Premature coronary artery disease, risk factors, clinical presentation, angiography and interventions: Hospital based registry

Background & aims: Premature coronary artery disease (CAD) is endemic in India. We performed a study to identify risk factors, clinical presentation, angiographic findings and interventions in premature CAD. Methods: Successive patients who underwent percutaneous intervention (PCI) were enrolled from January 2018 to June 2021. Premature CAD was defined as women 45-59 y and men 40-54 y and very premature as women <45 y and men <40 y. Descriptive statistics are presented. Univariate odds ratio (OR) and 95% confidence intervals (95%CI) were calculated to identify differences in various groups. Results: 4672 patients (women 936, men 3736) were enrolled. Premature CAD was in 1238 (26.5%; women 31.9%; men 25.1%) and very premature in 212 (4.5%; women 6.5%, men 4.0%). In premature and very premature vs non-premature CAD, OR (95%CI) for high cholesterol _x0001_200 mg/dl [women 1.52(1.03 e2.25) and 1.59(0.79e3.20); men 1.73(1.38e2.17) and 1.92(1.22e3.03)], non-HDL cholesterol _x0001_130 mg/dl [women 1.84(1.35e2.52) and 1.32(0.72e2.42); men 1.69(1.43e1.90) and 1.67(1.17e2.34)], LDL cholesterol [men 1.10(0.95e1.25) and 1.04(0.77e1.41)], and tobacco [women 1.40(0.84e2.35) and 2.14(0.95e4.82); men 1.63(1.34e1.98) and 1.27(0.81e1.97)] were higher while hypertension, diabetes and chronic kidney disease were more in non-premature(p < 0.05). Presentation as STEMI was marginally more in women with premature [1.13(0.85e1.51)] and very premature [1.29(0.75e2.22)] CAD and was significantly higher in men [1.35(1.16e1.56) and 1.79(1.29e2.49)]. Location and extent of CAD were not different. Conclusions: In India, a third of CAD patients presenting for coronary intervention have premature disease. Important risk factors are high total and non-HDL cholesterol and tobacco (men) with greater presentation as STEMI. Extent and type of CAD are similar to non-premature CAD indicating severe disease.

What a Clinical Hematologist should Know about B Cells?

B cells are very crucial part of our immune system. They protect us from various infections by secreting antigen-specific antibodies, which neutralize the infectious agents. It is important for a clinical hematologist to know about the B cell development, function and the diseases developing from the quantitative or qualitative defects in B cells. This simple and short review is focused on the basic understanding and clinical hematologist’s perspective of B cells.

Biomarker testing for advanced lung cancer by next-generation sequencing; a valid method to achieve a comprehensive glimpse at mutational landscape

Background: Next-generation sequencing (NGS) based assay for finding an actionable driver in non-small-cell lung cancer is a less used modality in clinical practice. With a long list of actionable targets, limited tissue, arduous single-gene assays, the alternative of NGS for broad testing in one experiment looks attractive. We report here our experience with NGS for biomarker testing in hundred advanced lung cancer patients. Methods: Predictive biomarker testing was performed using the Ion AmpliSeq™ Cancer Hotspot Panel V2 (30 tumors) and Oncomine™ Solid Tumor DNA and Oncomine™ Solid Tumor Fusion Transcript kit (70 tumors) on IonTorrent sequencing platform. Results: One-seventeen distinct aberrations were detected across 29 genes in eighty-six tumors. The most commonly mutated genes were TP53 (43% cases), EGFR (23% cases) and KRAS (17% cases). Thirty-four patients presented an actionable genetic variant for which targeted therapy is presently available, and fifty-two cases harbored non-actionable variants with the possibility of recruitment in clinical trials. NGS results were validated by individual tests for detecting EGFR mutation, ALK1 rearrangement, ROS1 fusion, and c-MET amplification. Compared to single test, NGS exhibited good agreement for detecting EGFR mutations and ALK1 fusion (sensitivity- 88.89%, specificity- 100%, Kappa-score 0.92 and sensitivity- 80%, specificity- 100%, Kappa-score 0.88; respectively). Further, the response of patients harboring tyrosine kinase inhibitor (TKI) sensitizing EGFR mutations was assessed. The progression-free-survival of EGFR positive patients on TKI therapy, harboring a concomitant mutation in PIK3CAmTOR and/or RAS-RAF-MAPK pathway gene and/or TP53 gene was inferior to those with sole-sensitizing EGFR mutation (2 months vs. 9.5 months, P = 0.015). Conclusions: This is the first study from South Asia looking into the analytical validity of NGS and describing the mutational landscape of lung cancer patients to study the impact of co-mutations on cancer biology and treatment outcome. Our study demonstrates the clinical utility of NGS testing for identifying actionable variants and making treatment decisions in advanced lung cancer

