Disparities in All-cancer and Lung Cancer Survival by Social, Behavioral, and Health Status Characteristics in the United States: A Longitudinal Follow-up of the 1997-2015 National Health Interview Survey-National Death Index Record Linkage Study

Most research on cancer patient survival uses registry-based (e.g., SEER) incidence and survival data that have limited socioeconomic status and health-risk information. In this study, we used the 1997-2015 National Health Interview Survey-National Death Index prospectively-linked pooled cohort database (n = 40,291 cancer patients) to examine disparities in patient survival by a broad range of social determinants, including race/ethnicity, nativity, educational attainment, income/poverty level, occupation, housing tenure, physical and mental health status, smoking, physical activity, body mass index, and alcohol consumption. We used Cox proportional hazards models to estimate mortality hazard ratios and cause-specific 1-year, 5-year, and 10-year survival rates for all-cancer and lung cancer. During 1997-2015, the 10-year age-adjusted (all-cause) survival rate for cancer patients with professional and managerial occupations was 89.66%, significantly higher than the survival rate of 83.17% for laborers or 83.66% for the unemployed. Cancer patients with renting house had significantly lower age-adjusted survival rates than those owning house (82.65% vs. 85.80%). The 10-year age-adjusted survival rates were significantly greater among cancer patients with regular physical activity than those without regular physical activity (90.18% vs. 83.24%). Age-adjusted survival rates were significantly reduced for cancer patients with lower income and education, poor health, and serious psychological distress, and among current and former smokers. The gap in survival narrowed with additional sociodemographic, health, or behavioral adjustment. Similarly large differentials were found in lung cancer survival. Marked disparities in all-cancer and lung cancer survival were found by a wide range of sociodemographic and health characteristics.

Evaluation Of Nasopalatine Canal Using Cone Beam Computed Tomography – A Retrospective Study

Background:Implantology is a very significant branch of dentistry that deals with the rehabilitation of edentulous patients. Thus, knowledge of anatomical variations of related neurovascular structures such as the nasopalatine canal is essential. Aim:The aim of study was to determine the form, length, and diameter of the nasopalatine canal using CBCT. Materials and Methods:In this retrospective study, images were archived from CBCTunit and visualized using Romexis software. The nasopalatine canals of 50 patients between the age range of 18-59years were analyzed. The shape of the nasopalatine canal, length of the nasopalatine canal and the diameter of incisive foramen were assessed in sagittal and coronal section. The width of labial and palatal alveolar bone around the canal and inclination of the nasopalatine canal to hard palate were evaluated. Statistics: (1) if there is any relation between the gender and the assessed parameters (2) if there is any relation between edentulous and partially edentulous patients with the assessed parameters.Results:The most common shape of the nasopalatine canal was cylindrical. The average length of the nasopalatine canal was 12.14±2.41 mm and the average diameter of incisive foramen 3.45±0.84 mm anteroposteriorly and 3.77±0.94mm mediolaterally. The average inclination of the nasopalatine canal to hard palate was 119.93±9.73°Conclusion:This study highlights the variations seen in the nasopalatine canal. The close vicinity of nasopalatine canal and implant can lead to sensory disturbances and damage of the tissues. Thus, a thorough knowledge before the surgical - implant procedure using cone beam computed tomography seems beneficial.

Comparison of fasting and non-fasting serum lipid profile in healthy population

Background: Serum lipids are routinely used for the assessment of cardiovascular risk. The test is usually performed under fasting condition. However, recently non-fasting lipid profile is also measured in certain cases. The present study was intended to estimate the concentration of total cholesterol (TC), triglyceride (TG), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C) and VLDL cholesterol (VLDL-C) in fasting as well as non-fasting blood samples of a group of normal male and female subjects.Methods: The study recruited 50 normal healthy male and female subjects within the age group of 12-48 years. The concentration of TC, TG, HDL-C, LDL-C and VLDL-C in serum of these subjects were quantitatively determined using the commercially available kits based on CHOD/POD method.Results: The mean concentration of non-fasting TC, TG, HDL-C, LDL-C and VLDL-C was found to be 141.20 mg/dl, 132.20 mg/dl, 50.39 mg/dl, 64.30 mg/dl, 26.44 mg/dl respectively. On the other hand, the mean concentration of fasting TC, TG, HDL-C, LDL-C and VLDL-C was found to be 112.37 mg/dl, 100.90 mg/dl, 38.59 mg/dl, 53.59 mg/dl and 20.18 mg/dl respectively. The concentration of fasting lipid profile parameters was significantly low from the respective parameters of non-fasting lipid profile.Conclusions: The present study reveals that there was an increase in the levels of TC, TG, HDL-C, LDL-C, and VLDL-C in non-fasting state compared to the fasting state. Measuring the lipid profile parameters under non-fasting state cannot be usually considered for assessment of cardiovascular risk and for other clinical purposes.

