Cirrosis en una lactante como manifestación de un defecto congénito de la glicosilación

Se presenta el caso de una recién nacida a término valorada en el servicio de urgencias por ictericia sin criterios de fototerapia. En los controles analíticos posteriores se detecta hipertransaminasemia y dislipemia con aumento de LDL-colesterol. Tras no objetivar alteraciones en los diferentes parámetros estudiados se realiza biopsia hepática que muestra hallazgos compatibles con cirrosis. Se amplía el estudio metabólico y presenta un perfil alterado de sialotransferrinas lo que lleva a realizar un diagnóstico de defecto congénito de la glicosilación. Bajo este nombre se incluye un grupo amplio de enfermedades relacionadas con alteraciones en el proceso de unión de glicanos a las cadenas proteicas. Este defecto, de origen genético, implica cambios en la estructura y funcionalidad de las glicoproteínas. Las manifestaciones clínicas son heterogéneas, en función del gen afecto y del tipo de glicoproteínas alteradas, siendo lo más común la afectación hepática, neurológica y hematológica. (provisto por Infomedic International)

We present the case of a full-term newborn girl evaluated in the emergency department for jaundice without phototherapy criteria. Subsequent laboratory tests showed hypertransaminasemia and dyslipidemia with increased LDL-cholesterol. After finding no alterations in the different parameters studied, a liver biopsy was performed showing findings compatible with cirrhosis. The metabolic study was extended and the patient presented an altered sialotransferrin profile, which led to a diagnosis of congenital defect of glycosylation. This name includes a broad group of diseases related to alterations in the process of glycan binding to protein chains. This defect, of genetic origin, involves changes in the structure and functionality of glycoproteins. The clinical manifestations are heterogeneous, depending on the gene affected and the type of glycoproteins altered, the most common being hepatic, neurological and hematological involvement. (provided by Infomedic International)

Mapping the distribution and trends of co-circulating dengue virus serotypes in Odisha, India: A retrospective facility-based analysis

BACKGROUND Dengue, caused by mosquito bite, is an emerging disease of international concern. Evidence regarding the prevalent dengue serotypes is scarce, but essential for its management during the outbreaks. Hence, we mapped the distribution and trends of currently prevalent dengue virus (DENV) serotypes in Odisha. METHODS We conducted a facility-based retrospective study from referral samples sent for the diagnosis/confirmation of dengue in 2018. The samples were serologically tested for enzyme-linked immunosorbent assay (ELISA) IgM antibody and NS1. Only NS1-positive samples were chosen for sero-typing. A pool of 8–10 NS1-positive samples were analysed for district-wise serotypes. Ribonucleic acid extraction and nested polymerase chain reaction (PCR) was done from NS1-positive samples. The PCR products were then subjected to gel electrophoresis. RESULTS A total of 2892 samples were screened for dengue virus across various districts of Odisha where 763 samples were found to be NS1-positive. Thirteen of 18 districts covering all topographies of Odisha predominantly had DENV2 serotype. Only few districts such as Balangir, Kalahandi and Rayagada had mixed serotypes. CONCLUSION Although DENV2 is predominantly prevalent, mixed serotypes too exist in Odisha. Evidence based on variations of dengue serotypes across topographies, seasons, gender and age groups may support public health efforts in preventing the disease.

Estimation of Elder Abuse and its Associated factors in a Rural Area of Gujarat:A community based cross sectional study

Introduction: The Indian population experiencing rapid ageing. By 2050, elderly would be 19.5% of the total population. The increasing elderly in society brings with new social problems having tremendous health impact. Elder abuse is a serious but neglected social problem that has adverse consequence on health. Objective: To measure the prevalence of elder abuse and to determine associated factors of elder abuse. Method: A community based cross sectional study was conducted among elderly population aged 60 years and above in the Piparia village of Vadodara district. A sample of 126 study participants were interviewed to collect data on prevalence of abuse and associated factors leading to abuse. Descriptive and inferential statistics were applied to draw conclusion from collected data. Prevalence of elder abuse was foundResults: to be 28.57%. Emotional abuse was the commonest type of abuse reported. Socio economic status, family type, Tobacco use (Smoke and smokeless) were found to be significantly associated with elder abuse. Conclusion: Elder abuse is prevalent in rural Gujarat. Further evidence is needed to assess the magnitude of the problem and the type of intervention necessary to resolve it.

