Bioglass and nano bioglass: A next-generation biomaterial for therapeutic and regenerative medicine applications.

Biomaterials are an indispensable component in tissue engineering that primarily functions to resemble the extracellular matrix of any tissue targeted for regeneration. In the last five decades, bioglass has been extensively used in the field of therapeutic and tissue engineering. The doping of metal components into bioglass and the synthesizing of nano bioglass particles have found remarkable implications, both in vivo and in vitro. These include various medical and biological applications such as rejuvenating tissues, facilitating regeneration, and delivering biomolecules into cells and therapy, etc. Therefore, the current review discusses the various techniques used in synthesizing bioglass particles, trends of various ion-doped nano bioglass, and their applications in therapy as well as in regenerative medicine, specifically in the fields of dentistry, cardiovascular, skin, nervous, and respiratory systems. Apart from these, this review also emphasizes the bioglass combined with diverse natural polymers (like collagen, chitosan, etc.) and their applications. Furthermore, we discuss the effectiveness of bioglass properties such as antibacterial effects, biomolecular delivery systems, tissue compatibility, and regenerative material. Finally, the prospects and limitations are elaborated.

Conditioned medium-enriched umbilical cord mesenchymal stem cells: a potential therapeutic strategy for spinal cord injury, unveiling transcriptomic and secretomic insights.

INTRODUCTION: Spinal cord injury (SCI) leads to significant destruction of nerve tissue, causing the degeneration of axons and the formation of cystic cavities. This study aimed to examine the characteristics of human umbilical cord-derived mesenchymal stem cells (HUCMSCs) cultured in a serum-free conditioned medium (CM) and assess their effectiveness in a well-established hemitransection SCI model. MATERIALS AND METHODS: In this study, HUCMSCs cultured medium was collected and characterized by measuring IL-10 and identifying proteomics using mass spectroscopy. This collected serum-free CM was further used in the experiments to culture and characterize the HUMSCs. Later, neuronal cells derived from CM-enriched HUCMSC were tested sequentially using an injectable caffeic acid-bioconjugated gelatin (CBG), which was further transplanted in a hemitransection SCI model. In vitro, characterization of CM-enriched HUCMSCs and differentiated neuronal cells was performed using flow cytometry, immunofluorescence, electron microscopy, and post-transplant analysis using immunohistology analysis, qPCR, in vivo bioluminescence imaging, and behavioral analysis using an infrared actimeter. RESULTS: The cells that were cultured in the conditioned media produced a pro-inflammatory cytokine called IL-10. Upon examining the secretome of the conditioned media, the Kruppel-like family of KRAB and zinc-finger proteins (C2H2 and C4) were found to be activated. Transcriptome analysis also revealed an increased expression of ELK-1, HOXD8, OTX2, YY1, STAT1, ETV7, and PATZ1 in the conditioned media. Furthermore, the expression of Human Stem-101 confirmed proliferation during the first 3 weeks after transplantation, along with the migration of CBG-UCNSC cells within the transplanted area. The gene analysis showed increased expression of Nestin, NeuN, Calb-2, Msi1, and Msi2. The group that received CBG-UCNSC therapy showed a smooth recovery by the end of week 2, with most rats regaining their walking abilities similar to those before the spinal cord injury by week 5. CONCLUSIONS: In conclusion, the CBG-UCNSC method effectively preserved the integrity of the transplanted neuronal-like cells and improved locomotor function. Thus, CM-enriched cells can potentially reduce biosafety risks associated with animal content, making them a promising option for clinical applications in treating spinal cord injuries.

Efficacy of Eicosapentaenoic Acid (EPA) Containing Protein Supplement in Preventing Weight Loss in Head and Neck Cancer Patients Undergoing Curative Radiotherapy: Retrospective Observations with Historical Controls.