Rosuvastatin plus fenofibrate in diabetic dyslipidemia: a hospital record based study

Background: Cardiovascular diseases (CVD) are the leading cause of death throughout world population each and every year. Focus on dyslipidemia management is urgently required in India to halt the rising tide of CVD. The purpose of diabetic dyslipidemia study is a record based one, to find out the effect of Rosuvastatin plus Fenofibrate, in adult Type 2 diabetes with dyslipidemia, with high TGL/HDL ratio in Lipid profiles, in a tertiary care hospital in the Union territory of Puducherry.Methods: There were 101 patients hospital records were analysed in which male were 45 and females were 56. The various biochemical parameters like serum Total Cholesterol, HDL, LDL, TGL, Non-HDL, TCL/HDL Ratio and TGL/HDL ratio reports were collected before and after 12-weeks of Rosuvastatin 10 mg with Fenofibrate 145 mg combination, for the treatment period once daily for their lipid-lowering therapy.Results: The combination therapies of Rosuvastatin plus Fenofibrate were safe and feasible to achieve more TG goal and proved that has predominately decreased the elevated lipid profiles from the medical resources of our record based study. The use of combination medications of rosuvastatin (10mg) plus Fenofibrate (145mg) is often needed to effectively treat the lipid triad, by the potency of rosuvastatin to lower LDL-C and Fenofibrates effectiveness in lowering TG in treating mixed diabetic dyslipidemia.Conclusions: After Rosuvastatin (10mg) plus Fenofibrate (145mg), the lipid profile data proved that the importance of TGL/HDL ratio apart from the TCL/HDL ratio, for good lipid control in diabetic dyslipidemic patients.

Evaluation of cytogenic damage in the form of micronuclei in oral exfoliated buccal cells in tobacco users

Variety of substances such as tobacco, UV radiation, infrared rays, X-radiations, and chemicals on oral induction results in chromosomal aberrations and production of micronucleus (MN). Among them, tobacco-specific nitrosamines are potent mutagenic agents causing oral cancer. Objective: The objective of the study is to compare the genotoxicity in buccal mucosal cells, i.e. the MN count of all groups and to find the incidence of micronucleated cells (MNCs) in accordance to duration and frequency of tobacco usage and timing of contact of tobacco in the oral mucosa. Materials and Methods: Individuals without any oral diseases were divided into 3 groups having 25 in each group: smoking, chewing, and control. Smears were made from buccal exfoliated cells and stained with DNA-specific Feulgen stain. Frequency on MNC per 500 cells was assessed with one-way ANOVA and Tukey HSD multiple comparisons test and mean rank with Kruskal–Wallis test. Results: The mean micronucleus MN revealed that chewers had 8.00, smokers had 7.20 and controls had 0.4. The ANOVA test for mean frequency of micronucleated cell MNC revealed High significance (<0.001) for between groups comparison. The mean rank by Kruskal Wallis test revealed the MNC increases as the duration and frequency of habit increases. An increase in MNC in accordance to time of contact with buccal mucosa increases as the duration and time increases. Conclusion: Estimation of MN serve as an indicator of genetic damage and points that tobacco in chewing form induce genotoxic effect. This is studied in an easily accessible tissue- buccal mucosa in a non invasive manner.

Prevalence of Dengue Fever and Comparative Analysis of IgM and IgG Antibodies in Dengue Fever in Thoothukudi- Southern Coastal City, Tamil Nadu.

