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Background: The breast is a paired organ. The two breasts share many of the risk factors known to contribute to the development of cancer genetics, environmental exposure, diet, and estrogen exposure, etc. By studying differences in the occurrence of breast cancer between the left and right breast, we can control for these common risk factors. Previous studies of breast cancer asymmetry have established that the laterality ratio is greater than 1.0 in women.Methods: We have taken 420 total cases to study the breast tumour laterality in women and age wise incidence of carcinoma breast in northern India. The study included all consecutive adult patients with histologically confirmed breast cancer, either invasive or carcinoma in situ. Multiple cancers were defined as two or more primary cancers occurring in an individual that were not an extension, recurrence, or metastasis. Based on the chronology of presentation, they were categorized as synchronous or metachronous primaries.Results: Out of 420 cases of breast cancer it was seen that 193 patients i.e. 45.95% of women under observation had left sided breast tumour, 225 patients i.e. 53.57% of women had right sided breast tumour and only 2 patients i.e. 0.48% patients had bilateral lesions in the breast.Conclusions: This result suggests the possible role of estrogen hormone in the reversed lateralization of breast cancer in comparison to other paired organ cancers in post-menopausal women suggesting that North Indian population has higher incidence of right sided breast cancer.
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Smile is an important physical factor for reflection of inner emotions and well being of person. People with an aesthetic smile are judged socially attractive. It would be useful to represent some desirable characteristics of the smile, which help to achieve desirable results in surgical and aesthetic oral rehabilitation. To analyze the various aesthetic components of smile, assessing the teeth displayed during smile, relationship between curve formed by incisal line of anterior maxillary teeth and the curve of lower lip, the touch of this incisal line on lower lip, the alignment of facial midline with the arch midline and compared the data with the previous studies. The study comprises of 200 North Indian males age group 18-40 years. Prior informed written consent for this study was obtained from the subjects. The exclusion and inclusion criteria for the subjects were predefined. Photographs were taken both in rest position as well as in Smile position using digital camera with high resolution. Results show that during smile the position of upper lip was average in 49% of males, alignment of upper incisal edge to lower lip was convex in 47%, tooth lower lip was non touching in 60%, no. of teeth displayed during smile was 8-10 in 68%, midline from philtrum passing through the centre of central incisors in 76% and bilateral negative space was not visible in 92% males. So, it is concluded that smile is aesthetic in North Indian males.
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The aim of this study was to investigate development of third molars in 18 year old North Indian male population by means of CT scans and 3D software imaging. Methods: A retrospective analysis of CT scans of 50 patients aged 18 years at the time of their scan was conducted, and the developmental stages of the left third molars were evaluated using Demirjian's classification. Demirjian's classification system distinguished eight stages of crown and root development (Stages A-H). Results: The percentile distributions were recorded for each stage of development and variations for different stages were noted. The developmental and physiological changes of the tooth can be correlated to chronological age. Conclusion: The present investigation could provide reference data for third molar development in the North Indian population and maybe used in wider studies of tooth development and age prediction using dental radiographs for forensic and medico- legal purposes.
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Background “Coronary slow flow’’ (CSF) is delayed vessel opacification in the absence of epicardial stenosis. Studies in different ethnic groups have found variable risk factors associated with CSF. Aim of present study was to analyze the risk factors and angiographic profile of CSF in North Indian population, not studied till date. Methods 40 patients with CSF and 40 controls were studied. CSF was determined quantitatively by thrombolysis in myocardial infarction (TIMI) frame count method. Various clinical risk factors (age, sex, body mass Index (BMI), diabetes, hypertension, dyslipidemia, smoking), hematological and biochemical parameters (hematocrit, platelet count, uric acid, homocysteine, fibrinogen, high sensitivity C reactive protein (hsCRP), glycosylated hemoglobin (HbA1c) were assessed. Results Of the 40 patients with CSF, 37 (92.5%) were males. While 20 patients (50%) presented with chronic stable angina, rest 20 (50%) presented with acute coronary syndrome. [15 (37.5%) with unstable angina and 5 (12.5%) with non ST elevation myocardial infarction (NSTEMI)]. Patients with CSF had significantly higher BMI (27.27 ± 2.82 vs. 24.12 ± 2.35, p < 0.001), fibrinogen levels (398.48 ± 120.96 vs. 331.55 ± 162.6, p = 0.04) and smoking (24(60.0%) vs 14(35.0%), p = 0.02). On multivariable regression analysis, only BMI was found to have an independent association with CSF (odds ratio 1.613, 95% confidence interval 1.265–2.057, p < 0.001). Conclusion This is the first study to analyze clinical presentation, angiographic profile and risk factors associated with CSF in North Indian population. In this study, we found only BMI to have an independent association with CSF.