AN ELECTRO-CONVULSIVE REFRACTORY, DIFFICULT TO TREAT CASE OF RECURRENT SEVERE DEPRESSION WITH CATATONIA

We report on a 24 year old woman presented with low mood, reduced appetite, disturbed sleep and anxiety for which she was prescribed oral medication from a local practitioner in form of antidepressant(SSRI), anxiolytic(BZD) and upon no improvement, she underwent 8 rounds of successful electroconvulsive therapy (ECT) on which she responded partially and was discharged on SSRI. A few days after visited the same doctor and reported of having low mood, crying spells, referential and paranoid ideas and an attempt of suicide for which 10 more sessions of ECT were given. She presented in psychiatry OPD with catatonia where she was advised admission and diagnosed as a case of recurrent depressive disorder with catatonia and was managed with suprathreshold doses of SSRI and responded well.

Relationship between parental stress and attitude towards cochlear implantation outcomes in children in an Indian context

ABSTRACT Purpose The study was aimed to investigate the relationship between parental stress and attitude of parents towards the outcomes of cochlear implantation in an Indian scenario. Methods A total of 59 parents of children with cochlear implantation participated in the study. The outcomes of cochlear implant was measured using Parental attitudes of various aspects of cochlear implantation questionnaire and parental stress was measured using parental stress scale. The questionnaires were circulated to participants and data was collected in the form of e-survey. Results The present study showed that the parental stress level was similar among mothers and fathers. Further, the parental attitude towards communication abilities of children and education were positively correlated with the duration of cochlear implantation. Finally, a significant positive correlation was found between the parental stress and the parental attitude towards communication abilities of children and social skills. Conclusion The present study showed a positive relationship between parental stress and parental attitude towards the outcomes of cochlear implantation for aspects of communication abilities and social skills.

The Safety and Efficacy of Anakinra, an Interleukin-1 Antagonist in Severe Cases of COVID-19: A Systematic Review and Meta-Analysis

This study aims to assess anakinra's safety and efficacy for treating severe coronavirus disease 2019 (COVID-19). Numerous electronic databases were searched and finally 15 studies with a total of 3,530 patients, 757 in the anakinra arm, 1,685 in the control arm were included. The pooled adjusted odds ratio (OR) for mortality in the treatment arm was 0.34 (95% confidence interval [CI], 0.21 - 0.54, I2 = 48%), indicating a significant association between anakinra and mortality. A significant association was found regarding mechanical ventilation requirements in anakinra group compared to the control group OR, 0.68 (95% CI, 0.49 - 0.95, I2 = 50%). For the safety of anakinra, we evaluated thromboembolism risk and liver transaminases elevation. Thromboembolism risk was OR, 1.59 (95% CI, 0.65 - 3.91, I2 = 0%) and elevation in liver transaminases with OR was 1.35 (95% CI, 0.61 - 3.03, I2 = 76%). Both were not statistically significant over the control group. Anakinra is beneficial in lowering mortality in COVID-19 patients. However, these non-significant differences in the safety profile between the anakinra and control groups may have been the result of baseline characteristics of the intervention group, and further studies are essential in evaluating anakinra's safety profile.

The Safety and Efficacy of Anakinra, an Interleukin-1 Antagonist in Severe Cases of COVID-19: A Systematic Review and Meta-Analysis

This study aims to assess anakinra's safety and efficacy for treating severe coronavirus disease 2019 (COVID-19). Numerous electronic databases were searched and finally 15 studies with a total of 3,530 patients, 757 in the anakinra arm, 1,685 in the control arm were included. The pooled adjusted odds ratio (OR) for mortality in the treatment arm was 0.34 (95% confidence interval [CI], 0.21 - 0.54, I2 = 48%), indicating a significant association between anakinra and mortality. A significant association was found regarding mechanical ventilation requirements in anakinra group compared to the control group OR, 0.68 (95% CI, 0.49 - 0.95, I2 = 50%). For the safety of anakinra, we evaluated thromboembolism risk and liver transaminases elevation. Thromboembolism risk was OR, 1.59 (95% CI, 0.65 - 3.91, I2 = 0%) and elevation in liver transaminases with OR was 1.35 (95% CI, 0.61 - 3.03, I2 = 76%). Both were not statistically significant over the control group. Anakinra is beneficial in lowering mortality in COVID-19 patients. However, these non-significant differences in the safety profile between the anakinra and control groups may have been the result of baseline characteristics of the intervention group, and further studies are essential in evaluating anakinra's safety profile.

