Routine comprehensive geriatric assessment needs to be implemented in our setting as almost 50% of our geriatric patients undergo curative intent treatment.

Early diagnosis and treatment is the key to management of medulloblastoma, which still needs to be achieved. Bulky tumors have a poor outcome, efforts should be aimed at complete surgery and giving risk stratification based treatment. Resources need to be allocated to make more conformal methods of radiotherapy available, which will decrease the growth abnormalities and cognitive impairments.

<p class="abstract"><strong>Background:</strong> Foreign body ingestion and aspiration is a common clinical condition among the paediatric population. The management of the aero digestive foreign body requires clinical acumen, coupled with the radiological diagnosis and the necessary infrastructure for their management, it demands skill and expertise for removal of a foreign body.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was carried in the department of Otorhinolaryngology, between December 2016- May 2017, at Institute of Child Health and Hospital for Children, Madras Medical College. 68 cases were analysis of the nature of the foreign body was done. All the patients reported to the emergency department and the ENT surgeon opinion sought with aim of maintaining airway. Clinical assessment, with history, radiographs were obtained to ascertain level and nature of the foreign body and prompt removal by oesophagoscopy/bronchoscopy/direct laryngoscopy under general anaesthesia.  </p><p class="abstract"><strong>Results:</strong> The study of 68 children who reported with history /suspicion of foreign body ingestion/aspiration. There were 32 boys and 36 females, 37 cases of foreign body ingestion and 31 cases of foreign body aspiration. The most common foreign body in digestive tract was coin in 26 cases and peanut in the airway.</p><p class="abstract"><strong>Conclusions:</strong> Foreign bodies in aero digestive tract in paediatric age group, is a common problem encountered by the otorhinolaryngologist. Careful assessment, clinical evaluation, radiological investigations with effective management in emergency department prompt removal of the foreign body in the aero digestive tract will lead to reduced mortality and morbidity.</p>

Background: Published preclinical findings provided new insights into the functional 'cross-talk' between the oestrogen receptor (ER) and the progesterone receptor (PR) in breast cancer (BC) (Mohammed et al., Nature, 2015). Addition of a PR agonist to anti-oestrogens directly modifies ERa chromatin binding and the transcriptional response in breast cancer cells, and is anti-proliferative in vitro and in vivo. Megestrol Acetate (MA), an off-patent semi-synthetic derivative of progesterone, has been licensed for many years as treatment for ER+ metastatic BC. There is also good evidence for the effectiveness of MA as a supportive therapy to ameliorate endocrine therapy-related hot flushes. Trial design: PIONEER is a three-arm, open label, multi-centre randomized phase II pre-surgical window trial evaluating effects of 15 days of preoperative therapy with Letrozole (LET), or LET plus MA 40mg, or LET plus MA 160mg in postmenopausal women with ER+ HER2- invasive primary BC. Eligibility criteria: Inclusion CriteriaPostmenopausal women with histologically confirmed invasive BC, ≥T1c, clinical NX or N0-N3, ER+ (Allred≥3), and HER2-2 groups of patients are potentially eligible: Cohort A: Patients whose cancers have been deemed to be operable by the Multi-Disciplinary Team (MDT) with surgery planned for the next 2-6 weeks Cohort B: Patients with early or locoregionally advanced BC planned for primary endocrine therapy either in lieu of surgery or as neoadjuvant therapy before surgery ECOG performance status of 0-2Adequate Liver, Renal, Bone marrow function Exclusion CriteriaHormone replacement therapy in the last 6 monthsTreatment with tamoxifen or an aromatase inhibitor (AI) in the last 6 monthsA progestogen-containing intrauterine system in situ, unless removed prior to randomisationMetastatic disease on presentationRecurrent BC (patients with a new primary invasive BC are eligible) Specific aims: The primary endpoint is % change in proliferation between baseline and day 15 tumor biopsies, measured by Ki67 IHC assessment. Secondary endpoints include: expression of Aurora Kinase A, Caspase 3 and AR/PR/EMT markers by IHC; and safety endpoints. Exploratory endpoints: transcription factor mapping (ChIP-seq) and identification of differential ERa-associated proteins (RIME) on paired fresh-frozen tumor samples. PIONEER will help determine whether there is value in conducting a Phase III adjuvant study to investigate the longer term benefit of combining an AI with MA, and if so, at what dose (40mg vs. 160mg). Statistical methods: Patients are randomized in a 1:1.5:1.5 ratio into arms A:B:C. Based on results from previous clinical trials, a mean 66% reduction in Ki67 is anticipated for LET alone (arm A), and a 77.5% reduction for the combination arms B and C, based on preclinical data. Present and target accrual: Patients are being recruited in Cambridge, Cornwall, Belfast & London with 6 other UK sites due to open q3/4 2018. At the time of submission, 29 patients had been recruited. A recruitment total of 189 patients is required. Citation Format: Kumar SS, Benson J, McIntosh S, King P, Dougall G, Kateb A, Vallier A-L, Jones L, Qian W, Provenzano E, Caldas C, Pantziarka P, Carroll J, Baird RD. PIONEER- Pre-operative wIndOw study of letrozole plus PR agonist megestrol acetate versus letrozole aloNE in post-menopausal patients with ER-positive breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT1-01-07.