Weight loss is a major issue in Head and Neck cancer (HNC) patients undergoing curative radiotherapy. The principal objective of the study was to observe whether eicosapentaenoic acid (EPA) containing protein supplement was effective in mitigating the weight loss during in hospitalized HNC undergoing curative radiotherapy. A retrospective study was performed based on clinical, treatment and nutritional data of 53 patients received EPA containing supplement during their curative radiotherapy from October 2014 to January 2015 and was compared with 88 historical control group of patients (October 2013 to June 2014) who had indigenous protein rich diet planned by the dietician in the period immediately before the implementation of providing EPA containing protein supplement to the patients. The data was stratified based on gender, age, weight, treatment modalities, stage and site of cancer and analysed using unpaired t test. A p value of < 0.05 was considered significant. The results indicate there was no significant difference in the patient tumor and clinical details. The results indicate that the percent change in weight loss was less in the EPA cohorts when calculated from weight (P < 0.006) and Body Mass Index (BMI) perspective (P < 0.003). Detail analysis suggested that beneficial effects were more in males (P < 0.01), people affected with oral cancer (P < 0.02), people below the age of 40 (P < 0.001), and in people with early stage cancer (P < 0.003). Cumulatively all these results suggest that administering EPA containing protein supplement was effective in arresting weight loss in HNC patients undergoing curative radiotherapy.

Dietary agents in the prevention of radiation-induced nausea and vomiting (RINV): review addressing the scientific observations, benefits, lacunae and future direction.

PURPOSE: Radiation-induced Nausea and Vomiting (RINV) is an important side effect and conservative estimates are that 50-80% of the patients undergoing curative radiotherapy (RT) will experience some sought of retching, nausea, and/or vomiting during the course of their treatment. Conventionally, antiemetic drugs like the 5-hydroxytryptamine receptor antagonists and steroids are the mainstay of treatment. However, the use of these agents, especially steroids, can cause side effects and thereby negate the proposed benefits. The antiemetic effects of Centella asiatica (Indian pennywort), Hippophae rhamnoides (Sea buckthorn), oil of Mentha spicata (Spearmint) and the rhizomes of Zingiber officinale (ginger) have been addressed. CONCLUSIONS: Results indicate that Indian pennywort, Sea buckthorn, Spearmint oil and ginger are beneficial in mitigating RINV. Also, of the four plants investigated in preclinical models of study, mint oil and ginger seem to be more useful and merit structured systematic translational studies to ascertain the benefit of these two agents.

Effect of non-surgical periodontal therapy on CD14 + CD16+ monocyte counts in peripheral blood samples: a clinical interventional study.

Monocytes and their macrophage progeny are thought to be involved in tissue and alveolar bone destruction in periodontal disease. It has been documented that the proportion of (CD14 + CD16+) non-classical monocytes in the blood are elevated in chronic periodontitis;A total of 20 chronic generalized periodontitis patients who were otherwise healthy, were recruited for this study. At baseline and 3 weeks after non-surgical periodontal treatment, peripheral blood was obtained to assess the levels of C-reactive protein (CRP) and the proportion of monocyte subsets. Monocyte subsets were assessed using flow cytometry;The mean percentage of CD14 + CD16+ non-classical monocytes in the peripheral blood sample at baseline was 13.95 + 2.09, that reduced to 8.94 + 1.23 3 weeks after non-surgical treatment. A distinct significant reduction in the percentage of non-classical monocytes and a concomitant increase in classical monocytes were observed following periodontal treatment compared to baseline. There was a significant reduction in the all the periodontal parameters and CRP levels 3 weeks post non-surgical periodontal treatment. A positive correlation between CRP and percentage of non-classical monocytes was also observed; Periodontal treatment potentially modulates the host response effectively.

Link between Blood Cell-Associated Inflammatory Indices and Chemotherapy-Induced Hyperglycemia in Women Affected with Breast Cancer: Clinical Studies.

Krishna PrasadBackground Development of treatment-induced hyperglycemia/diabetes is a considerable problem in women undergoing chemotherapy for breast cancer. In this study, baseline levels of blood cell-associated inflammatory indices (BCAII) were analyzed to understand their role in the development of treatment-induced hyperglycemia and diabetogenesis. Materials and Methods This was a retrospective study, and information on women who were normoglycemic and nondiabetic and of women who were diabetic at the beginning of the treatment were collected from files. Demographic, pathology-related details, and complete blood profile were noted. Neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammatory index (SII) which indicate BCAII were calculated. Demographic details were subjected to frequency and percentage, while blood parameters were subjected to one-way analysis of variance followed by post hoc Bonferroni's multiple comparison tests. A p -value of <0.05 was considered significant. Results The results indicated that a significant difference in levels of total count ( p < 0.035), neutrophil, lymphocyte, and platelets ( p < 0.001) were observed. Regarding BCAII, when compared with women who were normoglycemic at the end of treatment, NLR, dNLR, PLR, and SII were significantly high for people who were known diabetics at the beginning of treatment ( p < 0.001). The dNLR ( p = 0.0008), PLR ( p < 0.001), and SII ( p < 0.001) were significant for people who developed secondary hyperglycemia/diabetes, while only dNLR was significant for people who progressed from normal to prediabetes stage ( p = 0.049) Conclusion To the best of the authors' knowledge, this is the first study that indicates difference in baseline BCAII and development of treatment-induced hyperglycemia/diabetes indicating that underlying low levels of inflammation may contribute to diabetogenesis in women affected with breast cancer.