Bilateral internal iliac artery ligation: the procedure of choice in life threatening postpartum haemorrhage

Background: The present study was to assess the indication and study the intraoperative and postoperative complications of bilateral internal iliac artery ligation. Aim of this study was to evaluate the effectiveness of internal iliac artery ligation in arresting postpartum haemorrhage.Methods: This is a retrospective study carried out between January 2015 to December 2018 at Shrimati Kashibai Navale Medical College and General Hospital, Pune. This study included 48 patients with life-threatening PPH. Bilateral internal iliac artery ligation was done by anterior approach in 7 patients and by posterior approach in 41 patients.Results: Intraoperative and postoperative complications were noted in all patients. Of the total patients, 10 required massive blood transfusion and 12 underwent obstetrical hysterectomies (n=12; 25%). Internal iliac vein injury was seen in 1 patient (n=1; 2.08%) and external vein thrombosis was noted in 3 patients (n=3; 6.25%). Maternal mortality was observed in 1 patient due to DIC on day 9 (n=1; 2.08%). The uterine salvage rate was 75%.Conclusions: Internal iliac artery ligation (IIAL) safe, rapid, effective, time tested method of controlling bleeding from genital tract.

Estimation of In-vitro Plasma Protein Binding of Ampicillin in Horses Based on Spectrophotometric Method

Estimation of plasma protein binding (PPB) is of paramount importance in the pharmacokinetics characterization of drugs, as it can cause significant change in volume of distribution, clearance and half-life of the drug. Ampicillin (α-amino benzyl penicillin) is most commonly used drug in equine practice. This study was conducted to determine the extent of PPB of ampicillin in apparently healthy horses (n=6). A simple spectrophotometric method was applied for the determination of ampicillin at 320 nm wavelength, based on acid degradation product of penicillin at 75°C in presence of citrate buffer (pH 5.2) and traces of copper salt. In the study, it was observed that this method permits the detection of ampicillin to a level not beyond 1.0 μg/ml. Various concentrations of ampicillin (3.125, 6.25, 12.5, 25, 50, 100 μg/ml) were prepared in triplicate in pooled plasma collected from healthy animals. In vitro binding of ampicillin to plasma proteins was determined by employing the equilibrium dialysis technique. The study revealed that the plasma protein binding of ampicillin was to the extent of 12.8 ± 0.07 %. Binding capacity of ampicillin to plasma protein (βi) and dissociation rate constant of protein-drug complex (Kβ) in the present study were 0.34 × 10-6 ± 0.02 × 10-6 mol.gm-1 and 0.003 × 10-9 ± 0.0003 × 10-9 mol, respectively in horses. Hence, the study concluded that usage of spectrophotometric method helps in quick, cost effective and efficient results in estimation of PPB for ampicillin

Ultrasound-guided multiple peripheral nerve blocks, a way out for anesthesia in morbidly obese patients for bone marrow aspiration / Múltiplos bloqueios de nervos periféricos guiados por ultrassom, uma saída para anestesia em pacientes com obesidade mórbida para aspiração de medula óssea

Abstract Morbid obesity is associated with various pathophysiological changes which affect the outcome of anaesthesia and surgery. So it's challenging to give anaesthesia to such patients. We present a 59-year-old adult morbidly obese, hypertensive, diabetic female with hypothyroidism operated for proximal humerus fracture and now presented with non-union of fracture, requiring percutaneous injection of bone marrow aspirate from the iliac crest to the site of non-union. The patient was extremely anxious and refused to undergo the procedure under local anaesthesia or sedation and demanded anaesthesia. Given her comorbidities general anaesthesia (GA) was avoided and the procedure was accomplished using Ultrasound (USG) guided Transversus abdominis plane (TAP) block and Lateral Femoral Cutaneous Nerve (LFCN) block for the bone marrow aspirate from the iliac crest and Intercostobrachial nerve block (T2) was given to prevent pain while injecting the aspirate into the non-union site. Dexmedetomidine and ketamine were given for deep level sedation and analgesia. TAP block and LFCN block is generally used for post-op analgesia but can be also used for surgical anaesthesia instead of General anaesthesia in specific scenarios. Its perioperative application and its potential use instead of GA have been discussed.

