Diallyl Trisulfide Inhibits Leptin-induced OncogenicSignaling in Human Breast Cancer Cells but Fails toPrevent Chemically-induced Luminal-type Cancer in Rats

Previous studies have demonstrated inhibitory effect of garlic component diallyl trisulfide (DATS) on growth of breast cancer cellsin vitro and in vivo. This study investigated the effect of DATS on oncogenic signaling regulated by leptin, which plays an importantrole in breast carcinogenesis. Leptin-induced phosphorylation and nuclear translocation of STAT3 was inhibited significantly in thepresence of DATS in MCF-7 (a luminal-type human breast cancer cell line) and MDA-MB-231 (a basal-like human breast cancer cellline). Leptin-stimulated cell proliferation, clonogenic cell survival, and migration and/or invasion ability in MCF-7 and/or MDA-MB-231cells were also suppressed by DATS treatment. DATS exposure resulted in inhibition of leptin-stimulated expression of protein and/or mRNA levels of Bcl-2, Bcl-xL, Cyclin D1, vascular endothelial growth factor, and matrix metalloproteinase-2. Western blotting revealeda decrease in protein levels of phosphorylated STAT3 in breast cancer xenografts from DATS-treated mice when comparedto controls in vivo. However, the incidence of N-methyl-N-nitrosourea-induced luminal-type breast cancer development in rats wasnot affected by oral administration of 5 mg/kg or 25 mg/kg DATS. The present study reveals that oncogenic signaling induced byleptin is inhibited in the presence of DATS but higher doses of this phytochemical may be required to achieve chemopreventive activity.

A Study On Mortality In Perforated Peptic Ulcer

NSAIDs are responsible for most of the perforated peptic ulcers. Patients with perforated peptic ulcer have a hospital mortality risk of 10% to 20%. It is a significant problem for India, so this study was done to determine the magnitude and management of mortality risk. Astudy of 132 cases of perforated peptic ulcer admitted in government general hospital, Kurnool, Andhrapradesh, India from August 2017 to July 2019 was carried out. Alcohol(38.6%), smoking and NSAIDs are important etiologic factors for peptic ulcer. The mortality in perforated peptic ulceration is 33.3%. Risk of mortality was associated with shock at presentation and time delay in presentation. Aperforated peptic ulcer is a surgical emergency. It is a life-threatening condition which requires early diagnosis and immediate surgery — delayed management results in mortality. Most require surgery with omental pedicle patch. Mortality is high with a time delay to the presentation, medical comorbidities, shock at the time presentation and old age (>60yrs)

Correlation Between Blood Pressure Measurement by Non-invasive and Invasive Methods in Critically-ill Children

Objective: To determine the correlation of non-invasive blood pressure obtained byauscultatory and oscillometric methods, with invasive blood pressure in critically ill children.Methods: We compared invasive with auscultatory and oscillometric blood pressures usingpaired t-test, Pearson’s correlation coefficient and Bland-Altman plot in 50 children (age 1-12y) admitted in Pediatric intensive care unit. Results: Systolic, diastolic, and mean arterialpressures of invasive methods significantly correlated with auscultatory and oscillometricmethods (P<0.001). Auscultatory and oscillometric measurements under-estimated systolicarterial pressures [mean (SD) difference 5.4 (12.2) mmHg and 6.3 (14.0) mmHg,respectively; P<0.001] and overestimated diastolic arterial pressures [-4.1 (5.8) mmHg and-3.6 (7.2) mmHg; P<0.001] compared to invasive blood pressure. Conclusion: Mean arterialpressure obtained by NIBP measurement is more closer than systolic or diastolic pressures,when compared with invasive blood pressure measurement.

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.

Kimura’s Disease of Face: A Clinicopathological Presentation and Review.

Kimura’s disease is an extremely unusual disorder of benign nature affecting the connective tissue, and primarily seen in young males in countries of Asian pacifi c region particularly in China and Japan. This is characterized by three essential components of diagnostic importance. (a) Painless benign subcutaneous masses and rarely lymph nodes most predominantly in the head and neck region and usually solitary, (b) Gross eosinophilia in the blood and also in the affected tissue, (c) Markedly elevated serum immunoglobulin E levels. We are reporting this extensive case in a male aged 28 years, and the lesion started when he was 15 years old, affecting the cheeks and submental region, right parotid gland, and associated lymph nodes. Since we operated all the three masses, we present our operative and clinical experiences along with histopathological fi ndings. We are also reviewing the cases already reported earlier and the problems of clinical diagnosis and to differentiate from other diseases which may simulate this disease. Relative merits of all the treatment protocols and the outcome of the disease is also discussed in the light of our experience with this patient.