Fingerprint patterns in neuropsychological disorder depression among south Indian population.

Depression is a pervasive mental health disorder characterized by persistent sadness and an inability to enjoy activities that were once enjoyable. This study compares the dermatoglyphic patterns of depressed patients with those of healthy, normal individuals in order to determine if dermatoglyphic patterns can be used as biomarkers for early diagnosis and prompt intervention of depression. A total of 100 depressive disorder patients of both sexes between the ages of 18 and 60 were selected for the study. Dermatoglyphic patterns of individual digits were analyzed using the "Ink and Paper" technique. The Whorl, Loop, and Arch patterns, as well as the AFRC, TFRC, and a-b ridge count, were examined using One-Way ANOVA significance and a Chi-Square test using SPSS 20.0. The results showed that the right hand in the depressive diseased group had decreased numbers of Whorls in the 2nd and 5th digits, and decreased numbers of Loops in all five digits. Similarly, decreased numbers of Whorls were found in the 1st, 2nd, 4th, and 5th digits of the left hand, as well as decreased Loops in the 4th digit. However, there were no changes in the Arches of either hand when compared to the control group. The AFRC and TFRC were significantly decreased (p<0.0001), but there was no significant decrease in the a-b ridge count in the depressive diseased group when compared to the control group. Dermatoglyphics, a noninvasive method, can serve as a screening indicator for depressive individuals, the appearance of the decreased count of whorls and loops parameters might be used as an exploratory sign.

Ayurvedic Drug Triphala in Combination with Providone Iodine Mitigates Radiation-Induced Mucositis in Head and Neck Cancer Patients without Affecting the Tumor Response.

Radiation-induced mucositis is a dose-limiting concern in the treatment of head and neck cancers (HNC). This study was conducted to determine the effectiveness of the Ayurvedic drug Triphala in reducing radiation-induced mucositis and influencing tumour control when combined with providone iodine. Data from patient files of HNC patients who received Triphala in conjunction with iodine or iodine alone over the course of curative radiotherapy (> 60 Gy) from May 2013 to February 2015 were extracted for this retrospective chart based study. Data was subjected to statistical analysis, X2 and unpaired t test using the Statistical Package for Social Sciences (SPSS), version 17 (IBM, Chicago, USA). When compared to iodine alone, the group that utilised Triphala gargling was very efficient in delaying mucositis, the extent of weight loss (p = 0.038), the incidence (p = 0.03), and the number (p = 0.02) of treatment breaks. However, it had no influence on the radiation-induced tumour response. According to the observations, Triphala coupled with iodine was more successful in preventing radiation mucositis, and without affecting the killing of tumour cells than iodine gargle alone. According to the authors, this is the first observation to demonstrate the value of combining providone iodine with Triphala in preventing radiation-induced oral mucositis.

The worldwide prevalence of latent autoimmune diabetes of adults among adult-onset diabetic individuals: a systematic review and meta-analysis.