Computerized tomography based evaluation of level I and II axillary lymph nodes by high conventional tangential fields in carcinoma breast

Background: Axillary radiation and surgery have provided equivalent local control in early breast cancer patients. It is believed that tangential field (TF) radiation that was used to treat the breast coincidently delivered radiation treatment to the lower axilla and eradicated the disease. In the era of CT-based three dimensional- (3D) radiotherapy planning, however concerns have been raised about the adequacy of coverage of the axillary levels in the tangential fields. In this study, author evaluated the coverage of the axillary nodal levels I and II using high conventional tangential fields in patients with or without axillary dissection.Methods: A prospective study was conducted which included 18 cases for a period of one year, radiation therapy was planned to the chest wall or whole breast by using the high conventional tangential field using 2D radiation portals. Central lung distance (CLD) and the distance of superior border was measured form the head of the humerus and were recorded. CECT chest was done in the same position alike during conventional simulation. All the images were shifted to the treatment planning system. The Contouring of Axillary lymph nodes level I and II was done on Oncentra contouring software.Results: The coverage of the axillary nodes was not related to central lung distance (CLD). However, some with CLD of 1cm had more coverage of the level I nodes than with CLD of 2 cm and the maximum CLD in the field was 2.5 cm. Of the 18 patients in the study, 13 patients had <2 cm distance from the humeral head and all the axillary level II LN covered in the field. Whereas 5 patients having distance >2 cm did not have adequate coverage of level II axillary LN’s.Conclusions: The distance of the cranial border of the tangent portal from the head of the humerus shows a relationship with coverage of level II nodes cranially. As the distance decreases the coverage of level II nodes cranially keeps increasing. In majority of the patients a distance of 2 cm or less than 2 cm ensured good coverage of level II nodes cranially. Similarly, no correlation was found between volumetric coverage of the axillary nodes with central lung distance.

Anemia among 6 - 59 months children in a rural area of Bareilly district: a cross sectional study

Background: Anemia is a global health problem affecting mostly in developing countries. Iron deficiency anemia is a significant health problem and especially in developing countries. It’s the most neglected micronutrient deficiency disorder among under-five children. The objective of the study was to assess the prevalence and determinants of anemia among under-five children and to suggest suitable remediable measures to prevent and control of anemia.Method: This is a cross-sectional study. Household survey carried out in twelve villages in a rural practice area Dhaura, Bareilly. A total of 396 children were contacted for obtaining blood samples by taking 33 children from each village. Blood samples were taken from all children between the 6th month to 59 months of age using simple random sampling. After the collection, data will be analyzed using the SPSS software version 20.Result: A total of 47.5% of the children were found to have anemia. Among them 25.5% had mild, 63.3% had moderate and 11.2% had severe anemia. The majority of them were male 269 (67.9%). The mean age of participating children was 17.351±7.785 months. 48.2% of anemic children were low birth weight.Conclusion: High prevalence could be due to deficiency in iron nutrition among under-five children associated with poor food availability, due to lack of nutritional education and other sociodemographic conditions, child’s age and worse household conditions also contributed to the prevalence of anemia.

