Publications by authors named "Mahendra Pal"

21 Publications

  • Page 1 of 1

Locoregional recurrence after cystectomy in muscle invasive bladder cancer: Implications for adjuvant radiotherapy.

Urol Oncol 2021 Feb 8. Epub 2021 Feb 8.

Department of Radiation Oncology, Tata Memorial Centre (TMH/ACTREC), Mumbai, India; Homi Bhabha National Institute (HBNI), Anushakti Nagar, Mumbai, India.

Purpose: We report the patterns of locoregional recurrence (LRR) in muscle invasive bladder cancer (MIBC), and propose a risk stratification to predict LRR for optimizing the indication for adjuvant radiotherapy.

Materials And Methods: The study included patients of urothelial MIBC who underwent radical cystectomy with standard perioperative chemotherapy between 2013 and 2019. Recurrences were classified into local and/or cystectomy bed, regional, systemic, or mixed. For risk stratification modelling, T stage (T2, T3, T4), N stage (N0, N1/2, N3) and lymphovascular invasion (LVI positive or negative) were given differential weightage for each patient. The cohort was divided into low risk (LR), intermediate risk (IR) and high risk (HR) groups based on the cumulative score.

Results: Of the 317 patients screened, 188 were eligible for the study. Seventy patients (37.2%) received neoadjuvant chemotherapy (NACT) while 128 patients (68.1%) had T3/4 disease and 66 patients (35.1%) had N+ disease. Of the 55 patients (29%) who had a recurrence, 31 (16%) patients had a component of LRR (4% cystectomy bed, 11.5% regional 0.5% locoregional). The median time to LRR was 8.2 (IQR 3.3-18.8) months. The LR, IR and HR groups for LRR based on T, N and LVI had a cumulative incidence of 7.1%, 21.6%, and 35% LRR, respectively. The HR group was defined as T3, N3, LVI positive; T4 N1/2, LVI positive; and T4, N3, any LVI. The odds ratio for LRR was 3.37 (95% CI 1.16-9.73, P = 0.02) and 5.27 (95% CI 1.87-14.84, P = 0.002) for IR and HR respectively, with LR as reference.

Conclusion: LRR is a significant problem post radical cystectomy with a cumulative incidence of 35% in the HR group. The proposed risk stratification model in our study can guide in tailoring adjuvant radiotherapy in MIBC.
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http://dx.doi.org/10.1016/j.urolonc.2021.01.015DOI Listing
February 2021

Prostate-Only Versus Whole-Pelvic Radiation Therapy in High-Risk and Very High-Risk Prostate Cancer (POP-RT): Outcomes From Phase III Randomized Controlled Trial.

J Clin Oncol 2021 Jan 26:JCO2003282. Epub 2021 Jan 26.

Department of Radiation Oncology, Tata Memorial Hospital and Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Homi Bhabha National Institute (HBNI), Mumbai, India.

Purpose: We report the clinical outcomes of a randomized trial comparing prophylactic whole-pelvic nodal radiotherapy to prostate-only radiotherapy (PORT) in high-risk prostate cancer.

Methods: This phase III, single center, randomized controlled trial enrolled eligible patients undergoing radical radiotherapy for node-negative prostate adenocarcinoma, with estimated nodal risk ≥ 20%. Randomization was 1:1 to PORT (68 Gy/25# to prostate) or whole-pelvic radiotherapy (WPRT, 68 Gy/25# to prostate, 50 Gy/25# to pelvic nodes, including common iliac) using computerized stratified block randomization, stratified by Gleason score, type of androgen deprivation, prostate-specific antigen at diagnosis, and prior transurethral resection of the prostate. All patients received image-guided, intensity-modulated radiotherapy and minimum 2 years of androgen deprivation therapy. The primary end point was 5-year biochemical failure-free survival (BFFS), and secondary end points were disease-free survival (DFS) and overall survival (OS).

Results: From November 2011 to August 2017, a total of 224 patients were randomly assigned (PORT = 114, WPRT = 110). At a median follow-up of 68 months, 36 biochemical failures (PORT = 25, WPRT = 7) and 24 deaths (PORT = 13, WPRT = 11) were recorded. Five-year BFFS was 95.0% (95% CI, 88.4 to 97.9) with WPRT versus 81.2% (95% CI, 71.6 to 87.8) with PORT, with an unadjusted hazard ratio (HR) of 0.23 (95% CI, 0.10 to 0.52; < .0001). WPRT also showed higher 5-year DFS (89.5% 77.2%; HR, 0.40; 95% CI, 0.22 to 0.73; = .002), but 5-year OS did not appear to differ (92.5% 90.8%; HR, 0.92; 95% CI, 0.41 to 2.05; = .83). Distant metastasis-free survival was also higher with WPRT (95.9% 89.2%; HR, 0.35; 95% CI, 0.15 to 0.82; = .01). Benefit in BFFS and DFS was maintained across prognostic subgroups.

