Multi-Institutional Clinical Outcomes of Biopsy Gleason Grade Group 5 Prostate Cancers Treated With Contemporary High-Dose Radiation and Long-Term Androgen Deprivation Therapy.

AIMS: This multicentric retrospective study reports long-term clinical outcomes of non-metastatic grade group 5 prostate cancers treated with external beam radiotherapy (EBRT) alone with long-term androgen deprivation therapy (ADT). MATERIALS AND METHODS: Patients treated across 19 institutions were studied. The key endpoints that were evaluated were 5-year biochemical recurrence-free survival (bRFS), metastases-free survival (MFS), overall survival, together with EBRT-related acute and late toxicities. The impact of various prognostic factors on the studied endpoints was analysed using univariate and multivariate analyses. RESULTS: Among the 462 patients, 88% (405) had Gleason 9 disease and 31% (142) had primary Gleason pattern 5. A prostate-specific membrane antigen positron emission tomography-computed tomography scan was used for staging in 33% (153), 80% (371) were staged as T3/T4 and 30% (142) with pelvic nodal disease. The median ADT duration was 24 months; 66% received hypofractionated EBRT and 71.4% (330) received pelvic nodal irradiation. With a median follow-up of 56 months, the 5-year bRFS, MFS and overall survival were 73.1%, 77.4% and 90.5%, respectively. Primary Gleason pattern 5 was associated with worse bRFS, MFS and overall survival with hazard ratios of 0.51 (95% confidence interval 0.35 to 0.73, P < 0.001), 0.64 (95% confidence interval 0.43 to 0.96, P = 0.031) and 0.52 (95% confidence interval 0.28 to 0.97, P = 0.040), respectively, whereas pelvic nodal disease was associated with worse bRFS (hazard ratio 0.67, 95% confidence interval 0.46 to 0.98, P = 0.039) and MFS (hazard ratio 0.56, 95% confidence interval 0.37 to 0.85, P = 0.006). The acute and late radiation-related toxicities were low overall and pelvic nodal irradiation was associated with higher toxicities. CONCLUSION: Contemporary EBRT and long-term ADT led to excellent 5-year clinical outcomes and low rates of toxicity in this cohort of non-metastatic grade group 5 prostate cancers. Primary Gleason pattern 5 and pelvic node disease portends inferior clinical outcomes.

Comparative analysis of contraceptive use in Punjab and Manipur: exploring beyond women's education and empowerment.

BACKGROUND: Women's education and empowerment are important predictors of contraceptive use across countries. However, two of the Indian states, namely, Punjab and Manipur, showed large variations in contraceptive use, despite the similar level of women's educational attainment and empowerment. Therefore, this paper attempts to understand variation in contraceptive use between these states, despite having similar level of educational attainment and empowerment among the married women. METHODS: This study primarily used cross-sectional data of the National Family Health Survey (NFHS) 2015-16 and to some extent the District Level Household Survey (DLHS) 2012-13 data. The analytical sample includes 13,730 currently married women in Punjab and 8,872 in Manipur. Modern contraceptive prevalence rate (mCPR) is the key outcome variable of this study. Bivariate, multivariate, and multilevel regression analysis are applied to understand the differences in mCPR between these states and its determinants. RESULTS: Mean years of schooling was about 8 years among women of both the states, and about 34% of the women in Punjab and 27% of the women in Manipur have high level of autonomy. Despite this, use of modern method was 66% in Punjab and only 13% in Manipur. Coverage of family planning program indicators were significantly lower in Manipur than Punjab - frontline workers' (FLWs) outreach for family planning was only 18% in Manipur compared to 52% in Punjab. Similarly, only 11% of the public health facilities in Manipur compared to 50% of the health facilities in Punjab were ready to provide at least one clinical method of family planning. CONCLUSION: Despite the similar level of individual level characteristics across the two states, poor coverage of family planning programs - low outreach of FLWs, low level of facility readiness, as well as sociocultural norms discouraging contraceptive use - might be responsible for lower contraceptive use in Manipur than Punjab. This implies for strengthening the health system for family planning in Manipur to meet the contraception needs of women by addressing sociocultural barriers in the state.

Drudgery assessment and ergonomic evaluation of pedal operated Ragi (Eleusine Coracana) thresher.

