Comparison of clinical and biometric characteristics between nanophthalmic children and age-matched controls

Purpose: To compare the clinical and biometric characteristics of children presenting with nanophthalmos (NO group) with that of age?matched controls (CO group). Methods: Electronic medical records of 40 children (<18 years of age) with diagnosis of nanophthalmos (NO), presented to a tertiary center in Tamil Nadu between January 2010 and December 2019, were reviewed and compared with 30 age?matched controls (CO) presenting for routine eye examination between October 2019 and December 2019. Clinical parameters compared were best?corrected visual acuity (BCVA), axial length (AxL), keratometry (K), anterior chamber depth (ACD), lens thickness (LT), retinochoroidal scleral thickness (RCS), corneal diameter, central corneal thickness (CCT), intraocular pressure (IOP), lens axial length factor (LAF), and lens thickness/anterior chamber depth ratio (LT/ACD). Results: Mean age of the NO group was 8.95 ± 4.0 years. Mean spherical equivalent (SE) in NO group was 10.87 ± 3.1 D and was inversely correlated to AxL (r = ?0.46, P value = 0.003). All biometric parameters (AxL, ACD, LT, RCS, LAF, and LT/ACD), except CCT were significantly different between NO and CO groups. NO group children had 52.5% visual impairment with BCVA ? 6/24 and 17.5% had esotropia. Common ocular associations in NO group were amblyopia (64.3%), primary angle?closure glaucoma (PACG) (17.8%), pigmentary retinopathy (14.3%), and retinal detachment (3.6%). Angle?closure disease was seen in 50% of NO group and 30% underwent laser peripheral iridotomy (LPI). There was a significant difference in SE, ACD, and LAF among NO children with AxL <17 mm or >17 mm. Multivariable regression analysis revealed a significant correlation of SE and ACD with AxL. Conclusion: Nanophthalmos in children often present as amblyopia with visual impairment and strabismus. NO group with AxL <17 mm, had angle?closure disease as a common association with significantly lower ACD, higher SE, and LAF. All morphometric characteristics, except CCT, were significantly different between NO and CO groups. Close monitoring with serial biometry in NO group is needed for the timely diagnosis and prompt intervention to avoid visual impairment, due to glaucoma

Cross-sectional observational analysis of the genetic referral practices across pediatric ophthalmology outpatient departments in an urban setting

Purpose: To analyze the genetic referral practices of pediatric ophthalmologists in an urban setting. Methods: (1) The first limb of the study: cross?sectional, observational study among children visiting the outpatient department of pediatric ophthalmology across five centers in Mumbai. All pediatric patients were screened separately by pediatric ophthalmologists and a clinical geneticist for their ophthalmic and systemic complaints. Children were marked for referral to genetics (RTG) by both the specialists based on identification of distinctive features (red flag) and were requested to meet a local geneticist. (2a) Twenty?three months later, patients who had been marked for RTG were contacted telephonically to follow?up if they had met the geneticist. (2b) Additionally, the last 20 proformas from each center were checked retrospectively to note the RTG marked by the ophthalmologist alone. Results: (1) In the first aspect of the study, 126 patients (male: female = 1.2:1) were included. Forty?nine (38.3%) patients were referred for genetic evaluation, of which three (6.1%), 31 (63.26%), and 15 (30.6%) cases were referred by the ophthalmologist alone, geneticist alone, and by both the specialists, respectively. Glaucoma (100%), nystagmus (86%), and leukocoria (83%) were the most prominent ocular diagnoses in cases referred for genetic evaluation. Facial dysmorphism (55.1%) and neurodevelopmental delays (51%) were among the most common systemic red flags found in patients referred to genetics. (2a) Twenty?three months later, on contacting the 49 patients marked for RTG, only one family had met the geneticist. (2b) Retrospective evaluation of 100 proformas: only three patients were marked for RTG by ophthalmologist alone. Conclusion: This study found that the genetic referrals by pediatric ophthalmologist were far lesser than those by geneticist. The study highlights an area of knowledge gap among pediatric ophthalmologists, prompting a need for heightened awareness in this area.