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Background: The gene encoding eNOS is located on chromosome 7q36, a genetic region previously linked to metabolic syndrome, cardiovascular and renal diseases. Generally, in diabetes there are numerous genes involved, each being a small contributor in type 2 diabetes mellitus (T2DM) manifestation. A 27 bp variable number of tandem repeat (27 bp VNTR a/b) in intron 4 of enos gene has gained attention and this polymorphism may affect the expresssion of eNOS. We studied the association of eNOS-27 bp VNTR with T2DM in north indian population. Material and methods: Blood samples were collected in 0.5 M EDTA from 200 T2DM patients and 210 age/sex matched healthy controls. Genomic DNA was extracted from peripheral blood mononuclear cells (PBMCs) using the salting out method. The 27-VNTR polymorphism was determined by standard PCR amplification using forward and reverse primers 5'-AGGCCCTATGGTAGTGCCTTT-3’ and 5'-TCTCTTAGTGCTGTGGTCAC-3’ respectively. The genotypes were determined by analyzing the amplified products on 2% agarose gels. Genotypic and allelic frequencies were calculated by SPSS (version 15.0). Results: Clinical and biochemical profiles of healthy controls and T2DM cases as well as gender wise comparisons showed significant association in certain parameters (p<0.001). Five different alleles (I, II, IV, V and VI) were found in the study population. The genotypic frequency was significantly associated with T2DM (P <0.001). Conclusion: A significant role of allele ‘I’ in T2DM susceptibility was an interesting observation. Therefore, The 27 bp VNTR in eNOS gene polymorphism can be used as a probable marker in determining susceptibility to T2DM in north Indian population.
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Introduction: Sex estimation of skeletal remains is an important issue in both forensics and bioarchaeology. Many mammalian species display sexual dimorphism in the pelvis, where females possess larger dimensions of the obstetric canal than males. This is contrary to the general pattern of body size dimorphism, where males are larger than females. Pelvic dimorphism is often attributed to selection relating to parturition, or as a developmental consequence of secondary sexual differentiation. Current opinion regards the hip bone as the most reliable sex indicator because it is the most dimorphic bone, particularly in adult individuals. Material & Methods: In the present study, an attempt has been made to find the base line data of thirteen parameters pertaining to ilia of 100 hip bones of known sex and side. Variables studied were: Total length of iliac crest, lengths of its ventral & dorsal segments; distance between Anterior Superior Iliac Spine & Iliac Tubercle; Iliac height; Ventral, Sacral, Direct, Lower & Upper iliac heights; Iliac breadth; Lower, Ventral & Sacral iliac breadths, Length of pelvic & sacral parts of Chilotic Line. Results: The results obtained were tabulated, statistically analysed & compared to the earlier literature. It was seen that almost all the parameters except Sacral Iliac Height, Lower Iliac Height & Pelvic parts of Chilotic line were longer in males. Conclusion: To conclude, the morphometry of ilium also constitutes an important mean of sexual dimorphism. However its parameters are longer in males as it does not form a part of birth canal so is independent of sex hormones & is akin to general rule that male bones are larger than female bones.
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Pulmonary function parameters are the most important and widely used exploratory tool in respiratory disorders. Most of the studies on these parameters describe lung capacities and flow rates in terms of absolute values. There are various equations to derive the predicted values of these parameters. Most of these equations are framed for Caucasian, American or Africans, but are frequently used in Indian subjects. There are very few equations for Indian subjects, which are also region specific. Hence, the present study was undertaken to compare the various regression equations for calculating predicted parameters in North Indian subjects. We used eight regression equations which are frequently used for calculating predicted values. The data of 75 Indian healthy subjects was used in these equations for comparison. The regression equations provided predicted value of pulmonary function parameters which varied markedly (0.24-123%) based on type of regression formula used. The closet seems to be Chatterjee and Vijayan equation. The anthropometric variable used in these equations can have a lot of bearing on the predicted values. However, based on literature and our experience of using eight regression equations, we found that none of these is perfectly suited for North Indian subjects.
