Breast cancer is the commonest cancer among women the world over. In India, the reported age adjusted incidence of breast cancer in women is about 26.7/1 00 000 population (NCRP, 1992). Unlike the West, in India, majority of the patients (about 60%) present with locally advanced breast cancer (LABC) or disseminated disease (Goel et al, 1995). In LABC, the treatment policy followed at most centres, is neoadjuvant chemotherapy (NACT) followed by surgery and local or locoregional radiotherapy. The response to NACT is assessed by clinical evaluation and supplemented by radiological measurement of reduction in tumour volume by mammography and/or ultra sonography. None of the currently available indicators of response (clinical and radiological) correlate well with the actual response as assessed on histopathological examination of the tumour.MR imaging (MRI) is a valuable new tool for diagnostic mammography (Orel et al, 1996;Friedrich, 1998; Harms, 1998;Orel, 1998). Recently, dynamic contrast enhanced MRI techniques have also been developed for differentiation between benign and malignant tumours (Kaiser, 1991;Harms et al, 1993; Haywang-Kobrunner et al, 1997;Piccoli, 1997;Daniel et al, 1998). The above techniques, however, do not provide any metabolic/ biochemical information. On the contrary, magnetic resonance spectroscopy (MRS) permits non-invasive detection of metabolic (biochemical) differences between tumours and normal tissues, and can also be used to monitor response to different treatment regimens. Recently, we have shown that in LABC, the assessment of response to NACT can be made using water-to-fat ratio calculated from volume localized proton MRS (Jagannathan et al, 1998(Jagannathan et al, , 1999. In addition, we also reported the presence of choline in a majority of the breast cancer patients (Jagannathan et al, 1998).In this study, results of evaluation of choline in LABC and its response to NACT using in-vivo proton MRS are presented. The objectives are: (i) to evaluate the potential of proton MRS in the study of breast cancer, and (ii) to investigate further, the recent observation of choline containing compounds in malignant breast tissues and its response to NACT. To the best of our knowledge, this is the first report assessing the response of breast cancer to NACT in a large cohort of patients using in-vivo proton MRS. PATIENTS AND METHODS Patients67 women with cytologically confirmed infiltrating ductal carcinoma (IDC) were recruited. Necessary clearance from the Institute ethical committee and written informed consent were obtained prior to examination from patients and controls. Patients were evaluated clinically and tumour size was measured using Vernier calipers. Metastatic workup included liver function tests, chest

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There was a high prevalence of micronutrient deficiencies amongst the PW of the area, possibly due to the poor dietary intake of food and low frequency of consumption of food groups rich in micronutrients. The concurrent prevalence of two, three, four and five micronutrient deficiencies were common.

Background and aims The lasting impact of COVID 19 pandemic and associated restrictions are bound to be significant on lifestyle-related behaviour including diet, physical activity and sleep which is one of the important components in the management of diabetes mellitus and metabolic syndrome. This study was conducted to develop and validate a questionnaire to assess changes in individual’s lifestyle-related behaviour during COVID 19 pandemic. Materials and methods The questionnaire was developed through a standardised methodology including literature review, focus group discussion, expert evaluation, pre-testing and validation. The face validity and content validity of the questionnaire were analysed. A cross-sectional survey was carried out on 103 participants to validate the questionnaire that used a 5-point Likert scale for the response option. Exploratory factor analysis was performed to establish construct validity. Cronbach’s alpha was calculated to test the internal consistency of the whole questionnaire. Results A questionnaire with 20 items to assess the lifestyle-related behaviour of people was developed. The questionnaire shows a satisfactory validity and a good internal consistency with the Cronbach’s alpha value of 0.72. Conclusion The developed tool is valid and reliable to assess the changes in lifestyle-related behaviour of individuals during COVID 19 pandemic.

PurposeTo evaluate the use of the water‐to‐fat (W‐F) value obtained from in vivo proton (1H) MR spectroscopy (MRS) as a response indicator of cytologically confirmed patients with locally advanced breast cancer (LABC), and to monitor the therapeutic response of such patients to neoadjuvant chemotherapy (NACT)Materials and MethodsSerial 1H MR spectra were recorded both before and after the completion of chemotherapy in 33 LABC patients (with infiltrating ductal carcinoma (IDC)) at 1.5T. In addition, spectra from normal breast tissues of 28 healthy volunteers were recorded.ResultsMalignant breast tissues showed elevated W‐F values compared to normal breast tissues of controls. Statistically significant higher pretherapy W‐F value (P < 0.01) was observed in patients compared to controls. In patients who received NACT resulting in the reduction of the primary tumor size, the W‐F value showed a decrease that was statistically significant (P < 0.01). Analysis of the MR data further indicates that the W‐F value had no correlation with the menstrual status of the patients. A comparison of pretherapy W‐F value with pretherapy tumor volume showed a fair correlation (P = 0.05), while the posttherapy W‐F value showed no such correlation with the posttherapy tumor volume.ConclusionThis study demonstrates that simple, conventional in vivo 1H MRS is a useful technique for monitoring the therapeutic response of breast cancer patients. The observed trend in the reduction of W‐F value provides a noninvasive response indicator to monitor the clinical outcome of locally advanced breast cancer patients to NACT J. Magn. Reson. Imaging 2006. © 2006 Wiley‐Liss, Inc.