BACKGROUND: Ragi (Eleusine Coracana) is a major food crop for the tribal population of India. OBJECTIVE: This study emphasizes the need to consider ergonomics aspects in the design and development of a pedal operated ragi thresher (PORT) for tribal people, and assesses the drudgery as well as ergonomic evaluation of a developed thresher against the conventional practice. METHODS: Thirty subjects (male = 15 and female = 15) from the tribal region were evaluated ergonomically. The physiological responses of the subjects were studied and their performance was compared. RESULTS: The results revealed that the working heart rate, oxygen consumption rate and overall discomfort rating were significantly higher in case of traditional threshing as compared to those in case of PORT. Postural analysis identified the traditional method as the most fatigue one as the person has to lift the hand above shoulder level repeatedly and has to sit in a squatting posture for long period. CONCLUSION: The drudgery and occupational hazards to public health involved in the traditional method of threshing was reduced by using the PORT. Furthermore, the traditional method involved continuous stressed actions across the entire body, whereas the PORT involved only the lower limbs.

Status of pesticide residues in water, sediment, and fishes of Chilika Lake, India.

Chilika Lake is the largest coastal lagoon in Asia and the second largest in the world covering an area of 1100 km2 and spread over three districts of Odisha state of India. It is the first Indian wetland designated as a wetland of international importance under the Ramsar Convention in 1981. The lake ecosystem sustains large and diversified resources of plants and animals including fisheries. Pollution of the ecosystem caused by residues of pesticides originating from different sources was assessed through multiple sampling from 2012 to 2016 from three potential sites of contamination, viz., Palur Bridge, Daya River Estuary, and Makara River. Incidence of organochlorinated (OC) pesticide residues was noticed in about 25% water samples. HCH (α, γ&δ), DDD (op|), DDE (op|&pp.|) and heptachlor were the OCs detected in concentration varying from 0.025 to 23.4 µg/l. None of the eight targeted synthetic pyrethroid (SP) pesticides was found in water, but among the organophosphates (OP), chlorpyrifos (0.019-2.73 µg/l), and dichlorvos (0.647 µg/l) were recorded. In sediment samples, residues of OC or OP pesticides were not present, but one SP pesticide was recorded. Fish samples were contaminated to the extent of 55%, mostly with residues of OCs and OPs and less with SPs. However, their concentrations were below the permissible limit, so there was no direct threat of health hazards to humans.

"Is Cone Beam Computed Tomography (CBCT) a Potential Imaging Tool in ENT Practice?: A Cross-Sectional Survey Among ENT Surgeons in the State of Odisha, India.

This questioner survey aimed about awareness of the Cone Beam Computed Tomography (CBCT) machine and its various clinical applications in ENT, among the ENT surgeons in the state of Odisha. 150 questioner forms on CBCT were distributed to the all the participating ENT surgeons at a state level ENT conference, out of which the response rate was 110. The participants were asked to answer 30 multiple choice questions, which were divided into 3 parts; general information on CBCT, general approach to CBCT and practice related to CBCT. The statistical analysis of the data collected was carried out by a Chi square test to compare the means at a significance level of P < 0.05. The response rate for this study was 73%. The mean age of the participant ENT surgeons was 47.9 (±19.2). Of the study population, 71.2% (89) did not ever advice CBCT in their practice. Only 33.9% (38) of the population believed that CBCT is more beneficial in the field of ENT. Only 25% (28) knew that CBCT requires lower radiation dose than conventional CT. 28.1% (31) of population believed that the spatial orientation is better in CBCT than CT. 62.5% (69) of the population did not knew that CBCT can be used in imaging sinusitis of dental origins. 75% (83) of the population did not knew that CBCT can be used in diagnosis of obstructive sleep apnoea and visualizing airway space. Only 18.8% (21) of the study population agreed that the CBCT has the potential to replace conventional CT in ENT imaging in future. In the conclusion, this study clearly showed that the number of ENT surgeons advising CBCT imaging in their practice is very less. The knowledge about various advantages and clinical applications of CBCT had been very limited. However, through continuing medical education and conducting various seminars and workshops on CBCT, imparting chapters on CBCT, in the undergraduate and post graduate curriculum will definitely help increase the awareness on CBCT among ENT fraternity.

Neuronal beacon.

The controlled navigation of the axonal growth cone of a neuron toward the dendrite of its synaptic partner neuron is the fundamental process in forming neuronal circuitry. While a number of technologies have been pursued for axonal guidance over the past decades, they are either invasive or not controllable with high spatial and temporal resolution and are often limited by low guidance efficacy. Here, we report a neuronal beacon based on light for highly efficient and controlled guidance of cortical primary neurons.

Fiber-optic two-photon optogenetic stimulation.