Conclusion: Prophylactic pelvic irradiation for high-risk, locally advanced prostate cancer improved BFFS and DFS as compared with PORT, but OS did not appear to differ.
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http://dx.doi.org/10.1200/JCO.20.03282DOI Listing
January 2021

Blood testis barrier revisited-Analysis of post-chemotherapy germ cell tumor orchidectomy and retroperitoneal lymph node dissection specimens.

J Surg Oncol 2021 Mar 11;123(4):1157-1163. Epub 2021 Jan 11.

Homi Bhabha National Institute, Mumbai, India.

Objective: To assess the response of chemotherapy on the primary tumor, compare it with the response in retroperitoneal disease, and study factors associated with pathological complete response.

Methods: We conducted a retrospective audit of all high inguinal orchidectomies (HIOs) performed after chemotherapy between 2012 and 2019 at a tertiary cancer center in India. Patient characteristics and histopathological response were extracted from electronic medical records, and predictors of testicular disease response were assessed.

Results: Of the 260 retroperitoneal lymph node dissections (RPLNDs) performed in the study period, 37 HIOs (14.23%) were carried out after chemotherapy. The median age of presentation was 28 years (16-41). Histopathology was divided into a viable tumor, mature teratoma, and necrosis/scarring. Residual disease was seen in 17 RPLND (46.0%) and 18 HIO (48.6%) specimens respectively. Of these 18, three patients had a residual viable tumor in the testis, and the remaining had a mature teratoma. Clinico-radiological assessment showed an average reduction of 61% in testicular disease size following chemotherapy. On orchidectomy histopathological assessment, the median tumor size was 9, 4, and 1.5 cm in specimens with a viable tumor, mature teratoma, and necrosis/scarring, respectively.

Conclusions: A low threshold for upfront chemotherapy in patients with a high disease burden may be considered as tumors within the testis respond to chemotherapy in more than half of the patients. Discordance rates of residual cancer in RPLND and HIO specimens exist but post-chemotherapy tumor size in testis correlates with the presence of a residual viable tumor.
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http://dx.doi.org/10.1002/jso.26374DOI Listing
March 2021

The Curious Case of Primary Prostatic Seminoma.

Urology 2020 Oct 3;144:e6-e9. Epub 2020 Aug 3.

Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.

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http://dx.doi.org/10.1016/j.urology.2020.07.035DOI Listing
October 2020

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2): An Update.

Cureus 2020 Mar 26;12(3):e7423. Epub 2020 Mar 26.

Clinical Microbiology, Prathima Institute of Medical Sciences, Karimnagar, IND.

Coronaviruses (CoVs) belong to the family of Coronaviridae, the order Nidovirales, and the genus Coronavirus. They are the largest group of viruses causing respiratory and gastrointestinal infections. Morphologically, CoVs are enveloped viruses containing a non-segmented positive-sense, single-stranded ribonucleic acid (RNA) viruses. CoVs are categorized into four important genera that include Alphacoronavirus, Betacoronavirus, Gammacoronavirus, and Deltacoronavirus. A novel member of human CoV that has recently emerged in Wuhan, China, is now formally named as SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). This is a unique strain of RNA viruses that have not been previously observed in humans. The virus has wide host adaptability and is capable of causing severe diseases in humans, masked palm civets, mice, dogs, cats, camels, pigs, chickens, and bats. The SARS-CoV-2 typically causes respiratory and gastrointestinal sickness in both humans and animals. It can be transmitted through aerosols and direct/indirect contact, as well as during medical cases and laboratory sample handling. Specific structural proteins, which might be found on the surface of the virus, play an important role in the pathogenesis and development of the complications. The disease is characterized by distinct medical signs and symptoms that include high fever, chills, cough, and shortness of breath or difficulty in breathing. The infected people may also present with other symptoms such as diarrhea, myalgia, fatigue, expectoration, and hemoptysis. It is important from the public health and economic point of view as it affects the growth of the country, which is majorly attributed to the restriction in the movement of the people and the cost associated with the control and prevention of the disease. Since there is no specific therapeutic intervention nor a vaccine available against the virus, supportive management and treatment with non-specific therapeutic agents (repurposed drugs) may provide relief to the patients. Some preventive strategies of the disease include blocking the routes of transmission of the infections, disinfection of instruments used during medical case handling, using personal protective equipment, proper and early diagnosis of the disease, avoiding contact with the sick patients, and quarantine of the infected/exposed people.
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http://dx.doi.org/10.7759/cureus.7423DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182166PMC
March 2020

Study protocol of a randomised controlled trial of prostate radiotherapy in high-risk and node-positive disease comparing moderate and extreme hypofractionation (PRIME TRIAL).