PURPOSE: The actual global burden of Latent Autoimmune Diabetes of Adults (LADA) remains unknown even though its prevalence is almost equal to the type 1 form of diabetes. Hence the present systematic review and meta-analysis were performed to estimate the prevalence of LADA among diabetic individuals using the studies published at global levels. METHODS: A comprehensive literature revival was performed to identify articles on the prevalence of LADA published till 2023. The prevalence estimates were calculated using DerSimonian and Laird random-effects models with a heterogeneity measure by Cochrane Q and I2 statistics. Publication bias was assessed by the Doi plot and Luis Furuya-Kanamori asymmetry index (LFKindex). P < 0.05 was considered statistically significant. RESULTS: The overall pooled prevalence of LADA obtained from a total of 51,725 diabetic individuals was found to be 8.9% (95%CI 7.5-10.4, P < 0.001) with a prevalence range of 2.3% in to 18.9% in United Arab Emirates and Bahrain respectively. Subgroup analysis of LADA in the context of the IDF geographic regions showed a higher prevalence in North America (13.5%), 9.5% in Middle East and North Africa, 9.4% in Africa, 9.2% in South East Asia, 8.3% in Western Pacific and the lowest prevalence of 7.0% in Europe. CONCLUSION: The Meta-analysis revealed a worldwide prevalence of LADA as 8.9%, with the highest prevalence in Bahrain and the lowest in United Arab Emirates. Further, the higher prevalence in some IDF regions and the inconsistent association between socioeconomic status and LADA recommend more research in the future.

"Cancer Education on Wheels," a Novel Cost-Effective Method in Creating Awareness in the Community: a Pilot Study.

Cancer education raises disease awareness, the value of early identification and importantly the need for prompt screening and treatment when diagnosed. In this study, an effort was made to understand how well a unique cancer education program, "Cancer Education on Wheels," transfers knowledge in general public in society. The community was shown prerecorded cancer awareness videos using a TV monitor, CD player, and speaker system mounted on an eight-seat Toyota Innova. Before and after seeing the video presentation, consenting volunteers filled out questionnaires asking about demographics and understanding of cancer. Frequency and percentage calculations were done on the demographic information and a Wilcoxon signed-rank test was run on the overall subject score. Data was stratified based on demographic information and compared by applying Kruskal-Wallis test and Mann-Whitney test. p values under 0.05 were regarded as significant. A total of 584 people completed the pre-test and post-test questionnaires. The Wilcoxon signed-rank test revealed a difference between the pre-test and post-test (3.29 ± 2.48 vs. 6.78 ± 3.52; P = 0.0001). The pre-test results showed that volunteers between the ages of 18 and 30; men; students; urban residents; single volunteers; graduates; people who had known a person/or family member with cancer; and people who were aware of the suffering cancer causes had a high baseline knowledge of cancer (p = 0.015 to 0.001). The post-test results show that participants who had less baseline scores like housewives and unemployed people performed better (p = 0.006 to 0.0001). The findings unambiguously demonstrated that "Cancer Education on Wheels" was successful in raising participants' awareness of cancer signs and screening. Additionally, the findings showed that volunteers who were aged, married, housewives, and unemployed had higher scores. Most importantly, this approach to cancer education is simple to organize and carry out in a local setting. It is also affordable and simple to execute using readily available technological equipment and manageable logistics. According to the authors' knowledge, this is the first study to use "Cancer Education on Wheels" to spread awareness of cancer throughout the neighborhood especially in budget constrained areas.

Efficacy of chlorhexidine/herbal formulation for microbial reduction in aerosol generated following ultrasonic scaling - A double-blinded randomized controlled trial.

Background: Ultrasonic scaling is a potential source of aerosol contamination in dental clinics. The two primary sources of microbial load in aerosols are from the oral cavity and dental unit water line. Literature evidence suggest that the use of preprocedural mouth rinse reduce the bacterial load in aerosol generated during ultrasonic scaling. Aim: The aim of the study is to assess the comparative efficacy of reduction in viable bacteria in the aerosol at patient's chest area, doctor's mask area and two feet beside the patient following use of chlorhexidine/herbal formulation diluted in the water source by a randomized controlled clinical trial. Materials and Methods: Forty-five subjects (with chronic gingivitis) were matched for age, gender, and gingival index score. The subjects were randomized and received ultrasonic scaling with distilled water (control)/chlorhexidine (tTest)/herbal formulation (test). Aerosol produced during scaling was collected at patient's chest area, doctor's mask area, two feet beside the patient on blood agar plates, which were incubated at 37°C for 48 h and total colony forming units (CFUs) were counted. Results: A significant reduction in the total CFUs' counts was observed at all the three sites sampled in test groups (chlorhexidine group and herbal formulation group) as compared to control (P < 0.01). Conclusion: The addition of antiseptic agents to the water source contributed to a significant reduction of the cultivable microbial counts in the aerosol and hence can be used to reduce the risk of cross-infection during ultrasonic scaling.

