IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Presented at the American Society for Clinical Oncology Gastroenterology in January 2017 in San Francisco by Eric Raymond
Background: Sunitinib was approved by the FDA in 2011 for treatment of progressive, well-differentiated, advanced pancreatic neuroendocrine tumors (pNETs) based on a pivotal phase III study (NCT00428597) that showed a significant increase in progression-free survival (PFS) over placebo following early study termination. Subsequently, the FDA requested a post-approval study to support these findings.
Methods: In this open-label, phase IV clinical trial (NCT01525550), patients with progressive, well-differentiated, unresectable advanced/metastatic pNETs received continuous sunitinib 37.5 mg once daily. Eligibility criteria were similar to the phase III study. Primary endpoint was investigator-assessed PFS per RECIST 1.0. This study is ongoing.
Results: Sixty one treatment-naïve and 45 previously treated patients with progressive pNETs were treated with sunitinib: mean age, 54.6 years; males, 59.4%; white, 63.2%; ECOG PS 0, 65.1% or PS 1, 34.0%; and prior somatostatin analog, 48.1% (treatment-naïve, 39.3%; previously treated, 60.0%). At the data cutoff date, 82 (77%) patients discontinued treatment, mainly due to disease progression (46%). Median duration of treatment was ~11.9 months. Investigator-assessed median PFS (mPFS) was 13.2 months (95% CI, 10.9–16.7) in the overall population, with comparable mPFS in treatment-naïve and previously treated patients (13.2 vs 13.0 months). mPFS per independent radiologic review was 11.1 months (95% CI, 7.4–16.6). Objective response rate (ORR) per RECIST was 24.5%: 21.3% in treatment-naïve and 28.9% in previously treated patients. Median overall survival, although not yet mature, was 37.8 months. Treatment-emergent, all-causality adverse events (AEs) reported by ≥20% of all patients included neutropenia, diarrhea, leukopenia, fatigue, hand–foot syndrome, hypertension, abdominal pain, dysgeusia, and nausea. Most common grade 3/4 AEs were neutropenia (22%) and diarrhea (9%).
Conclusions: The mPFS of 13.2 months and ORR of 24.5% observed in this study support the outcomes of the pivotal phase III study of sunitinib in pNETs and confirm its activity in this setting. AEs were consistent with known safety profile of sunitinib.
Factors associated with developing esophageal adenocarcinoma in Barett's esop...Dr Sayan Das
Based on the study “Rates and predictors of progression to esophageal carcinoma in a large population-based Barrett’s esophagus cohort” by Krishnamoorthi R et al published in “HHS Public Access” on 2016 July
Critical evaluation of an article titled " Systematic review of basket trials, umbrella trials, and platform trials: A landscape analysis of master protocols"
A dramatic increase in the incidence of the diffuse form of gastric adenocarcinomas and particularly signet ring cell carcinomas has been observed in Western countries. Evidence is accruing that signet ring cell carcinomas may have inherent chemo resistance leaving many clinicians unsure of the benefits of delaying surgery to pursue a neoadjuvant approach.
Presented at the American Society for Clinical Oncology Gastroenterology in January 2017 in San Francisco by Eric Raymond
Background: Sunitinib was approved by the FDA in 2011 for treatment of progressive, well-differentiated, advanced pancreatic neuroendocrine tumors (pNETs) based on a pivotal phase III study (NCT00428597) that showed a significant increase in progression-free survival (PFS) over placebo following early study termination. Subsequently, the FDA requested a post-approval study to support these findings.
Methods: In this open-label, phase IV clinical trial (NCT01525550), patients with progressive, well-differentiated, unresectable advanced/metastatic pNETs received continuous sunitinib 37.5 mg once daily. Eligibility criteria were similar to the phase III study. Primary endpoint was investigator-assessed PFS per RECIST 1.0. This study is ongoing.
