PERCEIVED SOCIAL SUPPORT IN RELATION TO QUALITY OF LIFE AMONG SCHOOL TEACHERS

The purpose of this study is to examine the relationship of various levels of social support with quality of life (QOL) among school teachers in Kashmir. It has been found that social support and its three dimensions namely support from significant others; support from family and support from friends had a positive significant relationship with quality of life and its four dimensions. Understanding the relationship between perceived social support and QOL in teachers may provide guidance to the healthcare providers, family members and social services about the importance of social support to the nation builders of the society.

Delay in Diagnosis of Stomach Cancer Patients Attending a Tertiary CareHospital in Kashmir: A Hospital Based Cross Sectional Study

Introduction: cancers is associated with a favourable outcome. Stomach cancer is one of the most common cancers of gastrointestinal tract. Majority patients visit physicians in developed stages. To evaluate theObjective: reporting pattern of stomach cancer patients living in Kashmir valley in order to determine the median time of delay from the beginning of symptoms to diagnosis. Total 116 proven stomach cancer patientsMethod: were evaluated for the pattern of presentation at endoscopy laboratory of Super Speciality Hospital, Shireen Bagh Kashmir from April 2019 to September 2020. In this study, the mean age (SD) of participantsResults: was 60.22 ± (11.90) years. Majority of the participants (69.8%) were males. Cases were predominantly from the rural area (58%).Only 15.5 % of the cases were diagnosed within one month of their symptoms while as 3.4% of the cases had a total delay of more than 12 months. The study found a considerable total delay in the diagnosis of stomach cancer. The mean of the patient delay was 45.6 days. The median total delay was 20 weeks. Since stomach cancer has high mortality and morbidity rates associated, creatingConclusion: awareness among the population and training of physicians regarding timely referral of patients seems important

A series of 777 pellet gun ocular injuries over a 4-month period in Kashmir

Purpose: To examine the incidence, clinical findings and management of pellet gun–related ocular injuries that occurred during protests in Kashmir region. Methods: This retrospective study included records from 777 patients diagnosed with pellet gun–related ocular injuries admitted to a tertiary hospital in Srinagar, India, between July and November 2016. By reviewing the clinical records, the following data were collected: demographics, clinical information pertaining to the injury, imaging reports including computer tomography and ultrasonography B?scan, management in the emergency setting, and follow?up treatment. Results: Mean age was 22.3 ± 7.2 years and majority patients were male (97.7%). In terms of laterality, 94.3% and 5.7% of the patients sustained monocular and binocular injuries, respectively. In terms of the nature of injury, 76.3% of the eyes had open globe injury while 23.7% of the eyes had closed eye injury. Emergency surgical exploration was performed in 67.7% of closed globe injuries while emergency primary repair was done in 91.1% of open globe injuries. The vast majority of patients (98.7%) who required surgery underwent surgical intervention on the day of admission or the next day. Final best?corrected visual acuity (BCVA) after treatment was counting fingers or worse in 82.4% of the eyes. Conclusion: Pellet gun–related ocular injuries resulted in significant ocular morbidity, mostly manifesting as open globe injuries. Treatment often required surgical interventions, but despite expeditious management, visual prognosis remained poor for most of the patients.

Assessment of Delivery of Routine Immunization in Kashmir: A Qualitative Study

Introduction: Immunization is one of the splendid public health interventions that remarkably reduced child morbidity, mortality, and disability. Despite attaining substantial immunization coverage in Kashmir, assessment of the immunization system is quintessential for sustaining the gains and exploring the gaps. Objective: To assess the gaps in the delivery of routine immunization services in Kashmir Valley. Method: In-depth face-to-face interviews were conducted with thirty-two (32) important stakeholders, who were purposively selected as they play an active role in the planning and implementation of the Immunization Program and devise strategies at different levels of healthcare delivery. At the state level, SEPIO and SMO were interviewed at the District level, DIO/Deputy CMO was interviewed in all ten (10) districts of Kashmir Valley. From all ten Districts, two Medical-Blocks were selected from each District, and one Block Medical Officer and one Medical Officer were interviewed alternatively from each Medical-Block. Results: The thematic qualitative analysis approach was used and the analysis process generated five themes. Each of these themes included many sub-themes. 1. Factors facilitating the implementation of Routine Immunization (RI), 2. Limitations and deficits related to knowledge, attitude, monitoring, 3. Constraints encountered in the implementation of (RI) program, 4. Difficulties in the implementation of RI revealed by respondents, 5. Transformational steps to bridge gaps in the delivery of Immunization (RI) Conclusion: There were visible deficits related to knowledge, attitude, and monitoring among health professionals. Certain constraints encountered in the implementation of the program were financial constraints in the training of health care professionals and human resources constraints. The study showed the need for transformational steps to bridge gaps in the delivery of the Immunization (RI), which included regular monitoring and review meetings, teamwork and peer learning, training, and improvement in cold chain maintenance

