Nevin Manimala

J Cancer Res Ther. 2021 Jan-Mar;17(1):106-113. doi: 10.4103/jcrt.JCRT_854_19.

ABSTRACT

CONTEXT: Malignant peripheral nerve sheath tumor (MPNST) is a rare and aggressive soft-tissue sarcoma.

AIMS: The aim of this study was to analyze various prognostic factors and treatment outcome of patients with MPNST.

SETTINGS AND DESIGN: This was a retrospective study.

SUBJECTS AND METHODS: Ninety-two patients, who presented with MPNST at a tertiary care cancer center from 2011 to 2018, were included in this study. The median follow-up of all living patients was 33 months. Neurofibromatosis 1 (NF1) was seen in 12 (13%) patients. Sixty (65.2%) patients received curative-intent treatment.

STATISTICAL ANALYSIS USED: Kaplan-Meier method was used for survival analysis. Log-rank test was used for univariate analysis, and multivariate analysis was done by Cox proportional hazard ratio method.

RESULTS: The 5-year overall survival (OS) of all patients was 47.2% and the 5-year disease-free survival (DFS) of operated patients was 41.5%. On univariate analysis, association with NF1 (P = 0.009), grade (P = 0.017), and margin status (P = 0.002) had a significant effect on DFS, whereas association with NF1 (P = 0.025), metastatic disease on presentation (P < 0.0001), palliative intent of treatment (P < 0.0001), grade (P = 0.049), and margin status (P = 0.036) had a significant effect on OS. On multivariate analysis for patients who were treated with curative-intent treatment, grade (P = 0.015), and margin status (P = 0.028) had a significant effect on DFS, whereas association with NF1 (P = 0.00026) and location of tumor (P = 0.040) had a significant effect on OS.

CONCLUSIONS: The presence of distant metastasis, palliative intent of treatment, association with NF1, location of the tumor in the head and neck, high tumor grade, and positive margin status were the risk factors associated with poor survival for the patients with MPNST. Wide local excision with negative resection margin is the highly recommended treatment.

PMID:33723140 | DOI:10.4103/jcrt.JCRT_854_19

J Cancer Res Ther. 2021 Jan-Mar;17(1):99-105. doi: 10.4103/jcrt.JCRT_32_19.

ABSTRACT

CONTEXT: Radiotherapy may have side effects on the brain, such as radiation necrosis, cognitive impairment, and a high chance of tumor recurrence, which has been considered the most common cause of treatment failure.

AIMS: Using intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) techniques, we aimed to test the potential outcome of sparing the contralateral hippocampus (CLH) in radiotherapy for brain tumors by comparing dosimetric parameters.

SETTINGS AND DESIGN: A prospective clinical comparative study.

SUBJECTS AND METHODS: Using IMRT and VMAT, sparing CLH in radiotherapy of brain tumors was tested in ten patients, and various dosimetric parameters were compared. The treatment plans were accepted only if they met the set of planning objectives defined in the protocol.

RESULTS: The dose delivered to 95% of the CLH volume (CLH D95), and the mean (CLH Dmean) and max (CLH Dmax) doses were found to be significantly highest in the standard IMRT (P = 0.002, <0.001, and < 0.001, respectively). The lowest CLH D95, CLH Dmean and CLH Dmax for the hippocampus were detected in sparing VMAT planning than in the other plans (P < 0.05). None of the post hoc comparisons for CLH D95 was different among any of the plans, whereas the mean dose to CLH was statistically different among all paired comparisons (P < 0.008). The maximum dose to CLH was also statistically different among all paired plans (P < 0.008), except the dose difference between standard VMAT and IMRT plans.

CONCLUSIONS: Although VMAT planning is troublesome and time-consuming, the advantage of sparing the hippocampus is beneficial, preserving the hippocampus and cognitive functions during radiotherapy.

PMID:33723139 | DOI:10.4103/jcrt.JCRT_32_19

J Cancer Res Ther. 2021 Jan-Mar;17(1):69-74. doi: 10.4103/jcrt.JCRT_217_19.

ABSTRACT

BACKGROUND: Malignant pleural mesothelioma (MPM) is a pleural tumor with high mortality rate and short-term survival expectancy after diagnosis. Assessment of the response to chemotherapy, which is the first choice in treatment of MPM, is important for the transition to alternative chemotherapy protocols and immunotherapy. There is no clarity in the response to chemotherapy treatment.

