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Pioneering Brain Malformation Treatment in India Using Radiosurgery Technology

By MedImaging International staff writers
Posted on 20 Oct 2009

A 17-year-old female with a complex arteriovenous malformation (AVM) of the brain has become the first person in India to be treated using an advanced and fast radiosurgery platform.

The technology involved in the therapy was the Novalis Tx radiosurgery platform system, developed by Varian Medical Systems, Inc. (Palo Alto, CA, USA) and BrainLAB (Munich, German). Doctors at Kokilaben Dhirubhai Ambani Hospital (Mumbai, India) performed the pioneering stereotactic radiosurgery treatment in a single session that took just a few minutes to complete. "The patient's malformation, which was near the motor cortex on the right side of the brain, had been partially embolized and it was considered that no further treatment was possible,” said Dr. Ram K. Narain, the hospital's chief operating officer. "Following Novalis Tx radiosurgery treatment the patient's symptoms had alleviated considerably. She will now have an MRI [magnetic resonance imaging] scan every six months to monitor her progress. The medical team was very happy with her treatment.”

Arteriovenous malformations are abnormal connections between veins and arteries and are normally congenital and frequently inoperable. Bleeding from an AVM can be devastating, especially in the brain, where it can cause severe and often fatal strokes.

Dr. Narain reported that Kokilaben Hospital was proud to be the first in India to introduce the Novalis Tx radiosurgery platform clinically. "Image-guided, frameless, and noninvasive radiosurgery is very much today's innovation and tomorrow's radiosurgery technique of choice,” he said. "It offers a more patient-friendly alternative to conventional radiosurgery systems that require immobilization with a head ring that attaches to the skull. With this system, we can deliver a highly conformal and homogenous dose to irregularly shaped lesions in a single session, which was not achievable with conventional radiosurgery techniques. These faster treatments can be completed in minutes rather than the hours taken by conventional techniques and they can be carried out on lesions anywhere in the body, not just in the brain.”

According to Dr. Narain, the team at Kokilaben Hospital will use the Novalis Tx radiosurgery platform to perform radiosurgery and stereotactic radiotherapy for a number of indications, including lung, brain, liver, and prostate metastases, recurrent brain tumors, pituitary adenomas, acoustic neuromas, and meningiomas. "In particular it will help us to manage complex skull-base tumors and arteriovenous malformations with multimodality treatments, including stereotactic radiosurgery.”

The Novalis Tx radiosurgery platform features very high dose delivery rates, which contribute to shorter treatment times. It also provides dynamic fine beam-shaping and noninvasive, precise patient positioning for rapid and more comfortable treatments. Integrated imaging capabilities pinpoint the target before and during treatment and enable positioning of the patient with millimeter precision.

Kokilaben Hospital is a private center that treats approximately 3,000 new cancer patients each year from across India. Waiting lists are a major problem for cancer patients in India, and the speed and flexibility of the Novalis Tx radiosurgery platform will enable Kokilaben Hospital to treat more patients.

Ten Novalis Tx platforms have been ordered by Indian cancer centers in the two years since its introduction, making them among the most enthusiastic adopters of Novalis Tx technology to date.

Varian Medical Systems is a world-leading manufacturer of medical devices and software for treating cancer and other medical conditions with radiotherapy, radiosurgery, proton therapy, and brachytherapy. The company supplies informatics software for managing comprehensive cancer clinics, radiotherapy centers, and medical oncology practices.

BrainLAB develops, manufactures, and markets software-driven medical technology that enables procedures that are more precise, less invasive, and less expensive than traditional treatments. Among the core products are image-guided systems that provide highly accurate real-time information used for navigation during surgical procedures.

Related Links:
Varian Medical Systems
BrainLAB

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61 (88.930130004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

62 (148.05793762207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

63 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

64 (102.99682617188): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

65 (407.93418884277): SELECT fid FROM jos_deeppockets WHERE id=294726060 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294726060 AND published='1' LIMIT 1

66 (61.03515625): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

67 (51.975250244141): select jos_twitters.link from jos_twitters where cat=10

68 (33.855438232422): select jos_facebook.link from jos_facebook where cat=10

69 (32.901763916016): select jos_google_plus.link from jos_google_plus where cat=10

70 (35.04753112793): select jos_linkedin.link from jos_linkedin where cat=10

71 (36.001205444336): SELECT fid FROM jos_deeppockets WHERE id=294726060 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294726060 AND published='1' LIMIT 1

72 (36.954879760742): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

73 (198.8410949707): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294726060 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (134.94491577148): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294726060 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (72.002410888672): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

76 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (54.121017456055): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (48.87580871582): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294726060 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (41.961669921875): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294726060 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (!!!!! 1553.0586242676): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

93 (76.055526733398): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (173.09188842773): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

108 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

109 (184.05914306641): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294726060 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (133.99124145508): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294726060 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (180.00602722168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

112 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

113 (156.87942504883): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294726060 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (636.81602478027): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294726060 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (607.96737670898): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

116 (360.01205444336): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

117 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

118 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

119 (49.829483032227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

120 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

121 (44.822692871094): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

122 (39.100646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

123 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

124 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

125 (288.00964355469): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

126 (!!!!! 43933.868408203): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

127 (576.01928710938): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294726060 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294726060 AND type='deeppockets_item' AND published='1' LIMIT 1

128 (!!!!! 16638.994216919): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

129 (69.141387939453): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

130 (42.915344238281): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

131 (30.994415283203): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

132 (47.922134399414): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

133 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

134 (360.96572875977): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

135 (41.961669921875): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

136 (36.001205444336): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

137 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

138 (!!!!! 1147.985458374): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (394.82116699219): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (38.862228393555): SELECT name FROM jos_deeppockets WHERE id=211

141 (30.040740966797): SELECT name FROM jos_deeppockets WHERE id=211

142 (540.01808166504): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

143 (443.93539428711): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

144 (!!!!! 2211.0939025879): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

145 (75.817108154297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

146 (!!!!! 12677.907943726): TRUNCATE TABLE jos_trademed_module

147 (101.80473327637): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294726060 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (56.982040405273): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294726060 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

149 (864.02893066406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

151 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

152 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

153 (!!!!! 1436.9487762451): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

154 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

155 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

156 (55.074691772461): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294726060 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294726060 AND type='deeppockets_item' AND published='1' LIMIT 1

157 (510.93101501465): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

158 (72.956085205078): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

159 (123.02398681641): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

160 (141.85905456543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

161 (53.882598876953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726060 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726060 AND published='1' LIMIT 1

162 (46.014785766602): select jos_twitters.link from jos_twitters where cat=10

163 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

164 (31.948089599609): select jos_google_plus.link from jos_google_plus where cat=10

165 (41.961669921875): select jos_linkedin.link from jos_linkedin where cat=10

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