Objective: The study was conducted to study the role of strain wave elastography in evaluating the response to neo-adjuvant chemotherapy (NACT) in patients with locally advanced breast cancer (LABC). Methods: In this Institutional review board approved study, 86 patients of LABC were investigated with strain wave elastography. Females receiving NACT had the affected breast scanned by strain wave elastography before each cycle of chemotherapy and immediately before surgery by two independent observers. Changes in elastographic parameters (size ratio, strain ratio) were documented and then compared to clinical and pathologic tumor response as evaluated after mastectomy. Results: Elastographic strain ratio parameters demonstrated high sensitivity and moderate specificity for determining response even after the first cycle of neo-adjuvant chemotherapy [97.7% sensitivity (Sn), 68.7% specificity (Sp)]. Elastographic size ratio parameters showed moderate sensitivity and specificity for response detection after second and third cycle of neo-adjuvant chemotherapy (Sn, Sp: after second cycle of NACT Sn 83.3% Sp 80%; after third cycle of NACT Sn 77.8% Sp 100%). Conclusion: Strain ratio is the earliest predictor of treatment response in patients of LABC. Serial imaging with elastography has the potential to predict treatment response early during the course of NACT, which may prove vital in management of patients with breast cancer. Advances in knowledge: Strain wave elastography is a powerful tool to predict chemoresponse early during the course of management, thereby providing an optimal window to change treatment protocols.

Fifty-five adult Down's syndrome subjects resident at Northgate Hospital were screened for the presence of thyroid dysfunction. Approximately 50% of the subjects had clinical features suggestive of hypothyroidism, sufficient to require thyroid-function tests. Twenty-two per cent of the total suffered from some degree of hypothyroidism, and 16% had positive antibodies to thyroid tissue.

Objectives: To evaluate the role of contrast-enhanced ultrasound (CEUS) quantitative parameters in predicting neoadjuvant chemotherapy (NACT) response in patients with locally advanced breast cancer (LABC). Methods: 30 patients with histologically proven LABC scheduled for NACT were recruited. CEUS was performed using a contrast bolus of 4.8 ml and time intensity curves (TICs) were obtained by contrast dynamics software. CEUS quantitative parameters assessed were peak enhancement (PE), time-to-peak (TTP), area under the curve (AUC) and mean transit time (MTT). The parameters were documented on four consecutive instances: before NACT and 3 weeks after each of the three cycles. The gold-standard was pathological response using Miller Payne Score obtained pre NACT and post-surgery. Results: A decrease in mean values of PE and an increase in mean values of TTP and MTT was observed with each cycle of NACT among responders. Post each cycle of NACT (compared with baseline pre-NACT), there was a statistically significant difference in % change of mean values of PE, TTP and MTT between good responders and poor responders (p-value < 0.05). The diagnostic accuracy of TTP post-third cycle was 87.2% (p = 0.03), and MTT post--second and third cycle was 76.7% (p = 0.004) and 86.7% (p = 0.006) respectively. Conclusion: In responders, a decrease in the tumor vascularity was reflected in the CEUS quantitative parameters as a reduction in PE, and a prolongation in TTP, MTT. Advances in knowledge: Prediction of NACT response by CEUS has the potential to serve as a diagnostic modality for modification of chemotherapy regimens during ongoing NACT among patients with LABC, thus affecting patient prognosis.

Background: There was increasing evidence that gender differences are important in epidemiology, treatment and outcomes of many diseases, relevant for non-communicable diseases.Methods: Study was conducted in Department of General Medicine, GSL Medical College. Patients who were admitted with type 2 diabetes were recruited in the study. Each patient was interviewed to obtain detailed history and examined thoroughly as per predetermined protocol, national diabetes data group and WHO diagnostic criteria was used. Myocardial infarction was diagnosed by convex ST segment elevation in corresponding leads (early) or QS complexes or abnormal Q waves i.e. Q waves of 0.04 seconds or more in width (or) 25% or more of the voltage of the R wave in the same lead or both in the corresponding leads (late) or T wave inversion in the corresponding leads (late). Statistical analyses were done by using SPSS software version 21.0. Chi-square test was used to assess the association between different categorical variables; p<0.05 was considered statistically significant.Results: Out of 250 participants, 97 were diagnosed as coronary artery disease (CAD), maximum between 51-60 years age group; the difference was statistically significant (p<0.05). The association between dyslipidemia and CAD was statistically significant (p<0.05). Out of 188 post-menopausal cases, CAD was diagnosed in 86 cases; out of the 62 non post-menopausal cases, CAD was diagnosed in 11 cases; The difference was statistically significant (p<0.05).Conclusions: In premenopausal women, the prevalence of CHDs are significantly higher when compared to postmenopausal women.

<p class="abstract"><strong>Background:</strong> Carcinoma of the breast from the very beginning has been a feared disease. Advanced disease is treated by neoadjuvant chemotherapy (NACT). With this, a study was conducted to evaluate the pathologic response to NACT in locally advanced breast cancer.</p><p class="abstract"><strong>Methods:</strong> Study was conducted in GSL Medical College, approved by institutional ethics committee, females aged &gt;18 years with locally advanced breast cancer were included in the study. Female &lt;18 years and breast cancer male were not considered. The dimensions are marked and size of the lump compared before and after NACT. Chi-square test was used to find out the significance of study parameters; p&lt;0.05 was considered statistically significant.</p><p class="abstract"><strong>Results:</strong> Total 110 patients were included in the study, mean age was<strong> </strong>50.63±10.76 years and 53% were in pre menopausal women. When pathological response was considered, 12.7% had complete response, 66.4% had partial response and 20.9% had no response to NACT; statistically there was significant difference between pre and post treatment tumor sizes (p&lt;0.05).</p><p class="abstract"><strong>Conclusions: </strong>Most of the individuals belonged to premenopausal group. Tumour size showed significant decrease after NACT. The overall response rate (complete and partial) after NACT was significant in our study group.</p>