Pattern of care and epidemiology of brain metastasis over past 10 years: A retrospective study from tertiary cancer center

Background: In adults most common intracranial malignant lesion is brain metastasis, far outnumbering primary brain tumor. The most common primary site is lung cancer (18–64%), followed by breast (25–21%), malignant melanoma (4–16%), and colorectal cancer (2–12%). It is hypothesized that the incidence of brain metastasis might be increasing, as a result of increasing survival from recent advance in cancer treatment, more frequent brain screening for specific primary malignancy that known to have a higher prediction for brain metastasis and greater availability and use of magnetic resonance imaging (MRI) of brain. In clinical oncology, understanding brain metastasis is important, because it has profound effect on length of survival, quality of life, and in one-third to one-half of affected patients, they represent the direct cause of death despite current improvement in therapeutic approach. Epidemiological data of brain metastasis are lacking in India. Objectives: Aims of our retrospective analysis are to study epidemiology and pattern of care of brain metastasis over last one decade in Nil Ratan Sircar Medical College and Hospital, Kolkata. Materials and Methods: Between 2006 and December 2017, a total of 710 patients of brain metastasis treated in our department with palliative intent were analyzed retrospectively. New-onset neurological symptoms in a known case of cancer we always presumed that, symptoms were due to brain metastasis until proven otherwise. Hence, all patients presenting with acute neurological signs and symptoms underwent through clinical examination, contrast-enhanced (CE) computed tomography brain, and/or CEMRI of brain. Epidemiology, pattern of care, and outcome in the form of overall survival (OS) and disease-free survival were determined. Results: Fifty-seven percent patients were male. The median age was 62 years at the time of diagnosis. Lung carcinoma was most common primary site seen in 52% patients, followed by carcinoma breast second most common primary site, seen in 32% patients. Headache (73%) and motor weakness were most common presenting symptoms. Supratentorial location most common site, out of which parietal region is most common. The only small number of patients was offered best supportive care alone whereas majority of the patients were considered fit for palliative therapy. Treatment consisted of metastasectomy when possible and palliative whole-brain radiotherapy (WBRT) alone or followed by systemic therapy. Optimal supportive care in addition to chemotherapy or radiotherapy is given to all patients. A total of 254 patients were given blood product, erythropoietin, granulocyte-colony-stimulating factor following chemotherapy. Hospitalization required in 71% patients and tumor-related problem was most common cause (46%). Remaining patients were hospitalized for delivery WBRT or CCT. The median OS is 9 months. Patients with younger age and breast primary associated with better prognosis than lung primary. Conclusions: We can conclude that carcinoma lung in male and carcinoma breast in females was most common cause of brain metastasis. Because advance in palliative therapy, outcome of patients with brain metastasis has improved, and patients with brain metastasis benefit from palliative radiotherapy and chemotherapy and this treatment could be delivered easily on outpatients basis.

External beam radiation plus intraluminal brachytherapy in locally advanced, inoperable carcinoma esophagus: A retrospective study from tertiary cancer care center

