinusal infiltration of the liver and the spleen, respectively by expression of the T-cell receptor Î³Î´ chain, and by a number of other frequent clinicopathologic features, including aggressive course of disease. Secondary involvement of liver by hematopoietic malignancies is much more common as compared to primary liver involvement. Primary involvement of liver by non- Hodgkin's lymphoma (NHL) is documented and mostly DLBCL (diffuse large B cell lymphoma) type. But, T cell lymphoma primarily arising from liver is very rare. It occurred commonly in immunocompromised patients and prognosis is very poor. Here, we present two case reports of Hepatosplenic gamma-delta T-cell lymphoma (HSGDTCL) and both are immunocompetent patients. Liver biopsy from the mass and subsequent IHC (immunohistochemistry) were performed for the purpose of diagnosis, which were positive for LCA (leukocyte common antigen), CD2 and negative for CD5, CD20 and CD79a. First patient was a 63-year-old female with hepatitis C virus seropositivity presented with liver mass simulating hepatocellular carcinoma. Second patient was a 60-year- old male, chronic alcoholic patient, presented with liver mass and lytic bony lesion in pelvis. Both patients were managed with conventional CHOP (cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisolone) and showed complete response after 4 cycles of chemotherapy. After completion of 6 cycles of chemotherapy, both patients remained under 6-month surveillance period for any recurrence of the disease.

Aleukemic Leukemia Cutis Presenting as a Sole Sign of Relapsed Paediatric Acute Lymphoblastic Leukemia.

The author describes paediatric case of relapsed acute lymphoblastic leukaemia (ALL) presented as aleukemic leukaemia cutis (ALC). A 2 year old child was admitted in tertiary oncology centre. He suffered from pre B cell ALL with absent Philadelphia chromosome. This patient received multiagent induction chemotherapy as per Berlin-Frankfurt-Munster (BFM) protocol for ALL. He achieved remission after 28 days of treatment. Subsequently he presented with multiple skin lesions in the form of multiple small erythematous violaceous macules, papules, plaques and nodules on face, chest and back regions. Histopathological examination of biopsy of skin revealed diffuse infiltration of tumor cells with prominent nucleoli, scant eosinophilic cytoplasm and numerous mitotic figures consistent with LC. Immunohistochemistry was positive for CD 10, CD 19, CD 22, CD 24, CD 79-a and TdT while negative for surface immunoglobulin. At the time of presentation his peripheral blood smear and bone marrow examination was negative for malignant cells. Sanctuary sites including central nervous system and testicles were not involved. So patient was diagnosed as ALC. He was managed as per BFM relapse protocol for ALL. Skin lesions disappeared completely after 2 weeks of treatment. Unfortunately patient developed bone marrow and testicular relapse after 2 months. He was given testicular radiotherapy and systemic chemotherapy for relapsed ALL. But his marrow was showing persistent activity and he expired after 4 months.

Study of clinical profile in patients with H1N1 influenza in Surat district, June 2009-March 2010.

BACKGROUND: During spring of 2009, pandemic of Influenza A (H1N1) virus emerged and spread globally. We describe the clinical profile of patients who were found H1N1 Positive in Surat district from 27th June 2009 to march 2010. METHODS: Retrospective data of 824 patients from surat districts who were suspected with influenza like illness was collected They were subjected to throat swab testing for H1N1. Out of them 154 were positive for 2009 H1N1 virus with use of real time reverse transcriptase polymerase chain reaction assay. (TAQ MAN real time PCR CDC protocol). Clinical parameters of these 154 patients were analyzed. RESULTS: Out of 824 suspected H1N1, 154 (18.68%) patients were confirmed (positive) for 2009 HIN1. Maximum (70.77%) patients are in age group 14-50 years. Male [86 (55.84%)] were affected more than Females [68 (44.15%)]. 58 (37.66%) had underlying Co-Morbid condition. Fever (98.70%) and cough (94.15%) were the most common presenting symptom. Total 41 (26.62 %) patients were put on mechanical ventilator, out of them 17 (41.46%) survived. Total 24 (58.53%) patients were initially put on noninvasive (Bipap) ventilator followed by invasive Mechanical ventilator, while 9 (21.95%) patients were put on only noninvasive (Bipap) ventilator and total 8 patients were put directly on invasive Mechanical ventilator. 154 H1N1 positive patients, who underwent chest x-ray on admission 112 (72%) had findings consistent with pneumonia/ARDS. Most common site is lower zone and simultaneous involvement of both lungs is more common than single lung involvement. Out of the 154 patients, those patients who received oseltamivir within 48 hour of onset of illness all were cured. Patients who expired had received oseltamivir after 48 hrs. Our data suggests that the use of oseltamivir was beneficial in hospitalized patients even up to 72 hrs of onset of symptoms. We observed no significant side effect of oseltamivir 150 mg twice day dose for 5-7 days. We observed two peaks of H1N1 during this period, second peak was less severe than first one. CONCLUSIONS: During evaluation period, 2009 H1N1 influenza caused severe illness requiring hospitalization, including pneumonia and respiratory distress and co-morbid condition. Maximum patients were between age group of 14-50 year. Fever and cough were most common presenting symptoms. Nearly 36.36% patients had one or more underlying medical conditions. Mechanical ventilatory support had role in reduction in mortality. Patients seemed to be benefited from antiviral therapy if started within 72 hour of onset of symptom. There were no significant side effects of Oseltamivir observed in this study. Development of ARDS, requirement of Mechanical ventilation and having co-morbid condition were poor prognostic factors. We observed two peaks of H1N1 during this period second peak was less severe than first one. It may be due to development of immunity, Disease awareness, early diagnosis and treatment and health education.