Late Onset Subacute Profound Biotinidase Deficiency Caused by a Novel Homozygous Variant c.466-3T>G in the BTD Gene

Biotinidase defciency (BD) is an autosomal recessive disorder caused by bi-allelic mutation in the BTD gene. Clinical manifestations in BD mainly depends on residual biotinidase enzyme activity, although there are some exceptions. Broadly BD disorders are classifed as profound BD and partial BD. Further profound BD can be early onset, late onset, and sometimes may be asymptomatic. Clinically late-onset profound BD can present with spectrum of manifestations ranging from single organ to multiple organ involvement, typically afecting function of brain, eye, ear, and skin. Here, a frst-born child to consanguineous parents with late-onset profound BD presenting with hyperventilation secondary to lactic acidosis, hypotonia, evolving spasticity, and abnormal neuroimaging fndings caused by novel homozygous variant, c.466-3T>G in the BTD gene is reported.

Precursor B-lineage acute lymphoblastic leukemia patients with aberrant natural killer cell and T cell - lineage antigen expression: experience from a tertiary cancer care center

Abstract Introduction Flow cytometric immunophenotyping (FCI) plays a major role in diagnosing hematologic malignancies. In patients diagnosed with precursor B-lineage acute lymphoblastic leukemia (B-ALL), expression of certain non-lineage/cross lineage antigens is of prognostic and cytogenetic relevance. There is a paucity of studies that have comprehensively analyzed the clinical and laboratory profiles of B-ALL patients showing aberrant T/natural killer (NK) cell antigen expression. Materials and methods This is a prospective study where 152 consecutive B-ALL patients were analyzed for aberrant expression of T/NK cell antigens (CD1a, CD5, CD4, CD7, CD8 and CD56) by FCI. The clinical and laboratory profile of these T/NK-cell antigen-expressing B-ALL patients was statistically analyzed against conventional B-ALL patients. Results In our B-ALL cohort, CD5, CD7 and CD56 expression were observed in one, six and nine patients, respectively. CD56-expressing B-ALL patients were predominantly children (89%) and presented as standard clinical risk (p = 0.010) disease with frequent ETV6-RUNX1 fusion (p = 0.021) positivity. On the contrary, CD7-expressing B-ALL patients were adolescent-young adult/adult-age skewed (83%) and had an adverse cytogenetic profile (p = 0.001), especially for the frequent presence of BCR-ABL1 fusion (p = 0.004) and KMT2A rearrangement (p = 0.045). CD7-expressing B-ALL patients had inferior event-free survival (p = 0.040) than their CD56-expressing counterparts, but there was no significant difference in the overall survival (p = 0.317). Conclusion In comparison to conventional B-ALL patients, there are significant differences in the age, cytogenetic profile and event-free survival of T/NK-cell antigen-expressing B-ALL patients.

In vitro cytotoxicity assay of Fucoidan extracted from Turbinaria conoides against cancer cell lines MCF7, A549, and normal cell line L929

Abstract The main aim of the study is to quantify the cytotoxic property of the Fucoidan extracted from the Turbinaria conoides using the MTT assay with the standard fucose. Fucoidan was extracted using the soaked water method and it was determined using the HPLC procedure the obtained Test sample Fucoidan extracted from the Turbinaria conoides and standard fucose was subjected to the cytotoxicity assay against the MCF7 Human breast cancer cell line, A549 lung cancer cell line, and L929 normal mouse fibroblast cell line. From the results it was found that the Test sample showed good IC50 value for MCF7 cell line then A549 with an increasing concentration 24 hours incubation at 37°C The IC50 for MCF7 was 115.21 µg/ml and A549 396.46µg/ml and the Fucoidan extract was checked for its cytotoxicity against the normal mouse fibroblast cell line L929, Fucoidan was found non-lethal to the L929 mouse fibroblast normal cell line. Standard fucose also gave a significant result towards MCF7 and against the L929. This indicates that the Fucoidan extracted from Tubinaria conoides shows better anticancer potential in it. Hence its application can be further extended in the pharmacological fields.