Fruits and their phytochemicals in mitigating the ill effects of ionizing radiation: review on the existing scientific evidence and way forward.

Although helpful in treating cancer, exposure to ionizing radiation can sometimes cause severe side effects, negating its benefit. In addition to its use in clinics, a nontoxic radioprotective agent can also be beneficial in occupational settings where humans are occupationally exposed for prolonged periods to low doses of radiation. Scientific studies using laboratory animals have shown that the fruits Aegle marmelos, Capsicum annuum, Citrus aurantium, Citrullus lanatus, Crataegus microphylla, Eugenia jambolana, Emblica officinalis, Garcinia kola, Grewia asiatica, Hippophae rhamnoides, Malus baccata, Malpighia glabra or Malpighia emarginata, Mangifera indica, Prunus domestica, Prunus avium, Prunus armeniaca, Psoralea corylifolia, Punica granatum, Solanum lycopersicum, Terminalia chebula, Vaccinium macrocarpon, Vitis vinifera and Xylopia aethiopica, and the phytochemicals gallic acid, ellagic acid, quercetin, geraniin, corilagin, ascorbic acid, hesperetin, ursolic acid, lycopene, naringin, hesperidin, rutin, resveratrol, ß-sitosterol, apigenin, luteolin, chlorogenic acid, caffeic acid, mangiferin, diosmin, ferulic acid, and kaempferol are effective in preventing radiation-induced ill effects. Clinical studies with Emblica officinalis and Punica granatum have also shown that fruits help mitigate radiation-induced mucositis, dermatitis, and cystitis. For the first time, the current review summarizes the beneficial effects of fruits and phytochemicals in mitigating radiation-induced damage, the underlying mechanisms and the existing lacunae for future studies to be undertaken for the benefit of humans and the nutraceutical and agri-based industries.

Functionally gradient three-dimensional graphene foam-based polymeric scaffolds for multilayered tissue regeneration.

Physiological bioengineering of multilayered tissues requires an optimized geometric organization with comparable biomechanics. Currently, polymer-reinforced three-dimensional (3D) graphene foams (GFs) are gaining interest in tissue engineering due to their unique morphology, biocompatibility, and similarity to extracellular matrixes. However, the homogeneous reinforcement of single polymers throughout a GF matrix does not provide tissue-level organization. Therefore, a triple-layered structure is developed in a GF matrix to closely mimic native tissue structures of the periodontium of the teeth. The scaffold aims to overcome the issue of layer separation, which generally occurs in multilayered structures due to the poor integration of various layers. The 3D GF matrix was reinforced with a polycaprolactone (PCL), polyvinyl alcohol (PVA), and PCL-hydroxyapatite (HA) mixture, added sequentially, via spin coating, vacuum, and hot air drying. Later, PVA was dissolved to create a middle layer, mimicking the periodontal fibers, while the layers present on either side resembled cementum and alveolar bone, respectively. Scanning electron microscopy and micro-computed tomography revealed the structure of the scaffold with internal differential porosities. The nanoindentation and tensile testing demonstrated the closeness of mechanical properties to that of native tissues. The biocompatibility was assessed by the MTT assay with MG63 cells (human osteosarcoma cells) exhibiting high adhesion and proliferation rate inside the 3D architecture. Summing up, this scaffold has the potential for enhancing the regeneration of various multilayered tissues.

Usefulness of walkathon in improving knowledge on cancer: A cross-sectional study with the participants.

AIM: Globally, walkathon, a type of community event involving walking a determined distance to raise awareness and/or collect donations for a social cause is gaining a lot of public attention. This study was conducted to understand the usefulness of walkathon in creating cancer awareness among the participants. MATERIALS AND METHODS: This was a pre- and post-test study and was carried out on World Cancer Day on February 4, 2019 in Mangalore, Karnataka, India. The study subjects were the walkathon participants willing to be volunteers for the study. Differences in the answers were calculated by ascertaining the difference between the pretest and posttest using McNemar, Chi-square, or Fisher's exact test. A P < 0.05 was considered statistically significant. RESULTS: Pretest scores indicated most volunteers were aware of the role of tobacco and alcohol in cancer, while most were unaware of the importance of fruits and consumption of vegetables and sedentary lifestyle in the development of cancer. Posttest showed a significant increase in knowledge gain (P = 0.003 to <0.001). CONCLUSIONS: For the first time, this study shows Walkathon to be helpful in improving cancer knowledge in the participants. Walkathon is an inexpensive and joyful way to educate people and warrants further study on a range of medical and social themes affecting society to establish its usefulness in public health education.

