This Viewpoint discusses the need for multi-institutional prospective randomized trials of new technologies in radiotherapy to improve the therapeutic ratio and safety of radiotherapy treatments.

<h3>Objective:</h3> <b>Temporal trends in clinico-epidemiological parameters of stroke among Indian women have not been studied. We aimed to study the changes in these parameters over the last decade</b> <h3>Background:</h3> Scant literature is available from India regarding the clinico-epidemiologic parameters of stroke among women.. Sociocultural issues might lead to a delay in seeking health care and thrombolysis, leading to poorer stroke outcomes among Indian women. Hence, this study was conducted to understand whether there is any paradigm shift in demographic parameters and other risk factors contributing to both ischemic and hemorrhagic stroke in Indian women over a 12-year period. <h3>Design/Methods:</h3> 417 strokes (ischemic/hemorrhagic) were prospectively recruited in two timelines. In total, 267 strokes were recruited in 2005 while 150 strokes were recruited in 2016–17. Patients underwent stepwise evaluation via a structured proforma. Demographic factors, stroke subtypes, and risk factors were analyzed. <h3>Results:</h3> Female strokes had a higher mean age in 2017 compared to 2005 (60.90 ± 16.9 vs. 53.21 ± 16.75 years, <i>P</i> = 0.002). Hemorrhagic strokes among females increased over the last decade. Female strokes with dyslipidemia were significantly lower in 2017 compared to 2005 (<i>P</i> = 0.002). Proportion of hypertensive and diabetic strokes were not significantly different between these two periods. <h3>Conclusions:</h3> Our study showed that acute stroke (ischemic/hemorrhagic) among Indian women is occurring at a later age. Hemorrhagic stroke among women has increased over the last decade. Furthermore, dyslipidemia among stroke patients has decreased over the past decade. However, hypertension and diabetes prevalence among stroke patients has not decreased significantly and requires urgent strengthening of public health measures. <b>Disclosure:</b> Prof. Dhamija has nothing to disclose. ABHISHEK AGGARWAL has nothing to disclose. Dr. Saluja has nothing to disclose. Dr. Parihar has nothing to disclose.

Background : Locally advanced breast carcinoma (LABC) includes a wide range of clinical scenarios- advanced primary tumors (T4), advanced nodal disease and inflammatory carcinomas(1). Traditionally, treatment of LABC included a combination of Chemotherapy, Radiation and Surgery(2). However, there has been a shift to Neoadjuvant Chemotherapy in recent times.(3)&#x0D; Histological status and the number of axillary lymph nodes with metastasis is one of the most important prognostic factors and most powerful predictor of recurrence and survival in patients of breast carcinoma and remains so, even after neo-adjuvant chemotherapy. (3) Information derived from the sentinel lymph node is considered valuable, with less discomfort to the patient when compared with axillary dissection.(4) However, its role in detecting nodal metastasis after neo-adjuvant chemotherapy in LABC is still debatable and definitive studies to evaluate its role are still evolving. (5)&#x0D; Materials and Methods: Patients of LABC were evaluated using ultrasonography (USG) of axilla. Neo-adjuvant chemotherapy (NACT) was administered and patients were reassessed by USG of axilla. Thirty patients with node negative axillary status were subjected to Sentinel lymph node mapping using isosulfan blue followed by Modified Radical Mastectomy and Axillary Lymph Node Dissection. Histopathological evaluation of stained and unstained lymph nodes done and the data, thus obtained, was statistically analysed.&#x0D; &#x0D; Results: Sentinel lymph node biopsy performed using Isosulfan Blue dye alone, after neo-adjuvant chemotherapy predicts the status of axillary lymph nodes with low accuracy.&#x0D; &#x0D; Conclusions: Further studies would be required to establish the role of sentinel lymph node biopsy in patients with LABC after NACT.

HIV infection is a major public health problem especially in the developing countries. Once a person infects with HIV, it remained infected for lifelong. The advanced stage developed after 10–15 y of HIV infection that stage is called acquired immunodeficiency syndrome (AIDS). From 1990 to 2000 the number of people living with HIV rose from 8 million to 27 million; since the beginning of the HIV/AIDS epidemic, AIDS has claimed almost 39million lives so far. Till now, there is no cure for HIV infection; however, after the introduction of effective treatment with antiretroviral (ARV) drugs the HIV individual can enjoy healthy and productive lives. Vaccine is safe and cost-effective to prevent illness, impairment, disability and death. Like other vaccines, a preventive HIV vaccine could help save millions of lives. All vaccines work the same way i.e. the antigen stimulate the immune system and develop antibodies. The ultimate goal is to develop a safe and effective vaccine that protects people worldwide from getting infected with HIV. However, some school of thought that vaccine may protects only some HIV people, it could have a major impact on the rates of transmission of HIV and this will help in control of epidemic, especially in populations where high rate of HIV transmission. In the past, some scientist doubted on the development of an effective polio vaccine, but now we are near to eradicate the polio from the world this is possible because of successful vaccination programmes. HIV vaccine research is aided by the not-for-profit International AIDS/HIV vaccine Initiative (IAVI), which helps to support and coordinate vaccine research, development, policy and advocacy around the world. Although the challenges for scientist are intimidating but scientists remain hopeful that they can develop safe and effective HIV vaccines for patients in future.

Various reported scores for congenital talipes equinovarus are presented with observer variations and lack in objective evidence of severity of deformity. Anteromedial foot bimalleolar angle (FBM), an objective assessment of deformity and correction, was correlated and compared with Pirani scores 0.5-2, 2.5-4, 4.5-6 as grouped I to III for mean and SD in 244 club feet in 137 children. The mean FBM angles of groups I to III were 79.72°, 68.4°, and 53.27°, respectively. The FBM angle gives an objective assessment of the severity of deformity and can be used as objective evidence of improvement/deterioration of deformity.

Sixty three male patients with billowing mitral leaflet syndrome (BML) and forty one age and sex match controls were studied with emphasis on the cineangiographic features of coronary arteries. In the BML group, the coronary arteries were considered normal in five and abnormal in fifty eight. In fifty eight with abnormal coronary arteries, twelve showed atherosclerotic occlusive lesions, fifteen showed combined occlusive lesions and nonocclusive abnormalities and thirty one showed nonocclusive abnormalities alone. The non-atherosclerotic abnormalities consisted of redundancy of the coronary arteries manifested by bizarre changes in configruation and motion. These abnormalities were present in only five patients in the Control Group. On the basis of our observations and corroborative evidence in the literature, a hypothesis is presented; the salient features of which are that: (1) the spectrum of BML may be considerably more complex than hitherto suspected, (2) a combination of BML and tortuous coronary arteries may form a distinct subset of this spectrum and (3) the increased tortuousity may result in impaired coronary perfusion causing myocardial ischemia thus offering a possible explanation for some of the symptoms — such as chest pain, arrhythmias and even sudden death seen in this syndrome.