Surgical treatment pattern and outcomes in epithelial ovarian cancer patients from a cancer institute in Kerala, India.

OBJECTIVE: To evaluate the treatment and survival pattern of patients with advanced epithelial ovarian cancer. METHODS AND RESULTS: Retrospective study of all advanced epithelial ovarian cancer patients treated in the department of gynaecologic oncology from an academic centre, in a four year period from 1 January 2008-31 December 2011. SELECTION CRITERIA: All patients with advanced epithelial ovarian cancer (stage III and IV) who underwent surgery from 2008-2011and had a follow-up of at least three months after completion of treatment were included. The decision on whether primary surgery or neoadjuvant chemotherapy (NACT) in advanced ovarian cancer was based on age, performance status, clinical and imaging findings. RESULTS: A total of 178 cases of epithelial ovarian cancer were operated on during this four year period. Among them 28 patients were recurrent cases, 22 had early stages of ovarian cancer, and the rest 128 had stage III and IV ovarian cancer. In these 128 patients, 50(39.1%) underwent primary surgery and 78(60.9%) had NACT followed by surgery. In the primary surgery group 36(72.0%) patients had optimal debulking while in the NACT group 59(75.6%) patient had optimal debulking. With a median follow-up of 34 months, the median overall survival (OS) and progression free survival (PFS) was 53 and 49 months respectively. Patients who underwent primary surgery had better median PFS than patients who had NACT (56 months versus 39 months, p = 0.002). In stage III C the difference median PFS was significant for those treated with primary surgery when compared with NACT (55 months versus 39 months, p = 0.012). In patients who had optimal debulking to no residual disease (n = 90), primary surgery gave a significant improved PFS (59 months versus 38 months, p = 0.001) when compared with NACT. In univariate analysis, NACT was associated with increased risk of death (HR: 0.350; CI: 0.177-0.693). CONCLUSION: In advanced epithelial ovarian cancer, primary surgery seems to have a definite survival advantage over NACT in patients who can be optimally debulked to no residual disease.

Assembly, growth and nonlinear thermo-optical properties of nitropeptides.

The molecular self-assembly, growth and nonlinear thermo-optical properties of three synthetic aromatic­aliphatic hybrid nitropeptides have been investigated. The X-ray crystallography of nitropeptide 2 containing a glutamic acid moiety shows that the peptide adopts a dimeric structure using intermolecular hydrogen bonding as well as face to face π­π stacking interactions. Moreover, nitropeptide 2 exhibits nonlocal nonlinear optical properties. When a Gaussian laser beam passes through nitropeptide 2, the peptide shows several concentric rings due to spatial self-phase modulation (SSPM). However, the homologous peptide 1 containing an aspartic acid moiety and peptide 3 containing an achiral α-aminoisobutyric acid (Aib) moiety adopt sheet-like structures and have no self-phase modulation effect. The report describes the thermo-optical properties consistent with assumption and calculation and is promising for their applications in nonlinear optical modulation devices.

Parkinson's Disease, Depression, and Quality-of-Life.

BACKGROUND: Depression is the most common psychiatric disorder associated with Parkinson's disease (PD) but is often under diagnosed and under treated leading to worsening of symptoms and deterioration of the quality-of-life of the people suffering from this disease. AIMS: The current study aims to determine the correlation between depression and health-related quality-of-life (HRQOL) domains in patients with PD. MATERIALS AND METHODS: A sample of 65 consecutive patients attending the specialty Parkinson's clinic was assessed by a psychiatrist as part of the treatment protocol. Diagnosis of depression was done using the International Classification of Diseases-10 by a psychiatrist and depression was scored using the Geriatric Depression Scale (GDS). QOL-BREF Malayalam version was used to assess quality-of-life in the patients. STATISTICAL ANALYSIS: One-way ANOVA was used to find the difference in the quality-of-life experienced by different age categories, duration of the disease, psychiatric co-morbidity. Independent sample t-test was used to find the difference in the quality-of-life experienced by genders, co morbid conditions and to find the difference in the scores on GDS and domains of WHO QOL BREF. Association of H and Y staging and duration of Parkinsonism with GDS Scores were computed using Pearson's Chi-square test. RESULTS AND CONCLUSIONS: There was a significant association of female gender and depression with the physical and psychological domains of QOL while the duration and staging of PD did not have any association with QOL Domains. Depression thus emerges as one of the main predictors of poor quality-of-life in PD.