Experiences of Stigma and Discrimination of Women Living with HIV/AIDS in Health-Care Settings of Kashmir

Stigma and discrimination create barriers for women living with HIV/AIDS (WLHA) in accessing quality health‑care services, affecting their well‑being and also increasing the number of cases. The current article studies issues of stigma and discrimination that WLHA experience in health‑care settings and highlights the importance of building awareness and sensitivity regarding HIV among all health‑care workers. This hospital‑based study was conducted in an anti‑retroviral therapy center in Kashmir. Twenty‑one WLHA participated in the study. The WLHA internalizes stigma and experiences shock, guilt, anger, and numbness while receiving a diagnosis. The stigma is socially constructed, having very little medical or logical basis. Verbal abuse, gossiping, expression of shock and disbelief of health‑care workers, discriminatory attitudes such as wearing multiple surgical gloves, denial of care and treatment, and disclosing their HIV‑positive status without their consent to their families and others have been learned. These experiences in health‑care institutions are disempowering for WLHA. Gender stereotyping and inequalities within health‑care settings and the discriminatory approach of some health practitioners toward women is the main barrier to accessing the services for HIV prevention, treatment and support services.

COVID-19 Pandemic: Trend Analysis with Respect to District Anantnag, Jammu and Kashmir, Northern India

With 1st case being reported in Wuhan city of China in December 2019, COVID?19 infection cases made their way to every corner of the world. Then, on January 07, 2020, laboratory results led to pneumonia being named as COVID?19. Scant data is available from Northern India, thus to reveal the trend of COVID?19 infection since last year of COVID?19 pandemic onset, this study took shape. The unit of analysis of our study was District Anantnag, Jammu and Kashmir. Till February 05, 2021, a total of 4625 cases of COVID?19 virus were reported in District Anantnag, Jammu and Kashmir. Negative history of close contact with COVID?19 patient (66.1%) constituted the most common exposure, majority (84.4%) were asymptomatic and comorbidities were present in 68 (1.5%). COVID?19 infection was more prevalent among younger age group, with higher male predominance, with comorbid being at higher risk, hence most stringent measures must be adopted.

Immediate psychological impacts on the inmates of a quarantine-isolation facility in North Kashmir: a pilot study

Background: During the current COVID-19 pandemic as part of various control measures quarantine-isolation facilities have been setup throughout India. To the best of our knowledge no study has been done so far on the mental health aspects of the inmates from Kashmir region.Methods: This was a questionnaire based qualitative cross sectional pilot study. A cohort of 301 inmates (196 males and105 females) consented and completed the study questionnaire from March 2020 to June, 2020. The relevant data was statistically analyzed.Results: Short lived negative impacts were seen in a sizeable number of patients. These negative correlates of mental health remained manageable as we followed the guidelines of MOHFW. Only a small percentage of ~ 4% (11 of 301) inmates needed psychiatric consultation and treatment. However they safely completed their mandatory stay period in the facility.Conclusions: Based on the results of our study, we conclude that optimum medical care during the pandemic remains the main focus and rightly so, but nevertheless mental health domain needs to be equally strengthened at the facilities in particular for short term impacts and the community in general for long term impacts.