Results: Sixty one treatment-naïve and 45 previously treated patients with progressive pNETs were treated with sunitinib: mean age, 54.6 years; males, 59.4%; white, 63.2%; ECOG PS 0, 65.1% or PS 1, 34.0%; and prior somatostatin analog, 48.1% (treatment-naïve, 39.3%; previously treated, 60.0%). At the data cutoff date, 82 (77%) patients discontinued treatment, mainly due to disease progression (46%). Median duration of treatment was ~11.9 months. Investigator-assessed median PFS (mPFS) was 13.2 months (95% CI, 10.9–16.7) in the overall population, with comparable mPFS in treatment-naïve and previously treated patients (13.2 vs 13.0 months). mPFS per independent radiologic review was 11.1 months (95% CI, 7.4–16.6). Objective response rate (ORR) per RECIST was 24.5%: 21.3% in treatment-naïve and 28.9% in previously treated patients. Median overall survival, although not yet mature, was 37.8 months. Treatment-emergent, all-causality adverse events (AEs) reported by ≥20% of all patients included neutropenia, diarrhea, leukopenia, fatigue, hand–foot syndrome, hypertension, abdominal pain, dysgeusia, and nausea. Most common grade 3/4 AEs were neutropenia (22%) and diarrhea (9%).
Conclusions: The mPFS of 13.2 months and ORR of 24.5% observed in this study support the outcomes of the pivotal phase III study of sunitinib in pNETs and confirm its activity in this setting. AEs were consistent with known safety profile of sunitinib.
Factors associated with developing esophageal adenocarcinoma in Barett's esop...Dr Sayan Das
Based on the study “Rates and predictors of progression to esophageal carcinoma in a large population-based Barrett’s esophagus cohort” by Krishnamoorthi R et al published in “HHS Public Access” on 2016 July
Critical evaluation of an article titled " Systematic review of basket trials, umbrella trials, and platform trials: A landscape analysis of master protocols"
A dramatic increase in the incidence of the diffuse form of gastric adenocarcinomas and particularly signet ring cell carcinomas has been observed in Western countries. Evidence is accruing that signet ring cell carcinomas may have inherent chemo resistance leaving many clinicians unsure of the benefits of delaying surgery to pursue a neoadjuvant approach.
Richard S. Finn, MD, Anthony El-Khoueiry, MD, and Josep M. Llovet, MD, PhD, prepared useful practice aids pertaining to hepatocellular carcinoma for this CME activity titled "Breaking the Paradox: Expanding Options and New Questions in HCC Management: Mapping the Pathways to Better Patient Outcomes." For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2HU6L5K. CME credit will be available until February 14, 2020.
Open-label uncontrolled pilot study to evaluate complementary therapy with Ru...home
Some patients treated with Ruta graveolens 9c had a transitory improvement
in QoL, but the effectiveness of this treatment remains to be confirmed in further
studies.
Neoadjuvant rh-endostatin, docetaxel and epirubicin for breast cancer: effica...Enrique Moreno Gonzalez
Recombinant human endostatin (rh-endostatin) is a novel antiangiogenesis drug developed in
China. Previous experiments have shown that rh-endostatin can inhibit the proliferation and
migration of endothelial cells and some types of tumor cells. In this study, we evaluated the
efficacy and safety profiles of combination therapy of rh-endostatin and neoadjuvant
chemotherapy for breast cancer patients in a prospective, randomized, controlled, phase II
trial.
cystatin C as an early marker of cisplatin-induced AKIد.محمود نجيب
discussion presentation for master degree in Nephrology with the title of Cystatin C as an early predictor of acute kidney injury induced by cisplatin and its analogues
Richard S. Finn, MD, Anthony El-Khoueiry, MD, and Josep M. Llovet, MD, PhD, prepared useful practice aids pertaining to hepatocellular carcinoma for this CME activity titled "Breaking the Paradox: Expanding Options and New Questions in HCC Management: Mapping the Pathways to Better Patient Outcomes." For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2HU6L5K. CME credit will be available until February 14, 2020.
Open-label uncontrolled pilot study to evaluate complementary therapy with Ru...home
Some patients treated with Ruta graveolens 9c had a transitory improvement
in QoL, but the effectiveness of this treatment remains to be confirmed in further
studies.
