Treatment of paediatric pontine glioma with oral trophosphamide and etoposide

To evaluate the overall survival of paediatric patients with pontine gliomas treated with oral trophosphamide and etoposide. Patients between 3 and 17 years of age with either typical diffuse pontine glioma on MRI or histologically proven anaplastic astrocytoma/glioblastoma multiforme located in the pons, were eligible. Treatment consisted of oral trophosphamide 100 mg m−2 day−1 combined with oral etoposide at 25 mg m−2 day−1 starting simultaneously with conventional radiation. Twenty patients were enrolled (median age 6 years, male : female=9 : 11). Surgical procedures included: no surgery: five, open biopsy: three, stereotactic biopsy: six, partial resection: three, and sub-total resection: three. Histological diagnoses included pilocytic astrocytoma: one, astrocytoma with no other specification: three, anaplastic astrocytoma: three, glioblastoma multiforme: eight, no histology: five. The most frequent side effects were haematologic and gastrointestinal. There was no toxic death. The response to combined treatment in 12 evaluable patients was: complete response: 0, partial response: three, stable disease: four, and progressive disease: five. All tumours progressed locally and all patients died. The overall median survival was 8 months. The overall survival rates at 1 and 4 years were: 0.4 and 0.05 respectively. This was not different from a control group of patients documented in the same population. Oral trophosphamide in combination with etoposide did not improve survival of pontine glioma patients. The treatment was well tolerated and should be evaluated for more chemoresponsive paediatric malignancies

ASSOCIATION OF VITAMIN D LEVEL WITH FASTING PLASMA GLUCOSE IN TYPE 2 DIABETIC PATIENTS

BACKGROUND : The prevalence of vitamin D deficiency has increased in India. Recently there have been plenty of research studies pointing to the essentiality of vitamin D beyond bone health. Type 2 diabetes is also found to be more prevalent in individuals with hypovita minosis D. AIM: To evaluate the levels of vitamin D in type 2 diabetic patients and age matched healthy controls in South Indian population and also to correlate vitamin D level with fasting plasma glucose level and lipid profile in type 2 diabetic patient s. MATERIALS AND METHODS: This cross - sectional study include d 51 type2 diabetic patients and 51 healthy controls. Estimation of Fasting blood glucose and lipid profile was done in Beckmann - Coulter auto analyzer using standard kits. Vitamin D was estimated by Chemiluminescent Immuno Assay (C.L.I.A.) Statistical analysis was done using SPSS version 21 software. RESULTS: The vitamin D level was significantly lower in the diabetic patients. The fasting plasma glucose, total cholesterol, triglycerides, low densi ty lipoproteins and very low density lipoproteins were increased in patients with vitamin D deficiency (i.e. vitamin D < 20 ng/ml) but the increase was statistically significant only in fasting blood glucose and triglycerides(p<0.01). The level of high den sity lipoproteins was statistically significantly lower in the vitamin D deficient group (p<0.01). By Pearson’s correlation vitamin D was found to be negatively correlated significantly (p value < 0.01) with fasting blood sugar and triglycerides and was fo und to be positively correlated significantly (p value <0.01) with HDL. CONCLUSION: There is high prevalence of Vitamin D deficiency in type 2 diabetic patients. These individuals have also been proved to have atherogenic dyslipidemia that may lead to vasc ular complications. Whether supplementing diabetic patients with vitamin D helps in reducing further complications is yet to be proved by interventional studies

<i>In vitro </i>adventitious shoot formation from leaf cultures of <i>Clerodendnan inerme </i>(L) Gaertn.

1274-1276In vitro adventitious shoots (about 28) of Clerodendrum inerme were regenerated from leaf segments on MS medium containing BA (4 mg/L). These shoots developed directly from the leaf explants without callusing after 5 weeks. Leaf explant when cultured in MS medium containing BA (2 mg/L) and NAA (0.5 mg/L) developed compact callus that became nodular and regenerated shoots (about 50) after 5 weeks. The in vitro developed shoots were rooted in MS medium supplemented with IAA (2 mg/L). The hardened plantlets were successfully established in the field with 90% survival.</i

Mucoceles: a neurosurgical perspective

The neurosurgical manifestations in three patients with sphenoid sinus mucoceles and two others with fronto-eth-moidal mucoceles are presented. In two patients, sphenoid sinus mucoceles produced visual loss while in the other severe headache was the only symptom. Both patients with fronto-ethmoidal mucoceles presented with proptosis. All patients had surgical treatment. While other symptoms were relieved following treatment, visual loss remained unchanged in both patients in whom it was present. We recommend a high level of suspicion for mucoceles as a cause of sudden or progressive visual loss. Prompt surgical therapy is needed to achieve good visual outcome