Usefulness of structured teaching module in improving knowledge about cancer in Accredited Social Health Activist: A pilot study.

AIM: In India, the Accredited Social Health Activists (abbreviated as ASHA) are an important group of community health workers and are involved in initiating and maintaining health care programs in the rural communities they live. This study was conducted with a purpose to evaluate the effectiveness of a structured teaching module in improving knowledge on cancer cause, diagnosis, and treatment in the ASHA workers. MATERIALS AND METHODS: This was a cross-sectional pretest posttest study and was conducted from April 2017 to February 2020 with ASHA workers working in the various Primary Health Centers in Udupi and South Kanara districts of Karnataka and Kasargod district of Kerala in India after obtaining the permission from the medical officer in charge of the respective primary health centers. The participants were briefed about the study objective and also that confidentiality will be maintained. A validated investigator developed questionnaire consisting of 20 questions categorized into four domains (general, subject, diagnosis, and treatment aspects) was distributed to the willing volunteers before the start of the program. They were instructed to fill the pretest form before and posttest after the teaching program. Informed content was taken in a separate sheet and volunteers were informed not to write any personal or identification details. Resource persons with experience in cancer cause, diagnosis and treatment delivered the structured talk in the local language Kannada. The data collected from the filled questionnaires were subjected to frequency, percentage, mean, and standard deviation and appropriately subjected to Chi-square test or paired t-test. A P < 0.05 was considered statistically significant. RESULTS: The demographic detail suggest that majority of the women were Hindus (79.3%), married (93.7%), between the age of 31-40 (46.7%) and had only matriculation as the highest education (68%). The analysis of the pretest administration collected before the start of teaching program indicates that most participants were aware of self-breast examination (79.74%) and that cancer is a disease as old as human civilization (70.26%), while only 8.82% were unaware of which is the leading type of cancer in rural women. The results analyzed from posttest indicate that the highest percentage change (323.96%) was observed for domain on treatment aspects followed by for general (64.03%), diagnosis (56.70%), and subject (36.42%) aspect and was significant (P < 0.001). The total mean values changed from 6.48 ± 2.01 in pretest to 11.81 ± 2.15 in posttest indicating an increase of 5.33 ± 1.91 and percentage change of 82.25% (P < 0.001). The results also showed that 60.8% had average, while 39.2% had good increment in the knowledge at the end of the program. CONCLUSIONS: The observations of the current study indicate the usefulness of the structured teaching module in improving knowledge on cancer cause, diagnosis and treatment in the ASHA workers. It is proposed that with further training ASHA workers can be very useful in the propagation of cancer awareness and screening in the community they serve.

Plan Quality Index - An Integrated Dosimetric Approach for Plan Evaluation with Consideration of Quality of Dose Coverage to Tumors and Quality of Organs' Sparing.

PURPOSE: To find an integrated solution for plan evaluation with multiple dosimetric parameters in order to ensure quality of target dose coverage and sparing of organs collectively. MATERIALS AND METHODS: A mathematical logical expression called Plan Quality Index (PQI) was formulated. It includes two integrated indices 1.Integrated Dosimetric Index for tumor (IDITumor) dose coverage and 2.Integrated Dosimetic Index (IDIorgans) for Organs At Risk (OARs). PQI was used to select better dosimetric plan form multiple VMAT plans of a Nasopharynx case. In addition, the PQI was used for comparison of VMAT and IMRT plans of 64 patients with Head and Neck cancer. The plan with lesser PQI was considered as a better dosimetric plan. For statistical comparison between two techniques, paired't' and Wilcoxon signed rank test were used with consideration p< 0.05 as a statistically significant. RESULTS: The unambiguous evaluation results with PQI showed that VMAT plan was achieved the entire given dose constraints significantly better than IMRT plan in all the patients (p<0.001). CONCLUSION: Plan evaluation with PQI can be an unambiguous method. It evaluates the quality of tumor dose coverage (IDITumor) and sparing of OARs (IDIorgans) collectively. It enables to change the priority of evaluation criteria of a specified structure based on the clinical requirements. It does not require any specialized program. It can be calculated using ordinary excel program. Using the single value as PQI, the effective determination of a quality plan among many plans can be possible and it can be used for comparison of different techniques.