Neoadjuvant rh-endostatin, docetaxel and epirubicin for breast cancer: effica...Enrique Moreno Gonzalez
Recombinant human endostatin (rh-endostatin) is a novel antiangiogenesis drug developed in
China. Previous experiments have shown that rh-endostatin can inhibit the proliferation and
migration of endothelial cells and some types of tumor cells. In this study, we evaluated the
efficacy and safety profiles of combination therapy of rh-endostatin and neoadjuvant
chemotherapy for breast cancer patients in a prospective, randomized, controlled, phase II
trial.
cystatin C as an early marker of cisplatin-induced AKIد.محمود نجيب
discussion presentation for master degree in Nephrology with the title of Cystatin C as an early predictor of acute kidney injury induced by cisplatin and its analogues
This study was performed to analyze the efficacy and safety of con-current radiotherapy and weekly paclitaxel in the treatment of carcinoma of uterine cervix. Hundred patients with locally advanced (stages IIB to IVA according to FIGO classification) carcinoma of uterine cervix were enrolled, radiotherapy was conventionally administered: 50.4 Gy/28 fractions by external beam (whole pelvis) followed by HDR-Intracavitary brachytherapy, 4 fractions of 7 Gy each. Paclitaxel was administered on weekly basis at dose of 40 mg ∕m2 during entire course of external beam radiotherapy. Treatment response was evaluated three months after the end of radiotherapy by means of clinical examination and ultrasonography. Complete Regression (CR) in 83%, partial response (PR) 14% and progressive disease 3%. At 26 months of median follow up 73 patients alive, 58 patients are disease free. The results of this study suggest that concurrent chemo radiotherapy is feasible in treatment of carcinoma cervix with acceptable and manageable toxicity and paclitaxel act as radio sensitizer in locally advanced cervical cancer.
Benefit of Serum-Thymidine Kinase 1 Concentration for Risk Assessment from Ga...eshaasini
Human Thymidine kinase 1 (hTK1), a key enzyme involved in the DNA synthesis during S-phase of the cell cycle and upregulation of cell proliferation, thus it is reliable tumor proliferating biomarker for assessment of tumor proliferation rate in serum and in tissue in oncology. This meta-analysis is investigation whether the serum TK1 concentration(STK1p)based on hTK1-IgY-polyclonal-antibody can provide a benefit for risk assessment from gastric neoplasm progression to gastric carcinoma (GC) as well as for evaluation of treatment effect in GC.
Benefit of Serum-Thymidine Kinase 1 Concentration for Risk Assessment from Ga...semualkaira
Human Thymidine kinase 1 (hTK1), a key enzyme involved in the DNA synthesis during S-phase of the cell cycle and upregulation of cell proliferation, thus it is reliable tumor proliferating biomarker for assessment of tumor proliferation rate in serum and in tissue in oncology. This meta-analysis is investigation whether the serum TK1 concentration(STK1p)based on hTK1-IgY-polyclonal-antibody can provide a benefit for risk assessment from gastric neoplasm progression to gastric carcinoma (GC) as well as for evaluation of treatment effect in GC.
Benefit of Serum-Thymidine Kinase 1 Concentration for Risk Assessment from Ga...semualkaira
Human Thymidine kinase 1 (hTK1), a key enzyme involved in the DNA synthesis during S-phase of the cell cycle and upregulation of cell proliferation, thus it is reliable tumor proliferating biomarker for assessment of tumor proliferation rate in serum and in tissue in oncology. This meta-analysis is investigation whether the serum TK1 concentration(STK1p)based on hTK1-IgY-polyclonal-antibody can provide a benefit for risk assessment from gastric neoplasm progression to gastric carcinoma (GC) as well as for evaluation of treatment effect in GC.
Benefit of Serum-Thymidine Kinase 1 Concentration for Risk Assessment from Ga...semualkaira
Human Thymidine kinase 1 (hTK1), a key enzyme involved in the DNA synthesis during S-phase of the cell cycle and upregulation of cell proliferation, thus it is reliable tumor proliferating biomarker for assessment of tumor proliferation rate in serum and in tissue in oncology. This meta-analysis is investigation whether the serum TK1 concentration(STK1p)based on hTK1-IgY-polyclonal-antibody can provide a benefit for risk assessment from gastric neoplasm progression to gastric carcinoma (GC) as well as for evaluation of treatment effect in GC.