BMJ Open 2020 02 28;10(2):e034623. Epub 2020 Feb 28.

Division of Uro-Oncology, Tata Memorial Centre, Mumbai, India.

Introduction: There has been an interest in studying the efficacy of extreme hypofractionation in low and intermediate risk prostate cancer utilising the low alpha/beta ratio of prostate. Its role in high-risk and node-positive prostate cancer, however, is unknown. We hypothesise that a five-fraction schedule of extreme hypofractionation will be non-inferior to a moderately hypofractionated regimen over 5 weeks in efficacy and will have acceptable toxicity and quality of life while reducing the cost implications during treatment.

Methods And Analysis: This is an ongoing, non-inferiority, multicentre, randomised trial (NCT03561961) of two schedules for National Cancer Control Network high-risk and/or node-positive non-metastatic carcinoma of the prostate. The standard arm will be a schedule of 68 Gy/25# over 5 weeks while the test arm will be extremely hypofractionated radiotherapy with stereotactic body radiation therapy to 36.25 Gy/5# (7 to 10 days). The block randomisation will be stratified by nodal status (N0/N+), hormonal therapy (luteinizing hormone-releasing hormone therapy/orchiectomy) and centre. All patients will receive daily image-guided radiotherapy.The primary end point is 4-year biochemical failure free survival (BFFS). The power calculations assume 4-year BFFS of 80% in the moderate hypofractionation arm. With a 5% one-sided significance and 80% power, a total of 434 patients will be randomised to both arms equally (217 in each arm). The secondary end points include overall survival, prostate cancer specific survival, acute and late toxicities, quality of life and out-of-pocket expenditure.

Discussion: The trial aims to establish a therapeutically efficacious and cost-efficient modality for high-risk and node-positive prostate cancer with an acceptable toxicity profile. Presently, this is the only trial evaluating and answering such a question in this cohort.

Ethics And Dissemination: The trial has been approved by IEC-III of Tata Memorial Centre, Mumbai.

Trial Registration Number: Registered with CTRI/2018/05/014054 (http://ctri.nic.in) on 24 May 2018.
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http://dx.doi.org/10.1136/bmjopen-2019-034623DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7050316PMC
February 2020

Management of clinically node-negative groin in patients with penile cancer.

Indian J Urol 2020 Jan-Mar;36(1):8-15

Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.

Malignant penile neoplasms are commonly squamous etiology, with the inguinal nodes being the first echelon of spread. The disease spreads to the pelvic lymph nodes only after metastases to the groin nodes, and this is the most important prognostic factor in penile carcinoma. While treatment of penile carcinoma with proven metastases to the inguinal lymph nodes mandates ilioinguinal lymph node dissection, the treatment of patients with impalpable nodes is more controversial. Overtreatment leads to excessive treatment-related morbidity in these patients, while a wait-and-see policy runs the risk of patients presenting with inguinal and distant metastases, which would have been curable at presentation. Unfortunately, no single imaging modality has been proved to be convincingly superior in the staging, and hence, management of the clinically negative groin has been subject to debate. While some high volume centers have promoted the use of dynamic sentinel lymph node biopsy, others advocate the use of the modified inguinal lymph node template to stage the groin adequately. Newer techniques such as video endoscopic inguinal lymph node dissection have been introduced as an alternative to the original radical inguinal lymphadenectomy to reduce morbidity.
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http://dx.doi.org/10.4103/iju.IJU_221_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961429PMC
January 2020

Late toxicity and quality of life with prostate only or whole pelvic radiation therapy in high risk prostate cancer (POP-RT): A randomised trial.

Radiother Oncol 2020 Apr 7;145:71-80. Epub 2020 Jan 7.

Department of Radiation Oncology, Tata Memorial Hospital and Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Homi Bhabha National Institute (HBNI), Mumbai, India.