Utility of Indian Fruits in Cancer Prevention and Treatment: Time to Undertake Translational and Bedside Studies.

The World Health Organization predicts a 70% increase in cancer incidents in developing nations over the next decade, and it will be the second leading cause of death worldwide. Traditional plant-based medicine systems play an important role against various diseases and provide health care to a large section of the population in developing countries. Indigenous fruits and their bioactive compounds with beneficial effects like antioxidant, antiproliferative, and immunomodulatory are shown to be useful in preventing the incidence of cancer. India is one of the biodiversity regions and is native to numerous flora and fauna in the world. Of the many fruiting trees indigenous to India, Mango (Mangifera indica), Black plum (Eugenia jambolana or Syzygium jambolana), Indian gooseberry (Emblica officinalis or Phyllanthus emblica), kokum (Garcinia indica or Brindonia indica), stone apple or bael (Aegle marmelos), Jackfruit (Artocarpus heterophyllus), Karaunda (Carissa carandas) and Phalsa (Grewia asiatica), Monkey Jackfruit (Artocarpus lakoocha) and Elephant apple (Dillenia indica) have been shown to be beneficial in preventing cancer and in the treatment of cancer in validated preclinical models of study. In this review, efforts are also made to collate the fruits' anticancer effects and the important phytochemicals. Efforts are also made to address the underlying mechanism/s responsible for the beneficial effects of these fruits in cancer prevention and treatment. These fruits have been a part of the diet, are non-toxic, and easily acceptable for human application. The plants and some of their phytochemicals possess diverse medicinal properties. The authors propose that future studies should be directed at detailed studies with various preclinical models of study with both composite fruit extract/juice and the individual phytochemicals. Additionally, translational studies should be planned with the highly beneficial, well-investigated and pharmacologically multifactorial amla to understand its usefulness as a cancer preventive in the high-risk population and as a supportive agent in cancer survivors. The outcome of both preclinical and clinical studies will be useful for patients, the healthcare fraternity, pharmaceutical, and agro-based sectors.

Serum zinc status and the development of mucositis and dermatitis in head-and-neck cancer patients undergoing curative radiotherapy: A pilot study.

Background: Radiation-induced mucositis and dermatitis are severe side effects and compromise the health of the head-and-neck cancer patient undergoing treatment. Zinc supplementation during the course of the treatment is shown to have protective effects against both radiation-induced mucositis and dermatitis. The aim of this study was to understand whether the level of serum zinc has an effect on the development of mucositis and dermatitis. Materials and Methods: This was noninterventional study where the levels of serum zinc were ascertained before the start of treatment by spectrophotometric methods. The patients were treated every day with no more than one fraction of 2 Gy per day, five times a week without any intended gaps for a planned target dose of 60-70 Gy (6-7 consecutive weeks). The patients were assessed for radiation-induced dermatitis and mucositis in accordance with the standard guidelines. The association between the levels of serum zinc with the development of different grades of mucositis and dermatitis (on the day of development) was ascertained using the Pearson correlation coefficient (r). A statistical value of P < 0.05 was considered to be statistically significant. Results: A total of 52 consecutive patients satisfying the inclusion criteria were enrolled. The results indicate that serum zinc levels showed a significant correlation (r = 0.29; P < 0.038) for Grade 1, while it was insignificant for Grades 2 and 3. For dermatitis, a significant correlation for all the grades (Grade 1 [r = 0.28; P < 0.043]; Grade 2 [r = 0.39; P < 0.006]; and Grade 3 [r = 0.49; P < 0.047]) was observed. Conclusions: For the first time, the results of this pilot study indicate that the serum level of zinc had an inverse association with the early development of mucositis and dermatitis, with better effects seen in dermatitis where it was also effective in Grades 2 and 3.