A study to know the various causes of pleural effusion and role of pleural fluid adenosine deaminase enzyme in tuberculous pleural effusion

Background: India has the maximum burden of both non MDR tuberculosis (TB) and Multidrug-Resistant (MDR) TB, as per data reported in Global TB Report 2018 and tuberculosis is remains one of the most common cause of pleural effusions.Methods: This was a cross-sectional study conducted in Department of Respiratory Diseases and a total of 110 patients with pleural effusion were included in the study, which were enrolled for treatment from July 2018 to June 2019.Results: One hundred and ten patients with pleural effusion were enrolled during the study period. There were 65 males (59%) and 45 (40.9%) females.  The overall mean age for males and females were 44.4±18.84 years (35-87 years) and 38.28±17.66 years (35-87 years) respectively. Tuberculous Pleural Effusion group (TPE) seen in 82 patients. Right sided pleural effusion (69.5 %) were more common than left sided (30.4 %). In TPE group the mean pleural fluid ADA level were 86.41±38.08 IU/L (range: 14-195 IU/L). The Malignant Pleural Effusion (MPE) group included 21 patients. In MPE group the mean pleural fluid ADA level were 34.10±32.88 IU/L (range: 8-144 IU/L). The difference in pleural fluid ADA levels between TPE and MPE group was statistically highly significant.Conclusions: Tuberculous pleural effusion was the most common cause of pleural effusion in present study and observed in 74.5% cases.

Identification of QTLs in oil palm (Elaeis guineensis Jacq.) using SSR markers through association mapping

Oil palm (Elaeis guineensis Jacq.) is a perennial vegetable and a high oil-yielding crop (4–6 t/ha). There is a large scope for increasing the oil yield by selecting elite planting material for breeding programme in germplasm evaluation, characterization and utilization. In the present study, a diverse range of 150 oil palm genotypes were characterized using 12 quantitative variables with 54 genomic microsatellite markers. A wide variation was observed in the morphological traits among indigenous populations. Highly significant and positive correlations were observed between vegetative dry matter (VDM) and total dry matter (TDM) (0.862), and height and height increment (0.838). The first two principal component analyses explained 67.7% of total variation among morphological traits. The genotypes IC0610001-59 (Pune-2) and IC0610001-60 (Pune-2) were found highly promising based on less height increment, more TDM with high yield. For the mapping study, general linear model (GLM) approach, quantitative-trait loci (QTL) for annual height increment, number of bunches, bunch yield and bunch index were linked to simple-sequence repeat (SSR) loci mEgCIR3649 with phenotypic variance of 15.08, 10.43, 11.74, 15.39. TDM and VDM were linked to mEgCIR0192 (27.34 and 24.19%), mEgCIR3684 (16.84 and 18.30%), SPSC00163 (18.8 and 15.39%) and mEgCIR0555 (16.47 and 18.81%), with at a significant threshold (P) level of B0.001 and by mixed linear model (MLM) approach. TDM was linked to mEgCIR0555 with phenotypic variance of 20.72%, bunch yield and bunch index were linked to mEgCIR2813 at phenotypic variance of 17.11% and 12.88%, respectively, at a significant threshold (P) level of B0.01.

Estimation of BCL-2 protein in carcinoma of the breast and its clinical correlation in locally advanced breast cancer.

The change in expression of apoptotic markers (Bcl-2 and Bax proteins) brought about by various chemotherapeutic regimens is being used for its predictive value for assessing response to neoadjuvant chemotherapy (NACT) in locally advanced breast carcinoma (LABC). AIMS: (1) Estimation of Bcl 2 expression in LABC, (2) Any change in Bcl 2 expression following chemotherapy in LABC, (3) Any relation of Bcl 2 estimation to changes in size of tumor, nodal status, age, and menopausal status. SETTINGS AND DESIGN: This was a prospective study of 120 cases of LABC. MATERIALS AND METHODS: All cases were subjected to biopsy and the tissue was evaluated immunohistochemically for apoptotic marker Bcl-2 family protein. Three cycles of NACT were given at three-weekly intervals. Modified radical mastectomy was performed and the specimens were re-evaluated for any change in the Bcl-2 family protein. The clinical response and immunohistochemical response were correlated and compared. STATISTICAL ANALYSIS: Coefficient of correlation was calculated by Pearson correlation coefficient (P-value). RESULTS: Clinical response, as measured by reduction in the tumor size, was observed in 81 (67.5%) patients while immunohistochemical response was observed in 67 (55.8%) patients. Correlation between immunohistochemical and clinical response was found to be statistically significant (P = 0.02). Nodal response was seen in 72 (60%) patients. There were no patients in the N o group; 22 (53.7%) of the N 1 patients were down-staged to N o , while 19 (46.3%) remained N 1 . In patients with N 2 disease, 11 (13.9%) were down-staged to N o status, 39 (49.4%) were down-staged to N 1 status, and 29 (36.7%) did not show any response. Immunohistochemical response was observed in 67 (55.8%) patients. Correlation between immunohistochemical and nodal responses was also found to be statistically significant (P = 0.03). CONCLUSIONS: This significant positive correlation between clinical and immunohistochemical responses highlights the importance of apoptotic marker Bcl-2 family protein in predicting the response of LABC to NACT.

Isolated left lung aplasia with bronchial asthma.

Congenital lung anomalies are categorised as pulmonary agenesis, aplasia and hypoplasia with distinct clinical implications. An 8-year-old boy was referred for an opaque left hemithorax for which he had received antituberculous therapy. A detailed evaluation including flowing contrast computed tomography of the thorax and fiberoptic bronchoscopy led to a diagnosis of left lung aplasia. He also had wheezing dyspnea, which was confirmed as bronchial asthma. Congenital lung defects with associated asthma was reported only twice till date. A high index of suspicion is required to recognise such a patient.

Sequential MTX-5 FU chemotherapy in pallination of advanced cancer cervix.

Twenty four patients with advanced cancer of cervix were submitted to sequential chemotherapy 5FU and MTX. The response rate was 85% in stage III and 50% in stage IV. Overall response rate was 75%. Patients who had not received radiotherapy earlier responded better than those who had received it earlier. This easy and economical modality has importance in view of late reporting and advanced stage of disease encountered in our set up.