Aim: To report toxicity and quality of life (QOL) outcomes from a randomised trial of prostate only versus whole pelvic radiotherapy in high risk, node negative prostate cancer.

Materials/methods: Patients with localised prostate adenocarcinoma and nodal involvement risk > 20%, were randomised to prostate only (PORT, 68 Gy/25# to prostate) and whole pelvis (WPRT, 68 Gy/25# to prostate and 50 Gy/25# to pelvis) arms with stratification for TURP, Gleason score, baseline PSA, and type of androgen deprivation therapy (ADT). Image guided intensity modulated radiotherapy (IG-IMRT) and two years of ADT were mandatory. Acute and late genitourinary (GU) and gastrointestinal (GI) toxicities were graded using RTOG grading. QOL was assessed using EORTC QLQ-C30 and PR-25 questionnaire pre-treatment and every 3-6 months post RT.

Results: Total 224 patients were randomised (PORT 114, WPRT 110) from November 2011 to August 2017. Median follow up was 44.5 months. No RTOG grade IV toxicity was observed. Acute GI and GU toxicities were similar between both the arms. Cumulative ≥ grade II late GI toxicity was similar for WPRT and PORT (6.5% vs. 3.8%, p = 0.39) but GU toxicity was higher (17.7% vs. 7.5%, p = 0.03). Dosimetric analysis showed higher bladder volume receiving 30-40 Gy in the WPRT arm (V30, 60% vs. 36%, p < 0.001; V40, 41% vs. 25%, p < 0.001). There was no difference in QOL scores of any domain between both arms.

Conclusion: Pelvic irradiation using hypofractionated IG-IMRT resulted in increased grade II or higher late genitourinary toxicity as compared to prostate only RT, but the difference was not reflected in patient reported QOL. CLINICALTRIALS.GOV NCT02302105: Prostate Only or Whole Pelvic Radiation Therapy in High Risk Prostate Cancer (POP-RT).
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http://dx.doi.org/10.1016/j.radonc.2019.12.006DOI Listing
April 2020

Bladder cancer demographics and outcome data from 2013 at a tertiary cancer hospital in India.

Indian J Cancer 2019 Jan-Mar;56(1):54-58

Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.

Background: Bladder cancer (BCa) is the ninth most common cancer accounting for 3.9% of all cancer cases as per the Indian Cancer Registry data. There is a scarcity of data on urinary Bca from India.

Aim: The aim of this study was to know demographic background, stage distribution, utilization of various treatment modalities, and oncological outcome in Indian patients presenting with bladder cancer to a tertiary care cancer center in Mumbai.

Methodology: We performed a retrospective audit of all patients registered as urinary BCa in our hospital from January 1, 2013 to December 31, 2013. Electronic medical records of these patients were checked for most of the information gathered.

Results: Median age of patients at presentation was 59 years with a range of 18-88 years. There were 84% male and 16% female patients. Forty seven percent of patients had nonmuscle invasive bladder cancer (NMIBC), 36% had muscle invasive bladder cancer and locally advanced disease, and 17% had metastatic disease. Eight patients were treated with trimodality bladder preservation protocol. Recurrence was seen in 38 (22.6%) patients with NMIBC. Out of them. 44.7% and 55.3% were in low- and high-grade tumors, respectively. Overall survival and disease-free survival estimated for 3 years were 63% and 57%, respectively.

Conclusion: Bladder cancer has a varied spectrum of presentation. Bladder cancer patients presenting to our hospital generally have a higher stage and grade of disease compared with that in the west.
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http://dx.doi.org/10.4103/ijc.IJC_351_18DOI Listing
August 2019

Prevalence, risk factors and molecular characterization of Cryptosporidium infection in cattle in Addis Ababa and its environs, Ethiopia.

Vet Parasitol Reg Stud Reports 2018 Aug;13:79-84

Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.

A cross-sectional study was conducted to determine the prevalence and risk factors of infection and identify species of the parasite in cattle in central Ethiopia. Faecal samples, collected from 392 dairy cattle managed under intensive and extensive production system, were analyzed by the Modified Ziehl-Neelsen (MZN) microscopy, Nested PCR, PCR-RFLP and sequence analyses of the SSU rRNA gene of . The overall prevalence, the prevalence in the extensive and intensive farms was 18.6%, 11% and 21%, respectively. The infection was detected in 37.7% of the investigated farms with prevalence range of 7.4% -100%, and all of the six surveyed districts with significant ( = 0.000) prevalence difference. Restriction digestion and sequence analysis showed and in 27% and 73% of the infections, respectively, showing an age related distribution pattern, exclusively occurring in calves <2 months old and only in heifers and adult cattle. The infection was significantly associated with management system, farm location, herd size, source of drinking water, weaning age, presence of bedding, pen cleanness and cleanness of hindquarter. In conclusion, infection due to and was prevalent in cattle in the study area. has the concern of public health importance, especially to farm workers and people in close contact with cattle. Instigation of imperative control measure is suggested to lessen the risk of human infection and loss of production in dairy farms.
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http://dx.doi.org/10.1016/j.vprsr.2018.03.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6076407PMC
August 2018

Kidney cancer demographics and outcome data from 2013 at a tertiary cancer hospital in India.