Correlation between Trans-Vaginal Ultrasound and Endoscopy in Infertility

Introduction: Infertility is defined as inability to conceiveafter one or more years of unprotected intercourse. Thisstudy was taken up to evaluate the correlation of transvaginal ultrasound with endoscopies both hysteroscopy andlaparoscopy in the evaluation of infertile patients.Material and methods: A prospective study was carriedout in the department of Obstetrics and Gynaecology, MMMedical College and Hospital, Kumarhatti, Solan, HP, Indiafor a period of 6 months from October 2017 to March 2018conducted on 50 subjects.Results: 50 patients were evaluated with diagnosis of primaryand secondary infertility. TVS (Transvaginal scan) showedabnormal findings correctly in 38% of cases, and 62% caseswere undiagnosed. Hysteroscopy showed alterations in 58%cases, predominantly uterine synechiae and endometrialpolyp. There were no complications during hysteroscopy.Diagnostic Laparoscopy showed, normal pelvic findings andpatent tubes in 30% cases of primary infertility and 8% casesin secondary infertility.Conclusion: Hystero-Laparoscopy is better than TVS alonefor the diagnosis of infertility pathology as its diagnosis ismore précised and we can treat them simultaneously, butstill TVS remains the best non-invasive method for study ofuterine as well as adnexal pathology in infertility.

A study of contaminated sharp injury and associated morbidity among health care workers

Background: Needles are one of the biomedical waste materials generated during the treatment or procedure in the hospital. Improper handling, capping or disposal technique causes a major health hazard among the health care workers (HCWs). Needle stick injuries (NSIs) can occur accidentally at any time when people use, disassemble, or dispose needle. The aim of the present study were to find out the burden of chronic morbid condition due to NSIs to HCWs, to find out various risk factors responsible for causing chronic disease to HCWs and to suggest the prevention and control of needle stick injury among the HCWs.Methods: A cross-sectional study, conducted among HCWs. Sample size was estimated by using standard formula and 312 HCWs were taken in study. Equal number of respondent was taken from each group. The information has been collected and data entry has been done using specific software SPSS version 20.0.Results: Most of the HCWs were infected with hepatitis B (24.0%) followed by hepatitis C virus (8.7%) and HIV (1.9%) after the percutaneous injuries with needle of infectious patients during any intervention procedures of the patients.Conclusions: Occupational exposures to percutaneous injuries are substantial source of infections with blood borne pathogens among health-care workers because of the poor practice as well as not opting personal protective equipment’s during intervention process regarding preventive and control measures. These infections are highly preventable and should be eliminated.

A cross sectional study regarding awareness of HIV/AIDS and practices of condoms among slum dwellers of Ajmer, Rajasthan, India

Background: People living in slums are often deprived of health-care facilities and it make them vulnerable to infection like HIV/AIDS. Health education and behavioural changes is pivotal for prevention of  HIV and HIV-related stigma.  Methods: It was community based cross sectional study carried among 288 slum dwellers of Ajmer, Rajasthan, India.Results: Out of 288 study subjects (male and females in the group of 15-54 years) 144 (50%) males and 144 (50%) females. Out of 288 study subjects 278 (96.53%) were heard about HIV/AIDS. Out of 249 study subject who were aware about condom, 107 (42.97%) study subjects [74 (56.06%) male and 33 (28.21%) female] were presently using of condom. out of 278 study subject who had ever heard about HIV/AIDS majority 215 (77.34%) subjects got the information regarding HIV/AIDS through TV/cinemaConclusions: Present study shows that the study subjects of slums at Ajmer has inadequate awareness regarding the HIV/AIDS and poor practice of condoms.