Optogenetic stimulation of genetically targeted cells is proving to be a powerful tool in the study of cellular systems, both in vitro and in vivo. However, most opsins are activated in the visible spectrum, where significant absorption and scattering of stimulating light occurs, leading to low penetration depth and less precise stimulation. Since we first (to the best of our knowledge) demonstrated two-photon optogenetic stimulation (TPOS), it has gained considerable interest in the probing of cellular circuitry by precise spatial modulation. However, all existing methods use microscope objectives and complex scanning beam geometries. Here, we report a nonscanning method based on multimode fiber to accomplish fiber-optic TPOS of cells.

An integrated µLED optrode for optogenetic stimulation and electrical recording.

In this letter, we developed an integrated neural probe prototype for optogenetic stimulation by microscale light-emitting diode (µLED) and simultaneous recording of neural activities with microelectrodes on a single-polyimide platform. Optogenetics stimulates in vivo neural circuits with high-cellular specificity achieved by genetic targeting and precise temporal resolution by interaction of light-gated ion channels with optical beam. In our newly developed optrode probe, during optogenetic stimulation of neurons, continuous sensing of neuronal activities in vicinity of the activation site can provide feedback to stimulation or examine local responses in signal pathways. In the device, focusing the light from the µLED was achieved with an integrated photo-polymerized lens. The efficacy of the optrode for cortical stimulation and recording was tested on mice visual cortex neurons expressing channelrhodopsin-2. Stimulation intensity and frequency-dependent spiking activities of visual cortex were recorded. Our device has shown advantages over fiber-coupled laser-based optrode in terms of closed-loop integration, single-implant compactness and lower electrical power requirements, which would be clinically applicable for future prosthetic applications in personalized medicine.

An unusual case of bilateral renal enlargement due to primary renal lymphoma.

Primary renal lymphoma is an uncommon variant of extranodal non-Hodgkin's lymphoma. Manifestations are usually nonspecific hematuria, fever, flank pain, and renal insufficiency. Pathological data are scanty; few reports indicate it has a very poor prognosis. We describe a child with bilateral symmetrically palpable kidneys, low-grade pyrexia, and arthralgia. Clinically, diagnosis was missed partly due to the fact that bilateral large renal tumors commonly produce asymmetric renal swelling, renal dysfunction, and hematuria which were absent in this case and partly due to rarity of the condition. However, radiological investigations combined with renal histology helped in establishing diagnosis in the present case.

New method for synthesis of Pt nanoparticles embedded in a carbon matrix.

Platinum (Pt) nanoparticles embedded in a carbon matrix were synthesized for the first time in benzene by an electric plasma discharge generated in the cavitation field of benzene due to an ultrasonic horn. Transmission electron microscopy (TEM) and X-ray diffraction (XRD) were used to study the particle size, structure and morphology of the synthesized nanoparticles. The Pt nanoparticles have FCC bulk Pt crystal structure. On the average Pt nanoparticle diameter ranged from 8 nm to 40 nm when synthesized at 4.1 kV and from 5 nm to 25 nm when synthesized at 3.4 kV. X-ray photoelectron Spectroscopy (XPS) and Energy dispersive X-ray Spectroscopy (EDX) were used to study the chemical composition of the synthesized nanoparticles. A cost effective new method for carbon supported Pt nanoparticles will be of potential interest in fuel cell and catalysis applications.

Staphylococcus aureus colonization of anterior nares of school going children.

OBJECTIVE: To determine the colonization rates of S. aureus in anterior nares of school going children, evaluate the antimicrobial resistance of such isolates against various antibiotics. METHODS: Nasal swabs taken for S. aureus in 392 healthy school going children aged between 5 and 15 yr belonging to three schools surrounding Kamineni Institute of Medical Sciences, Narketpally, Andhra Pradesh, India. Swabs were inoculated in to Mannitol Salt Agar (MSA) and incubation at 37 degrees C for 24hr, Staphylococcus aureus isolates were identified by standard microbiological methods such as Gram's stain, catalase and coagulase. MICs were determined by Agar dilution technique against Vancomycin, Ciprofloxacin, Sparfloxacin, Sparfloxacin beta Cyclodextrin. Antimicrobial resistance patterns of all the isolates against Oxacillin (1 microg) Penicillin (10 units), Ampicillin (10 microg), Co-trimoxazole (23.75 microg), Erythromycin (15 microg), Tetracycline (30 microg) and Gentamicin (10 microg) were tested using Kirby-Baeur disk diffusion method in accordance with CLSI standards. RESULTS: Of the 392 samples screened 63(16%) showed the growth of Staphylococcus aureus. 12(19%) isolates were found to be MRSA. Antimicrobial susceptibility testing using Agar dilution method against Vancomycin, ciprofloxacin, Sparfloxacin, and Sparfloxacin beta Cyclodextrin revealed MICs in the range of 0.52 microg/ml, 0.51 microg/ml, 0.5 microg/ml and <0.0312-0.250 microg/ml respectively. Disk diffusion method showed that all the isolates were resistant to Penicillin and Ampicillin. A resistance of 14.3%, 25% and 22.2% was observed against Co-trimoxazole, Erythromycin and Tetracycline respectively. Gentamiicin was the only antibiotic against which most of the isolates were sensitive. CONCLUSION: Our results suggests that healthy school going children under 16 yr of age are potential carriers of S. aureus and in particular MRSA and multi-drug resistant strains.

