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Background Synovial sarcoma (SS) is a malignant mesenchymal neoplasm with variable epithelial differentiation, with a propensity to occur in young adults. The pathognomonic t(X;18) chromosomal translocation and subsequent development of the SS18:SSX fusion oncogenes are the driver of the distinct genomic features. Aim To study the Clinicopathological, immunohistochemical and molecular features of SS occurring in all the organ systems. Method A retrospective observational study was conducted over a period of 4 years at a tertiary cancer centre. Result One hundred eight patients were included in the study based on exclusion and inclusion criteria. The median age of patients was 30.5 years and mean tumor diameter was 10.5 cm. Most common site was lower limb followed by lung, and arm. 50 patients underwent surgery and 49 patients received adjuvant chemotherapy or radiotherapy. 87 patients (81%) presented with monophasic subtype and 21 (19%) with biphasic subtype. The most helpful immunohistochemical markers for diagnosis and exclusion of close differentials were TLE1, EMA, Pancytokeratin, S-100, BCL2, and CD99. Molecular diagnostic confirmation was attained in 10 out of 15 patients. On median follow-up of 7.58 months, mean 4-year overall survival of the patients was 91.39%. Conclusion Meticulous pathologic evaluation and awareness of the typical and atypical histology of SS along with the apt application of immunohistochemical marker such as TLE1 and/or cytogenetics (SYT translocation) assist in precise recognition of this not so common entity. The main therapeutic modality is surgical excision with negative margins, with the addition of radiotherapy and/or chemotherapy based on patient and tumour characteristics.

HER2-positive metastatic breast cancer (MBC) represents a challenging subtype of breast cancer, characterized by aggressive disease and poor clinical outcomes. Trastuzumab emtansine (TDM1), an antibody–drug conjugate combining trastuzumab and emtansine, has demonstrated efficacy in clinical trials as a second-line treatment for patients progressing after prior therapies. This study aims to provide real-world evidence on the efficacy and safety of TDM1 in HER2-positive MBC patients. A retrospective analysis was conducted on 70 HER2-positive MBC patients treated with TDM1 at our centre between January 2020 and December 2022. Clinical characteristics, progression-free survival (PFS), overall survival (OS), response rates, and toxicity were evaluated using hospital records. PFS and OS were calculated using Kaplan–Meier methods, and survival curves were compared with log-rank tests. The median age of patients was 47 years, with a majority presenting with advanced disease and prior treatment lines. The median PFS was 6.1 months (95% CI, 4.5–7.6), and the median OS was 14.4 months (95% CI, 10.2–18.0). The objective response rate was 75.7%, with 12.8% achieving a complete response and 62.8% a partial response. PFS was significantly longer in hormone receptor-positive patients compared to hormone receptor-negative patients (8.1 vs. 4.1 months, p = 0.035). Toxicity was manageable, with grade 3–4 adverse events including elevated transaminases (8.5%), thrombocytopenia (5.7%), and anemia (4.2%). The efficacy of TDM1 in this real-world cohort aligns with clinical trial data, though PFS and OS were somewhat lower compared to trials, likely due to the inclusion of patients with more extensive disease and prior treatments. Notably, TDM1 demonstrated activity against CNS metastases and a manageable safety profile, with higher incidence of hepatic and hematologic toxicities. Our study supports the use of TDM1 as a viable option for treating HER2-positive MBC in routine clinical practice, confirming its effectiveness and safety profile observed in clinical trials.