Injury pattern and outcome of road traffic accident victims attending major referral institutions of the Kashmir valley

Background: Road traffic accidents (RTAs) have emerged as a major global public health problem of this century. WHO global burden of disease study, shows it as the 10th leading cause of death in South-East Asia. In India, according to WHO, road traffic accident is the 6th leading cause of death. The present study aims to assess the magnitude and injury pattern of RTA victims attending three major referral institution of the Kashmir valley.Methods: This prospective observational study was conducted for a period of one year in three major referral institutions of Kashmir valley. Burden of RTA victims was studied from hospital records. For studying detailed injury patterns, the accident victims fulfilling the inclusion criteria and admitted in the wards of these hospitals formed the main study group.Results: RTAs constituted 3% of the total admissions. Most (82.7%) of the studied victims were males. Most (40.3%) of the RTA victims were pedestrians. Head on collision was the most common type of accident (62.9%). 97.6% victims were grievously hurt and head (59.9%) was the most affected part of the body. 88.3% of RTA victims survived while 11.7% died.Conclusions: Young males are the predominant victims of RTAs and head on collision (63%) remains the commonest type of accident. Almost all (97.6%) RTA victims were grievously hurt with 60% having head injuries followed by lower limbs 59.4% and upper limbs 26.8% injuries and 47% victims had multiple injuries.

Spectrum of Paediatric Tuberculosis at a Tertiary Care Children`s Hospital in Kashmir: A Prospective Study

Introduction: Paediatric tuberculosis (TB) accounts for10-15% of all TB with pulmonary TB and extra-pulmonary TBcontributing to 70-80% and 20-30% respectively in children.Incidence of EPTB is on rise as reported in recent studies. Nosuch study on paediatric TB has been conducted in Kashmirvalley before. Current research aimed to study the spectrumof paediatric TB in Kashmir valley and categorize childrentreated for TB into Definite TB, Probable TB, Possible TB andNo TB.Material and Methods: Children with suspected TB aged>1month upto 18 years were prospectively enrolled at atertiary care hospital in Srinagar, Jammu and Kashmir, Indiaover a period of 2 years.Results: overall 136 children received anti-tuberculosistreatment (ATT) which included 78 (57.35%) cases ofpulmonary TB and 58 (42.65%) cases of EPTB. Tubercularmeningitis (TBM) 21 (36.2%) was the most common formof EPTB followed by abdominal tuberculosis 14 (24.13%),tuberculous lymphadenopathy 11(18.96%), tuberculouspleural effusion 9(15.52%) and miliary TB 3(5.2%). A total of60(44%) children had bacteriological evidence of TB (definiteTB), 67 (49.3%) were diagnosed on clinical grounds (ProbableTB) and TB couldn’t be ruled out in 9 (6.7%) cases. Only36 (26.47%) children were <5 year old, 65(47.8%) childrenwere male, 112(82.35%) children were malnourished. BCGscar was present in 95(69.83%) cases and 56 (41.2%) weretuberculin skin test (TST) positive. History of TB contact waspresent in 65(47.8%) cases and none of the child was HIVpositive.Conclusion: Although Extra-pulmonary TB is increasing,Pulmonary TB is still the most common type of paediatric TB.BCG offers some protection against severe forms of TB andYoung children are at increased risk of severe forms of TB.

Serological, Isolation and Molecular Studies on Brucellosis in an Organized Farm, Jammu and Kashmir, India

The present study was conducted in an organized farm of Jammu region, Jammu and Kashmir state having history of late-term abortions in cattle and buffaloes to elucidate the role of brucellosis in causing abortions on the farm. The farm had 46 animals (23 adults, 15 heifers and 9 calves). The farm was positive in herd test (milk ring test). Serological tests viz., Rose Bengal plate test (RBPT) and serum agglutination test (SAT) were conducted on 30 serum samples and 11 samples were found positive in both tests. Five vaginal swabs from abortion cases were processed for isolation and 3 isolates of Brucella were obtained which on further characterization by biochemical tests, genus-specific PCR and species-specific PCR were identified as B. abortus biovar 1. As brucellosis is an anthropozoonoses, the high prevalence of brucellosis in livestock of farm demands the surveillance of disease in humans working on the farm and necessitates the control of disease on the farm.