Indian J Cancer 2017 Oct-Dec;54(4):601-604

Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.

Introduction: The stage at diagnosis of renal cell cancer (RCC) in developed countries is lower due to increased utilization of routine health checkups by patients compared to developed countries. This study aims to determine the sociodemographic and clinical distribution of RCC in patients presenting to Tata Memorial Hospital (TMH).

Subjects And Methods: We performed a retrospective audit of all patients presenting to TMH with a diagnosis of RCC. Data were retrieved from our electronic medical record system from January 1, 2013 to December 31, 2013. The survival analysis was done by Kaplan-Meir analysis method of estimating survival. Log-rank test of comparison was applied to estimate the difference in the survival among the different stages of renal cancer.

Results: Of the 35,197 new registered patients at TMH, 338 were diagnosed with RCC. Most patients were in the 50-60 years age group, with 56.6 years being the median age at presentation. Among patients treated at TMH, 84 underwent surgery and tyrosine kinase inhibitor was given in 55 (16%) patients. The patients' characteristics, clinical characteristics of RCC, treatment modalities offered, and survival of patients treated for RCC are presented in this paper.

Conclusion: In the absence of robust Indian data on RCC, this audit provides baseline information on epidemiology, stage at presentation, and outcomes of RCC at our center compared with the West.
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http://dx.doi.org/10.4103/ijc.IJC_644_17DOI Listing
October 2018

Prevalence and Antibiogram Assessment of in Beef at Municipal Abattoir and Butcher Shops in Addis Ababa, Ethiopia.

Biomed Res Int 2018 6;2018:5017685. Epub 2018 May 6.

Ethiopian Institute of Agricultural Research, Addis Ababa, Ethiopia.

Objective: A cross-sectional study was conducted from October 2013 to April 2014 to determine the prevalence and antibiotic resistance of from beef of Addis Ababa Abattoir and butcher shops in Addis Ababa. Seven hundred sixty-eight swab samples were taken from the abattoir and butcher carcasses using a systematic random sampling. One hundred twenty swab samples were also taken from hooks, cutting tables, and knives from the abattoir. positive isolates were taken for antibiotic susceptibility test. A questionnaire survey was conducted in the abattoir and butcher workers to assess the hygienic practice and possible risk factors regarding the contamination of meat.

Results: The prevalence of in the abattoir, butcher, cutting table, hook, and knife was 9.4%, 19.8%, 15%, 15%, and 22.5%, respectively. The prevalence of in the knife and butcher was found to be 2.8 (OR = 2.8, CI = 1.2-6.4) and 2.4 (OR = 2.4, CI = 1.6-3.6) times that of the abattoir results ( < 0.01). The antimicrobial susceptibility testing was also conducted on 133 isolates of using the disc diffusion susceptibility method. Bacitracin, neomycin, and methicillin were found to be 100% resistant to . To avoid the presence of pathogenic isolates, preventive measures using good hygienic practices during slaughtering and handling of the beef carcasses are recommended.
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http://dx.doi.org/10.1155/2018/5017685DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5960511PMC
October 2018

Cadaveric study for ideal dorsal pedicle screw entry point.

J Craniovertebr Junction Spine 2017 Apr-Jun;8(2):127-131

Department of Orthopedics, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India.

Objective: To determine the entry for the dorsal pedicular screw in relation to the notch present at the junction of base of the lateral margin of superior articular process with superior border of transverse process in dorsal spine. The advantage of this technique is a constant and easily identifiable entry point which does not involve partial resection of the inferior facet, thus maintaining stability and maintaining the well defined transverse and sagittal screw angles and decreasing the incidence of medial and inferior pedicle violation.