Background The present article details a new technique for the repair of rectovestibular fistula. Materials and Methods Twenty‐five patients with rectovestibular fistula, between 13 days and 4 years of age underwent surgical correction by transfistula anorectoplasty (TFARP). The technique, described in detail, involves mobilization of the fistula and the rectum through the fistula and creation of a new anus in the anatomically normal site by preserving both the perineal skin bridge (skin between the neo‐anus and the posterior fourchette) and the levator muscle. Results The mean operating time was 85 min, and the mean hospital stay was 5 days. Moderate anal stenosis developed in 1 patient and was treated successfully by anal dilatations using Hegar dilators. A diverting colostomy was not required in any patient, and none of the patients developed rectal prolapse. Eleven patients who are now 3 years of age or older have voluntary bowel movements with good fecal continence scores. The 14 neonates and infants, who are still too young to be evaluated for continence, have symmetric anal contraction to stimulation and strong squeeze on digital rectal examination. The average number of bowel movements per day was three to five, without the need for any laxative or enema. Conclusions Transfistula anorectoplasty is a simple surgical procedure that does not divide the levator muscle or the perineal body. Preservation of these structures contributes significantly toward improvement of the aesthetic appearance of the perineum and of fecal continence.

Metastatic breast cancer (MBC) patients have numerous options for treatment. However, it is essential to consider treatments with favorable toxicity profiles and convenient modes of administration. Eribulin has shown effectiveness in aggressive MBC, but there is a lack of sufficient real-world data specific to Indian patients. We conducted a retrospective audit of patients with MBC who received intravenous Eribulin between 2019 and 2023 at a dosage of 1.4 mg/m on days 1 and 8 every 3 weeks. The median Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. During the specified time, 107 consecutive patients with MBC received Eribulin treatment. The median age was 52 years (range, 28-75 years) with 3 patients with male breast cancer. The median number of prior chemotherapy lines and involved sites were 3 (range, 2-5) and 3 (range, 1-6), respectively. Visceral involvement was present in 84 (78.5%) patients. A median of 3 cycles of Eribulin (range, 1-11) was administered. Eribulin resulted in partial responses in 49 (45.8%) patients, stable disease in 11 (10.3%) patients and progressive disease in 47 (43.9%) patients. The median PFS was 4.0 months (95% CI: 3.4-4.6), and the median OS was 10.0 months (95% CI: 8.3-11.7). For patients with triple-negative breast cancer (TNBC), the median OS was 8 months (95% CI: 5.6-10.4), whereas non-TNBC patients had a median OS of 11 months (95% CI: 9.1-12.8) (hazard ratio, 1.9, 95% CI: 1.2-3.1, = 0.002). Eribulin was well-tolerated, with dose reduction was needed in 9 (8.4%) of the patients in the overall cohort. Eribulin is a viable and safe option for treating heavily pre-treated MBC in real-world settings. The study found comparable efficacy in both TNBC and non-TNBC patients.

We evaluated whether the addition of docetaxel (D) to a combination comprising 5-fluorouracil/leucovorin (5-FU/LV) or capecitabine (C) plus oxaliplatin (O) (DOF/DOX) improved overall survival (OS) compared with 6 months of 5-fluorouracil (5-FU) or capecitabine in combination with oxaliplatin (FOLFOX/CAPOX) alone in advanced HER2-negative gastroesophageal junction and gastric adenocarcinomas (G/GEJ). This study was an investigator-initiated, open-label, multi-institutional, randomized phase III trial in adult patients with HER2-negative advanced G/GEJs. The primary endpoint of the study was a comparison of median OS by Kaplan-Meier method. Next-generation sequencing was performed on tissue. Of the 324 patients randomly assigned between July 2020 and November 2022, 305 patients were evaluable for analysis (FOLFOX/CAPOX: 156; DOF/DOX: 149). With a median follow-up time of 19.2 months (95% Confidence Interval [CI] = 16.5 months to 21.9 months) for the entire cohort, the median OS was 10.1 months (95% CI = 9.2 to 10.9) for FOLFOX/CAPOX and 8.9 months (95% CI = 7.3 to 10.5) for DOF/DOX, and this difference was not statistically significant (P = .70). An increased proportion of grade 3 or grade 4 neutropenia (21% vs 3%; P < .001) and grade 2/3 neuropathy (17% vs 7%; P = .005) was seen in patients receiving DOF/DOX. Genomic profiling revealed a low incidence of microsatellite instability (1%) and a high incidence of BRCA1 (8.4%) and BRCA2 (7.5%) somatic alterations. FOLFOX or CAPOX chemotherapy for 6 months remains one of the standards of care in advanced HER2-negative gastroesophageal junction and gastric adenocarcinomas, with no additional survival benefit seen with the addition of docetaxel. Genomic profiling of patients revealed a higher than previously known incidence of somatic BRCA alterations, which requires further evaluation.CTRI (Clinical Trial Registry of India: CTRI/2020/03/023944).