OBJECTIVE: Our study aims to compare the assessment of chemotherapy response using the Modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria and volumetric measurements and to correlate with median survival.

MATERIALS AND METHODS: Thirty-two patients (16 females and 16 males) were included in the study, and their ages ranged from 28 to 78 years. Chemotherapy response was determined by both mRECIST and volumetric approach. Tumor volume was measured by linear interpolation and semi-automatic segmentation. Log-rank multiple cutoff analysis was used to determine appropriate cutoff values of volumetric response criteria.

RESULTS: According to both mRECIST and volumetric approach, median survival times in partial response, stable disease, and progressive disease groups were 24, 15, and 9 months, respectively. The survival times of the three groups were different (logrank: 17.76; P < 0.001) by mRECIST. The survival of the progressive disease group was shorter than that of the other groups (logrank: 18.91; P < 0.001) by volumetric approach.

CONCLUSIONS: In the assessment of chemotherapy response, even though classifications obtained according to the mRECIST criteria and volumetric measurements are statistically compatible, we think that the measurement of the volumetric values will increase the standardization. In our study, threshold values for volumetric measurements were determined; however, these values should be supported by large-scale multicenter studies.

PMID:33723135 | DOI:10.4103/jcrt.JCRT_217_19

J Cancer Res Ther. 2021 Jan-Mar;17(1):62-68. doi: 10.4103/jcrt.JCRT_915_17.

ABSTRACT

OBJECTIVE: The main objective of the study was to evaluate the cytotoxicity of selected essential oils on human skin, gastric, and brain cancer cell lines using microculture tetrazolium test.

MATERIALS AND METHODS: Phytochemical analysis, as well as acute oral toxicity tests, was carried out in female albino mice with cardamom oil, lemon oil, and jasmine oil according to the Organization for Economic Co-operation and Development guidelines 425. Anticancer activities of the above test drugs were performed using human cancer cell lines. The studies were carried out at Skanda Life Sciences Pvt. Ltd., Bengaluru.

RESULTS: Phytochemical analysis has shown the presence of carbohydrates and flavonoids in cardamom oil. While lemon oil has shown the presence of carbohydrates, flavonoids, steroids, terpenoids, and tannins, jasmine oil has shown the presence of carbohydrates, alkaloids, flavonoids, steroids, terpenoids, and glycosides. Toxicity studies showed that cardamom oil, lemon oil, and jasmine oil were all found to be safe up to 2000 mg/kg body weight. Results have shown that lemon oil exhibited the strongest cytotoxicity toward three human cancer cell lines, namely skin cancer (A431), gastric cancer (MKN-45), and brain cancer (U-87 MG) cell lines, with higher IC₅₀ values of 62.82 μg/ml, 220.9 μg/ml, and 440.1 μg/ml compared to standard. Jasmine oil exhibited the strongest cytotoxicity toward skin cancer and brain cancer cell lines, whereas cardamom oil has shown stronger cytotoxicity only toward skin cancer cell line but did not show any level of inhibition of growth of brain and gastric cancer cells.

CONCLUSION: Our study reveals that lemon oil, jasmine oil, and cardamom oil possess potent antitumor activity compared to standard. At different concentrations, lemon oil has shown statistically significant (***P < 0.0001) anticancer activity toward all the three human cancer cell lines. While jasmine oil has shown statistically significant (***P < 0.0001) anticancer activity toward skin and brain cancer cell line, cardamom oil has also shown statistically significant (***P < 0.0001) anticancer activity but only toward skin cancer cell line.

PMID:33723134 | DOI:10.4103/jcrt.JCRT_915_17

Niger J Clin Pract. 2021 Mar;24(3):425-434. doi: 10.4103/njcp.njcp_112_20.

ABSTRACT

OBJECTIVE: This study aimed to compare the clinical efficacy and survival rates of the hall technique (HT), and conventional restoration (CR) for the management of occlusoproximal carious lesions in primary molars.

MATERIALS AND METHODS: This clinical study observed 35 children (aged 4-8 years). Exclusion criteria included symptoms of pulpal or periradicular pathology or systemic conditions requiring special dental considerations. For each child, at least one tooth was treated with HT and one with CR. The primary outcome measures were minor and major clinical failure rates. Plaque and gingival scores of the teeth were also evaluated. Friedman test and Wilcoxon signed ranks test were used to compare the plaque and gingival index scores for each arm. Chi-square tests were used for comparisons of clinical outcomes, plaque-gingival index, and distribution of ICDAS categories among treatment arms (P < 0.05).