Background: Worldwide, an estimated 572,034 esophageal cancer cases and 508,585 deaths occurred in 2018 and it accounts for approximately 3.2% of all malignancy. Because esophagus has no serosal covering with extensive, longitudinal connecting system of lymphatic plexus, direct invasion to contiguous structures and lymph node metastasis occurs early. Unresectable or metastatic disease at the time of diagnosis is seen in approximately 80% of patients, with cure rate <15% and thus making carcinoma of esophagus is one of the most dreaded malignancies. As most of the patients are diagnosed in locally advanced or metastatic stage, so curative surgical resection is not an option. Hence, in these groups of patients, other treatment modalities including concurrent chemoradiation have been tried. However, many of these patients are in a poor general condition so that radical concurrent chemoradiation as an alternative surgical resection could not be offered. In this group of patients, only radiotherapy (RT) is an option in intention to improve quality of life and to increase disease-free survival (DFS) if possible. As there is more chance local failure when patients treated with only external beam RT (EBRT), increasing dose to tumor may improve local control. Intraluminal brachytherapy (ILBT) is an important treatment option for dose escalation along with EBRT in the treatment of locally advanced and inoperable carcinoma esophagus. ILBT provides focal dose escalation, rapid reduction tumor, rapid restoration of swallowing function with sparing of surrounding normal tissue, and potentially improving therapeutic ratio. Hence, based on these facts, following EBRT, ILBT is an effective adjuvant modality to delivered high tumoricidal dose which can facilitate good local control, DFS with acceptable toxicity. We have used ILBT alone as palliative RT and combined modality with EBRT as radical treatment approach. Objectives: The aim of our study is to evaluate efficacy and safety of external beam radiation plus ILBT in locally advanced, inoperable carcinoma of esophagus in terms of improving local control, DFS, toxicity, and quality of life. Materials and Methods: A total of 58 carcinoma esophagus patients treated with EBRT plus ILBT in our RT department from 2012 to 2015 analyzed retrospectively. EBRT, total dose of 40 Gy/20 fractions, delivered in 4 weeks, using anteroposterior posteroanterior portal in cobalt-60 machine. Two–three weeks after completion of EBRT, ILBT was done using esophageal budgie. The total dose of brachytherapy was 10 Gy in two fractions, 1 week apart, 5 Gy in each fraction. EBRT and ILBT treatment completed in 8–9 weeks. Response assessed by clinical assessment, upper gastrointestinal endoscopy, and contrast-enhanced computed tomography chest and abdomen initially at 3 months and then at 6 months. Results: Local disease control seen in 65% of patients. With a median follow-up of 15 months, the median DFS was 8 months and median overall survival was 14 months. Regional nodal failure and distant metastasis were seen in 35% and 46% of patients, respectively. The incidence of acute mucositis was seen in 75% of patients and late toxicity is seen in 25% of cases. Swallowing function preserved in >87% of patients. Conclusion: In patients with locally advanced carcinoma of esophagus and poor performance status who are unable to tolerate radical concurrent chemoradiation, combination of EBRT plus ILBT produces good local control, DFS, and durable relief of dysphagia with acceptable toxicity.

Concurrent chemoradiation with paclitaxel in locally advanced head and neck cancer: A feasibility study from tertiary cancer care center

Background: In India, the majority of the head and neck squamous cell carcinoma (SCC) of head and neck (60–80%) presented in locally or locoregionally advanced stage but non-metastatic disease as compared to 40% in developed nations. Uncontrolled local and/or locoregional disease causes most fatalities and predominant failure pattern is local and/or locoregional. Concurrent chemoradiation (CRT) is now standard of care. However, regarding either the optimal scheduling of chemotherapy regimen or radiotherapy (RT) dose fractionation scheme, no consensus exists. Paclitaxel is also active agents against squamous cell carcinoma of head and neck. Weekly paclitaxel appeared to be equivalent to weekly cisplatin with concurrent radiation in the treatment of locally advanced SCC of head and neck cancer (HNC). Concurrent chemoradiotherapy with paclitaxel in locally advanced head and neck malignancy is recommended in NCCN Guideline. Objectives: The aim of our study is feasibility and efficacy of CRT with paclitaxel for the treatment locally advanced HNC in our institute, Nil Ratan Sircar Medical College and Hospital, Kolkata. Material and Methods: Between January 2014 and December 2018 ninety eight (98) previously untreated patients with locally advanced histologically confirmed carcinoma oral cavity, oropharynx, and hypopharynx treated with CRT. Chemotherapy consisted of paclitaxel at a dose 40 mg/m2 over 1 h given once weekly from 1st week of RT, up to 4–6 cycles. RT consisted of 66 Gy/33#/61/2 weeks, 2 Gy/fraction, delivered by two parallel opposed lateral face and neck and low anterior neck portal, in cobalt 60 machines. Toxicity was graded using Common Terminology Criteria for Adverse Events v3. To assess response to therapy contrast-enhanced computed tomography (CECT) head and neck and/or magnetic resonance imaging head and neck; CECT chest or whole-body fluorodeoxyglucose and positron emission tomography computed tomography scan were done. Results: Overall complete response (CR) rate seen in 68% and partial response seen in 32% patients. Two-year disease-free survival, progression free survival, and overall survival were 59%, 72% and 85%, respectively. Grade II acute skin reaction seen in 45% patients and Grade III acute skin reaction seen in 55% patients. Similarly, Grades II and III mucosal reaction is seen in 48% and 52% patients. All patients experience Grade II dysphagia and managed conservatively. Conclusions: CRT with paclitaxel in locally advanced HNC is safe and confers high CR rate with acceptable toxicity. However, more randomized study with large number of patients is needed to come to conclusions regarding its efficacy.