Resumo A obesidade mórbida se associa a várias alterações fisiopatológicas que afetam o desfecho da anestesia e cirurgia. É, portanto, um desafio anestesiar tais pacientes. Apresentamos uma mulher adulta de 59 anos, obesa mórbida, hipertensa, diabética, com hipotiroidismo, submetida a cirurgia devido a fratura proximal do úmero e que compareceu ao serviço com fratura não consolidada, e com indicação de injeção percutânea de aspirado de medula óssea da crista ilíaca na fratura não consolidada. A paciente estava extremamente ansiosa e recusou o procedimento sob anestesia local ou sedação e exigiu anestesia. Em função de suas comorbidades, Anestesia Geral (AG) foi evitada e o procedimento foi realizado usando bloqueio do Plano Transverso Abdominal (PTA) guiado por Ultrassonografia (USG) e bloqueio do Nervo Cutâneo Femoral Lateral (NCFL) para aspiração de medula óssea da crista ilíaca. O bloqueio do nervo Intercostobraqueal (T2) foi realizado para evitar dor durante a injeção do aspirado. Dexmedetomidina e ketamina foram dadas para sedação profunda e analgesia. O Bloqueio PTA e bloqueio NCFL geralmente são usados para analgesia pós-operatória, mas também podem ser usados para anestesia cirúrgica substituindo a anestesia geral em condições clínicas específicas. O emprego desses bloqueios no perioperatório e seu uso potencial no lugar de AG têm sido discutidos.

Full Mouth Rehabilitation in Dental Fluorosis Patient - A Time Restrained Scenario.

Dental Fluorosis which is endemic in nature is considered to be a serious problem in nearly 15 states of India.1 It is defined as hypo-mineralization of enamel resulting from excessive ingestion of fluoride (more than 1 ppm) during tooth development. Excessive fluoride basically disturbs mineralization in the developing tooth by decreasing free calcium ion concentrations in the mineralizing matrix. In turn, it indirectly interferes with the proteinases which degrade matrix proteins during the maturation phase of amelogenesis,2 resulting in delayed enzymatic degradation of enamel matrix proteins.3The fluoride-induced retention of enamel matrix proteins is responsible for impaired and incomplete crystal growth resulting in the increased porosity of enamel, and the subsequent optical and physical changes.4

Stings of the missing string: missing Copper T thread

Background: Missing CuT thread is a worrisome complaint for a woman. The string may be curled in or the Cu T might have expelled or migrated.Methods: It was a retrospective study. Authors collected the data between January 2017 to December 2017. Data was collected from OPD, OT register and Indoor patient record file. The objective was to ascertain the symptomatology, type of insertion, investigations and mode of retrieval of CuT.Results: There were 63 cases of missing CuT thread, out of which, 42 were postpartum. 33 patients were asymptomatic. Irregular vaginal bleeding (19 patients) was commonest complaint, followed by abdominal pain (10 patients). Pregnancy was detected in one patient. Transvaginal ultrasonography (TVS) detected intrauterine location of CuT in 60 cases. X-ray abdomen erect was needed in 3 cases, which detected intra-abdominal migration of CuT in two cases. CuT was expelled in third case. In 31 patients, CuT was removed by artery forceps in OPD. In 17 cases, hysteroscopic Copper T removal was needed. Two cases with migrated CuT underwent laparoscopy for retrieval of CuT. One patient had to be converted to laparotomy to rule out bowel injury.Conclusions: Missing CuT thread is commonest with postpartum IUCD. TVS should be first investigation in missing CuT thread. X-ray abdomen is needed only if CuT is not visualized on TVS. Hysteroscopy can be used in patients where CuT retrieval with artery forceps fails. Laparoscopy and laparotomy may be required in migrated CuT cases.

To Study Adrenal Insufficiency and to Determine Relationship between Serum Albumin and Serum Cortisol Levels in Cirrhotic Patients

Introduction: In patients with cirrhosis, albumin synthesis isdecreased because of the loss of hepatic cell mass. Adrenalinsufficiency (AI) has been demonstrated in patients withsevere liver disease.The percentage of AI in cirrhotic patientsvaries among different studies and depends on differentmethods and criteria used to evaluate adrenal function. Asboth serum albumin and cortisol levels are low in cirrhoticpatients we want to determine relationship between serumalbumin and cortisol levels. Current research aimed to studyadrenal insufficiency in patients of cirrhosis and to determinethe relationship between serum albumin and serum cortisollevels.Material and Methods: Prospective study was done on50 patients of cirrhosis who were admitted in medicine/gastroenterology ward of DMC & H, Ludhiana. Depending onthe levels of cortisol, patients were categorized into 3 groups.Clinically diagnosed patients of cirrhosis were included inour study whereas HIV/Immunodeficiency, Severe chronicheart disease, Chronic obstructive lung disease, Chronichemodialysis, Severe sepsis, septic shock and patients onsteroid therapy were excluded.Results: The data was analyzed using Microsoft excel andSPSS version 20.0 (IBM SPSS, Chicago, Illinois). Meanand standard deviation were computed for the variables. Thecomparison between groups were done by Chi square andANOVA. AI was present in 14 (28%) patients of Cirrhosis.The difference between cortisol levels with respect to Albuminwas found to be statistically significant (0.05).Conclusion: AI forms important part of spectrum of Cirrhosisand these patients should be evaluated for adrenal dysfunction.

