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Background: Framingham risk score (FRS) is a widely recognized tool used by clinicians worldwide to determine and estimate the 10-year risk of manifesting clinical cardiovascular disease (CVD) of an individual and classify them into different risk categories on the basis of which necessary intervention can be taken. However, there is certain evidence questioning its predictive ability for risk stratification among ethnic Indian and Asian population. Aims and Objectives: In this study, we wanted to determine the predictive ability of FRS in the Indian population and to assess how the risk score is associated with certain variables which are not included in original FRS. Materials and Methods: It was a single institutional, retrospective, and observational study in patients with evidence (by ECG or Cardiac biomarker test -Preferably Troponin T) of diagnosis of acute myocardial infarction for first time. Eligible patients were assessed for their previous clinical records to calculate risk score as per FSRcoronary heart disease 2002. Predictive ability of FRS and association with different risk factors was tested for statistical significance. Results: The most of the study participants (63.8%) had low risk and only 4.8% of study population had high risk for developing CVD. Patients in the low risk group had significantly better high-density lipoprotein profile than other risk groups (P=0.001). Mean systolic blood pressure was significantly higher in highrisk population (155 vs. 131 vs. 138 mm of Hg; P=0.005). The left ventricular ejection fraction was significantly lower in high-risk group (39.2% vs. 53% vs. 52%, P=0.008). Serum creatinine level was also significantly higher in high-risk group (P=0.03). Conclusion: This clearly showed underestimation of FRS in prediction of CVDs in our study. Perhaps FRS needs a calibration and modified form with inclusion of other risk factors and parameters to determine and predict the future risk of development of CVD more accurately in Indian population. [ABSTRACT FROM AUTHOR]

Background: Cisplatin based Concurrent chemo-radiation (CTRT) is the corner stone for treatment of locally advanced head and neck carcinoma. Epidermal growth factor receptor(EGFR) expression by squamous cell carcinoma which is associated with cancer development and progression, leads to emergence of anti-EGFR agents as a therapeutic option. In this study we compare cisplatin based CTRT against gefitinib based CTRT in terms of disease control and acute toxicity profile. Material and Methods: Stage III and IV squamous cell carcinoma of Head and neck region (excluding nasopharynx) were randomised into two groups. Control group received conventionally fractionated radiotherapy of 66Gy in 33fractions, over six and half weeks with concurrent weekly cisplatin. Study group received same dose of radiation with concurrent daily oral Gefitinib. All patients were followed up weekly during the treatment and then 6-8 weeks after completion of treatment and thereafter 3 monthly. Results: Overall response rate (complete response + partial response) was comparable for both arms (75% vs 76.2%, p value-0.881). Radiation with cisplatin was associated with significantly higher skin (28.6% vs 15%, p value-0.037) and mucosal (23.8% vs 5%, p-value-0.047) toxicities. Gefitinib containing arm showed significantly higher grade 3 diarrhoea (10% vs 0%, p-value-0.01) and skin rash (6% vs 0%, p -value-<0.001). With a median follow-up of 12.5 months Disease free survival (DFS) was not significantly different between the arms(12 vs 13 months). Conclusion: Gefitinib based CTRT is non-inferior to cisplatin based CTRT for the treatment of locally advanced head and neck carcinoma with acceptable toxicity profile. [ABSTRACT FROM AUTHOR]

Background: Concurrent chemoradiotherapy with cisplatin is the standard treatment for locally advanced carcinoma cervix. Cisplatin can be given either as weekly or a tri-weekly regimen with radiotherapy. However, there were few studies comparing both, so our study aimed at comparing weekly versus tri-weekly cisplatin-based chemoradiation in terms of loco-regional control and acute toxicity profile. Aims and Objectives: To compare the treatment response and acute toxicity profile of these two concurrent chemotherapy schedule. Materials and Methods: Patients with non-metastatic, squamous cell carcinoma of uterine cervix International Federation of Gynecology and Obstetrics stage IB2-IVA were randomized into two arms-control arm patients received external beam radiotherapy (50Gy in 25 fractions over 5 weeks) with concurrent weekly cisplatin (40mg/m²), and study arm patients received radiotherapy with same dose, along with tri-weekly concurrent cisplatin (75 mg/m²) for two cycles. After that, all patients received brachytherapy 21 Gee/3 fractions, one fraction/week. All patients were followed up weekly during treatment and then monthly for at least a period of 6 months for evaluation of toxicity and treatment response. Results: Six weeks after treatment completion, complete treatment response was comparable in both the arms(43.33% vs. 46.67%, P=0.35). Incidences of leucopenia were significantly high in weekly cisplatin arm (P=0.002).Nephrotoxicity of higher grade was also numerically more in control arm (P=0.654). However, treatment compliance was better in tri-weekly cisplatin arm, reflected by reduced treatment interruptions (46.67% vs. 53%). Conclusion: Tri-weekly cisplatin-based concurrent chemoradiation is equally effective as weekly cisplatin-based approach with comparable acute toxicity in treatment of carcinoma cervix. [ABSTRACT FROM AUTHOR]