10-Year survival of GCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) GC characteristics; 9) anthropometric data; 10) surgery type. Optimal diagnosis and treatment strategies for GC are: 1) screening and early detection of GC; 2) availability of experienced abdominal surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunotherapy for GCP with unfavorable prognosis.
Long Term Effects of Using Medicinal Mushroom Preparations in Human Colorecta...Neven Jakopovic
52 patients with bowel cancer and 89 with breast cancer used medicinal mushroom extracts from Myko San company with standard oncological treatments. In this cohort study, lasting from 2005-2010, we analysed the long term effects of using medicinal mushroom products in cancer patients.
While medicinal mushrooms are not 'magic bullets', this study provides unquestionable evidence of the benefits of their use as supportive therapy in cancer patients, leading to significantly improved outcomes.
This work was presented by Neven Jakopovic at the 6th International Medicinal Mushroom Conference in Zagreb, Croatia, in 2011.
RESEARCH & TREATMENT NEWS: Highlights from the 2014 GI Cancer SymposiumFight Colorectal Cancer
Each January, the brightest minds in colorectal cancer research meet at the Gastrointestinal Cancer Symposium.
Fight Colorectal Cancer and The Colon Cancer Alliance are partnering to bring you the big news in colorectal cancer from the symposium. Dr. Allyson Ocean will be presenting.
Get insights about new types of treatments on the horizon, diagnostic tests available, research for upcoming drugs/biomarkers and the way colorectal cancer is treated. We’ll take a look back and a look forward. You’re not going to want to miss it.
This lecture was part of an educational course performed by the IATTGI group this August in Buenos Aires and describes novel targets and novel drugs in hepatocellular carcinoma.
Clinic Correlation and Prognostic Value of P4HB and GRP78 Expression in Gastr...JohnJulie1
Prolyl 4-hydroxylase, beta polypeptide (P4HB) and Glucose‑regulated protein 78 (GRP78) represent for poor prognosis of various cancers, while rare research investigate correlation of them. This study aimed to explore correlation and prognostic value of them in gastric cancer (GC).
Clinic Correlation and Prognostic Value of P4HB and GRP78 Expression in Gastr...EditorSara
Prolyl 4-hydroxylase, beta polypeptide (P4HB) and Glucose‑regulated protein 78 (GRP78) represent for poor prognosis of various cancers, while rare research investigate correlation of them. This study aimed to explore correlation and prognostic value of them in gastric cancer (GC).
Clinic Correlation and Prognostic Value of P4HB and GRP78 Expression in Gastr...NainaAnon
Prolyl 4-hydroxylase, beta polypeptide (P4HB) and Glucose‑regulated protein 78 (GRP78) represent for poor prognosis of various cancers, while rare research investigate correlation of them. This study aimed to explore correlation and prognostic value of them in gastric cancer (GC).
Clinic Correlation and Prognostic Value of P4HB and GRP78 Expression in Gastr...EditorSara
Prolyl 4-hydroxylase, beta polypeptide (P4HB) and Glucose‑regulated protein 78 (GRP78) represent for poor prognosis of various cancers, while rare research investigate correlation of them. This study aimed to explore correlation and prognostic value of them in gastric cancer (GC).