Prevalence of diabetes mellitus and its association with life style factors among adults in Tirupati, Andhra Pradesh.

Background: The National Urban Diabetes Survey in India (2010) has reported an age standardized prevalence of diabetes to be 12.1%. The prevalence of diabetes mellitus is known to vary with lifestyle factors. Aims and objectives: The present study was conducted to find the prevalence of diabetes mellitus among adults and its association with certain life style factors like current smoking, alcohol intake, saturated fat intake and physical exercise. Material and methods: This present study was cross sectional and analytical study carried out in 900 adults in the age group of 30 years and above during June 2014 to December 2014. A random blood sugar test was conducted among the selected study subjects and the prevalence of diabetes mellitus was estimated using the cut off level of 180 mg% Those subjects who were already known to be diabetics with or without treatment were also classified as diabetics. The findings were analyzed using Epi-info software 7 version (CDC, Atlanta, USA). Results: The prevalence of diabetes mellitus in the present study was found to be 12.4%. Significantly higher proportion of current smoking was found in diabetics (17.0%) than in non-diabtics (6.1%). Current alcohol intake was significantly higher in diabetics than in non-diabtics (8.0% vs 2.4%); current saturated fat (ghee) intake was similar in diabetics and non diabtics (5.4% and 5.5% respectively). Paradoxically higher proportion of physical exercise was found in diabetics (15.2%) than in non-diabetics (5.1%). Conclusion: The prevalence of diabetes mellitus showed significant association current smoking and current alcohol intake.

Vitamin D Receptor fok I Gene Polymorphism in Angiographically Proven Coronary Artery Disease Subjects: Case - Control Study.

Aims: Coronary artery disease (CAD) is multifactorial disease resulting from modifiable and non modifiable risk factors. Gene polymorphism is one of the non modifiable risk factors, which may contribute to disease susceptibility. Identifying genetic polymorphisms is essential for better understanding of pathophysiology and treatment strategies for a particular disease. The objective of our study was to evaluate the association of vitamin D receptor (VDR) fok I polymorphism with CAD. . Place and Duration of the Study: The study samples were collected at Narayana Medical College Hospital, Nellore and genetic analysis done at Sri Ramachandra University, Chennai, India, from Nov 2013 to June 2014. Materials and Methodology: The study included 40 angiographically proven CAD subjects as cases and 40 normal healthy controls .VDR fok I polymorphism was analysed by PCR-RFLP method. Chi Square and odds ratio was used to find the association. Results: F allele frequency is 66.25% in CAD vs 52.5% in controls. There is no significant association of FF (p= 0.099), Ff (p= 0.851), ff (p= 0.138) with CAD. Conclusion: There is no significant association of VDR fok I polymorphism with CAD in south Indian population. According to our study F allele frequency is more in CAD than in controls.

Differences in care between general medicine and respiratory specialists in the management of patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease

Hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease [AECOPD] may be managed by either respiratory specialists [RS] or general medicine physicians [GMP]. While previous studies have audited the hospital AECOPD management of RS, only a small number of studies have evaluated the management of GMP. The aims of this study were to firstly examine the differences in AECOPD management of GMP and RS and secondly compare their care to national COPD guidelines. A retrospective review was undertaken of consecutive AECOPD patients admitted to two hospitals [one hospital where all AECOPD patients were managed by RS and another where all AECOPD patients were managed by GMP] over a 3-month period. Electronic medical records, medical case notes, pathology and radiology data for the admission were reviewed. There were 201 COPD exacerbations in 169 patients [49.7% male, mean age 72.3]. GMP managed 84 [41.7%] exacerbations. In comparison to RS, GMP performed fewer spirometry tests, blood gas analysis and less frequently treated patients with guideline-recommended medications. Referral to pulmonary rehabilitation was poor for both groups of clinicians. Median length of stay was shorter in GMP patients versus RS patients [3 days vs. 5 days, P = 0.001]. There were no differences in the 12-month re-admission [41.7% vs. 38.5%, P = 0.664] and mortality rates [10.7% vs. 6%, P = 0.292] between both groups of patients. Our study found differences in the hospital AECOPD management of GMP and RS, but these did not translate into different clinical outcomes between their patients. We also found suboptimal adherence to national COPD guidelines, suggesting that there is scope for improvement in the AECOPD management of both groups of clinicians

Fulminating septicemia due to persistent pan-resistant community-acquired metallo-β-lactamase (IMP-1)-positive Acinetobacter baumannii

Acinetobacter baumannii is considered as an emerging nosocominal pathogen and is renowned for its multi-drug resistance. We report a case of community-acquired pan-resistant A. baumannii strain isolated from blood, pus , urine and tracheal aspirate was confirmed by 16S r-RNA sequence homology and found positive for metallo-ß-lactamase IMP-1, and was found to be a strong biofilm producer The isolate was only susceptible (moderately) to colistin.