Rich-poor gap in utilization of reproductive and child health services in India, 1992-2005.

This paper examines the trends in utilization of five indicators of reproductive and child health services, namely, childhood immunization, medical assistance at delivery, antenatal care, contraceptive use and unmet need for contraception, by wealth index of the household in India and two disparate states, Uttar Pradesh and Maharashtra. The data from three rounds of the National Family and Health Survey conducted during 1992-2005 are analysed. The wealth index is computed using principal component derived weights from a set of consumer durables, land size, housing quality and water and sanitation facilities of the household, and classified into quintiles for all three rounds. Bivariate analyses, rich-poor ratio and concentration index are used to understand the trends in utilization of, and inequality in, reproductive and child health services. The results indicate huge disparities in utilization of these services, largely to the disadvantage of the poor. Utilization of basic childhood immunization among the poorest and the poor stagnated in India, as well as in both states, during 1998-2005 compared with 1992-1998. The use of maternal care services such as medical assistance at delivery and antenatal care remained at a low level among the poor over this period. However, contraceptive use increased relatively faster among the poor, even with higher unmet need. Of all these services, the inequality in medical assistance at delivery is consistently large, while that of contraceptive use is small. The state-level differences in service coverage by wealth quintiles over time are large.

Organization of microscale objects using a microfabricated optical fiber.

We demonstrate the use of a single fiber-optic axicon device for organization of microscopic objects using longitudinal optical binding. Further, by manipulating the shape of the fiber tip, part of the emanating light was made to undergo total internal reflection in the conical tip region, enabling near-field trapping. Near-field trapping resulted in trapping and self-organization of long chains of particles along azimuthal directions (in contrast to the axial direction, observed in the case of large tip cone angle far-field trapping).

Consent and coercion: examining unwanted sex among married young women in India.

CONTEXT: Although there is a growing body of research examining the issue of nonconsensual sex among adolescents, few studies have looked at coerced sex within marriage in settings where early marriage is common, or at sex that may not be perceived as forced, but that is unwanted. METHODS: A cross-sectional study, using both survey research and in-depth interviews, was conducted among 1,664 married young women in Gujarat and West Bengal, India. Descriptive data and multinomial logistic regression were used to identify the prevalence and risk factors for occasional and frequent unwanted sex. Qualitative data were analyzed to examine the context in which unwanted sex takes place. RESULTS: Twelve percent of married young women experienced unwanted sex frequently; 32% experienced it occasionally. The risk of experiencing unwanted sex was lower among women who knew their husband fairly well at the time of marriage, regularly received support from their husband in conflicts with other family members or lived in economically better-off households. Frequent unwanted sex was associated with not yet having had a child or having become pregnant, with lower education and with agreeing with norms that justify wife beating. CONCLUSION: For married young women, sex is not always consensual or wanted. Further research is required to determine the effects of unwanted sex on sexual and reproductive health outcomes and to help programs develop the best strategies for dealing with coerced sex within marriage.

Optical micromanipulation methods for controlled rotation, transportation, and microinjection of biological objects.

The use of laser microtools for rotation and controlled transport of microscopic biological objects and for microinjection of exogenous material in cells is discussed. We first provide a brief overview of the laser tweezers-based methods for rotation or orientation of microscopic objects. Particular emphasis is placed on the methods that are more suitable for the manipulation of biological objects, and the use of these for two-dimensional (2D) and 3D rotations/orientations of intracellular objects is discussed. We also discuss how a change in the shape of a red blood cell (RBC) suspended in hypertonic buffer leads to its rotation when it is optically tweezed. The potential use of this approach for the diagnosis of malaria is also illustrated. The use of a line tweezers having an asymmetric intensity distribution about the center of its major axis for simultaneous transport of microscopic objects, and the successful use of this approach for induction, enhancement, and guidance of neuronal growth cones is presented next. Finally, we describe laser microbeam-assisted microinjection of impermeable drugs into cells and also briefly discuss possible adverse effects of the laser trap or microbeams on cells.