An Examination of Effectuation Dimension as Financing Practice of Small and M...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Does Goods and Services Tax (GST) Leads to Indian Economic Development?iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Childhood Factors that influence success in later lifeiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Emotional Intelligence and Work Performance Relationship: A Study on Sales Pe...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Customer’s Acceptance of Internet Banking in Dubaiiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A Study of Employee Satisfaction relating to Job Security & Working Hours amo...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Consumer Perspectives on Brand Preference: A Choice Based Model Approachiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Student`S Approach towards Social Network Sitesiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Broadcast Management in Nigeria: The systems approach as an imperativeiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A Study on Retailer’s Perception on Soya Products with Special Reference to T...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A Study Factors Influence on Organisation Citizenship Behaviour in Corporate ...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Consumers’ Behaviour on Sony Xperia: A Case Study on Bangladeshiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Design of a Balanced Scorecard on Nonprofit Organizations (Study on Yayasan P...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Public Sector Reforms and Outsourcing Services in Nigeria: An Empirical Evalu...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Media Innovations and its Impact on Brand awareness & Considerationiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Customer experience in supermarkets and hypermarkets – A comparative studyiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Social Media and Small Businesses: A Combinational Strategic Approach under t...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Secretarial Performance and the Gender Question (A Study of Selected Tertiary...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Implementation of Quality Management principles at Zimbabwe Open University (...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Organizational Conflicts Management In Selected Organizaions In Lagos State, ...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Gemcitabine and Cisplatin In Metastatic Carcinoma Gallbladder. A Single Institution Retrospective Analysis
1. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 12 Ver. I (Dec. 2015), PP 09-11
www.iosrjournals.org
DOI: 10.9790/0853-141210911 www.iosrjournals.org 9 | Page
Gemcitabine and Cisplatin In Metastatic Carcinoma Gallbladder.
A Single Institution Retrospective Analysis
H.U.Ghori1
, Vivek Tiwari, O.P.Singh, Veenita Yogi Abhishek Shrivastava,
Varsha Mandloi,.
1
Department of Radiation Oncology, Gandhi Medical College, Bhopal (M.P.) INDIA.
Abstract: Background- Metastatic gall bladder cancer (GBC) is an aggressive disease and is often prone to
delayed diagnosis. Chemotherapy is the modality most often employed to prolong survival and is superior to
best supportive care alone.
Aim- The aim of this study was to analyse the effect of gemcitabine and cisplatin (G+C) based chemotherapy in
metastatic GBC.
Design- Retrospective single institution analysis.
Material and methods- Medical records of patients with a histopathologic proven diagnosis of metastatic GBC
presenting from January 2014 to July 2015 to the department were reviewed, and data were collected from the
departmental case files.
Results- Total number of patients analysed was 25. The median overall survival was 36 weeks (range 3.4-95
weeks). The median time to progression was 20.6 weeks (range 1-82 weeks). 7/25 (28%) patients achieved a
complete response, 8/25 (32%) patients had stable disease while 10/25 (40%) patients had progressive disease.
The toxicities encountered were chiefly ototoxicity (7.5%), neuropathy (7.5%), anaemia (4.33%) and nausea-
vomiting (3.5%).
Conclusion- G+C appears to be a safe and effective regimen for advanced GBC in the subset of patients
presenting to our institute. The results achieved by us are comparable to literature.
Keywords: Cisplatin, Gemcitabine, metastatic gall bladder cancer, survival, toxicity.
I. INTRODUCTION
Biliary tract cancers (BTC) include cancers of the biliary tract, gallbladder cancer (GBC),
cholangiocarcinoma of intrahepatic and extrahepatic bile ducts and cancers of the ampulla and papilla of Vater
[1]. The incidence varies widely in different geographic regions, with the lowest incidence rates seen in Western
countries, and the highest in Asia and Latin America [2]. GBC are the most common type of BTC. It is a
common cancer in the northern/ north eastern states of India [3] and ranks among the first 10 cancers in the
Indian council of medical research registries (2006-2008) of Delhi, Dibrugarh, Kolkata, Bhopal and Mumbai
[3]. Surgery is presently the only curative modality but the 5-year survival rate for surgically resected patients
remains a dismal 5% [3]. Majority patients of with GBC present in advanced stages as the symptoms are
nonspecific and many present after cholecystectomy with GBC diagnosed on histopathology. Clinical findings
of jaundice, cachexia, anorexia, ascites, left supraclavicular lymphadenopathy and hard lump in right
hypochondrium are usually seen in advanced GBC [4]. Although surgery still remains the only curative
treatment, chemotherapy (CT) has been reported to prolong survival in advanced BTC when compared to best
supportive care alone [5, 6]. There is still discrepancy with respect to a standard CT regimen addressing the
BTC. Valle J et al [7] in a large multicentric phase III trial have shown a significant survival advantage with
gemcitabine and cisplatin (G+C) as compared to gemcitabine alone in the management of BTC and the
subgroup analysis showed that combination therapy can also prolong the survival of GBC patients. GBC differs
from the other BTC at the molecular and clinical level and has been reported to show a better response rate, but
a shorter overall survival than cholangiocarcinomas [8]. Several gemcitabine based combination therapies
(gemcitabine-oxaliplatin as well as combinations involving targeted therapies) have been reported in the
management of BTC, with the most substantial evidence reported for G+C. The aim of the present study was to
assess the tolerability and efficacy of G+C combination in advanced GBC presenting to our institution.