Background: The most challenging problem associated with patient management in Dengue infection is early diagnosis. Secondary infection with dengue virus is the most accepted risk factor for the development of dengue haemorrhagic fever. Serologic diagnosis of dengue virus infection using ELISA of both IgM and IgG distinguishes primary and secondary infections. Aim: To determine the prevalence of Dengue Fever in Thoothukudi, the coastal district of Tamilnadu by serological tests IgM ELISA and IgG ELISA, to compare the IgM and IgG status of the dengue cases to differentiate between the primary and secondary dengue cases. Methods: A cross sectional comparative study in patients with fever suspicious of dengue, fevers with other causes excluded. Detailed history is obtained and complete clinical examination done. IgM and IgG Elisa test were performed. Results: Out of 50 patients, 28 (56%) were positive for dengue and 22 (44%) were negative. 13 cases had primary Dengue (IgM positive) and 15 had secondary Dengue (IgM and IgG positive and IgG positive). Among the 28 positive cases 16 are paediatric, 10 cases had hemorrhagic manifestations, all were secondary dengue. Conclusion: As this study was conducted during an outbreak in Thoothukudi, unusually high prevalence is seen particularly among the pediatric ages. Higher morbidity is seen in secondary dengue cases. Thus, early discrimination of primary and secondary dengue helps to reduce the morbidity and mortality.

Comparative Evaluation of Several Gene Targets for Designing a Multiplex-PCR for an Early Diagnosis of Extrapulmonary Tuberculosis

PURPOSE: Diagnosis of extrapulmonary tuberculosis (EPTB) poses serious challenges. A careful selection of appropriate gene targets is essential for designing a multiplex-polymerase chain reaction (M-PCR) assay. MATERIALS AND METHODS: We compared several gene targets of Mycobacterium tuberculosis, including IS6110, devR, and genes encoding MPB-64 (mpb64), 38kDa (pstS1), 65kDa (hsp65), 30kDa (fbpB), ESAT-6 (esat6), and CFP-10 (cfp10) proteins, using PCR assays on 105 EPTB specimens. From these data, we chose the two best gene targets to design an M-PCR. RESULTS: Among all gene targets tested, mpb64 showed the highest sensitivity (84% in confirmed cases and 77.5% in clinically suspected cases), followed by IS6110, hsp65, 38kDa, 30kDa, esat6, cfp10, and devR. We used mpb64+IS6110 for designing an M-PCR assay. Our M-PCR assay demonstrated a high sensitivity of 96% in confirmed EPTB cases and 88.75% in clinically suspected EPTB cases with a high specificity of 100%, taking clinical diagnosis as the gold standard. CONCLUSION: These M-PCR results along with the clinical findings may facilitate an early diagnosis of EPTB patients and clinical management of disease.

Oral Bio Dissolving Films in Dentistry: A New Perspective in Treatment Modality.

The environment of oral cavity provides a large surface area for the delivery of drugs bypassing the first pass metabolism in the liver. Hence, the oral cavity is being targeted for providing quicker delivery of drugs for immediate action. However, oral delivery system in the form of tablets/ capsules needs modifications in elderly, children, and unconscious patients because of the fear of choking and aspiration. To overcome these problems much research is being undertaken to develop oral bio dissolving films as an alternative to tablets. The objective of the article was to provide an overview of the composition, advantages and disadvantages, and uses of bio dissolving films in the field of medicine and dentistry.

Nonspecificity of 35 kDa protein: A proposed marker for the differential diagnosis of M. avium infection in the Indian population.

Objective: The subunit vaccine strategies and development of various diagnostic reagents for Mycobacterium avium infection relies on the presence of secreted, species-specific mycobacterial antigens. The M. avium 35 kDa protein has been suggested as a candidate for vaccine/diagnostic reagent, specifically for M. avium infection. The present study was conducted to evaluate the diagnostic specificity of the M. avium 35 kDa protein in the Indian population. Materials and Methods: Culture filtrate proteins were isolated by growing the bacilli in modified Youman's medium. The 35 kDa protein was purified by high-resolution preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis and a blast search was carried out. Western blotting was performed with either monoclonal antibody CS-38 or serum samples of tuberculosis (TB) patients. The 35 kDa-specific immunoglobulin G antibody titer was estimated in the sera of TB patients and healthy individuals by indirect enzyme-linked immunosorbent assay (ELISA). Results: Despite the absence of gene for the 35 kDa protein, the sera of TB patients and TB patient's contacts nonspecifically recognize it. Of 109 TB patients tested, the sera of 84 patients in ELISA (percentage recognition = 87.5%) and 27 of 29 TB patients tested in western immunoblotting (percentage recognition = 93.10%) recognized the M. avium 35 kDa protein, while with sera of TB patient's contacts, the recognition was 50%. Conclusion: Contrary to Western studies, the M. avium 35 kDa protein does not seem to be a good candidate for the specific diagnosis of M. avium infection in the Indian population.