Post Operative Evaluation of Patients of Laparoscopy Cholecystectomy with and without Drain with the Help of Ultrasonography

Introduction: Most common complaints after laparoscopiccholecystectomy are abdominal pain, shoulder tip pain, andnausea, vomiting in the post-operative period. These havebeen attributed to high pressure pneumoperitoneum usingcarbon dioxide gas causing irritation of the diaphragm andother abdominal viscera. Thus, a drainage tube is insertedto decrease the intra-abdominal pressure to mitigate thesesymptoms. However, the role of routine drainage afterlaparoscopic cholecystectomy is still controversial. Severalstudies including some meta-analysis performed to assessthe role of drains in reducing complications in laparoscopiccholecystectomy could not definitively establish the same.The surgical community is divided on this issue due to thelack of evidence on usefulness of drain. Therefore, we planneda controlled randomized comparative study to assess the valueof drain in uncomplicated laparoscopic cholecystectomy.Material and methods: The study was conducted indepartment of General surgery Maharishi MarkendeshwarMedical college and Hospital, Kumarhatti, Solan, HimachalPradesh, India from July 2018 to June 2019. During a periodof one year, 50 patients (group A) were randomized to havea drain placed, with No. 14 Ryles tube, kept in sub hepaticspace after laproscopic surgery, whereas the other 50 patients(group B) did not have any drain in the subhepatic space.These patients were evaluated regarding any differences inmorbidity, postoperative pain, wound infection and hospitalstay between the two groups.Result and Conclusions: The present study was unableto substantiate the utility of subhepatic drain following theelective laproscopic cholecystectomy procedure.

Impact of socio-demographic variables and morbid conditions on general health component of perceived health using SF-36 form

Background: Perceived health (PH) is a subjective assessment of the health and it is a strong, independent and reliable predictor of morbidity, mortality. It includes so many aspects that are difficult to capture clinically such as incipient disease, physiological, psychological reserves. We assessed the impact of diabetes mellitus (DM), hypertension (HTN), co-morbidity and other associated factors on the general health (GH) dimension of the PH of the patients attending the outpatient department (OPD), Inpatient department (IPD), rural health training centre (RHTC) and urban health training centre (UHTC) of Shri Ram Murti Smarak Institute of Medical Sciences (SRMS, IMS), Bareilly.Methods: PH status of the patients was assessed by the GH dimension of the physical component summary of PH using the 36-Items short form health survey (SF-36).Results: The impact of morbidity deteriorate the GH score but hypertensive patients scored poor results as compared to those with DM and comorbid patients (p>0.05). Age was inversely related with GH scores but male gender, higher education (p<0.05) and good occupation were all associated with higher GH score. There was not much influence of geographical area on the GH scores but urban score slightly better and the association was insignificant (p>0.05).Conclusions: Male young patients from urban area, educated and good job performed better score for GH and association was significant for education and occupation. The presence of morbidity and co-morbid condition deteriorate the GH of the patients. The impact of various socio-demographic factors on the PH status was also evident in the study.

Bacteriological Aspect of Bile in Cholecystectomy Patients

Cholecystectomy is currently a frequent performed operation. The presence of gallstones within either the gallbladder or biliary tree is associated with the bacterial colonization of the bile. Acute cholangitis spans a continuous clinical spectrum and can progress from a local biliary infection to advanced disease with sepsis and multiple organ dysfunction syndrome. Therefore, it is important to know the microbiological flora of the gallbladder before prophylactic antibiotics are given. Aim and objectives: 1.To evaluate the bacteriological profile of bile in patients undergoing cholecystectomy. 2. To determine the appropriate antibiotics for prophylaxis in cholecystectomy patients based on the bacteriological profile of bile in our study. Methods: The study was a prospective study carried out in Guru Nanak Dev Hospital, Amritsar. A total of 100 patients undergone cholecystectomy who met the inclusion criteria were included in the study. Bile was aspirated from all patients, this collected bile from gallbladder was transported to the Microbiology Department in 5cc sterile syringe. The specimen was evaluated to find out whether it is sterile or has any bacteria present. Sensitivity of isolated organisms was done against antibiotics. Results: 25 patients showed positive bile culture (25%), whereas bile was sterile in 75 patients (75%). E.Coli was the most common isolated bacteria (60%) followed by Enterococcus (20%), Staph Aureus (8%), Salmonella (8%) and Pseudomonas (4%). Postoperative wound infection was more common (20%) in group of patients with isolated organisms from bile. Conclusion: 25% of bile samples were culture positive. E coli was the most common aerobic bacteria to be isolated from the bile culture . E. coli, salmonella and pseudomonas were most sensitive to piperacillin + tazobactum and imipenum (100%). E. coli also showed sensitivity to amikacin and gentamicin (73.33% each). Enterococcus was most sensitive to linezolid and ampicillin + salbactum (100%) followed by gentamicin and amoxicillin + clavulanate (80% each). Staphylococcus was most sensitive to linezolid (100%). Antimicrobial susceptibility of potential causative organisms and the local susceptibility pattern must be taken into consideration when prescribing drugs to patients with biliary disease.