Epidemiology and prevalence of breast cancer: A retrospective study in a tertiary health care center in Kolkata over one decade

Background: Breast cancer is a major public health problem for women throughout the world. According to GLOBOCAN 2012, India along with the United States and China is responsible for almost one-third of global breast cancer burden. There has been 11.54% increase in incidence and 13.82% increase in mortality due to breast cancer in India from 2008 to 2012. According to GLOBOCAN 2018, for both sexes, breast cancer second most common cancer after lung cancer accounting for 11.6% of total cases. Most of the cases diagnosis at an advanced stage because of inadequate screening, lack of appropriate medical facilities thereby increasing breast cancer mortality. It is the second most common malignancy among Indian women accounting for 7% of global burden of breast cancer. Incidence of breast carcinoma varied in the different regions of the world with lowest incidence in Africa, Asia and highest incidence in North America and Europe. This geographic variability is not only to environmental factors but also to lifestyle. There is a paucity of epidemiological data regarding carcinoma of breast. Objectives: The aims of our study were to evaluate the prevalence and epidemiology of breast cancer in our institution, N.R.S. Medical College Kolkata. Materials and Methods: We have analyzed 4172 newly diagnosed breast carcinoma cases, registered at N.R.S. Medical College and Hospital, Kolkata, West Bengal, India, over one decade, in between January 2008 and December 2017 retrospectively. A total of 4172 cases confirmed by pathological examination were included for analysis. Demographic and clinicopathological profile and management offered to the breast cancer patients were recorded from the medical records file. The staging was performed using American Joint Committee on Cancer tumor, node, and metastasis classification staging system. Results: In our study, about 63% of the patients came from urban areas and 37% from rural areas. The mean age at diagnosis was 52 ± 9.5 years, with a range from 26 to 82 years. The age at menarche in this study ranged from 10 to 16 years, mean being 12 ± 1.5 years. Age at the time of first pregnancy ranged from 19 to 32 years, with the mean age being 22 ± 6.2 years. Family history of breast carcinoma in first and second degree relatives was found in 92 (2.2%) patients in this study. Approximately 5% (216) patients were nulliparous. About 63% of the patients were postmenopausal while 36% were premenopausal. Common presenting symptoms include breast lump (100%) and axillary swelling (33%). Histologically, 99.5% cases were infiltrating ductal carcinoma, and it was most common histology. Most patients were diagnosed with Grade II tumors (45%) followed by Grades I and III, and approximately 75% of the patients were in Stages II and III and 10% patients in Stage IV. The most common site of metastasis was lung (33%), bone (26%), liver (23%), and brain (14%). Conclusions: The majority of the breast carcinoma patients presented with Stages II and III disease, approximately 99% cases were infiltrating ductal carcinoma, not otherwise specified and were mainly Grade II followed by Grade III disease. The prevalence of estrogen receptor, progesterone receptor hormone receptor status and Her2/neu status in the population needs further investigation in the future. The government needs to urgently strengthen and augment the existing facilities including screening, which is inadequate at present to handle the current breast cancer load in India.

Palliative radiotherapy in locally advanced and metastatic carcinoma of lung with two radiotherapy regimens: A randomized comparative study from tertiary health-care cancer center

