ABSTRACT
BACKGROUND: One of the genetic alterations implicated in tumor progression in colorectal cancers (CRCs) are abnormalities in Kristen Rat Sarcoma (KRAS) gene. Evaluation of KRAS mutation status is an important prognostic factor and has predictive value in deciding first line therapy based on monoclonal antibodies such as Cetuximab and Panitumumab in metastatic CRCs. MATERIALS AND METHODS: In this retrospective study, we analyzed 7 different somatic mutations in Exon 2 of KRAS gene in 299 unselected incidental CRC patients who visited the hospital for clinical management during the period 2009–2013. Most of the tumors were primarily originating from colon and rectum; nevertheless, there were a few from rectosigmoid, sigmoid, ceacum and anal canal in the study group. Genomic DNA extracted from paraffin embedded tumor tissues was screened for 7 point mutations located in Codons 12 and 13 of KRAS gene, using Scorpions amplified refractory mutation system real time polymerase chain reaction technology. Statistical analysis was performed to assess bivariate relationship between different variables that includes: mutation status, mutation type, tumor location, tumor morphology, age and sex. RESULTS: Prevalence of mutation in Codons 12 and 13 was 42.8% in the study group. Well‑differentiated tumors had significantly more mutation positivity than moderately and poorly differentiated tumors (P = 0.001). 92% of the mutations were from Codon 12 and 8% in Codon 13. Glycine to Arginine was relatively more common in rectosigmoid followed by ceacum, while Glycine to Alanine mutation was relatively more prevalent in sigmoid, followed by rectum and rectosigmoid. CONCLUSION: The results suggest a prevalence of KRAS mutation at 42.8% in Indian population indicating that this testing is very crucial for targeted therapy management in metastatic CRC in India. Further analysis on mutation status of other homologues such as NRAS and downstream partner, v‑raf murine sarcoma viral oncogene homolog B1, would add value to understanding the role of anti‑epidermal growth factor receptor therapy in CRC management.
ABSTRACT
Obesity is a major health problem in developed as well as developing countries. The “carbo-insulin connection” theory was popularized by late Dr. Shrikant Jichkar from 1997 to 2004. He advocated the idea of eating only twice a day to lose weight and prevent obesity. The author tried this theory on himself from January to March 2013 and lost 8kg of weight and 2 inches from his belly! Since then the author is conducting lectures for lay people educating them about eating twice and losing weight. Author has addressed audiences in many cities and towns of Maharashtra. The present study provides the encouraging results of this public health campaign. Methods: This study was a self-controlled community trial. The tenure of the study was from 1st July 2013 to 30th June 2014. The subjects were enrolled in the study after taking their informed consent during the author’s lectures on weight loss arranged in various cities and towns of Maharashtra. The author got pretested questionnaires filled from the audience who attended his lectures on weight loss. The follow up was done on phone every fortnightly. Total 446 individuals participated in this campaign. Results: The weight loss and decrease in waist circumference in participants was as below: weight loss: average 1.5 kg in first month, 4.2 kg in 3 months and 6.8 kg in 6 months; inches loss: average 0.5 cm in 1st month, 1.5 cm in 3 months and 3.5 cm in 6 months. No side effects were observed. Conclusions: The weight loss activities have taken a form of exploitative business for many. Poor and ignorant people are being looted. This simple method of weight loss costs nothing, there is no requirement of a doctor and contrary to many other successful methods of weight loss, can be followed for a life time. Hence such a simple method should be advocated for all. There is a need to spread this message in the form of a public health campaign.