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Background: Anthropometry, the science of measurement of living subjects has been shown to be useful in reconstructive surgery and in orthodontics, where the soft tissue morphology of the face can be studied more reliably as compared to radiographs. Objectives: The purpose of the study was to create base data of the vertical measurements of the lower lips and proportion of lower lip parameters. Material and methods: The study comprises of lower lip proportion of 600 North Indian adults (300 males and 300 females). Prior informed written consent for this study was obtained from the subjects. The exclusion and inclusion criteria for the subjects were predefined. The measurements were statistically analyzed by using ‘t test’ by SPSS version 15. Results: The lower lip parameters showed sex dimorphism. The height of cutaneous lower lip, height of vermilion lower lip and total lower lip height was significantly (p<0.001) more in males. Two Lip indices was calculated. The lip index 2 was significantly more in males. Conclusion: In case of lower lip, less than half of total lower lip height was occupied by cutaneous portion of lower lip and rest was covered by vermilion portion of lower lip. This study highlights the applied significance of observations of present study to forensic namely personal identification, racial and sex dimorphic criteria of identification.
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Background: Portal vein size is a diagnostic index useful in measuring portal hypertension which is found in many disease conditions including cirrhosis where it occurs in > 60% of cases. Aims: The aim of this work is to determine the normal portal vein diameter in adult North Indian population. There is paucity of work describing the portal vein diameter in this population. Method: In this work we used a 2 D ultrasound- a non invasive method to assess the portal vein size in 400 adults aged 20-80 years of both sexes(146 males & 254 females). Results: The mean diameter of normal portal vein in the male subjects was 10.33 mm ± 1.004 & in female 9.41 mm ± 1.16. Conclusion: The portal vein diameter obtained in this work is comparable to that found in Caucasians. This information can be useful in diagnosing and treating portal hypertension in a variety of clinical situations.
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Background: This study was conducted on 600 Adults (300 males and 300 females) of North Indian origin in age group of 18 to 40 years. Method: Prior informed written consent was obtained from the subjects. Exclusion and inclusion criteria for the subjects were predefined. The aim of this study was to document the mean morphometric standards for nose and face of North Indian population which could be of importance in clinical practice and forensicidentification. Nasal height, length, breadth, depth, facial length and breadth were measured using a sliding and spreading caliper.Result: Sexual dimorphism was observed in most parameters of nasal region with all linear measurements being more in Males. Males also had a higher nasal index. Mesorrhine type of nose was found in both sexes. Females had mesoprosopic face whereas males had leptoprosopic face.
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Background & objectives: Repeated apnoeic/hypoapnoeic episodes during sleep may produce cerebral damage in patients with obstructive sleep apnoea (OSA). The aim of this study was to determine the absolute concentration of cerebral metabolites in apnoeic and non-apnoeic subjects from different regions of the brain to monitor the regional variation of cerebral metabolites. Methods: Absolute concentration of cerebral metabolites was determined by using early morning proton magnetic resonance spectroscopy (1H MRS) in 18 apnoeic patients with OSA (apnoeics) having apnoea/hypopnoea index (AHI) >5/h, while 32 were non-apnoeic subjects with AHI< 5/h. Results: The absolute concentration of tNAA [(N-acetylaspartate (NAA)+N-acetylaspartylglutamate (NAAG)] was observed to be statistically significantly lower (P<0.05) in apnoeics in the left temporal and left frontal gray regions compared to non-apnoeics. The Glx (glutamine, Gln + glutamate, Glu) resonance showed higher concentration (but not statistically significant) in the left temporal and left frontal regions of the brain in apnoeics compared to non-apnoeics. The absolute concentration of myo-inositol (mI) was significantly high (P<0.03) in apnoeics in the occipital region compared to non-apnoeics. Interpretation & conclusions: Reduction in the absolute concentration of tNAA in apnoeics is suggestive of neuronal damage, probably caused by repeated apnoeic episodes in these patients. NAA showed negative correlation with AHI in the left frontal region, while Cho and mI were positively correlated in the occipital region and Glx showed positive correlation in the left temporal region of the brain. Overall, our results demonstrate that the variation in metabolites concentrations is not uniform across various regions of the brain studied in patients with OSA. Further studies with a large cohort of patients to substantiate these observations are required.