Effect of Combining EGFR Tyrosine Kinase Inhibitors and Cytotoxic Agents on Cholangiocarcinoma Cells / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#The potential of members of the epidermal growth factor receptor (ErbB) family as drug targets in cholangiocarcinoma (CCA) has not been extensively addressed. Although phase III clinical trials showed no survival benefits of erlotinib in patients with advanced CCA, the outcome of the standard-of-care chemotherapy treatment for CCA, gemcitabine/cisplatin, is discouraging so we determined the effect of other ErbB receptor inhibitors alone or in conjunction with chemotherapy in CCA cells. Materials and Methods ErbB receptor expression was determined in CCA patient tissues by immunohistochemistry and digital-droplet polymerase chain reaction, and in primary cells and cell lines by immunoblot. Effects on cell viability and cell cycle distribution of combination therapy using ErbB inhibitors with chemotherapeutic drugs was carried out in CCA cell lines. 3D culture of primary CCA cells was then adopted to evaluate the drug effect in a setting that more closely resembles in vivo cell environments. @*Results@#CCA tumors showed higher expression of all ErbB receptors compared with resection margins. Primary and CCA cell lines had variable expression of erbB receptors. CCA cell lines showed decreased cell viability when treated with chemotherapeutic drugs (gemcitabine and 5-fluorouracil) but also with ErbB inhibitors, particularly afatinib, and with a combination. Sequential treatment of gemcitabine with afatinib was particularly effective. Co-culture of CCA primary cells with cancer-associated fibroblasts decreased sensitivity to chemotherapies, but sensitized to afatinib. Conclusion Afatinib is a potential epidermal growth factor receptor targeted drug for CCA treatment and sequential treatment schedule of gemcitabine and afatinib could be explored in CCA patients.

Effect of Combining EGFR Tyrosine Kinase Inhibitors and Cytotoxic Agents on Cholangiocarcinoma Cells / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#The potential of members of the epidermal growth factor receptor (ErbB) family as drug targets in cholangiocarcinoma (CCA) has not been extensively addressed. Although phase III clinical trials showed no survival benefits of erlotinib in patients with advanced CCA, the outcome of the standard-of-care chemotherapy treatment for CCA, gemcitabine/cisplatin, is discouraging so we determined the effect of other ErbB receptor inhibitors alone or in conjunction with chemotherapy in CCA cells. Materials and Methods ErbB receptor expression was determined in CCA patient tissues by immunohistochemistry and digital-droplet polymerase chain reaction, and in primary cells and cell lines by immunoblot. Effects on cell viability and cell cycle distribution of combination therapy using ErbB inhibitors with chemotherapeutic drugs was carried out in CCA cell lines. 3D culture of primary CCA cells was then adopted to evaluate the drug effect in a setting that more closely resembles in vivo cell environments. @*Results@#CCA tumors showed higher expression of all ErbB receptors compared with resection margins. Primary and CCA cell lines had variable expression of erbB receptors. CCA cell lines showed decreased cell viability when treated with chemotherapeutic drugs (gemcitabine and 5-fluorouracil) but also with ErbB inhibitors, particularly afatinib, and with a combination. Sequential treatment of gemcitabine with afatinib was particularly effective. Co-culture of CCA primary cells with cancer-associated fibroblasts decreased sensitivity to chemotherapies, but sensitized to afatinib. Conclusion Afatinib is a potential epidermal growth factor receptor targeted drug for CCA treatment and sequential treatment schedule of gemcitabine and afatinib could be explored in CCA patients.