Use and inappropriate use of proton pump inhibitors in hospitalized patients

Background: The discovery of Helicobacter pylori infection in etiology of peptic ulcer disease and proton pump inhibitors (PPI) in management of upper gastrointestinal diseases had been the milestones in medical science. PPI are currently being both overused and misused. In countries like India, where over 500 branded formulations of PPI are available, probability of misuse and abuse increases exponentially. The aim of the study was to find out inappropriate use of PPI, among hospitalized patients.Methods: In order to find answer to the research question a cross sectional study was conducted in indoor patient of a tertiary care private hospital at Jaipur, Rajasthan. Patients of either sex, aged 18 years or above belonging to rural and urban communities were participating in study. The sample size was 500.Results: It was noted that Inappropriate PPI use was observed in most of the hospital admitted patients (78%). Most common diagnosis among inappropriate PPI use was dengue fever (due to increased number of dengue cases during study period), followed by cerebrovascular accidents and urinary tract infection. Most common indication for appropriate PPI use was stress ulcer prophylaxis, again in dengue case (due to cardinal manifestation of thrombocytopenia).Conclusions: Almost all patients were once prescribed PPI after admission and discharged on PPI (99.2%). Thus, we recommend evidence-based prescription of PPI, to reduce side effects and excess cost.

A cross-sectional study to evaluate sonographic foetal humerus length for estimation of gestational age in normal singleton pregnancies at a tertiary care centre

Background: Accurate knowledge of gestational age of the foetus is essential for planning a timely and uneventful outcome. Biparietal diameter, head circumference, abdominal circumference and femur length reliably predict gestational age. The humerus length is not widely used as biometric parameter for determining the GA so the present study was done to estimate foetal gestational age by measuring humerus length between 18 to 36 weeks of normal singleton pregnancies and to compare humerus length with routine parameters.Methods: This was a hospital based descriptive cross-sectional study, 200 women with viable singleton pregnancy, with known LMP, between 18 weeks to 36 weeks of gestation were included. Various foetal measurements such as biparietal diameter, head circumference, abdominal circumference, femur length and humerus length were measured using electronic calipers on ultrasound. Data were statistically analyzed.Results: The mean humerus length at 18 weeks was 25.27±1.16 mm and at 36 weeks of gestation was 57.11±1.58 mm. Simple linear regression analysis shows a strongly significant linear relationship between humerus length and gestational age. Where, gestational age (weeks) Y= 0.5213 x humerus length (X) + 4.905; with high degree of correlation coefficient (R2 =0.9785 and P≤0.0001). When Compared with BPD, HC, AC and FL, humerus length also shows a linear correlation.Conclusions: The measurement of the humerus length can be an important additional parameter for estimating gestational age along with other parameters and can be used to predict the gestational age of fetuses in special circumstances.

A Study to Evaluate the Effect of Saroglitazar in Type 2 Diabetes

Introduction: Type 2 diabetes mellitus is a commoncondition characterized by high blood sugar level. This riskgets inflated by lipid abnormalities additionally. Diabeticshave high risk of developing dyslipidemia (AtherogenicDiabetic Dyslipidemia-ADD) which is characterized by hightriglycerides and/or low HDL-C and/or small dense LDL-C.Study aimed to assess difference in mean Fasting plasmaglucose (FPG), Post prandial plasma glucose (PPPG), Lipidparameters [ triglycerides (TG), total cholesterol (TC), verylow density lipoprotein (VLDL), low density lipoprotein(LDL), high density lipoprotein (HDL) and non-HDL] beforeand after adding saroglitazar in patients of type 2 diabetes.Material and Methods: A total of 36 cases with DiabetesMellitus Type 2 aged between 18 and 65 years with their BMI>25kg/m2, HbA1c between 7 and 9% and total cholesterollevels >150mg/dl were enrolled. Their baseline glycemicand lipid parameters were measured and they were givenSaroglitazar 4mg every day for 3 months and their parameterswere checked again at the end of 3 months.Results: It was found that the mean Fasting plasma glucose(FPG), Post prandial plasma glucose (PPPG), Lipid parametersdecreased after 3 months of Saroglitazar therapy and thisdecrease was found to be statistically significant (P<0.001).Conclusion: Thus, addition of Saroglitazar to the drugregimen of the patients with Diabetic Dyslipidemia can bringabout significant improvement in the glycemic and lipidparameters with the added advantage of insignificant adverseeffects, thus proving beyond doubt the efficacy and safety ofthis drug in the treatment of Diabetic Dyslipidemia.

