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Background: There is limited access to 1 year of adjuvant trastuzumab in resource-constrained settings. Most randomized studies have failed to prove non-inferiority of shorter durations of adjuvant trastuzumab compared to 1 year However, shorter durations are often used when 1 year is not financially viable. We report the outcomes with 12 weeks of trastuzumab administered as part of curative-intent treatment. Methods: This is a retrospective analysis of patients treated at Tata Memorial Centre, Mumbai, a tertiary care cancer center in India. Patients with human epidermal growth factor receptor (HER2)-positive early or locally advanced breast cancer who received 12 weeks of adjuvant or neoadjuvant trastuzumab with paclitaxel and four cycles of an anthracycline-based regimen in either sequence, through a patient assistance program between January 2011 and December 2012, were analyzed for disease-free survival (DFS), overall survival (OS), and toxicity. Results: A total of 102 patients were analyzed with a data cutoff in September 2019. The median follow-up was 72 months (range 6–90 months), the median age was 46 (24–65) years, 51 (50%) were postmenopausal, 37 (36%) were hormone receptor-positive, and 61 (60%) had stage-III disease. There were 37 DFS events and 26 had OS events. The 5-year DFS was 66% (95% Confidence Interval [CI] 56–75%) and the OS was 76% (95% CI 67–85%), respectively. Cardiac dysfunction developed in 11 (10.7%) patients. Conclusion: The use of neoadjuvant or adjuvant 12-week trastuzumab-paclitaxel in sequence with four anthracycline-based regimens resulted in acceptable long-term outcomes in a group of patients, most of whom had advanced-stage nonmetastatic breast cancer.
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Background: Diabetic neuropathy is one of the commonest complications of diabetes mellitus and associated with considerable morbidity and mortality. The influence of diabetes on gall bladder function was not demonstrated in many studies. In this study, the association of fasting gall bladder volume and gall bladder ejection fraction with degree of cardiac autonomic neuropathy was assessed and correlated with duration of diabetes and severity of diabetes..Methods: The study was conducted in Government Sivagangai Medical College Hospital, Sivagangai, Madurai during a period of January 2018 to September 2018 as a Prospective observational study conducted among 100 patients in study group and 50 healthy subjects in control group. The aim of the study was to find out the incidence of autonomic neuropathy in study group by simple bed side tests, to determine the fasting gall bladder ejection fraction in diabetics, comparison of gall bladder volume in both study and control group, correlation of gall bladder ejection fraction with autonomic neuropathy.Results: The incidence of CAN is found to be high with longer duration of the disease and the degree is also correlated with duration of the disease. The correlation coefficient of this association is 0.792 which indicates high correlation. The correlation of severity of DM with incidence and degree of CAN was 0.81 which indicates high correlation and also the study showed an increase in the FGBV and a decrease in the GBEF with increase in the severity of cardiac autonomic neuropathy.Conclusions: In patients with type 2 diabetes mellitus, the gall bladder ejection fraction is significantly related to the duration of diabetes mellitus and degree of hyperglycemia in addition to cardiac autonomic neuropathy(CAN). Similarly, fasting gall bladder volume (FGBV) is significantly increased in type 2 diabetes mellitus patients with cardiac autonomic neuropathy.
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Background: Many parents have poor understanding of vaccine preventable diseases (VPD) and many believe in false propagations about the contents, side effects and effectiveness of vaccines. Lack of good knowledge and positive attitude about childhood immunization was believed to be the root cause for resurgence of VPDs. Aim of the study was to assess the knowledge, attitude and practice regarding childhood immunization among mothers of under five children.Methods: A cross sectional study was done among mothers with at least one child in the under-five age group residing in the rural field practice area of a teaching institution. Assuming 61% mothers have good knowledge (Mangalore study) the sample size was calculated to be 235 with 20% error and 1.5 design effect. Data was collected with the help of pretested semi structured questionnaire by interviewing 15 eligible mothers from each of 16 wards. Descriptive analysis was done.Results: The average age of the participants was 27.30±5.42 years with many of them educated up to 10th grade (40.3%) and most being housewife (74.5%). Knowledge of mothers regarding the diseases that can be prevented by immunization was fairly good. But the knowledge regarding individual vaccines, their dosages and schedule were found to be low. Majority of mothers had good attitude about immunization. Immunization coverage of the locality was relatively good (87.7%). Significant relation was established between attitude and practice. Sick at the time of vaccination was the most common cause of being partially immunised (68.96%).Conclusions: Intensify the awareness classes for mothers and religious leaders on immunisation.
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OBJECTIVE: To identify genetic disorders associated with ophthalmologic abnormalities; type and frequency of various ophthalmologic abnormalities associated with selected genetic and inherited disorders; and devise a suitable classification for ophthalmologic abnormalities. METHODS: Pediatric cases referred with mental retardation, congenital malformations and suspected genetic and metabolic disorders were enrolled prospectively. Relevant clinical details (including an ophthalmologic examination) and investigations were recorded. RESULT: Of the 1308 patients enrolled, 679 (51.9%) had ophthalmologic abnormalities. 458 cases (67.45%) out of these 679 had mental retardation and 20 (2.94%) had neuroregression. Environmental (12.22%) and chromosomal anomalies (10.9%) were the largest etiological groups. Down syndrome was the commonest of the chromosomal anomalies and mongoloid slant and epicanthic folds were its commonest ophthalmologic features. Mucopolysaccharidoses (21.4%), Wilson disease (19.64%), oculocutaneous albinism (16.07%) and lipid storage disorders (14.29%) were the most common inborn errors of metabolism associated with ophthalmologic abnormalities. Of the 39 cases with Mendelian inheritance of disorders, autosomal dominant disorders (56.41%) were the commonest associated with ocular abnormalities. A simple anatomical classification has been devised for various ophthalmologic abnormalities encountered (wherein, positional and adnexal abnormalities were the commonest). CONCLUSION: Up to 50% of cases referred to the genetic services have ophthalmologic abnormalities. Conditions including chromosomal abnormalities, metabolic disorders, Mendelian syndromes and environmental factors are associated with ocular abnormalities. Anatomically, positional and adnexal abnormalities are the commonest.
Subject(s)
Adolescent , Child , Child, Preschool , Down Syndrome/complications , Eye Diseases/congenital , Humans , Infant , Infant, Newborn , Metabolism, Inborn Errors/complications , Prospective StudiesABSTRACT
A lipase gene from X. campestris pv. sesami (strain XcS 1) causal agent of leaf spot disease of Sesamum indicum, was cloned onto E. colt. XcS showed the presence of lip+ transformants on Dye's medium with 1% glycerol as sole carbon source. The recombinant plasmids were isolated and when digested with Eco R1, yielded 2 fragments with molecular weights 4.0 and 4.8 kb. Thus a 8.8 kb insert DNA fragment was obtained which showed lipase activity.