Nanocrystalline Pb 1–3 x /2 Gd x TiO 3 (where x  = 0.01) abbreviated as PGT has been synthesised by high energy ball milling at room temperature. X-ray analysis shows that single-phase tetragonal structure of nanocrystalline PGT was formed after 15-h milling. The average crystallite size was found to be 17 nm. The frequency-dependent AC conductivity of the PGT ceramic was studied in the range 100°C to 525°C. Complex impedance analysis suggested the dielectric relaxation to be of non-Debye type. The activation energy was found to be 1.04 ev. The mechanism of charge transport in nanocrystalline PGT was successfully explained by correlated hopping model.

The present article details a new technique for the repair of recto-vestibular fistula. Twenty-five patients with recto-vestibular fistula, between 13 days and 4 years of age underwent surgical correction by trans-fistula ano-recto-plasty (TFARP). The technique, described in detail, involves mobilization of the fistula and the rectum through the fistula and creation of a new anus in the anatomically normal site by preserving both the perineal skin bridge (skin between the neo-anus and the posterior fourchette) and the levator muscle. The mean operating time was 85 min, and the mean hospital stay was 5 days. Moderate anal stenosis developed in 1 patient and was treated successfully by anal dilatations using Hegar dilators. A diverting colostomy was not required in any patient, and none of the patients developed rectal prolapse. Eleven patients who are now 3 years of age or older have voluntary bowel movements with good fecal continence scores. The 14 neonates and infants, who are still too young to be evaluated for continence, have symmetric anal contraction to stimulation and strong squeeze on digital rectal examination. The average number of bowel movements per day was three to five, without the need for any laxative or enema. Trans-fistula ano-recto-plasty is a simple surgical procedure that does not divide the levator muscle or the perineal body. Preservation of these structures contributes significantly toward improvement of the aesthetic appearance of the perineum and of fecal continence.

Since man life's is open to risk of various kinds and degrees, which involve exposure to losses a scheme for dealing with some of these risked had been devised. Insurance protect man from uncertainty and risks in his personal and business life. In other words insurance provide protection against a peril, but does not eliminate the risk. Insurance therefore denotes a contract whereby one party, in consideration of money payment called premium, undertakes to indemnify another party against losses or to pay to that party an agreed sum of money on the happening of a certain event. It is a scientific method of combining individuals who are exposed to identical hazards. It has been defined by an insurance expert as \"a form of cooperation through which all those who really suffer a loss\". The story of insurance is probably as old as the story of mankind. The same instinct that prompts modern businessmen today to secure themselves against loss and disaster existed in primitive men also. They too sought to avert the evil consequences of fire and flood and loss of life and were willing to make some sort of sacrifice in order to achieve security.

Fetus-in-fetu (FIF) is a rare congenital condition in which a vertebrate fetus is incorporated within its host, a newborn or an infant. We report an interesting case of FIF presenting as an abdominal mass with respiratory distress in a 4-month-old girl, and review the existing literature. An ultrasound abdomen showed a right sided cystic mass containing multiple calcifications. Laparotomy revealed a well-encapsulated right retroperitoneal mass above the right kidney with two rudimentary limbs attached to an amniotic bag by an umbilical cord. Excision of the capsule revealed a yellowish fluid and an incompletely developed fetus covered by vernix caseosa. Pathologic examination showed an irregular fetiforme mass, weighing 1200 gm, with two rudimentary limbs, encephalus, stomach, duodenum, bowel, bone, cartilage, bone marrow, upper and lower respiratory tissue, and spleen. Complete excision of the FIF was performed. The postoperative period was uneventful and the patient was discharged on the seventh postoperative day.