II. MATERIAL AND METHODS
Twenty five patients with metastatic GBC treated with G+C during the period January 2014 to July
2015 were retrospectively analysed. Case files were evaluated for the patient characteristics, performance status,
history of weight loss, duration of symptoms and tumour characteristics. Patients between the age of 18 to 80
years with histologically confirmed, metastatic GBC, who had not received prior CT or radiotherapy, had a good
performance status with no central nervous system metastases, no uncontrolled infection, and a life expectancy
2. Gemcitabine And Cisplatin In Metastatic Carcinoma Gallbladder. A Single Institution Retrospective Analysis
DOI: 10.9790/0853-141210911 www.iosrjournals.org 10 | Page
of >3 months, adequate hematological parameters (neutrophils ≥4000/mm3
, platelets ≥100,000/mm3
), and
adequate renal and liver functions were included. All the patients received G+C regimen that comprised of
injection Gemcitabine @ 1000mg/m2
on days 1, 8 and injection Cisplatin 70mg/m2
on day 1. The primary end
point was the treatment efficacy of CT in terms of overall survival (OS). Secondary endpoints were assessment
of progression free survival (PFS) and toxicity of the G+C therapy. OS was defined as the time from the first CT
to death from all causes. PFS was defined as the time from the first CT to the earliest date of disease progression
(local, regional, distant and/or second cancer), death (from all causes) or data cut-off (from all causes).
Standard tumor measurements were used in keeping with the following definitions: Complete response
(CR) was defined as a complete disappearance of the tumor for at least 4 weeks after time documentation
;Partial response (PR) was defined as more than a 50% decrease in the sum of the products of the two largest
perpendicular diameters of all measurable lesions, as determined 4 weeks apart, consecutively; stable disease
(SD) was defined as not only no CR or PR, but also no objective progression; progressive disease (PD) was
defined as a 25% or greater increase in the size of any measurable lesion or the appearance of new lesions or
ascites.
Time to progression was calculated from the first treatment day to the identification date of PD or
death. Duration of response was measured from the date of response notation to the first record of disease
progression or death, and survival was measured from the first day of treatment to death.
III. RESULTS
All patients were assessable for toxicity from the time of the first CT dose. All patients who underwent
two or more treatment cycles were assessable for a response. Of 25 assessable cases, there were 4 males and 21
females. The median age was 60 years (range 31–69 years), and median Karnofsky performance status 80%
(range 60–90%). Seven cases (28%) achieved PR, 8 SD (33%), and 10 cases did not respond to chemotherapy
(PD) (40%). Toxicity was mild to moderate (Table 2), ototoxicity was observed in 7.5% cases, mild to moderate
nausea and vomiting were seen in all cases despite prophylactic antiemetics. Anemia grade 3 was seen in 4.33%,
neutropenia grade 3 in 1.73% and thrombocytopenia grade 3 in 2.38% of cases.
IV. FIGURES AND TABLES
Patient’s baseline characteristics - Table 1.
CHARACTERISTIC N (PERCENTAGE)
TOTAL PATIENTS 25 (100)
MALES 04 (16)
FEMALES 21 (84)
MEAN AGE 60 (range 40-75)
KARNOFSKY PERFORMANCE SCORE 80 (range 60-90)
Patient’s response characteristics - Table 2.