RESULTS: Thirty-three of 35 (94.2%) participants returned for 1-year follow-up. HT showed statistically significantly higher treatment survival rate and fewer minor failures than CR (P = 0.040). The rate of major failures was minimal (2 of 84 teeth) and did not differ between treatments (P = 0.092). In both treatment groups, the gingival score and plaque score were significantly decreased at the 1-year follow-up (P < 0.05).

CONCLUSION: HT was a more successful method for managing caries in primary molars than CR, both for symptoms of pulpal disease and longevity of the restorations. HT is a simplified method of managing carious primary molars using SSCs cemented with no local anesthesia, caries removal, or tooth preparation.

PMID:33723119 | DOI:10.4103/njcp.njcp_112_20

Niger J Clin Pract. 2021 Mar;24(3):418-424. doi: 10.4103/njcp.njcp_250_20.

ABSTRACT

OBJECTIVES: The aim of this study was to compare the formation of dentinal crack after root canal preparation performed with different heat treated single-file systems.

MATERIALS AND METHODS: Forty mandibular premolar teeth were randomly divided into four groups according to the file system to be used during the preparation (n = 10): Group 1: Reciproc Blue; group 2: One Curve; group 3: HyFlex EDM; group 4: (control group) hand files. During the cleaning and shaping, irrigation was performed with a total of 10 ml of 5.25% sodium hypochlorite and 2 mL of distilled water. Then sections were taken from the roots (3, 6 and 9 mm). Sections were examined on a stereomicroscope to determine the presence of cracks. Chi-square test was used for data analysis.

RESULTS: There was a significant difference between the groups in dentinal crack frequency (P <.05). HyFlex EDM (13.3%) caused less dentinal crack than One Curve (26.7%) and Reciproc Blue (30%). No cracks were observed in the control group. When 3, 6, and 9 mm were evaluated within themselves, dentinal crack formation did not differ according to the groups (P > 0.05). A statistically higher mean value was obtained in the control group compared to the other groups in terms of working time (P < 0.001).

CONCLUSIONS: All the files used during root canal preparation formed dentin crack. Hy-Flex EDM caused less dentinal cracks than other file systems. The flexibility of nickel-titanium instruments because of heat treatment seems to have a significant influence on dentinal crack formation.

PMID:33723118 | DOI:10.4103/njcp.njcp_250_20

Niger J Clin Pract. 2021 Mar;24(3):393-399. doi: 10.4103/njcp.njcp_280_18.

ABSTRACT

BACKGROUND: Self-efficacy is defined as the ability of an individual to perform an action successfully or her/his perception of being able to control events. The self-efficacy perception of diabetes management may affect well-being of the patient.

AIMS: This study aimed to examine the relationships between self-efficacy of diabetes management and well-being in patients with type 2 diabetes.

SUBJECTS AND METHODS: The study used a descriptive correlational design. Sample of the study included 200 patients with type 2 diabetes. Sociodemographic and disease-related questionnaire form “Self-Efficacy Scale for Diabetes Management” and “Well-Being Questionnaire” have been used as data collection tools. Multiple linear regression analysis was performed to explore the predictors of well-being in patients with type 2 diabetes.

RESULTS: Self-efficacy level, age, level of compliance with treatment, and state of doing exercise were found to be statistically significant predictors of well-being in type 2 diabetic patients. Self-efficacy level for diabetes management was found to be the strongest predictor of well-being in patients with type 2 diabetes.

CONCLUSION: Self-efficacy level of diabetes management is a factor that affects well-being in type 2 diabetes patients and it should be considered during interventions for improving the well-being of patients.

PMID:33723114 | DOI:10.4103/njcp.njcp_280_18

Zhonghua Yan Ke Za Zhi. 2021 Mar 11;57(3):223-227. doi: 10.3760/cma.j.cn112142-20200317-00195.