Synthesis, anti-oxidant and anti-bacterial properties of diethyl (4-flouro-3-nitro phenylamino) (substituted phenyl) methyl phosphonates.

A new class of α–aminophosphoantes 4a-j have been synthesized by condensation of imines 3a-j with dialkyl phosphite under catalyst free conditions in dry toluene at reflux conditions via pudovik reaction in high yields. All the title compounds were confirmed by physico-spectral analysis. All the title compounds were screened for antioxidant properties by radical scavenging methods such as 1,1-diphenyl-2-picryl hydrazyl (DPPH), hydroxyl radical scavenging method and lipid peroxidation. They exhibited potent in vitro antioxidant activity dose dependently. Their bioassay showed them to possess significant antibacterial activity.

Changing characteristics of Vibrio cholerae: emergence of multidrug resistance and non-O1, non-O139 serogroups.

The serogroups and antimicrobial susceptibility patterns of V. cholerae isolated in Hubli, India during the years 2000 to 2004 were monitored. A total of 256 V. cholerae isolates were obtained during the study period, of which 129 (50.4%) belonged to serogroup O1 while the O139 and non-O1, non-O139 serogroups constituted 61 (23.8%) and 66 (25.8%) isolates, respectively. V. cholerae O1 Ogawa was the predominant isolate during the first 2 years of the study. However, this was replaced by V. cholerae non-O1, non-O139 serogroups in the following years. The V. cholerae, which was susceptible to most enteric antimicrobials in 2000, was found to be multidrug resistant in subsequent years, with the development of fluroquinolone resistance since 2002. Surveillance of the epidemiological and microbiological characteristics of V. cholerae provides useful information for managing cholera cases. The V. cholerae non-O1, non-O139 serogroups coupled with multiple antimicrobial resistance may form a group of emerging diarrheal pathogens in the tropics.

Prodigiosins: a novel family of immunosuppressants with anti-cancer activity.

Prodigiosins (PrGs) are a family of promising therapeutic molecules, isolated mostly from Gram-negative bacteria and characterized by a common pyrryldipyrrylmethene structure with varying side chains. They show a broad spectrum of activities such as anti-microbial, anti-malarial, anti-cancer and immunosuppressive. PrGs are attracting increasing attention due to the ongoing research for less toxic, but effective agents for cancer chemotherapy and immunosuppression for preventing allograft rejection and autoimmunity. Different analogues have been synthesized and evaluated. This review discusses the immunosuppressive and anti-cancer activities of this class of compounds, as both involve inhibition of cell proliferation. The main focus is on the in vitro and in vivo immunosuppressive activity of the different PrGs and the mechanisms involved. PrGs primarily target the T cells, though some effects are observed on other cell types also. Unlike the well-known immunosuppressant cyclosporin A, PrGs do not inhibit the secretion of IL-2 but inhibit the mitogenic signaling from IL-2, suggesting a different mechanism of action. Janus tyrosine kinase 3 (Jak3) that associates with IL-2R upon activation is considered as the molecular target for PrGs. Its restricted expression makes Jak3 as an attractive target for immunosuppressive therapy. However, the available literature suggests that some other pathways are also influenced by the PrGs. These may be important for the anti-cancer activity, as well as immunosuppressive action. Therefore, PrGs appear to be potential candidates for pharmaceutical development as immunosuppressants and also as anti-cancer agents.

Extended spectrum beta lactamase producing Klebsiella pneumoniae in neonatal intensive care unit.

OBJECTIVE: As infections due to Extended Spectrun beta Lactamase (ESbetaL) producing Klebsiella pneumoniae were increasing in the NICU at Karnataka Institute of Medical Sciences Hospital, Hubli, India, the present study was carried out to identify any environmental sources and the mode of transmission. METHODS: Environmental samples from various sites were collected monthly for a period of six months. RESULTS: ESbetaL producing K. pneumoniae were isolated from all the sites except room air at least on one occasion. ESbetaL producing K. pneumoniae was always isolated from one of the incubators, medicine trolley and sink; while at least one of the health care workers carried it in the hands four out of six times tested. ESbeta L producing K. pneumoniae with similar antibiogram were also isolated from the clinical samples obtained from the neonates. CONCLUSION: Widespread use of third generation cephalosporins as a pre-emptive antibiotic for suspected cases of septicaemia may have contributed to emergence of ESbetaL producing K. pneumoniae in addition to other risk factors. ESbetaL producing K. pneumoniae have extensively colonised the environment of the NICU. Transmission of these pathogens to the neonates has probably occurred through the healthcare workers. Efforts to improve hand hygiene among the healthcare workers and mothers are urgently needed.

