Verbal learning in schizophrenia in remission, first-degree relatives, and correlation to symptoms

Background: Cognitive impairments are fundamental in schizophrenia with verbal memory impairments commonly occurring not only in patients but also in unaffected genetically susceptible individuals. Deficits in verbal memory produce difficulty in problem-solving, emotional distress, and worsening of daily life skills resulting in a poor quality of life. Objectives: This study aims to evaluate the verbal memory in unaffected first-degree relatives of patients of schizophrenia in comparison to healthy controls as well as patients of schizophrenia in remission and to find correlation to symptom domains. Methods: It was a hospital-based, descriptive, cross-sectional case-control study. Three groups (n=40, each group) of patients, first-degree relatives, and controls were taken. Subjects were screened for mental retardation and remission was ascertained in the patient group by the Positive and Negative Syndrome Scale (PANSS). Rye’s Auditory Verbal Learning (RAVL) test was used to assess verbal leaning. Results: Verbal memory impairments were significant both in patients and unaffected first-degree relatives. Further, these impairments showed a strong correlation to negative symptoms. Conclusion: Significant (p<0.05) verbal learning impairments were noted in patients and first-degree relatives which showed a correlation to negative symptoms.

Interfraction physical dose variations in high-dose-rate brachytherapy for carcinoma cervix based on computed tomography image dataset to find the compatibility of the first fraction plan to treat successive fractions

Context: Due to limited resources and/or affordability by majority of the patients, many centers in low- and middle-income countries are still not able to adapt three-dimensional image-based brachytherapy planning in their routine practice. Aim: The aim of the study was to see the feasibility of using computed tomography (CT)-based plan of the first fraction to treat successive fractions of intracavitary brachytherapy based on the estimation of the physical dosimetric differences between successive applications. Materials and Methods: CT image-based brachytherapy plans of 38 patients who received three insertions of intracavitary application with high-dose-rate brachytherapy have been analyzed. Revised plans for the second and third insertions were generated by adapting dwell time and dwell position of the first insertion plan. The dose to point “A” and maximum doses to 2, 1, and 0.1 cc volumes of the rectum and bladder have been used for dosimetric comparison. Results: The statistical differences of mean point “A” doses were observed insignificant except between original and revised plans for the second insertions. The dosimetric differences between consecutive original and revised plans for the bladder and rectum have not shown any significance except minimum dose to 0.1 cc volume of the rectum for the third insertions. Conclusions: Dosimetric deviation for tumor and organs at risk is within acceptable limit while using CT image-based brachytherapy plan of the first fraction for treating successive fractions

Bone metastases incidence and its correlation with hormonal and human epidermal growth factor receptor 2 neu receptors in breast cancer

Aim: In this paper, we present a prospective observational study, which determines the incidence of bone metastases and its correlation with hormonal receptors (estrogen receptor [ER]/progesterone receptor [PR]) and human epidermal growth factor receptor 2 (HER2) in breast cancer. Materials and Methods: From October of 2015 to July 2017, 262 patients were eligible for the study, of which 98 patients presented/developed bone metastases. ER/PR and HER2 receptor status were determined, and bone scintigraphy with a technetium-99 m was carried out on each patient during the study. Results: The incidence rate of bone metastases as found in this study was 25.25%, and the mean and median age at diagnosis were 47.23 and 46, respectively (age range = 28–80). Bone metastases were more prevalent in ER-positive tumors (P = 0.043), tumors with lymph node positivity (P = 0.002), and lower grade tumors (P = 0.002), whereas visceral metastases were more common with ER-tumors (P = 0.005), tumors with higher grade (P = 0.012), and tumors with lymph node positivity (P = 0.034). In this study cohort, the spine and pelvis were the most commonly involved subsites of bone metastases (P < 0.001). Conclusion: This study demonstrates that the metastatic patterns in breast cancer strongly correlate with various breast cancer subtypes, mainly designated by ER, PR, and HER2. Hormone receptor-positive tumors show a predilection for bones as the first site of relapse compared to hormone-receptor-negative tumors which have a proclivity to develop as visceral metastases.

Unilateral Vocal Cord Paralysis In Gastrointestinal Malignancies- A Rare Presentation

Background Advancements in diagnostic modalities have brought many hidden etiological causes of unilateral vocal cord paralysis (UVCP) to light. Here we are presenting two cases of gastrointestinal (GI) malignancies with metastases causing UVCP which can further add to another rare cause of UVCP. Case summary We are presenting a case of 40 year male with metastatic periampullary carcinoma leading to UVCP and another case of 45 year female with rectal carcinoma further causing UVCP. Both patients were under treatment while during follow-up, symptoms of UVCP were observed which changed our perspective towards cases of UVCP. Conclusion Vocal cord palsy is a symptom of an underlying disorder and not a disease. In above case reports metastases are the commonest etiology for vocal cord palsy. Relevant investigations have to be conducted in order to diagnose the etiology and the modality of treatment varies depending on the etiology of the condition.

Quantitative Assessment of Muscle Activity and Joint Load in Braced and Unbraced Osteoarthritis Knee by External Strain Gauge Sensor.

Objectives: Altered biomechanics leads to the development of degenerative joint disease. The joint pressure and dynamic loading varies during activities of daily living. The study was undertaken to assess the muscle activation pattern of the medial and lateral knee compartments (tibiofemoral joint) during gait in osteoarthritis subjects without and with knee brace undergoing either exercise therapy or balance therapy. The joint load was assessed by the strain gauge transducer and the weight shift pattern is taken as an indicator for the muscle activation pattern. Methods: In a prospective design study on 57 male subjects diagnosed osteoarthritis knee with KellagrenLawrennce scale walked barefooted with and without designed offloader knee brace on a level surface for three minutes. The subjects were allocated in two different study groups i.e. Conventional (exercise therapy) (Control Group, n=31) and Structured Neuromuscular Postural Training (SNPT) group (Balance therapy) (Study Group, n=26). The subjects were sub grouped as pre-elderly (40-60 Years) and elderly (>61 years) group in both. The quantitative assessment of muscle activity and joint loading with and without knee brace was done using designed strain gauge sensor instrument. The pressure changes of strain gauges of muscles around the knee joint viz. vastus medialis (VM), vastus lateralis (VL), semi membranosus / tendinosus (Medial Hamstring) (MH), Biceps Femoris (Lateral Hamstring) (LH), gastro-soleus (GS) and tibialis anterior (TA) muscles during normal gait were observed at baseline and 6 weeks follow up after undergoing exercise therapy or balance therapy treatment as per allocation of study groups. The digital values from MATLAB were recorded and analyzed. Results: At the end of 6 weeks conventional / SNPT (structured neuromuscular postural training) treatments, medial hamstring muscle activity showed significant difference (p<0.001) in pre-elderly subgroup, while significant difference was seen in vastus laterals (VL), medial hamstring (MH) (p<0.005) and lateral hamstring (LH) muscles (p<0.001) in elderly subgroup