Early Versus Delayed Laparoscopic Cholecystectomy In Patients With Mild Acute Biliary Pancreatitis

Background: Acute gallstone pancreatitis is the common condition marked by pancreatic inflammation. In general, patients with gallstone induced mild pancreatitis should undergo definitive treatment in the form of LC before discharge from hospital, during first admission itself. This is more important to prevent a further attack of acute pancreatitis, seen in as many as 30-50%, during the waiting period of LC. Our study analyzes various parameters in patients which were treated by early and delayed laparoscopic cholecystectomy who presented with mild acute biliary pancreatitis. Methods: A prospective study was conducted for one year, where 25 cases were operated early (within 8 days of pain abdomen) and another 25 cases were operated by delayed laparoscopic cholecystectomy for diagnosed mild acute biliary pancreatitis. Various parameters were assessed and compared which included both intra operative and postoperative events. Haemodynamically unstable, associated choledocholithiasis, severe AP and patients with malignancy were excluded from this study. Results: Twelve cases presented with recurrent attacks in waiting period which were delayed for surgery. In early group, operative time ranged from 19-40 minutes, operative blood loss about 10-50 ml, 3 patients were converted from LC to OC, 6 patients needed a drain and hospital stay ranged from 2-6 days. In delayed group, operative time ranged from 18-36 minutes, operative blood loss about 10-40 ml, 2 patients converted from LC to OC, 3 patients needed a drain and hospital stay ranged from 1-5 days. Post operative analgesia dose was also comparable. Conclusion: In new era of sophisticated technology, improved operative techniques and better post operative management; early LC is gold standard approach in patients with mild to moderate gall stone induced AP. It protects against further attacks of biliary pancreatitis, with no increase in complications or morbidity. Therefore, LC in the early period is safe, effective and feasible in patients of gallstone induced AP, preventing recurrent attacks, which otherwise cause significant morbidity and even mortality in patients.

Prevalence of metabolic syndrome and cardiovascular changes in patients with chronic plaque psoriasis and their correlation with disease severity: A hospital-based cross-sectional study.

Background: Previous epidemiological studies suggest an association between psoriasis and metabolic syndrome and risk of subclinical atherosclerosis. However, there is a paucity of data in the Indian population on these associations. Objectives: To evaluate the prevalence of metabolic syndrome and subclinical atherosclerosis in patients with chronic plaque psoriasis compared to healthy controls and to correlate the prevalence of metabolic syndrome with severity of psoriasis. Methods: A hospital-based cross-sectional study was performed on 140 patients with chronic plaque psoriasis and 140 controls. Psoriasis was categorized as mild, moderate and severe based on psoriasis area and severity index (<10, 10–14 and ≥15, respectively) and as disease of short (<1 year), intermediate (1–3 years) and long duration (>3 years). In all patients and controls, body mass index was calculated, blood pressure and waist circumference were measured and fasting blood sugar and lipid profi le were estimated. Metabolic syndrome was diagnosed by the presence of 3 or more of the modifi ed National Cholesterol Education Program’s Adult Treatment Panel III criteria. A subset of 30 psoriatic patients and 30 healthy controls were selected by the systematic sampling method for cardiac evaluation including electrocardiography, echocardiography and carotid intima-media thickness measurement. Results: The prevalence of metabolic syndrome was signifi cantly more in psoriatic patients than in controls (39.3% vs. 17.1%, odds ratio = 3.13). Psoriatic patients also had a signifi cantly higher prevalence of hypertension, abdominal obesity and diabetes. There was a signifi cant trend to increase in prevalence of metabolic syndrome, hypertension and type 2 diabetes with increased severity and longer duration of the psoriasis. Patients with psoriasis had signifi cantly higher carotid intima-media thickness (mean 0.61 mm ± 0.01 mm vs. 0.37 mm ± 0.01 mm) than controls. Limitation: This was a hospital-based cross-sectional study with a relatively small sample size. A prospective study with a larger sample would have validated the results further. Conclusion: There is a signifi cantly higher prevalence of metabolic syndrome in psoriasis patients as compared to controls; the prevalence of metabolic syndrome and its components increases with severity and duration of psoriasis. There is a higher prevalence of subclinical atherosclerosis in patients with psoriasis thus increasing the risk of cardiovascular disease. We suggest that patients with moderate to severe psoriasis be screened routinely for metabolic syndrome and cardiovascular disease and encouraged to correct modifi able cardiovascular risk factors.