Methicillin resistant Staphylococcus aureus infections-implications in hospital infection control.

BACKGROUND: A significant part of nosocomial infections are caused by methicillin resistant Staphylococcus aureus (MRSA). Nosocomial MRSA are known to be multidrug resistant and thus difficult to treat. METHODS: A 2 year study was conducted between January 2001 and December 2002 at Karnataka Institute of Medical Sciences Hospital, Hubli to assess the prevalence of MRSA and its antibiotic susceptibility pattern in various wards. RESULTS: S. aureus was isolated from 714 patients, 283 (37.53%) of which exhibited methicillin resistance. Although these MRSA were multidrug resistant in all the wards, the problem was more severe in NICU and orthopedic wards. CONCLUSION: The results highlight the need for effective implementation of infection control measures in the hospital. There is a need for the judicious use of antimicrobial agents in the hospital and outside as their indiscriminate use can exert pressure in selecting out MRSA and other multidrug resistant organisms.

Role of radionuclide scintigraphy in the detection of parathyroid adenoma.

BACKGROUND: Preoperative detection of parathyroid adenoma is a diagnostic challenge. The sonography and computerized tomography (CT) scan demonstrate high sensitivity but low specificity. The advent of radionuclide scanning technique has enhanced the specificity in this context. AIM: We undertook a study to assess the role of radionuclide scanning in suspected cases of parathyroid adenomas. MATERIALS AND METHODS: Totally 28 cases were incorporated in the study. The suspicion was raised either due to raised PTH levels or recurrent calcinosis. Most of these patients had estimation of calcium done as a routine or specific investigation. The parathyroid scan was performed using either of the two techniques - Dual isotope subtraction or Sestamibi washout technique. We also used the recent approach of fusion imaging (CT + tomographic nuclear images) in selected cases. RESULTS: There were 16 true positive, 10 true negative, 1 false negative and 1 equivocal scan findings. The findings were compared with sonography, CT Scan and PTH values. The true positive yield in our study was 57%, true negative 35% and the overall sensitivity and specificity was found to be 94% and 100% respectively. CONCLUSION: We conclude that parathyroid scintigraphy is a reliable and sensitive technique in the preoperative detection of parathyroid adenomas and should be the first choice of imaging modality in suspicion of parathyroid adenoma.

Neonatal sepsis caused by Salmonella enterica serovar Weltevreden.

Salmonella enterica serovar Weltevreden is an uncommon cause of gastroenteritis occurring worldwide. For the first time, we report 2 cases of neonatal sepsis caused by S. Weltevreden from Hubli, India. In the first case, the neonate had features of septicemia and S. Weltevreden was isolated from a blood culture. The other neonate had omplalitis and clinical features of septicemia. S. enterica serovar Weltevreden was isolated from the umbilical swab culture of this neonate. Even though extensive investigations were conducted, the source of infection could not be identified. Both neonates recovered completely after appropriate antibiotic and supportive therapy.

Dominance hierarchy and social grooming in female lion-tailed macaques (Macaca silenus) in the Western Ghats, India.

This article reports the structure of dominance and its relationship with social grooming in wild lion-tailed macaque females. The strength of dominance hierarchy was 0.79 on a scale of 0 to 1 indicating a moderate linearity in the ranking system. Dominance scores were converted into an ordinal as well as an interval scale. Grooming scores were also converted into interval scales using standard scores. Grooming received and grooming given correlated positively and negatively respectively with dominance ranks indicating that high ranking females received more and gave less grooming. Grooming was also positively related to encounter rates for dyads of females. More grooming among adjacent ranks, and grooming being more reciprocal, occurred only in the case of dominant females. The grooming patterns, therefore, appeared to be more of despotic than egalitarian nature. While ranking macaques into different Grades of social systems ranging from despotic to egalitarian, Thierry (2004) has placed lion-tailed macaques in Grade 3 corresponding to the 'relaxed' social system. Our results indicate that the grooming and dominance relationships in this species are more despotic, and hence, the Grade for this species requires to be shifted toward 2 or 1.