Background: Worldwide, leading cause of cancer mortality is lung cancer. Approximately 63,000/year new lung cancer cases reported in India. Around 80–85% of patients of lung cancer is non-small cell histology (non-small cell lung cancer) and over >90% of patients presented locally advanced and metastatic disease. Hence, in these patients, population curative treatment approach with radiotherapy (RT) and chemotherapy in most of the time is non-viable option yielding short survival and relatively poor prognosis. In majority of such cases, the only aim of treatment remains palliative, the main aim is to improve quality of life. Although there are other medical management of symptoms palliation, radiation therapy is the cheapest option, quite effective, time efficient, and well tolerated in providing relief from symptoms. The rate of palliation of symptoms is quite high for chest pain and hemoptysis at 60–80%, whereas cough and dyspnea are improved in only 50–70%. For intrathoracic disease with obstructive symptoms, 30 Gy/10# over 2 weeks are generally recommended. Patients with poor performance status, advanced age, and associated comorbidity at the time of diagnosis, for which daily RT over 2–3 weeks is logistically difficult, 1–2 fractions have been utilized with good results. There are multiple randomized trials showed that both short and long RT course were equally effective for symptoms control. Aims and Objectives: The aims of our study are to compare the outcome, symptom control and assess toxicity profile in locally advanced lung cancer patient with 17 Gy/2 fractions (8.5 Gy/fraction, × 2 fractions) only on Saturdays over 2 weeks versus 30 Gy/10 fractions (3 Gy/fraction) over 2 weeks and to compare quality of life. Materials and Methods: This study was a single-institutional, prospective, open-labeled, randomized controlled study. Eligible patients were age ≥18 years with histopathologically proven lung carcinoma which was inoperable Stage III or IV disease and too locally advanced to curative concurrent chemoradiation, pulmonary symptoms attributable to the primary tumor, Eastern Cooperative Oncology Group (ECOG) performance status ≤3, and adequate hematologic (hemoglobin >10 g/dl; absolute neutrophil count >1500; platelet count >100,000/ml; and hepatic and renal function calculated creatinine >60 ml/min). Patients with bleeding diathesis, emphysematous bullae, poor respiratory function or reserve, pregnancy, and ECOG performance status >3 were excluded from the study. Results: Age, stage, histopathology, and pre-treatment symptoms score between two groups were comparable and statistically not significant. Pain in chest due to lung cancer was decreased in both arms due to treatment (at treatment completion Arm A = 47.62 and Arm B = 38.09). However, at the 2nd follow-up, difference between two arms was statistically significant where Arm A = 27.78 and Arm B = 15.00; P = 0.005. Global health status of patients in this study was improved in both arms due to treatment. Physical functioning emotional functioning, role functioning, global health status, cognitive functioning, and social functioning were improved in both arms due to treatment and kept improving during follow-up, but difference between two arms was not significance. Conclusions: Although overall symptom palliation, toxicity profile, and quality of life parameters are almost equal in both arms, patients with short expected survival, 8.5 Gy × 2 fractions would be preferable, limiting the number of hospital visit to a minimum. On the other hand, 3 Gy × 10 fractions schedule can be chosen for those patients with longer expected survival and better ECOG status, due to prolong duration of palliative response.

Epidemiology of cervical cancer: A retrospective study in tertiary health-care center in Kolkata over one decade

Background: Globally, cervical cancer is the most common gynecological cancer and the 4th most common malignancy in women with over 526,000 cases diagnosed in 2015 and 239,000 dying of carcinoma cervix every year. Cervical cancer is more common in areas where women have less access to screening, including parts of Asia, Africa, and Central and South America. Cervical cancer is the second most common cancer among women in India and also the second most common cancer among women between 15 and 44 years of age and one of the leading causes of cancer mortality, accounting for 17% of all cancer death among women aged between 30 and 69 years. Nearly, all cases of cervical carcinoma can be attributable to human papillomavirus (HPV), and type 16 and 18 cause 70% of cervical cancer and precancerous cervical lesion worldwide. It is now well-established fact that persistence of HPV infection is a causative factor for cervical neoplasia. Epidemiological data regarding cervical cancer are lacking in India. Objectives: The aim of our study was to evaluate the prevalence and epidemiology of cervical cancer in our institution. Materials and Methods: Newly diagnosed carcinoma cervix cases registered at Nil Ratan Sircar Medical College, Kolkata, West Bengal, India, between January 2009 and December 2018, were analyzed retrospectively. A total of 4082 cases confirmed by histopathological examination included for analysis. Age, parity, age at marriage, residential area, symptoms, stage, and histological types collected from patient’s record file. Staging was done using Federation of Gynecology and Obstetrics staging system. Results: About 92% of patients came from rural areas and rest of the patients came from urban areas. Median age of diagnosis is 48 years. Most patients presented in Stage II and Stage III disease (85%). Squamous cell carcinoma found in 85% of patients and most common histology; adenocarcinoma second most common histology (14%). Lymph node metastasis seen in pelvic nodes (48%) followed by para-aortic node (9%) and supraclavicular metastasis in <1% of patients. The most common sites of distant metastasis seen in lung (19%) followed by bone (14%) most commonly to pelvic bone and lumbar vertebra. Conclusion: Most carcinoma cervix patients presented in Stages II and III and squamous cell carcinoma is the most common histology seen in 85% of patients. HPV related and molecular risk factors are needed further investigation in future. Multi-institutional and longer period of study may represent population-based data. Awareness of our society regarding needs for screening of asymptomatic patients and HPV vaccination initiative from government is needed for the reduction of incidence and death from cervical cancer.