A Rare Presentation of Primary Breast Tuberculosis in a Primigravida: A Case Report.

Tuberculosis is an endemic and very common disease in India. Breast tuberculosis is often confused with breast malignancy or pyogenic abscess. We report a rare case of breast tuberculosis which is successfully managed with Anti-tubercular drugs. After six months of compliant treatment patient delivered a healthy baby.

Assessment of morbidity profile in urban slum community of Udaipur (Rajasthan).

Background: The urban slums has diversity, but the universal characteristics refer to overcrowding and congestion, lack of hygiene, extremely poor sanitation, lack of garbage disposal facilities, high density of insects and rodents, makes the dwellers more prone to morbidity. Objectives: To study morbidity profile in urban slum dwellers. Methods: Cross sectional study had been carried out between January 2014 to July 2014 on slum dwellers of Udaipur. Information obtained by interviewing the head and/or other family members of about 76 households. Results: The morbidity rate for both sexes was 33.0%. About 31.2% males and 34.6% females were either suffering from or have a history of one or more illness within previous two weeks. Anemia was found in 11.2% of females. Respiratory tract infections and diarrhea were present in 8.8% and 2.1% of studied population respectively. Among five years above age slum dwellers, 18.9%, 38.3% and 31.2% had a habit of smoking, tobacco chewing and alcohol intake respectively. Conclusions: Slum dwellers were unaware of the effective information on hygiene, health and substance use, education, communication activities along with effective health care delivery measures needed.

Assessment of nutritional status in pre-school children in Teetardi village near Geetanjali hospital, Udaipur (Rajasthan).

Background: The pre-school age group (2-5 years) was evaluated for nutritional status at Teetardi village near Geetanjali hospital Udaipur. Objectives: To study the nutritional status in pre-school children. Methods: Cross sectional study carried out during February 2014 to June 2014 with 300 children at Teetardi village near Geetanjali hospital Udaipur. Body weight, height recorded with age, gender and also interviewing the mother. Results: The age and sex distribution of 300 children in present study was 52% males and 48% females. The nutritional status in the children was determined as per World Health Organization child growth standards. Result reveals that out of total male children 4.5% were severely stunted and out of total female children 4.2% were severely stunted. Out of total 10.3% of male children and 11.1% of female children were found stunted. Whereas out of total children 3.2% of male children and 4.9% of female children were severely wasted. Out of total children 10.9% of male children and 12.5% of female children were found wasted. Also 7.1% of male children and 5.5% of female children were overweight also found that 1.9% of male children and 0.7% of female children are obese. Conclusions: There is necessity of more education in reference to nutrition and dietary habits including proper antenatal care and postnatal care of mother to reduce the prevalence of nutrition related abnormalities in children.

A Prospective Study Comparing Single with Multiple Antibiotic Prophylaxis Dose in Elective Cholecystectomy.

