Vulvar carcinoma is a rare and aggressive gynecological malignancy. It affects elderly females, with the mean age at diagnosis being 55–60 years. Regional metastasis to inguinal lymph nodes is common. There is a high incidence of pelvic node involvement, especially in those with pathologically positive inguinal nodes. Surgery appears to be the only curative treatment option in the early stages of the disease. But in most patients, surgery is associated with considerable morbidities and psychosexual issues. Hence, in the quest for a less morbid form of treatment, multimodality approaches with various combinations of surgery, chemotherapy, and radiation therapy have been suggested for advanced vulvar cancers. Due to the low incidence of the disease, the level of evidence for the success of these treatment modalities is poor. In countries like India, a heterogeneous incidence of vulvar carcinoma exists across the country, with patients presenting at advanced stages when the option of surgery is often supplemented or replaced by chemotherapy and radiotherapy. In this review, we attempt to study the available published literature and trials and discuss the treatment options in various stages of vulvar carcinoma.
Nowadays exploration of novel lipid-based formulations is akin to a magnet for researchers worldwide for improving the in vivo performance of highly lipophilic drugs. Over the last few years, new compositions of lipids have been developed, and the probable bioavailability enhancement has been investigated. We reviewed the most recent data dealing with backlogs of conventional lipid-based formulations such as physical instability, limited drug loading capacities, drug expulsion during storage along with all the possible hindrances resulting in poor absorption of highly lipophilic drugs such as P-glycoprotein efflux, extensive metabolism by cytochrome P450 etc. In tandem with these aspects, an exclusive formulation approach has been discussed in detail in this paper. Therefore, this review focuses on resolving the concerned ambiguity with successful oral administration of highly lipophilic drugs through designing novel lipidic formulations (nanostructured lipid carriers [NLC]) that constitute a blend of solid and liquid lipids. The article highlights the potential role of such formulation in normalizing the in vivo fate of poorly soluble drugs. Finally, the present manuscript discusses the dominance of NLC over other lipid-based formulations and provides a perspective of how they defeat and overcome the barriers that lead to the poor bioavailability of hydrophobic drugs.
The reactive changes in the tumor stroma may alter the biological aggressiveness of oral cancer, and by incorporating this concept into a prognostic system, we may help to reflect the biologic diversity of oral cancer and predict its clinical outcomes.
Introduction:Human identification is based on scientific principles, mainly involving dental records, fingerprints, estimation of age, postmortem reports, differentiation by blood groups, and DNA comparisons. Sex assessment is one of the prime factors employed to assist with the identification of an individual.Aims and Objective:To investigate univariate sex differences in the dimensions of permanent first molars and to assess sex, based on buccolingual (BL) and mesiodistal (MD) dimensions of permanent first molars in a population of north India. In addition, the study intended to evaluate the reliability of dimensional variation of these teeth in assessment of sex among the population.Materials and Methods:The study sample consists of 410 adult individuals (200 males and 210 females), from a north Indian population. The BL and MD diameters of the permanent first molars were measured using digital vernier callipers.Results:It was observed statistically significant difference between males and females with P < 0.05, in maxillary casts in both BL and MD dimensions; but only in the MD dimension in mandibular casts. A high level of sexual dimorphism of 7.7% was found in the BL dimension of the maxillary right first molar. The accuracy of sex assessment by each dimension was deliberated by univariate analyses with an overall accuracy ranging from 67.5 to 88% for various dimensions.Conclusion:Sexual dimorphism of teeth is population specific and among north Indian population, BL and MD dimensions in maxillary first molar and MD dimension in mandibular first molar can be used for sex assessment.
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