Bevacizumab with paclitaxel and carboplatin for locally advanced (Stage IIIB) metastatic adenocarcinoma of lung: A feasibility study from tertiary care center

Background: Lung cancer is the most common cancer and leading cause cancer-related death in worldwide and also in India. Around 42% of these patients have adenocarcinoma. Most of these patients presented in locally advanced stage or metastatic disease. There is no significant difference in effectiveness among different chemotherapy regimens with median survival of 8 months only. Hence, additional treatment option including newer monoclonal antibodies is needed to improve tumor control and survival. Vascular endothelial growth factor (VEGF) is critical determinant of tumor angiogenesis, a process that is necessary component of tumor growth, invasion, and metastasis. Bevacizumab (Bev), a humanized monoclonal antibody (IgG1) targeting VEGF, effective in colorectal cancer, renal cell carcinoma, glioblastoma multiforme, and non-small cell lung cancer and approved for clinical use since 2004. Objectives: The aim of our study is feasibility of the combination of Bev with paclitaxel and carboplatin in locally advanced (Stage IIIB) metastatic adenocarcinoma of lung in our institute, N.R.S. Medical College and Hospital, Kolkata. Materials and Methods: Between February 2015 and December 2018, ninety-eight previously untreated patients with locally advanced metastatic (Stages IIIB and IV) adenocarcinoma of lung treated with Bev with paclitaxel and carboplatin. Paclitaxel at a dose of 175 mg/m2, carboplatin at an AUC 6 mg/ml/min, and Bev at a dose of 15 mg/kg given on the 1st day of chemotherapy. Chemotherapy administered every 3 weeks up to 6 cycles with maintenance Bev until disease progression or unacceptable toxicity whichever is earlier. Patients ECOG 2 or more, brain metastasis, squamous cell histology, and hemoptysis were not included in the study. Results: The Median overall survival (OS), progression free survival (PFS) were 9.4 and 5.2 months, respectively. Anemia (19%) and neutropenia (16 %) are most common toxicity. Conclusion: Bev with paclitaxel and carboplatin in selected patients with adenocarcinoma of lung is safe and confers survival benefit with acceptable toxicity.

Concurrent chemoradiotherapy for muscle-invasive bladder carcinoma for organ preservation: A feasibility study from tertiary care center

Background: The primary goal of treatment in oncology is cure but efforts should be made to preserve quality of life. The gold standard for treatment of muscle-invasive bladder cancer is radical cystectomy. However, radical cystectomy cannot be performed without risk of complications and often the outcome for the patient is a mediocre quality of life as the patient has to live with an artificial bladder or ileal conduit. Even after radical cystectomy, 40–50% of patients will succumb to distant metastases within 5 years. As in the case of several other malignancies, increasing efforts have been made over the last few decades to adopt organ sparing treatment. Bladder-sparing monotherapies lead to disappointing results, local disease control may be maximized using a trimodal approach based on complete transurethral tumor resection of bladder (TURB), followed by concurrent chemoradiotherapy and cisplatin-based systemic chemotherapy. Objectives: The aim of our study is feasibility of concurrent cisplatin with radiation in bladder preservation in our hospital. Materials and Methods: Thirty-two previously untreated patients of histologically proven transitional cell carcinoma of urinary bladder received concurrent chemoradiation (60 Gy) with cisplatin. All patients received concurrent chemotherapy with cisplatin infusion in a dose of 20 mg/m2/day on consecutive 5 days from Day 1 to Day 5 in 1st and 5th week of radiotherapy. Detailed clinical examination along with cystoscopy, TURB along with biopsy, and computed tomography scan of abdomen pelvis were done before treatment and to assess response toxicity, and disease-free survival (DFS) during follow-up period. Results: Median follows up period was 36 months. Local disease control was seen in 71% patients. Five years DFS is 58%. Five years overall survival is 64%. Conclusions: Concurrent chemoradiation in carcinoma of urinary bladder is feasible in our hospital and results in good local control, survival with acceptable toxicity.