Background: Cholecystectomy is one of the commonest, clean and contaminated surgery operations performed by the surgeons worldwide. Antibiotic prophylaxis in elective cholecystectomy is a controversial issue and our study was undertaken to evaluate the rate of infection and the usefulness and efficacy of antibiotic prophylaxis in elective cholecystectomies. Methods: The study comprised of 100 patients admitted for elective cholecystectomy. The first fifty patients undergoing elective cholecystectomy were given the prophylactic antibiotic outside the operation theater in the wards and the next fifty patients were given a single dose of injection cefuroxime (1.5 gm i.v). Results: In single dose antibiotic prophylaxis group 10.52% people developed surgical site infection in open cholecystectomy group while patients developed infection in laparoscopic cholecystectomy group but in multiple dose group 16.21% patients who underwent open cholecystectomy developed a surgical site infection while 10% developed an SSI in laparoscopic cholecystectomy group. In both the groups, results are statistically not significant. Conclusion: This study document that one single dose of prophylactic antibiotic, administered at induction of anaesthesia, is sufficient to prevent post-operative infective complications in patients undergoing elective cholecystectomy.

Curcumin sensitizes lung adenocarcinoma cells to apoptosis via intracellular redox status mediated pathway.

The present study demonstrates that curcumin acts as pro-oxidant and sensitizes human lung adenocarcinoma epithelial cells (A549) to apoptosis via intracellular redox status mediated pathway. Results indicated that curcumin induced cell toxicity (light microscopy and MTT assay) and apoptosis (AnnexinV-FITC/PI labeling and caspase-3 activity) in these cells. These events seem to be mediated through generation of reactive oxygen species (ROS) and superoxide radicals (SOR) and enhanced levels of lipid peroxidation. These changes were accompanied by increase in oxidized glutathione (GSSG), reduced glutathione (GSH) and -glutamylcysteine synthetase (-GCS) activity, but decrease in GSH/GSSG ratio. The induction of apoptosis and decrease in GSH/GSSG ratio was also accompanied by sustained phosphorylation and activation of p38 mitogen activated protein kinase (MAPK). On the other hand, addition of N-acetyl cysteine (NAC), an antioxidant, blocked the curcumin-induced ROS production and rescued malignant cells from curcumin-induced apoptosis through caspase-3 deactivation. However, L-buthionine sulfoximine (BSO), a GSH synthesis blocking agent, further enhanced curcumin-induced ROS production and apoptosis in A549 cells. Decreased GSH/GSSG ratio seems to be a crucial factor for the activation of MAPK signaling cascade by curcumin. The study therefore, provides an insight into the molecular mechanism involved in sensitization of lung adenocarcinoma cells to apoptosis by curcumin.

Absence of Mycobacterium avium ss paratuberculosis-specific IS900 sequence in intestinal biopsy tissues of Indian patients with Crohn’s disease.

Background and Objective The role of Mycobacterium avium ss paratuberculosis (MAP) in the etiopathology of Crohn’s disease (CD) remains controversial, because of conflicting reports demonstrating the presence of MAP-specific insertion sequence from intestinal biopsy tissues of patients clinically diagnosed for the disease. The present study was carried out to investigate the presence of MAP DNA in the intestinal tissues of CD patients to ascertain the relevance of MAP in Indian patients with CD. Methods Patients diagnosed as CD at our institute were recruited. Healthy individuals without inflammatory bowel disease served as controls. Mucosal biopsy specimens were collected from ileum and colon in duplicates and subjected to histopathological examination and polymerase chain reaction (PCR) amplification. Total DNA (81 CD patients, 85 healthy individuals) and total RNA (12 CD patients, 12 healthy individuals) isolated from tissue specimens was used for amplification of MAP-specific IS900 by nested PCR. Results MAP-specific IS900 DNA and RNA could not be detected by nested PCR in the intestinal tissues of any patient with CD. Conclusion Our results do not support the etiological role of MAP in the pathogenesis of CD in Indian patients.