Xanthogranulomatous pyelonephritis with calculus migration into the psoas abscess: an unusual complication

Xanthogranulomatous pyelonephritis (XGP) is a rare variant of chronic pyelonephritis. It is characterized by progressive parenchymal destruction caused by chronic renal obstruction due to calculus, stricture, or rarely tumor, resulting in kidney function loss. Herein, we describe the case of a 36-year-old female who presented with left loin pain, left lower limb pain, and dysuria. On contrast-enhanced computed tomography (CECT), multiple abscesses and an obstructive staghorn calculus were depicted in the left kidney with the classical appearance of "Bear Paw Sign." An abscess with calculi was also present within the left psoas muscle. Though psoas muscle abscess in association with XGP was described, a ureteric fistula and calculi within the psoas muscle have not yet been reported in the literature. Left nephrostomy was performed, which came out to be positive for E. coli on culture. The patient underwent left nephrectomy, and the histopathological report of the surgical specimen confirmed XGP.

Evaluation of the P16INK4a Expression in Cervical Biopsy Specimen SBMCH

In early 1980 human papillomavirus (HPV) were the risk factor and most commonly affects younger women. Many test have developed since then and among that a biomarker test system have developed and clinically evaluated. P16INK4a is used as an important marker for indicating neoplastic transformation for cervical dyplasia. This study was done to evaluate the P16INK4a expression in cervical biopsy in 50 cases. Two cases were identified a P16INK4a positive and remaining 48 didn’t show P16INK4a expression proving the hypothesis that p16INK4a is capable of showing the dysplasia positive cases

Efficacy of different doses and timing of tranexamic acid in major orthopedic surgeries: a randomized trial / Eficácia de diferentes doses e esquemas de administração de ácido tranexâmico em cirurgias ortopédicas de grande porte: estudo randomizado

Abstract Background: Tranexamic acid was studied in four different dosage regimens and their efficacy was compared for perioperative blood loss reduction, blood transfusion requirements and deep vein thrombosis (DVT) complication. Methods: Two hundred patients undergoing major orthopedic procedures were divided into five groups containing 40 patients each: Placebo, low dose (bolus 10 mg kg-1), low dose + maintenance (bolus 10 mg kg-1 + maintenance 1 mg kg-1 hr-1), high dose (bolus 30 mg kg-1) and high dose + maintenance (bolus 30 mg kg-1 + maintenance 3 mg kg-1 hr-1). Surgical blood loss was measured intraoperatively and drains collection in the first 24 hours postoperatively. Blood transfusion was done when hematocrit falls less than 25%. DVT screening was done in the postoperative period. Results: The intraoperative blood loss was 440 ± 207.54 mL in the placebo group, 412.5 ± 208.21 mL in the low dose group, 290 ± 149.6 ml in the low dose plus maintenance group, 332.5 ± 162.33 mL in the high dose group and 240.7 ± 88.15 mL in the high dose maintenance group (p < 0.001). The reduction in postoperative blood loss in the drain for first 24 hours was 80 ± 44.44 mL in the placebo group, 89.88 ± 44.87 mL in the low dose group, 56.7 ± 29.12 mL in the low dose plus maintenance group, 77.9 ± 35.74 mL in the high dose group and 46.7 ± 19.9 mL in the high dose maintenance group (p < 0.001). DVT was not encountered in any patient. Conclusion: Tranexamic acid was most effective in reducing surgical blood loss and blood transfusion requirements in a low dose + maintenance group.