Materials And Methods: The study was carried out using ten cadavers (four male and six female). Spinal column was dissected completely from cadavers. Before the experiment, normal anatomy was confirmed on all cadavers excluding cases of spinal deformity. Dissection was done by the spine surgeons taking care to preserve all the bony landmarks near the entry point. This study was carried out bilaterally on pedicles between the first and twelfth thoracic (T) vertebrae.

Results: The relation of the superior articular notch and transverse process to the thoracic spine pedicles was studied. It was found that superior third of the pedicle was related to the superior articular notch and the transverse process in the first five thoracic vertebrae. The relation of these structures to the pedicle of the sixth thoracic vertebra was somewhat equally distributed between the superior and middle third of the pedicle. From the 7 to 12 thoracic vertebrae the superior articular process and transverse process were related to the middle third of the pedicle in almost all the cases. It is important to note that the inferior 1/3 of the pedicle was not related to these landmarks at any of the levels.

Conclusion: We conclude that the ideal pedicle entry point described here should be considered by surgeons during thoracic pedicle screw instrumentation. The notch at the base of the superior articular process will always remain constant and therefore an important anatomical landmark in guiding the screw toward the entry of the pedicle.
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http://dx.doi.org/10.4103/jcvjs.JCVJS_5_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490346PMC
July 2017

High-dose-rate brachytherapy - a novel treatment approach for primary clear cell adenocarcinoma of male urethra.

J Contemp Brachytherapy 2015 Jun 15;7(3):248-51. Epub 2015 Jun 15.

Department of Radiation Oncology.

The incidence of male urethral cancer is rare with age preponderance of 50 to 60 years. The standard management approach is surgery. Here, we present a novel treatment approach for male urethral cancer. Thirty-six year old male, case of primary clear cell adenocarcinoma of urethra who refused surgery, underwent cystoscopic assisted intraluminal HDR brachytherapy. Patient received a dose of 36 Gy in 9 fractions (4 Gy per fraction) followed by a boost of 24 Gy in 6 fractions. At 11 months post treatment, disease is well controlled with no post treatment toxicity so far. Intraluminal brachytherapy seems to be an effective novel treatment for male urethral cancer.
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http://dx.doi.org/10.5114/jcb.2015.52316DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499518PMC
June 2015

Canine mycotic stomatitis due to Candida albicans.

Rev Iberoam Micol 2006 Dec;23(4):233-4

Department of Veterinary Public Health, College of Veterinary Sciences, Anand 388 001, Gujarat, India.

Candida albicans, a medically important opportunistic yeast is described as the etiologic agent of stomatitis in dogs. The oral swabs collected from 34 dogs showing symptoms of stomatitis or gingivitis such as anorexia, halitosis, bleeding within the oral cavity, dysphagia, ptyalism (salivation) and submandibular lymphadenopathy were cultured for isolation of the causative agent. C. albicans was isolated from four (11.8%) dogs. The isolates were sensitive to clotrimazole, fluconazole and amphotericin-B but were resistant to nystatin. The routine application of Pal's sunflower seed medium and Narayan stain in microbiological laboratories is highly emphasized. It is recommended that the role of C. albicans, as the etiologic agent of canine stomatitis, should be carefully investigated in various clinical related disorders of dogs as well as in other animals.
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http://dx.doi.org/10.1016/s1130-1406(06)70050-xDOI Listing
December 2006

Role of Geotrichum candidum in canine oral ulcers.

Authors:
Mahendra Pal

Rev Iberoam Micol 2005 Sep;22(3):183

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http://dx.doi.org/10.1016/s1130-1406(05)70040-1DOI Listing
September 2005

Tinea faciei in a goat handler due to Microsporum canis.

Rev Iberoam Micol 2005 Sep;22(3):181-2

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http://dx.doi.org/10.1016/s1130-1406(05)70039-5DOI Listing
September 2005

Pathogenicity of environmental strains of Cryptococcus neoformans var neoformans in murine model.

Authors:
Mahendra Pal

Rev Iberoam Micol 2005 Jun;22(2):129

Laboratory of Mycology, Institute of Tropical Medicine, Antwerp, Belgium and Department of Veterinary Public Health, College of Veterinary Science, Anand-388001, India.

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http://dx.doi.org/10.1016/s1130-1406(05)70025-5DOI Listing
June 2005

Efficacy of Narayan stain for morphological studies of moulds, yeasts and algae.

Authors:
Mahendra Pal

Rev Iberoam Micol 2004 Dec;21(4):219

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December 2004

Aspergillus fumigatus isolated from ornamental plants in India.

Authors:
Mahendra Pal

Rev Iberoam Micol 2004 Dec;21(4):218

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December 2004