Clinical correlation of vitamin D in depression

Background: Literature has substantially advanced our understanding of the action of vitamin D in depression, much is still unknown concerning how vitamin D relates to dimensions of depression. Hence, authors aimed to examine the relationship of vitamin D in patients of depression, its correlation with the severity of depression and different symptom domains of depression.Methods: This Hospital based case control study included 75 patients with depression and 50 controls who were age and gender matched. Beck’s Depression Inventory II was used to assess the severity and symptom domains of depression. Vitamin D levels was assessed using Enhanced Chemiluminescence Technique.Results: Vitamin D deficiency was found significantly (<0.001*) among cases than controls. Significant (0.003*) inverse correlation was observed between severity of depression and vitamin D level.In cognitive symptoms, pessimism, punishment feeling, self-criticism, suicidal thoughts and worthlessness were found significantly higher among vitamin D deficient patients. However, in somatic-affective symptoms, crying, indecisiveness, loss of energy, irritability, concentration difficulty and being tired were the significant by prominent symptoms in vitamin D deficient patients.Conclusions: Vitamin D (<50 nmol/L) was found to be significantly associated with depressive symptoms with cognitive and somatic-affective symptoms being affected by vitamin D deficiency.

A study of cesarean section rate by using modified Robson's ten group classification system

Background: High caesarean section rate worldwide including India is matter of concern. The Robson’s Ten-group classification system allows critical analysis of caesarean deliveries according to characteristics of pregnancy. The objective was to analyze caesarean section rates in a tertiary care centre according to Modified Robson’s ten groups classification.Methods: This retrospective study was conducted at GMERS Gotri Medical College, Vadodara, Gujarat, India. All patients who delivered between August 2018 and March 2019, were included in the study. Women were classified in 10 groups according to modified Robson’s classification using their maternal characteristics and obstetric history. For each group, authors calculated the caesarean section rate within the group and its absolute and relative contribution to the overall caesarean rate.Results: Total number of delivery in my study institute in 8 months was 1531 out of them 456 was cesarean section, so the overall caesarean section rate was 29.78%. The main contributions to overall caesarean rate was 40.78% by group 5 (previous CS, singleton, cephalic, >37weeks) followed by 14.25% by group 1 (nullipara, singleton, cephalic, >37 weeks, spontaneous labour), 11.40% by group 2 (nullipara, singleton, cephalic,>37 weeks, induced or CS before labour). CS rates among various group ranges from 100% among women with abnormal lie (group 9) to 98.4% in previous CS (group 5), 84% in nulliparous breech (group 6), 58% in multiparous breech (group 7) and least 8.2% in multipara spontaneous labour (group 3).Conclusions: The Robson’s classification is easy to use. It is time to implement obstetric audit to lower the overall CS rates.

Reversal of Hypermethylation in Tumor Suppressor Genes Using Phytochemicals in Cervical Cancer

Cervical cancer is most familiar neoplasm among women worldwide. Surgery, radiotherapy, and chemotherapy are common treatments, however high stage tumors have frequently poor prognosis. HPV 16 and 18 are major etiological factors for cervical cancer. Likewise, epigenetics is the study of inherited changes and modulated gene expression without alteration in DNA sequences. In mammals epigenetic modifications include DNA methylation, histone modifications and miRNA. Phytochemicals are mainly contained in fruits, seeds, and vegetables as well as in foods supplements. Numerous dietary compounds exhibit potent anti-tumor activities through the reversion of epigenetic alterations associated to oncogenes activation and inactivation of tumor suppressor genes in cervical cancer cell lines SiHa and HeLa, demethylation of the tumour suppressor genes such as RARβ2, MGMT, RASSF1A, DAPK etc. Reversal of hypermethylated genes as a tumor-suppressor gene, is related to inhibition of cell proliferation, development and differentiation. The impact of phytochemicals lead to the reversal of hypermethylation which may help to cure cervical cancer. This study concludes the effect of phytochemicals on genetic and epigenetic modifications and reveals how these modifications help to prevent various types of cancers and improve health outcomes.