Resumo Justificativa: O ácido tranexâmico foi avaliado em quatro esquemas com diferentes posologias, comparando-se a eficácia de cada esquema quanto a redução na perda sanguínea perioperatória, necessidade de transfusão sanguínea e ocorrência de Trombose Venosa Profunda (TVP). Método: Duzentos pacientes submetidos a procedimentos ortopédicos de grande porte foram divididos em cinco grupos de 40 pacientes de acordo com o esquema de administração de ácido tranexâmico: grupo placebo, grupo baixa dose (bolus de 10 mg.kg-1, grupo baixa dose e manutenção (bolus de 10 mg.kg-1 + manutenção de 1 mg.kg-1.h-1), grupo alta dose (bolus de 30 mg.kg-1), e grupo alta dose e manutenção (bolus de 30 mg.kg-1 + manutenção de 3 mg.kg-1.h-1). A perda sanguínea cirúrgica foi medida no intraoperatório. Além disso, nas primeiras 24 horas pós-operatórias, foi medido o volume de sangue coletado no dreno. Era realizada transfusão de sangue se o valor do hematócrito fosse inferior a 25%. Foi realizada avaliação quanto à ocorrência de TVP no pós-operatório. Resultados: A perda sanguínea intraoperatória foi de 440 ± 207,54 mL no grupo placebo, 412,5 ± 208,21 mL no grupo baixa dose, 290 ± 149,6 mL no grupo baixa dose e manutenção, 332,5 ± 162,33 mL no grupo alta dose, e 240,7 ± 88,15 mL no grupo alta dose e manutenção (p < 0,001). A redução na perda sanguínea pós-operatória pelo dreno nas primeiras 24 horas foi de 80 ± 44,44 mL no grupo placebo; 89,88 ± 44,87 mL no grupo baixa dose, 56,7 ± 29,12 mL no grupo baixa dose e dose de manutenção, 77,9 ± 35,74 mL no grupo alta dose e 46,7 ± 19,9 mL no grupo alta dose e manutenção (p < 0,001). TVP não foi observada em nenhum paciente. Conclusão: O ácido tranexâmico administrado em baixa dose combinado à manutenção foi mais eficaz em reduzir a perda sanguínea cirúrgica e a necessidade de transfusão de sangue.

Comparision of CT Colonoscopy and Conventional Colonoscopy in Evaluation of Colorectal Malignancies

CT colonoscopy is one of the recent advances in the field of Computed tomography with various post processing techniques. The aim of work is to evaluate and compare the role of CT colonoscopy and conventional colonoscopy in diagnosing and characterizing the colorectal malignancies. Subject and Methods:Our study included 50 patients with lower GI sypmtoms; 6 of them had colorectal malignancies. They ranged in age from 28 to 60 years. All patients were subjected to CT colonoscopy examination and results were compared to conventional colonoscopy and documented by histopathology in all cases. Results:The results in our study showed that CT colonoscopy has equal sensitivity and specificity in diagnosing colorectal malignancies when compared to conventional colonoscopy and further helps in delineating the locoregional extent of the lesion.

Evaluation of Giddiness with MRI

Giddiness is a non-specific symptom or feeling that includes sensations such as faintness, light headedness, vertigo and imbalance. The purpose of the study was to evaluate the role of magnetic resonance imaging (MRI) in diagnosing the cause of giddiness in symptomatic patients. A prospective cohort study was conducted in 106 patients who presented with giddiness. MRI scans of these patients were analysed, and we concluded that MRI can successfully demonstrate the significant findings which cause giddiness

Volume changes during head-and-neck radiotherapy and its impact on the parotid dose – A single-institution observational study