Variability of the EG95 antigen-coding gene of Echinococcus granulosus in animal and human origin: implications for vaccine development

In the present study, the genetic variability of the EG95 protein-coding gene in several animal and human isolates of Echinococcus granulosus was investigated. A total of 24 isolates collected from cattle, buffalo, sheep, goat, dog and man were amplified by Eg95-coding gene-specific primers. From the generated sequence information, a conceptual amino acid sequence was deduced. Phylogenetically, the Eg95 coding gene belongs to the Eg95-1/Eg95-2/Eg95-3/Eg95-4 cluster. Further confirmation on the maximum composite likelihood analysis revealed that the overall transition/transversion bias was 2.913. This finding indicated thatthere is bias towards transitional and transversional substitution. Using artificial neural networks, a B-cell epitope was predicted on primary sequence information. Stretches of amino acid residues varied between animal and human isolates when hydrophobicity was considered. Flexibility also varied between larval and adult stages of the organism. This observation is important to develop vaccines. However, cytotoxic T-lymphocyte epitopes on primary sequence data remained constant in all isolates. In this study, agretope identification started with hydrophobic amino acids. Amino acids with the same physico-chemical properties were present in the middle. The conformational propensity of the Eg95-coding gene of 156 amino acid residues had α-turns and β-turns, and α-amphipathic regions up to 129, 138–156 and 151–155 residues, respectively. The results indicated potential T-cell antigenic sites. The overall Tajima’s D value was negative (−2.404165), indicative of negative selection pressure.

Molecular appraisal of Indian animal isolates of Echinococcus granulosus.

BACKGROUND & OBJECTIVE: Cystic echinococcosis (CE) has a wide host range and distinct entities, not only reflected phenotypically but also by genotypic variation. Considering this fact, this study was undertaken to characterize the Indian isolates of Echinococcus granulosus to find out difference between Indian cattle, buffalo and sheep isolates on the basis of random amplification of polymorphic DNA (RAPD) PCR and PCR mediated restriction fragment length polymorphism (PCRRFLP) of internal transcribed spacer gene 1 (ITS1). METHODS: A total of 22 isolates of E. granulosus obtained from Indian cattle, buffalo and sheep (December 2004 - November 2005) were analysed by 26 random primers of 8-10 mers. After isolation of protoscoleces from fertile cyst, DNA was extracted, quantified and amplified by random primers. Internal transcribed spacer gene 1 (ITS1) was amplified using specific primer and digested by two restriction enzymes (Msp1 and Rsa1). RESULTS: Of the 26 primers, only two primers (5'ACC TGG ACA C3' and 5' TCA TCC GAG G3') could discriminate cattle, buffalo and sheep isolates collected from eastern part of India. Samples were further analysed by PCR mediated RFLP of internal transcribed spacer gene1 (ITS1) using two restriction enzymes (Msp1 and Rsa1). No ITS1 variants could be detected. INTERPRETATION & CONCLUSION: Our findings showed genotypic variation among Indian animal isolates of E. granulosus on the basis of RAPD fingerprinting.

Carcinoma of the gall bladder presenting as dermatomyositis.

Dermatomyositis (DM), manifested as paraneoplastic syndrome, is not a very common clinical entity but its association with various internal malignancies is well-documented in literature. We present such a case of DM associated with characteristic skin lesions and subacute onset of proximal muscle weakness, acquired from a very rare malignancy like adenocarcinoma of gall bladder.

Leptospirosis and Weil's disease in eastern India.

