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The optimal management of locally advanced rectal cancer requires a multidisciplinary strategy involving surgical resection with total mesorectal excision and combined use of radiotherapy and chemotherapy. The sequence of treatment can either be preoperative chemoradiation followed by surgery or upfront surgery followed by postoperative chemoradiation. This study compared survival outcomes of these two aforementioned approaches in 76 stage III rectal cancer patients, identified in the hospital database and treated between 2008 and 2014. The median locoregional recurrence free survival in the preoperative group was 34 months whereas it was 33 months in the postoperative group (p=0.583). The median distant metastases free survival was 17 months in the preoperative group versus 38 months in the postoperative group (p=0.039). The mean survival in the whole cohort was 46.97 months with 27 deaths reported at the time of last follow up. The mean survival in the preoperative group was 35.927 months versus 51.519 months in the postoperative radiotherapy group (p=0.129). In our set of patients, the sequence of chemoradiation whether preoperative or postoperative does not lead to differential survival. [ABSTRACT FROM AUTHOR]

The role of the library has always been to provide the best possible service to all its patrons, possibly, at all time. ICT came up with the facility to enhance the library services. Wi-Fi raised the profile of the library service and met demand for new technologies and services. Using Wi-Fi, library can expand its services and can provide new technology- based services to its users. To analyze the utilization of library facilities among the users a periodic review and evaluation is required. A study is carried out among the users to review the information seeking behavior and usage of library services at UPES, Dehradun. The inputs taken are the types of service, facility, purpose, location, frequency of visits, time spent and type of problems in accessing, among the users of UPES Library. [ABSTRACT FROM AUTHOR]

We report the case of a 25-year-old woman with tetralogy of Fallot who presented with chest pain and hypertension, and on further investigation, was diagnosed with a pheochromocytoma in the right adrenal gland. She underwent surgical excision of the tumor. While the simultaneous occurrence of these two diseases is extremely rare, the suspicion of a possible relationship has been raised in the past. [ABSTRACT FROM AUTHOR]

Background: Curative resection (R0) is the gold standard for Gastroesophageal junction adenocarcinomas(GECs) with expected cure rates of 20-25% with surgery alone. Adjuvant chemoradiotherapy is a valid option in USA whereas neoadjuvant/perioperative chemotherapy is widely practiced in Europe. There is no randomized controlled trial comparing the two options. We aimed to conduct the retrospective analysis of resectable Gastro-esophageal adenocarcinomas treated at our facility with either adjuvant chemoradiotherapy (ACT) or neoadjuvant/perioperative chemotherapy (NACT) and investigate their impact on the clinical outcome. Methods: A total of 79 patients of Gastro -esophageal junction adenocarcinomas completed treatment with curative intent between January, 2010 and December 2016 and were included in the analysis. 33 patients received adjuvant chemoradiotherapy after curative surgery as per Intergroup (INT0116) protocol. 46 patients underwent curative surgery after 3 cycles of neoadjuvant /perioperative chemotherapy as per UK MAGIC trial regimen. Statistical analysis was done with SPSS version 16 software. Results: The patients included 68 males and 11 females with age ranging from 22-81 years (median 60 years). The follow up ranged from 6-71 months (median 14 months). The number of lymph nodes removed at surgery was 5-25. The number of positive lymph nodes ranged from 0-9. In the adjuvant chemoradiotherapy group, out of 33 patients, 7 were dead of disease and 12 were alive with disease at last follow up. In the neoadjuvant/perioperative cohort, out of 46 patients, 13 were dead and 16 were alive with disease. Median disease free survival in the adjuvant chemoradiotherapy group was 22 months versus 14 months in the neoadjuvant/perioperative cohort. The difference was significant on Breslow analysis (Generalized Wilcoxon, p=.014) and on Tarone Ware (p=.037) but not on Log rank (Mantel-Cox, p=.190) implying more early events in the NACT group. Hazard ratio for ACT vs. NACT was 0 .703(95% CI 0.376-1.317, p=0.272). Hazard ratio for positive nodes was 1.125 ( 95% CI 0.96- 1.318, p=0.145).Median DFS for the whole group was18 months(SE 2.912, CI 12.292-23.708) and mean DFS was 23.725 months (SE 2.452, CI 18.919-28.532). Conclusion: The optimal management of resectable Gastro-esophageal junction adenocarcinomas remains a clinical dilemma and both the options of upfront surgery followed by adjuvant chemoradiotherapy and neoadjuvant /perioperative chemotherapy appear to be equivalent in terms of clinical outcome and survival. [ABSTRACT FROM AUTHOR]

Purpose Fingerprints of an individual are considered as mark of his/her identity. The identity of a person from fingerprints is based upon dermal ridges which have very large variations in the form of ridge characteristics. Though only few people have been reported for not having dermal ridges on their palmer and plantar surfaces, quite large number of population is reported with hand and foot deformities causing effect on dermal ridges also. Some of these deformities can be classified as syndactyly, polydactyly and polysyndactyly. In present work, cases of such deformities have been studied with respect to dermal ridges on distal phalanges of the fingers which are used for fingerprinting. Method Inked Fingerprints of affected fingers were obtained along with photographs of the hands with deformities. The pattern types, flow of ridges were recorded and relationship of these with deformity was attempted. Results Very interesting findings have been observed and have been reported in the paper, as commonness of ridge pattern or no pattern type of the ridges etc. It seems that there is a relationship between pattern type and type of deformity. Conclusion In spite of being brief study, it is hoped that it may lead to a study at larger scale to understand the dermal ridges configuration on hands with deformities. In the field of crime investigation when fingerprints having supernumerary finger are found at the crime scene, additional information about the culprit is available to draw the inferences. [ABSTRACT FROM AUTHOR]

The current study was undertaken to know whether febuxostat is superior to allopurinol in terms of efficacy and toxicity as hypouricemic agent in CML patients with hyperleucocytosis. 82 patients of CML with TLC>50000/cu.mm. were randomized to receive either febuxostat (40mg/day) or allopurinol (200- 300 mg/day) beginning 2 days before starting hydroxyurea. Complete blood count, renal function tests, liver function tests, serum uric acid and LDH were done at baseline and 1 week after starting urate lowering therapy. The entire cohort, with median age of 40 years (range 13-82 years) comprised of 45 males and 37 females. There were 41 patients in each arm. Mean TLC at presentation was 1,63,622/ cu.mm. In our series, hyperuricemia was seen in 28% patients at presentation. The mean uric acid level at baseline (UA1) was 6.57(±1.55) mg/dl (range 2.6-11.5) and at 1 week post therapy (UA2) was 5.74(±1.29) mg/dl (range 2.9-9). There was no difference between the two groups receiving febuxostat or allopurinol in terms of UA1 and UA2 (p=1.89). The mean reduction in uric acid levels by febuxostat was found to be 1.022mg/dl (±0.69SD) as compared to 0.6512mg/dl (±0.61SD) with allopurinol and the difference was statistically significant(p=0.012). The study has shown that febuxostat (40mg/day) might be superior to allopurinol in quantitative reduction of serum uric acid over the period of initial one week of therapy in CML patients with hyperleucocytosis. [ABSTRACT FROM AUTHOR]