Aims: This study aims at assessing the volume changes that occur in the targets (gross tumor volume and planning target volume [PTV]) and the organs at risk in squamous cell carcinoma of the head and neck during radiotherapy and assessing the dose changes that occur as a result of them. Settings and Design: This was a prospective observational study in a tertiary care center after obtaining the appropriate scientific and ethics committee clearance. Subjects and Methods: Forty-five patients diagnosed with squamous cell carcinoma of the head and neck, who were treated with intensity-modulated radiotherapy in the time period from March 2018 to May 2019, were enrolled in the study. A planning computed tomography (CT) scan (CTplan) was done for all patients, followed by scans after 15 fractions (CT15) and after 25 fractions (CT25). The volume changes and the subsequent dose changes were assessed and recorded. Statistical Analysis Used: Data entry was done in MS Excel spreadsheet. The continuous variables were expressed as mean + standard deviation. The comparison of normally distributed continuous variables was done by paired t-test. Data analysis was done by SPSS (Statistical Package for the Social Sciences) version 16.0. P < 0.05 was considered statistically significant. A multivariate linear regression model was constructed to study the correlation between mean dose to the parotid glands and the other variables. All statistical modeling and analysis were done using SAS (Statistical Analysis Software) version 9.4. Results: Of the 45 patients, 25 were male and 20 were female. The majority of the patients had malignancies in the oral cavity (16) and hypopharynx (14). Most of them had Stage III/IV (AJCC v 8) disease (41). There were a 36% decrease in the PTV-high risk (PTV-HR) volume and a 6.05% decrease in the PTV-intermediate risk (PTV-IR) volume CT15. In CT25, the volume decrease in the PTV-HR and the PTV-IR was 47% and 9.06%, respectively. The parotid glands also underwent a reduction in their volume which has been quantified as 21.7% and 20.9% in the ipsilateral and contralateral parotids in CT15 and 36% and 33.6% in CT25, respectively. The D2 (dose received by 2% of the volume) and D98 (dose received by 98% of the volume) of the PTV-IR showed changes of +3.5% and –0.2% in CT15 and + 4.6% and –0.31% in CT25, respectively. The homogeneity index and conformity number of the PTV-IR changes by 0.03 and 0.08 in CT15 and by 0.04 and 0.12 in CT25, respectively. The mean dose to the ipsilateral parotid gland increased by 14% in CT15 and 19% in CT25. The mean dose to the contralateral parotid gland increased by 17% in CT15 and 25% in CT25. Conclusion: The dose to the parotid glands increases as a result of the changes that occur during the course of radiation. The changes are significant after 15 fractions of radiation. A replanning at this juncture might be considered to reduce the dose to the parotid glands

A cross sectional study of prevalence of depression among patients with cerebrovascular accident

Background: Depression is one of the most common neuropsychiatric condition in patients with stroke. Early identification of depression for stroke patients can improve the outcome leading to better quality of life. Prevalence and determinants of post stroke depression are highly variable and there is paucity of data in Indian literature.Methods: This cross-sectional study was conducted at neurology department of Saveetha Medical College, Chennai. All patients with history of stroke within past one month attending neurology department who fulfilled the inclusion criteria were taken up for the study after getting consent. Neurological examination and CT brain findings were noted with the site of lesion. All patients were evaluated for depression using ICD 10 criteria. MADRS score was used to assess the severity of depression. Chi square was used for statistical analysis.Results: The mean age of subjects in the study was 56.54±10.82 years. The prevalence of depression among patients with stroke in our study was 75.8%. Among classifying those with depression based on severity using MADRS score, 35% had mild depression and 65% had moderate depression. There was no severe depression in our sample. There was no statistically significant difference between prevalence of depression based on side of lesion.Conclusions: In this study the prevalence of depression among patients with cerebrovascular accident was found to be 75.8%. From this study we learn that the prevalence of depression in patients with stroke is high and this shows that regular screening of patients with stroke for depression might help in earlier detection and management of depression.

Appraisal of Hydro-alcoholic Fruit Extract of Citrulluscolocynthis on Type II Collagen-induced Arthritis Mediated Diabetes in Rats

Context – Rheumatoid arthritis (RA) is a chronic inflammatory systematic auto-immune disease affectingthe synovial joints which is associated with progressive disability, premature death followed by socioeconomicburden. Citrullus colocynthisin its previous study has been reported for its anti-inflammatory activity onanimal models.Objective – The present study was designed to evaluate the effect of Citrullus colocynthis on type IIcollagen induced Arthritis mediated diabetes in Wistar rats.Materials and methods – The Collagen induced arthritis model was established and the animals wererandomly divided into five groups. Each group was orally administered with the extract (250 mg/kg and 500mg/kg). Treatment was started on the 14th day and persisted for 25 days. The symptoms of Collagen inducedArthritis and the extract treatment was compared and investigated.Results – Extract (500 mg/kg) showed a significant decrease of IL-6 and TNF –  followed by a decreasein the blood glucose levels when compared with the positive control. Extract treatment diminished theswelling of the hind limbs and monocyte infiltration in blood vessels in a Collagen induced arthritis animalmodel.Conclusion – The results indicate that Citrullus colocynthis extract could be used to improve arthritis byreducing the inflammatory factors such as TNF – and IL -6. However further experiments are required todetermine the influence of Citrullus colocynthis extract on signal transduction in animal models.