Determination of oxidative stress in vitiligo by measuring superoxide dismutase and catalase levels in vitiliginous and non-vitiliginous skin.

Background: Vitiligo is an acquired disorder characterized by circumscribed depigmented macules devoid of identifiable melanocytes. Complex genetic, immunological, neural and self destructive mechanisms interplay in its pathogenesis. According to autocytotoxic hypothesis, oxidative stress has been suggested to be the initial pathogenic event in melanocyte degeneration. Aims: The aim of our investigation was to evaluate the role of oxidative stress by measuring levels of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) in lesional and normal skin of patients with vitiligo and in the skin of normal controls. Methods: We determined the activity of SOD in lesional and non-lesional skin and CAT in lesional skin only of 25 vitiligo patients and 25 controls by using the spectrophotometric assay and Aebi's method, respectively. Results: There was statistically significant increase in the levels of SOD in vitiliginous and non vitiliginous skin of patient group compared to the control group ( P < 0.001). No significant difference was found between the levels of SOD in lesional skin and non-lesional skin of vitiligo patients. The levels of CAT in the skin of patients were found to be significantly lower than those of controls ( P < 0.001). Conclusions: There is increased oxidative stress in vitiligo as is indicated by high levels of SOD and low levels of CAT in the skin of vitiligo patients.

Evaluation of narrow-band UVB phototherapy in 150 patients with vitiligo.

BACKGROUND: Very few studies have been performed to evaluate the efficacy and safety of narrow-band ultraviolet B (NBUVB) therapy in Indian patients with vitiligo and are of small sample size. Aims: The purpose of this study is to know the efficacy and safety of NBUVB in 150 vitiligo patients of various age groups. METHODS: One hundred fifty patients (69 males, 81 females), aged 3-70 years, with vitiligo were treated twice weekly with NBUVB. The starting dose was 250 mJ/cm2 in adults and 150 mJ/cm2 in children, with 20% dose increments at each subsequent visit given for a maximum period of 1 year and were followed-up for 6 months for stability of repigmentation. Statistical methods were employed to establish the relation between the response and the number of exposures, duration of treatment, cumulative dose and the compliance. RESULTS: Analysis of our study showed that a majority of our cases, about 73, achieved 25-75% repigmentation, with an average of 51+/-19 exposures, 51 had <25% repigmentation, with an average of 19+/-11 exposures and 26 had >75% repigmentation, with an average of 74+/-24 exposures. Good response to therapy was directly associated with good compliance, more number of exposures and increasing cumulative dose, which was statistically significant (P<0.01). Adverse effects were minimal. Only three patients developed depigmentation of repigmented sites during follow-up. CONCLUSION: Our study proves that NBUVB therapy is an effective and safe tool in the management of vitiligo, with good stability of repigmentation and cosmetic appearance.

Herpes simplex virus 2 infection: a risk factor for HIV infection in heterosexuals.

