Summary1. In anaesthetized patients under controlled respiration, samples of lumbar cerebrospinal fluid were withdrawn 15 and 60 min after an intravenous injection of 30 mg tubocurarine. When tested on the frog rectus muscle preparation contracted by acetylcholine, they exerted curare-like activity which corresponded to between 0 05 and 0-33 ,ug/ml tubocurarine. 2. In dogs anaesthetized with pentobarbitone sodium and artificially ventilated, two procedures were adopted to find out if tubocurarine passes into the liquor space after an intravenous injection of 0-3 or 3 mg/kg and during its intravenous infusion at a rate of 10 (jug/kg)/minute. Either samples of cisternal cerebrospinal fluid (c.s.f.) were collected, or different regions of the liquor space were perfused with artificial c.s.f. and the effluent was collected. The samples of c.s.f. and the effluent were assayed for curare-like activity on the frog rectus muscle. 3. After the intravenous injection of tubocurarine samples of cisternal effluent collected during perfusion from lateral ventricle to cisterna exerted curare-like activity. It corresponded to 20 ng/min tubocurarine in the sample collected during the first 15 min after the injection of 0 3 mg/kg and to 40-60 ng/min in the samples collected up to 2 h after the injection of 3 mg/kg. 4 During intravenous infusion of tubocurarine the cisternal c.s.f. as well as the effluent from the perfused regions of the liquor space exhibited curare-like activity. Expressed in equivalents of tubocurarine, the activity in the cisternal c.s.f. ranged from between 0-1 and 0-75 ,ug/ml. On perfusion from lateral ventricle to aqueduct or cistema, the activity ranged from between 3 and 25 ng/min in the aqueductal and from between 4 and 40 ng/min in the cisternal effluent. On perfusion from the lumbar-spinal subarachnoid space to cisterna it ranged from between 6 and 55 ng/min in the cisternal effluent.

Breast cancer is a public health challenge globally as well as in India. Improving outcome and cure requires appropriate biomarker testing to assign risk and plan treatment. Because it is documented that significant ethnic and geographical variations in biological and genetic features exist worldwide, such biomarkers need to be validated and approved by authorities in the region where these are intended to be used. The use of western guidelines, appropriate for the Caucasian population, can lead to inappropriate overtreatment or undertreatment in Asia and India. A virtual meeting of domain experts discussed the published literature, real-world practical experience, and results of opinion poll involving 185 oncologists treating breast cancer across 58 cities of India. They arrived at a practical consensus recommendation statement to guide community oncologists in the management of hormone positive (HR-positive) Her2-negative early breast cancer (EBC). India has a majority (about 50%) of breast cancer patients who are diagnosed in the premenopausal stage (less than 50 years of age). The only currently available predictive test for HR-positive Her2-negative EBC that has been validated in Indian patients is CanAssist Breast. If this test gives a score indicative of low risk (< 15.5), adjuvant chemotherapy will not increase the chance of metastasis-free survival and should not be given. This is applicable even during the ongoing COVID-19 pandemic.

Summary1. Patients receiving an intravenous injection of 2-3-8 mg/kg gallamine showed gallamine-like activity in their lumbar c.s.f. collected 15 and 70-100 min after the injection. The activity assayed on acetylcholine contractions of frog rectus muscle was equivalent to between 0-1 and 0 75 ,ug/ml gallamine. 2. In anaesthetized dogs an intravenous injection as well as an intravenous infusion of gallamine led to the appearance of gallamine-like activity in the cisternal c.s.f. and, on perfusion of the cerebral ventricles, in the effluent collected from the cisterna magna. 3. After an intravenous injection of 1 mg/kg the activity in the cisternal c.s.f. corresponded to between 0-2 and 1 ug/ml and in the effluent to between 130 and 175 ng/min during the first 15 min perfusion and then declined. 4. On intravenous infusion of gallamine at a rate of 10 (ug/kg)/min for 2 h the cisternal c.s.f. showed a uniform gallamine-like activity corresponding to between 0 4 and 0-67 ,ug/ml during the infusion. In the cisternal effluent the gallamine-like activity rose initially to between 20 and 90 ng/min but declined before the infusion was ended. 5. The intravenous injection of gallamine caused respiratory paralysis but did not affect arterial blood pressure; its intravenous infusion caused no respiratory paralysis and did not affect arterial blood pressure.