ABSTRACT
BACKGROUND: In Ayurveda, several herbs and formulations are available for the treatment of Urolithiasis. However, they are not systematically evaluated for their safety, efficacy, indication and limitations. Herbmed Plus is one such herbal formulation that has been known for the management of urinary tract disorders. An attempt has been made to evaluate its efficacy on Urolithiasis. OBJECTIVE: To evaluate the efficacy and safety of Herbmed Plus in urolithic rats. MATERIALS AND METHODS: A total of 60 Wistar albino rats were used for this study. The male and female rats were divided into five groups: disease control, test (dose 90 mg/kg), standard I (Cystone), standard II (Alkaston insta) and normal control (six in each group). Urolithiasis was induced using ethylene glycol 0.75% in drinking water for 28 days. The rats with urinary oxalate crystals were dosed with oral test or standard treatments for 28 days. RESULTS: All the animals appeared normal and showed no clinical signs of toxicity. None of the groups reported mortality or adverse effect on body weight and food consumption. The treatment with test drug showed improvement in the SGPT level and urine output (5.4 vs 3.47 mL/24 h). A drastic reduction in number of crystals were observed in male 0.5 vs 22 and female rats 0 vs 22.7 in test and disease group. The kidney lactate dehydrogenase, alkaline phosphatase, urinary phosphorus and calcium oxalate level decreased in the test and standard drug groups as compared to disease groups. Microscopy of the urine samples showed reduction in the number of crystals after treatment compared to the urolithic group. Increase in citrate levels in urine in all the treatment groups indicated anti-urolithiatic activity. The test group showed a 69.70% recovery in males and 47.57% recovery in female rats compared to the disease control group. CONCLUSION: Herbmed Plus showed a significant reduction in oxalate synthesizing enzymes suggesting anti-urolithiatic activity and anti-inflammatory and regenerative property in cellular injury caused by crystal deposits.
ABSTRACT
RESILIENT (CTRI/2018/02/011808) was a single arm, open label, phase II/III study to test if label agnostic therapy regimens guided by Encyclopedic Tumor Analysis (ETA) can offer meaningful clinical benefit for patients with relapsed refractory metastatic (r/r-m) malignancies. Patients with advanced refractory solid organ malignancies where disease had progressed following ≥2 lines of systemic treatments were enrolled in the trial. Patients received personalized treatment recommendations based on integrational comprehensive analysis of freshly biopsied tumor tissue and blood. The primary end points were Objective Response Rate (ORR), Progression Free Survival (PFS) and Quality of Life (QoL). Objective Response (Complete Response + Partial Response) was observed in 54 of 126 patients evaluable per protocol (ORR = 42.9%; 95% CI: 34.3%-51.4%, p < 0.0001). At study completion, Disease Control (Complete Response + Partial Response + Stable Disease) was observed in 114 out of 126 patients evaluable per protocol (CBR = 90.5%; 95% CI: 83.9% - 95.0%, p < 0.00001) and Disease Progression in 12 patients. Median duration of follow-up was 138 days (range 31 to 379). Median PFS at study termination was 134 days (range 31 to 379). PFS rate at 90 days and 180 days were 93.9% and 82.5% respectively. The study demonstrated that tumors have latent vulnerabilities that can be identified via integrational multi-analyte investigations such as ETA. This approach identified viable treatment options that could yield meaningful clinical benefit in this cohort of patients with advanced refractory cancers.
ABSTRACT
Pulmonary blastoma is a rare form of lung cancer with a reported incidence of 0.25-0.55 of primary pulmonary cancers. Pleuropulmonary blastoma (PPB) is a common finding in children while it is rarely found in adults. In the past few years, the incidence of a second primary tumour has increased to 3.5% followed by third primary tumour at 0.5% and fourth tumour at 0.3%. The clinical significance of diagnosing and distinguishing a secondary primary tumour is often challenging. As per our knowledge, this is the first case of metachronous PPB in an adult patient previously diagnosed with endometrial cancer.
ABSTRACT
Astroblastoma is an uncommon neuroepithelial primary tumor of the brain which is of uncertain origin. We present a case of high-grade astroblastoma in an 18-year-old female with a severe headache, loss of appetite, vomiting and generalized weakness. The patient had undergone a right frontoparietal craniotomy. Large subfalcine meningioma was excised. The lesion was suspected to be a meningioma. Primary radiological investigation revealed a 6.8 cm × 5.8 cm × 5.4 cm lesion. Although the radiological and intraoperative findings were of an extra-axial tumor, the histology and immunophenotype was of an astroblastoma. The patient was treated with cyclophosphamide, cisplatin and etoposide chemotherapy regimen. The patient was later treated with bi-weekly bevacizumab. The patient had improved symptomatically post-chemotherapy. However, there was no significant difference in lesion size. The patient died after 2 weeks. The prognosis of patients with astroblastoma is extremely poor as observed in our case.