Leptospirosis is characterised by a broad spectrum of clinical manifestations varying from inapparent infection to fulminant fatal disease. Severe leptospirosis characterised by profound jaundice is referred to as Weil's disease. In the present study 20 patients of leptospirosis, of which 7 belonged to Weil's disease, were diagnosed based on the demonstration of IgM antileptospira antibody and supported by clinical correlation and appropriate biochemical markers. Overall, the male and female ratio was 17:3 and the same ratio for the Weil's disease was 6:1. The most common presentation involved fever, malaise and myalgia. Conjunctival congestion was found in 75% of the cases and jaundice was encountered in 90% of the cases. The prognosis of all these patients, including that of Weil's disease was excellent. Early recognition and initiation of antibiotic therapy were found to be important.

Individual and combined effect of mercury and manganese on phenol and proline content in leaf and stem of mungbean seedlings.

Mungbean (Vigna radiata L. Wilczelk cv. Pusa Baisakhi seedlings were raised in individual (0, 1, 10, 100 and 1000 ppm) and combined solutions (1 : 1, 10: 1, 1: 0 ppm Hg : Mn) of mercury and manganese for 6 days. Phenol and proline were found to accumulate in leaves in response to treatment with heavy metals. The magnitude of accumulation correlated with concentration of metals. However, a reverse trend was noticed in stem for phenol. Accumulation of phenol in response to heavy metal treatment was organ specific and occurred at higher rate in plant parts, which faced the stress mostly. However, accumulation of proline helped the plant to survive stress situation. In combined solutions, amelioration of mercurial toxicity by manganese was recorded.

Amelioration of mercurial toxicity by manganese. I. A case study in mung bean seedling.

Mercury, a non essential element renders inhibitory effect on many physiological activities of plants even at a low concentration. Plants absorb "Hg" from soil through root system. Manganese, an essential element has been found to counter the inhibitory effect of mercury mostly by preventing it's uptake from soil. Mung bean (Vigna radiata L. Wilczek) cv. Pusa Baisakhi grown in individual (1, 10, 100 and 1000 ppm) solution of Hg and Mn showed varied uptake of these heavy metals. However, in combined solutions (1 : 1, 10 : 1 and 1 : 10 ppm Hg : Mn), mercury uptake was mostly prevented in presence of 10 ppm Mn, indicating it's ameliorating effect.

Impact of cadmium toxicity on leaf area, stomatal frequency, stomatal index and pigment content in mungbean seedlings.

Effect of different concentrations of CdSO4 (10(-4) M, 5 x 10(-4) M and 10(-3) M) on leaf area, stomatal frequency, stomatal index and pigment content in 6 days old mungbean seedlings was studied under laboratory conditions. Except at 10(-4) M CdSO4, leaf area decreased with an increase in the concentration of CdSO4. Stomatal frequency on the leaf surface increased at 5 x 10(-4) M and 10(-3) M CdSO4 in comparison to untreated control. However, reverse was the case for stomatal index. Chlorophyll-a, chlorophyll-b, total chlorophyll, and chlorophyll a/b ratio were increased at 10(-4) M CdSO4, and decreased thereafter with an increase in the concentration of Cd2+. Possible reasons for the stimulatory effect at low concentrations and inhibitory effect with higher concentrations are discussed.

On structural aspects of peptidoglycan of bacterial cell wall with special attention on mycobacteria by computer modelling.

The cell wall components of mycobacteria are said to be vitally linked with their pathogenicity. Peptidoglycan, one of the major cell wall component in most of the bacteria are multilayered in gram positive bacteria and it is diverse in nature for the Gram positive strain rather than gram negative. The cell wall of bacteria are primary targets for many drugs and antibiotics and conformation of the major cell wall components provide invaluable information and understanding at molecular level to medicinal chemists and drug designers. Mycobacterial peptidoglycan has been studied critically by computer modelling on various aspects. A plausible structure and conformation has been identified and glycan chain is found to have a pseudo two fold symmetry taking disaccharide unit as monomer with Knox & Murthy H-bond scheme. This paper attempts to clarify the understanding of organisation and possible interaction mode of peptidoglycan of organisation in complex mycobacterial cell wall structure.

Studies on lipids in mycobacterial cell wall: their important structure and function relating to pathogenicity and their biological activity.

The lipids cord-factor, mycosides and sulpholipids are supposed to be vitally linked with the pathogenecity of mycobacteria. In this paper an attempt has been made to clarify the understanding of the occurrence, organisation and possible interaction of the diverse lipids present in the mycobacterial cell wall and their possible structure and function.