Ultra-widefield fundus fluorescein angiography in pediatric retinal vascular diseases

Purpose: To describe the utility of RetCam ultra-wide-field fundus fluorescein angiography in pediatric retinal vascular diseases. Methods: A retrospective chart review was carried out in 43 eyes of 22 pediatric patients who were diagnosed or suspected to have a retinal vascular disease. Fluorescein angiography was carried out using the 130 degree lens of RetCam 3. Fluorescein angiography guided treatment (laser/cryotherapy) was carried out wherever required. Results: Diseases studied included - coats disease, familial exudative vitreoretinopathy, retinopathy of prematurity, congenital retinal folds, double optic nerve head, persistent fetal vasculature and incontinentia pigmenti. RetCam assisted fluorescein angiography was helpful in establishing a diagnosis in 4 patients (18%), in decision making regarding treatment in 18 patients (82%), in deciding need for retreatment in 5 patients (23%), helped in staging of disease in 5 patients (23%) and in detecting clinically subtle findings in 6 patients (27%). Conclusion: RetCam assisted FFA is extremely useful to document peripheral retinal vascular pathologies in pediatric patients and helps to take crucial therapeutic and retreatment decisions.

A comparative study of lipid profile in smokers and non smokers between 30 to 40 years and prediction of 10 years risk of cardiovascular disease based on Framingham scores

Background: Atherosclerosis has been described as a lipid driven inflammatory disorder of the arterial wall. Smoking is one of the most common modifiable risk factors for atherosclerosis and is the major epidemiological factor in increasing morbidity and mortality of chronic heart diseases (CHD). The objectives of this study were based on to estimate the status of lipid profile in both smokers and non-smokers and compare with each other, to predict the 10 years risk of cardiovascular risk based on Framingham score in smokers and non-smokers.Methods: This retrospective, case-control study was conducted among 50 smokers (cases) and 50 normal individuals (controls) attending to the department of medicine during the period between December 2016 and May 2018. The socio-demographic data and clinical history was obtained using a semi-structured questionnaire and then patients were subjected to blood investigations including estimation of lipid profile by CHOD/PAP method.Results: The mean age of the study participants was 34.7±2.9 years. The duration of smoking among the smokers was 5.4±2.9 years on an average. There was a significant increase in serum cholesterol levels (245.6±39.8 versus 155.8±15.2 mg/dl), serum triglycerides (217.3±42.2mg/dl versus 127.4±10.6), LDL (171.1±35.2 versus 85.7±15.1 mg/dl) and VLDL (43.5±10.5 versus 15.3±5.5mg/dl) among the smokers versus non-smokers. There was a significant (p<0.001) decrease in HDL levels among the smokers (30.8±3.4 mg/dl) when compared with the non-smokers (44.8±5.3 mg/dl). There was a highly significant difference between Framingham risk scores of smokers and non-smokers.Conclusions: The study established that the lipid profile was deranged towards atherogenesis among the smokers when compared to the non-smokers which was reflected in the significant increase in risk as calculated by Framingham risk score.