RESPONSE
CHARACTERISTIC N(PERCENTAGE) MEDIAN (RANGE IN WEEKS)
PARTIAL REPONSE 7 (28)
STABLE DISEASE 8 (32)
PROGRESSIVE DISEASE 10 (40)
TIME TO PROGRESSION 20.6 (1-82)
RESPONSE DURATION 25.7 (8-65)
SURVIVAL 36.0 (3.4-95)
Patient’s toxicity characteristics - Table 3.
TOXICITY PERCENTAGE
Anemia grade III/IV 4.33/1
Neutropenia grade III/IV 1.73/2
Thrombocytopenia grade III/IV 2.38/0.59
Nephrotoxicity (increased creatinine) grade I 1.19
Ototoxicity grade II 7.5
Neuropathy grade II 7.5
Rash grade I/II 7.14/0.59
Nausea/vomiting grade II 3.57
V. DISCUSSION
No standard CT regimen has been established for advanced GBC. Clinical trials on CT for GBC have
not been actively pursued because it is rare in the West, the difficulties of obtaining an adequate biopsy
specimen, and high incidences of complications, such as, cholangiohepatitis and jaundice. A pooled analysis of
3. Gemcitabine And Cisplatin In Metastatic Carcinoma Gallbladder. A Single Institution Retrospective Analysis
DOI: 10.9790/0853-141210911 www.iosrjournals.org 11 | Page
clinical trials showed that the mean number of GBC patients per clinical trial was only 16.7 [9]. However, drug
activity in these cancers appears to be similar to that in adenocarcinoma, of the pancreas and GBC. Historically,
5-fluorouracil (FU) has been the most active single agent, although response rates are only in the order of 10–
15% [10]. Other agents that have been reported as active in biliary tract cancer are mitomycin, doxorubicin,
oxaloplatin, capecitabine, cisplatin and gemcitabine A phase III ABC-02 trial including 410 patients
demonstrated overall survival superiority of G+C combination over gemcitabine alone, establishing a new
standard in front-line CT for BTC (11.7 vs. 8.2 months, HR 0.64; 95%CI, 0.52 to 0.80; P < 0.001). The PFS was
8.0 months in the G+C arm versus 5.0 months in the control arm (P < 0.001). Adverse events were similar in
both groups, with the exception of more neutropenia in the combination arm [11]. Since the randomized
multicentric phase III ABC-02 trial, G+C combination is considered as the standard first-line CT in advanced
BTC [9]. However, Gemox CT is frequently preferred as first-line CT in many cancer institutions and is
frequently used in recent clinical trials in association with biotherapies in exploratory studies and as the
comparative arms [12, 13]. In clinical practice, Gemox and G+C are frequently used as first-line therapy in
advanced BTC but they have never been compared. In the present study, we enrolled 25 GBC patients, which is
a relatively good number. G+C resulted in a tumour PR of 28% and stable disease in 33%.Median time to
progression and OS were 5.3 and 6.8 months, respectively. Five phase II trials have been conducted exclusively
in GBC to determine the activities of palliative CT [14, 15, 16] and compared with those of present study. The
regimens used in these studies were single gemcitabine, 5 FU-cisplatin, or gemcitabine plus platinum agents.
The five studies and the present study, RRs ranged from 21.2% to 64% and median OS from 5 to 7.5 months.
However, because none of these studies had a control group, it is difficult to determine the merits and demerits
of the regimens used. Hematologic and nonhematologic toxicity of grade 3 or 4 occurred more frequently during
gemcitabine-cisplatin than gemcitabine-oxaliplatin studies. In a study by Valle et al [7] although results were
obtained by subgroup analysis of heterogenous biliary cancers rather than by analysis of an exclusive GBC
population, gemcitabine-cisplatin was found to be superior to gemcitabine alone in GBC patients, especially
when PS was good.
VI. Conclusion
The results obtained in the present study for a gemcitabine-cisplatin based combination therapy, and in
the previous studies, suggest that gemcitabine plus a platinum agent can be used to manage locally advanced or
metastatic GBC. Summarizing, the present study shows that gemcitabine -cisplatin chemotherapy is feasible
and safe in indian patients with advanced GBC.
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