ABSTRACT
Background: Until now, there is a need for novel tools helping the prompt diagnosis tuberculosis [TB]
Objective: This study aims to explore the extent of CD27 expression on ESAT-6 and CFP-10 antigen-specific CD4+ T cells as a recent biomarker for rapid diagnosis of active pulmonary TB in Egypt
Methodology: Based on IFN-alpha+ expression, ESAT-6 and CFP-10 antigen-specific CD4+ T cells were identified and the CD27 expression was analyzed for 60 M. tuberculosis-infected patients and 20 healthy controls
Results: The present data, in fact, displayed that patients with pulmonary TB had significantly lowered CD27 expression than healthy controls [P <0.001]. The persistent active TB patients had much lesser percentages of CD27+ T cells than culture-positive recently infected TB patients [P =0.014] and healthy controls [P< 0.001]. On evaluating the diagnostic performance of CD27 expression, it has been declared that at a cutoff value of 43.64%. CD27 had a sensitivity, specificity, positive predicted value [PPV], and negative predicted value [NPV] 86.7%, 100%, 100%, 71.4% respectively, for discrimination between patients with TB from healthy subjects
Conclusion: Thereby, proportion of CD27+ antigen-specific CD4 T cells could be used as an immunological marker for active TB
ABSTRACT
Worldwide, breast cancer is the most common cancer among women. In India and other developing countries, breast carcinoma ranks second only to cervical carcinoma among women. Although studies have been done globally, to find the association between breastfeeding and breast cancer, very few studies in India document such a benefit. A case-control study was done from August 2009 to July 2010 in the wards of General Surgery and Oncosurgery at Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India. A total of 128 histopathologically confirmed new cases of breast cancer during the study period were taken as cases. Equal numbers of controls were selected by simple random sampling. Controls were matched for age with a range of +/- 2 years. Subjects were interviewed using a pretested questionnaire after obtaining written informed consent. The categorical data were analyzed statistically using the Chi-square test and odds ratio with a 95% confidence interval. Continuous variables were analyzed using an independent t-test. All the analysis was done using SPSS, version 17. The age group of the cases was 25-78 years, while that of the controls was 24-79 years. The proportions of cases [56.3%] and controls [63.3%] living in rural areas were more than those living in urban areas. A significant association of breast cancer cases was found with caste, age at marriage, age at the first pregnancy, number of live births, and lifetime duration of breastfeeding. Breastfeeding has a significant role in reducing breast cancer, and so information, education, and communication activities for the promotion of breastfeeding and creating awareness about this fatal disease are the need of the hour
ABSTRACT
Naftopidil, approved initially in Japan, is an alpha1d-adrenergic receptor antagonist [alpha1-blocker] used to treat lower urinary tract symptoms [LUTS] due to benign prostatic hyperplasia [BPH]. It is different from tamsulosin hydrochloride and silodosin, in that it has a higher affinity for the alpha1D-adrenergic receptor subtype than for the alpha1A subtype and has a superior efficacy to a placebo and comparable efficacy to other alpha1-blockers such as tamsulosin. The incidences of ejaculatory disorders and intraoperative floppy iris syndrome induced by naftopidil may also be lower than that for tamsulosin and silodosin, which have a high affinity for the alpha1A-adrenergic receptor subtype. However, it remains unknown if the efficacy and safety of naftopidil in Japanese men is applicable to Indian men having LUTS/BPH. Two groups of 60 patients each, having LUTS due to BPH, were treated with tamsulosin 0.4 mg and Naftopidil 75 mg for three months. Ultrasonography [for prostate size, post-void residual volume], uroflowmetry, and the International Prostate Symptom Score [IPSS] and Quality of Life [QOL] score were recorded at the beginning of the study, and then at one and three months. The prostate size, post-void residual volume, all the uroflowmetry variables, and the IPSS QOL scores showed a statistically significant improvement [P < 0.001] in both the groups. The improvement in the average flow rate and the QOL index was better in the naftopidil group on the intergroup comparison and was statistically significant [P < 0.001]. Although the QOL life index was significantly better in the naftopidil group, overall both naftopidil and tamsulosin were found to be equally effective in the treatment of LUTS due to BPH
ABSTRACT
Controversy exists over the pain during prostate biopsy. Periprostatic nerve block [PNB] is a gold standard anesthetic technique during transrectal ultrasound [TRUS]-guided prostate biopsy. Recent studies showed that PNB alone is insufficient as analgesic. We compared the efficacy of tramadol and intraprostatic nerve block [INB] in addition to PNB. We conducted a prospective double blinded placebo controlled study at our institute in 150 consecutive patients. Patients were randomized into three groups. Group A received PNB with INB with 1% lignocaine. Group B received oral tramadol with PNB. Group C patients were administered PNB only with 1% lignocaine. Patients were asked to grade the pain level using 11 point linear visual analog scale [VAS] at the time of ultrasound probe insertion, at time of anesthesia, during biopsy, and 30 min after biopsy. The study groups were comparable in demographic profile, prostate-specific antigen [PSA] levels, and prostate size. Group A recorded the minimum mean pain score of 2.66 during prostate biopsy which was significantly lower than group 3 [P < 0.001]. Group B recorded significantly lower pain score at time of probe insertion and at anesthetic needle insertion than other two groups. PNB provides better pain control in TRUS-guided prostate biopsy but still there is need of additional analgesic in the form of tramadol or INB. Tramadol has advantage of oral intake and analgesic effect at time of probe insertion and at nerve block. Both tramadol and INB may be used in combination along with PNB.
Subject(s)
Humans , Male , Aged , Aged, 80 and over , Prostate/pathology , Rectum , Ultrasonography , Image-Guided Biopsy , Lidocaine , TramadolABSTRACT
PURPOSE: Controversy exists over the pain during prostate biopsy. Periprostatic nerve block is a commonly used anaesthetic technique during transrectal ultrasound (TRUS)-guided prostate biopsy. The recent trend toward increasing the number of cores has become popular. This practice further increases the need for a proper anaesthetic application. We compared the efficacy of periprostatic nerve block with or without intraprostatic nerve block. MATERIALS AND METHODS: We conducted a prospective double-blinded placebo-controlled study at our institute with 142 consecutive patients. Patients were randomly assigned into 3 groups. Group 1 received periprostatic nerve block with intraprostatic nerve block with 1% lignocaine. Group 2 patients were administered periprostatic nerve block only with 1% lignocaine. Group 3 received no anaesthesia. Patients were asked to grade their level of pain by using an 11-point linear analogue scale at the time of ultrasound probe insertion, at the time of anaesthesia, during biopsy, and 30 minutes after biopsy. RESULTS: The study groups were comparable in demographic profile, prostate-specific antigen (PSA) level, and prostate size. The mean pain scores at the time of biopsy in groups 1, 2, and 3 were 2.70, 3.39, and 4.16, respectively. Group 1 recorded the minimum mean pain score of 2.70 during prostate biopsy, which was significantly lower than the scores of groups 2 and 3 (p0.05). CONCLUSIONS: Periprostatic nerve block with intraprostatic nerve block provides better pain control than does periprostatic nerve block alone in TRUS-guided prostate biopsy.