ABSTRACT

Objective: To observe the changes of four pulley locations of extraocular rectus muscles and rectus muscle volumes, as well as superior and inferior part ratio of horizontal rectus muscles, in concomitant exotropia with small-angle vertical deviation in primary gaze. Methods: Cross-sectional study. Data was collected from January 2018 to December 2019 in Tianjin Eye Hospital. The pulley position changes and volumes of four extraocular rectus muscles in the coronal position of patients who had concomitant exotropia without vertical deviation (group A) or with small-angle vertical deviation in primary gaze (<5 prism diopter; group B) and normal controls (group C) were observed using MRI, and the changes of the volume ratio of the superior and inferior parts of the horizontal rectus muscle were calculated. One way analysis of variance and Kruskal-Wallis test were used for statistical analysis. Results: There were 19 patients (38 eyes; 10 males, 9 females) aged (30±7) years in group A, ten patients (20 eyes; 4 males, 6 females) aged (27±6) years in group B, and 20 healthy volunteers (40 eyes) in group C. Age and gender distribution were matched among the three groups (all P>0.05). Among the three groups, the pulley locations of the four extraocular rectus muscles were not significantly different (all P>0.05). The medial rectus muscle volume in groups A [(358.6±44.9) mm³; t=6.405, P<0.01] and B [(334.7±35.6) mm³; t=6.025, P<0.01] was significantly smaller than group C [(437.5±49.3) mm³]. There was no statistically significant difference in the superior and inferior muscle volume ratio of the lateral rectus in three groups (all P>0.05), while the ratio in group B was more dispersive. Conclusions: The pulley location changes of four extraocular rectus muscles of patients with concomitant exotropia and small-angle vertical deviation in primary gaze are not significant, but the medial rectus volume in patients who had concomitant exotropia with vertical deviation or not is significantly smaller. The dispersive superior and inferior muscle volume ratio of the horizontal rectus muscles may be related to the small angle of vertical deviation in clinical examinations. (Chin J Ophthalmol, 2021, 57: 223-227).

PMID:33721962 | DOI:10.3760/cma.j.cn112142-20200317-00195

Zhonghua Yan Ke Za Zhi. 2021 Mar 11;57(3):207-214. doi: 10.3760/cma.j.cn112142-20201020-00693.

ABSTRACT

Objective: To evaluate the quality of life of patients with primary open-angle glaucoma (POAG) and its related factors in Wenzhou. Methods: Cross-sectional analysis. A total of 339 POAG patients diagnosed in the Wenzhou glaucoma progression study conducted in the Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University from March 2014 to October 2019 were included. Quality of life of POAG patients was assessed by EQ-5D including the visual analogue scale (VAS). The effects of gender, age, visual field loss (VFL), family history of glaucoma, hypertension, diabetes, migraine, sleep quality, and amateur exercise on the quality of life were analyzed. The utility value (UV) and VAS score were expressed as the median (P₂₅, P₇₅), and Mann-Whitney U was used for the comparison between two groups. Kruskal-Wallis H was performed to compare the differences among multiple groups. Results: A total of 339 POAG patients were included in the study; 164 were males (48.4%), and 175 were females (51.6%). The mean age was (63±10) years. Thirty-four patients (10.0%) had received medication (including one with combined surgical treatment), while the remaining 305 patients (90.0%) had received no anti-glaucoma treatment. Among the patients, 10.5% (32/305) had no VFL, 68.9% (210/305) had mild VFL, 17.0% (52/305) had moderate VFL, and 3.6% (11/305) had severe VFL. In all patients, the median of UV was 1.000 (1.000, 1.000), the mean of UV was 0.964, and the median of VAS score was 80 (75, 90), the mean of VAS score was 81.58. Anxiety or depression and pain or discomfort occurred in 45.7% (43/94) and 34.1% (32/94), respectively, of POAG patients with decreased UVs, as well as mobility constraints in 13.8 % (13/94) and usual activity constraints in 6.4% (6/94). The median of UV of the eye with a better visual field in the group without VFL or with mild or moderate VFL was 1.000 (1.000, 1.000), and in the group with severe VFL was 1.000 (0.862, 1.000), but there was no significant difference in the UV and the VAS score of the eye with a better visual field among groups with different degrees of VFL (both P>0.05). There was statistically significant difference in the UV among groups with different sleep qualities (H=17.465; P<0.01). Using pairwise comparison, the median of UV of the very good sleep group was 1.000 (1.000, 1.000), significantly different to the slightly poor sleep group 1.000 (0.866, 1.000) (z=3.613; P<0.05). The median of UV in patients with migraine was 1.000 (0.875, 1.000), without migraine 1.000 (1.000, 1.000), and in patients with hypertension was 1.000 (0.875, 1.000), without hypertension 1.000 (1.000, 1.000), and in patients with diabetes was 1.000 (0.875, 1.000), without diabetes was 1.000 (1.000, 1.000), the difference was statistically significant (Z=-2.189, -3.864, -2.417; all P<0.05). The UV was not related to age, gender, family history of glaucoma, amateur exercise, alcohol and tobacco, and history of anti-glaucoma medication (all P>0.05). Conclusions: VFL is related to the UV of POAG patients in Wenzhou. Quality of life in mild POAG patients is good but decrease in advanced POAG patients. Sleep quality, systemic complications and physical or psychological discomfort impact on quality of life in POAG patients. (Chin J Ophthalmol, 2021, 57: 207-214).