BACKGROUND: Genital ulcerative disease is one of the risk factors for acquisition of HIV. As HSV-2 infection is currently the most common cause of genital ulcerative disease, it acts as a potential risk factor for HIV infection. The present study was undertaken to know the seroprevalence of antibodies to HSV-2 in HIV seropositive individuals and in the general population, and to ascertain if HSV-2 is a risk factor for developing HIV infection. METHODS: The study group included one hundred new HIV seropositive persons irrespective of active genital herpes or history of genital herpes. Fifty age- and sex- matched healthy volunteers were included as controls. In all patients and controls, diagnostic serology was done for HSV-2 using HSV-2-specific glycoprotein IgG2 by indirect immunoassay using the ELISA test. Statistical value 'P' was calculated using the Chi-squared test. RESULTS: Out of the 100 HIV seropositives, 66 were males and 34 were females with an age range of 20-54 years. In only 22 (19 males and 3 females) of these, positive history of genital herpes was obtained. In 49 out of the 100 HIV seropositives, IgG2 antibodies against HSV-2 were detected. In the control group, 11 out of 50 controls were seropositive for HSV-2 IgG2 antibody. There was a statistically significant association between HSV-2 and HIV seropositivity with 'P' value CONCLUSION: The high prevalence of HSV-2 seropositivity in the HIV-infected group (49%) as compared to normal controls (22%) was statistically significant. Prior HSV-2 infection could be an important risk factor for acquisition of HIV in our patients.

Forehead plaque: a cutaneous marker of CNS involvement in tuberous sclerosis.

BACKGROUND: Tuberous sclerosis complex (TSC) is a neurocutaneous genodermatosis characterized by hamartoma formation in multiple organs. There are no definite cutaneous markers suggestive of central nervous system (CNS) involvement in TSC. Aims: To study association of forehead plaque seen in tuberous sclerosis patients and CNS involvement in TSC. METHODS: This is a retrospective study of 15 cases of tuberous sclerosis in varying age groups - from 1.5 to 50 years. All the cases were thoroughly evaluated with detailed history; clinical examination; and relevant investigations like X-rays of chest, skull, hands and feet; ultrasound abdomen and computed tomography of brain. RESULTS: Out of the 15 cases, CNS involvement was seen in 8 cases. Seizures were present in 8 cases (53.33%) and mental retardation was seen in 6 cases (40%). Computerized tomography of brain revealed subependymal nodules (SENs) in eight cases (53.33%). In addition to SENs, subependymal giant cell astrocytomas and cortical tubers were seen in 2 cases each. Out of these 8 cases having CNS involvement, in 7 cases forehead plaque was observed. In 1 case, no forehead plaque was observed (X 2 = 1.07, P < 0.05). CONCLUSION: This study shows that there is a statistically significant relationship between the presence of a forehead plaque and CNS involvement in TSC. Therefore, forehead plaque may be considered as a novel cutaneous marker to know the CNS involvement in TSC at an early stage.

Production of moderately halotolerant, SDS stable alkaline protease from Bacillus cereus MTCC 6840 isolated from lake Nainital, Uttaranchal state, India

A moderately cold active, extracellular alkaline protease producing bacterium was isolated from a fresh water lake. The isolate was found to be a gram-positive, rod shaped organism later identified as Bacillus cereus MTCC 6840. The bacterium produced the maximum amount of enzyme when allowed to grow for 24 h at temperature 25º and pH 9.0. Among a variety of substrates used, fructose as a carbon source and a combination of yeast extract and peptone as nitrogen source, supported the maximum protease production by the organism (120 U/ml). Fe++ and Co++ stimulated the enzyme activity whereas Ca++, Cu++, K+, Mg++ and Mn++ inhibited it to different extents. The protease was found to be highly stable in the presence of NaCl, SDS and acetone. Treatment with EDTA and PMSF resulted in the considerable loss of enzyme activity. The enzyme was found to be optimally active at pH 9.0 and temperature 20ºC.

Uma bactéria produtora de protease alcalina extracelular, moderadamente ativa no frio, foi isolada da água de um lago. Trata-se de um bacilo Gram positivo, identificado como Bacillus cereus MTCC6840. A maior produção da enzima foi em 24h a 25ºC e pH 9,0. A produção máxima de protease (120 U/ml) ocorreu quando foi utilizada frutose como fonte de carbono e uma combinação de extrato de levedura com peptona como fonte de nitrogênio. Fe++ e Co++ estimularam a atividade da enzima, enquanto Ca++, Cu++, K+,Mg++ e Mn++ tiveram efeito inibitório, com intensidades diferentes. A protease permaneceu estável na presença de NaCl, SDS e acetona. O tratamento com EDTA e PMSF causou uma significativa perda na atividade. A enzima apresentou atividade ótima em pH 9,0 e temperatura de 20ºC.