Neoadjuvant concurrent chemoradiation in male breast cancer: Experience from a tertiary cancer center

BACKGROUND: Male breast cancers (MBC) account for 1% of all breast cancers. Neoadjuvant concurrent chemoradiation (CTRT) is not the standard of care for treating breast cancer. However, in our center, it has been routinely used in patients with locally advanced breast cancer to downsize the tumor and make it amenable to surgery. AIM: This study was conducted to examine the clinical and pathological profile and outcomes of patients with MBC treated at our institute with neoadjuvant CTRT. SETTINGS AND DESIGN: The study was conducted at a tertiary cancer center and was retrospective in nature. MATERIALS AND METHODS: All MBC patients treated with neoadjuvant CTRT at our center between 2001 and 2016 were enrolled in the study. Data were retrospectively extracted from the patients' case records. STATISTICAL ANALYSIS: Kaplan–Meier method was used for survival analysis and the outcome variables were compared using the log-rank test. RESULTS: Thirty-one MBC patients who received neoadjuvant CTRT were analyzed in this study. The median age of the patients was 53 years. Stage IIB disease was observed in 8/31 (26%) patients, stage III in 20/31 (64%), and stage IV in 3/31 (10%) patients. There was no grade 3 or 4 toxicity due to CTRT. Surgery was performed in 29/31 (94%) patients and none of the patients had a pathological complete response. The median duration of follow-up was 95.3 months. The 8-year event-free survival and overall survival for stage IIB, III, and IV were 75%, 50%, and 0% and 87.5%, 69%, and 0%, respectively. CONCLUSION: This is the first study to report on the use of neoadjuvant CTRT in MBC. Prospective evidence from phase-3 randomized controlled trials on the safety and efficacy of CTRT in breast cancer is required before its routine use can be recommended.

A study on neurological manifestations of primary varicella zoster virus infection

@#Background & Objective: About 95% of the adult population has been infected with varicella zoster virus (VZV). It can involve any part of the nervous system. This study aimed to determine the spectrum of neurological manifestations in patients with primary varicella zoster virus infection, its clinical course and prognosis. Methods: This was an observational study of patients who presented with primary VZV infection in the Institute of Neurology, Madras Medical college, Chennai between August 2015 and February 2018. Patients with neurological manifestations due to VZV reactivation were not included in the study. Detailed history, clinical examination, blood investigations, MRI brain and whole spine, CSF analysis including viral studies, nerve conduction studies, EEG were analysed. All primary VZV patients were found to have characteristic chickenpox rash and/or its scar. The course of disease and clinical outcome after treatment were studied. Results:Among the 22 patients, 10 patients presented with VZV meningoencephalitis, 4 patients with Guillain-Barré syndrome (GBS), 2 patients with meningoencephalitis with cerebellitis, 2 patients with cerebellitis, 1 patient as acute disseminated encephalomyelitis ( ADEM), 1 patient as neuromyelitis optica (NMO), Two patients had acute stroke like deficits due to VZV vasculopathy. GBS and ADEM patients were treated with intravenous immunoglobulin and NMO patient was treated with intravenous methylprednisolone and they clinically improved after 4 weeks. There were two mortalities (9%). Conclusion: Meningoencephalitis followed by GBS were the main manifestations of primary VZV from Chennai, India

Role of a 19S Proteasome Subunit- PSMD10(Gankyrin) in Neurogenesis of Human Neural Progenitor Cells

PSMD10(Gankyrin), a proteasome assembly chaperone, is a widely known oncoprotein which aspects many hall mark properties of cancer. However, except proteasome assembly chaperon function its role in normal cell function remains unknown. To address this issue, we induced PSMD10(Gankyrin) overexpression in HEK293 cells and the resultant large-scale changes in gene expression profile were analyzed. We constituted networks from microarray data of these differentially expressed genes and carried out extensive topological analyses. The overrecurring yet consistent theme that appeared throughout analysis using varied network metrics is that all genes and interactions identified as important would be involved in neurogenesis and neuronal development. Intrigued we tested the possibility that PSMD10(Gankyrin) may be strongly associated with cell fate decisions that commit neural stem cells to differentiate into neurons. Overexpression of PSMD10(Gankyrin) in human neural progenitor cells facilitated neuronal differentiation via β-catenin Ngn1 pathway. Here for the first time we provide preliminary and yet compelling experimental evidence for the involvement of a potential oncoprotein – PSMD10(Gankyrin), in neuronal differentiation.