PMID:33721960 | DOI:10.3760/cma.j.cn112142-20201020-00693

Zhonghua Yan Ke Za Zhi. 2021 Mar 11;57(3):201-206. doi: 10.3760/cma.j.cn112142-20201102-00734.

ABSTRACT

Objective: To evaluate the retinal vessel density in eyes with primary open-angle glaucoma (POAG) with single-hemifield visual field (VF) defects and its relationship to retinal nerve fiber layer (RNFL) thickness and visual field indices. Methods: Cross-sectional study. Twenty-eight POAG patients with single-hemifield VF defects and 31 normal controls were recruited from October 2015 to October 2018 in the Eye, Ear, Nose and Throat Hospital of Fudan University. All subjects underwent complete ophthalmological examinations, including RNFL, retinal ganglion cell complex (GCC) thickness and visual field tests, and the general information was collected. The peripapillary radial peripapillary capillaries (RPC) and macular superifical retinal capillary plexus (SCP) were derived from optical coherence tomography angiography. The retinal vessel density, structural values, and VF values were compared among the corresponding hemifields of POAG and healthy eyes using the Rank Sum test. Results: There were 16 males and 12 females in POAG patients, with the age of (47±12) years; there were no significant differences in gender distribution, age, intraocular pressure, central corneal thickness, axial length and intraocular perfusion pressure between POAG patients and the normal controls (all P>0.05). Among POAG patients, there were 19 cases with upper and 9 cases with lower visual field defect. In the POAG eyes, the vascular density of peripapillary RPC and macular SCP were 45.86% (34.92%-52.78%) and 39.31% (32.55%-46.79%), respectively. In the normal eyes, the vascular density of peripapillary RPC and macular SCP were 56.90% (51.69%-60.84%) and 47.48% (37.95%-52.25%), respectively. The difference was statistically significant (Z=-6.56, -5.86; both P<0.01). The RNFL and GCC thicknesses in the POAG group were 84.4 (62.1-97.1), 76.4 (60.3-92.5) μ m, respectively, which were smaller than those in normal controls [110.6 (95.7-131.6), 98.1 (84.0-109.2) μm; Z=-6.57, -6.36; both P<0.01]. In the POAG eyes, the peripapillary RPC [44.12% (34.73%-53.20%) vs. 51.85% (38.64%-61.02%); Z=-4.62; P<0.01] and macular SCP [36.81% (29.73%-47.82%) vs. 41.78% (33.93%-49.22%); Z=-4.12; P<0.01] vessel densities were reduced in the abnormal hemisphere compared with the opposite hemisphere. Compared with the normal eyes, the normal hemisphere of the POAG eyes had lower peripapillary RPC and macular SCP vessel densities (Z=-5.08, -4.95; both P<0.01), a thinner RNFL and a thinner retinal GCC [93.0 (61.9-116.5) μm vs. 110.6 (95.7-131.6) μm, Z=-5.15; 86.3 (67.2-98.2) μm vs. 98.1 (84.0-109.2) μm, Z=-5.35; both P<0.01]. But the mean deviation and pattern standard deviation values of the VF were not significantly different between them (both P>0.05). Conclusions: The retinal vessel density reduce in eyes with POAG with single-hemifield VF defects. The normal hemisphere of POAG eyes have a reduced retinal microcirculation along with the thinning of the RNFL and GCC, suggesting that vascular dysfunction and structural changes preceded VF loss in POAG. (Chin J Ophthalmol, 2021, 57: 201-206).

PMID:33721959 | DOI:10.3760/cma.j.cn112142-20201102-00734