Prevalence of Stress, Anxiety and Depression among Medical Undergraduate Students of Kashmir - A Cross-Sectional Study

Introduction: Considerable degree of psychologicalmorbidity has been reported among medical students rangingfrom stress, interpersonal problems and suicidal ideationto psychiatric disorders. The objective of this study was todetermine the level of stress, anxiety and depression amongmedical undergraduate students of Government MedicalCollege Srinagar using DASS-21 scale.Material and methods: A cross-sectional study includingundergraduate medical students was conducted after approvalfrom instituitional ethical committee. Depression, Anxietyand Stress Scale (DASS-21) having 21 statements to assessthe level of stress, anxiety and depression among participantswas used. As there were no earlier estimates of prevalenceof stress among medical students in Kashmir, so prevalenceof 50% was assumed. With 95% confidence limits and 5 %non-response rate, sample size of 403 was calculated. Afterobtaining informed consent, 400 students were included inthe study. The data was entered into Microsoft Excel anddescriptive statistics were obtained.Results: Most of the students (55%) who participated in thestudy were females. About 67.5% were in the age-group of17-19 years, mostly belonging to rural areas(77.5%). Studentsfrom all academic years participated with majority from1st and 2nd years. Only 2.5% students had a single parent orwere orphans with majority (75%) satisfied with their sociallife. About 25% were not satisfied with their academicperformance. Prevalence of depression, anxiety and stresswas found to be 40%,50% and 37.5% respectively in medicalstudents.Conclusion: A substantial proportion of medical students aresuffering from stress, anxiety and depression revealing theirmental health issues which require urgent attention

Patterns of Failure in Breast Cancer Patients of Kashmir Valley

Breast cancer is the most frequent cancer among women and also the leading cause of cancer related deaths in women. The patterns of failures in carcinoma breast seem to differ by cell type, pathological stage and by the treatment modality instituted. Breast cancers can recur locally, regionally and distantly. Survival rates decrease progressively as the stage of the disease increases. Aims & Objectives: To evaluate the patterns of failure in patients with Breast Carcinoma after definitive treatment modalities. Methods: We conducted an analytical, nonrandomized, cross-sectional study on the Patterns of Failure in 1238 patients with primary breast cancer who reported to our Regional Cancer Centre from 2002 to 2010. Results: A total of 1238 patients with 1189 females and 49 males were evaluated. Most of the patients were above fifty years of age with breast lump being the most common presentation. Infiltrating ductal carcinoma was the most common histology and stage II being the commonest stage of presentation. Most of the patients were hormone receptor positive and Her 2 neu receptor negative. Overall local failure was 3.9%, regional failure 2.7% and distant failure 22.5%. Overall 5 year disease free survival was 78.4%. Conclusion: The most common form of local failure is chest wall recurrence, regional failure is supraclavicular lymphadenopathy and distant failure is bone metastasis. The 5 year disease free survival is lower for all the stages when compared to world scenario. This may be attributed to more aggressive disease behaviour in our patients.

Evaluation of Integrated Child Development Services Program in Kashmir, India

occurrences ofCandidasp. isolated were C. albicans which was thepredominant species 10(21.5%),C. tropicals 5(5.4%),C. krusei 4(4.3%) andC. Parapsilosis3(3.2%) respectively.Conclusion:Candida albicansremains the most predominant species of Candidain patients suffering from pulmonary tuberculosis and colonizationby Candidaspshould not be ignored.The presence of Candida sp.might contribute to in one way totheprogression of the disease under supplementary nutrition. Immunization and health check-ups were not available for pregnant and lactating women, however, 53.3% received iron and folic acid (IFA) tablets and 4.17% were provided with referral services. 71.53% of adolescent girls received IFA tablets. Health check-ups and basic skills programmes were not conducted foradolescent girls, however, 5.56% were provided with referral services.Conclusion:The performance of ICDS in Kashmir in terms of coverage is very low and almost all the services except supplementary nutrition are not delivered properly. There are many reasons for the underperformance of the scheme including socio-economic and other aspects of the grassroot workers including anganwadi workers (AWWs) and anganwadi helpers (AWHs), inadequacy of equipment for proper implementation, undesirable condition of AWCs, lack of professionalism in implementing staff, lack of co-ordination between AWCs and other associated personals like Lady Health Visitor (LHV)/Auxiliary Nurse Midwife (ANM). In Kashmir the political environment makes the implementation of ICDS scheme even more complicated and difficult. A realignment is the need of hour and the state government must identify the specific problems faced by the scheme and convey them to all the stake holders so that a better and modified version of the scheme is implemented.

The practice of exclusive breastfeeding: its socio-demographic determinants in Kashmir, North India

Background: Breastfeeding is a well-established and recommended intervention for the improvement of child nutrition. Formula feeding is a major public health problem. Objective of the current study was to know the significance of demography, socioeconomic, parental education and employment and mode of delivery on exclusive breast-feeding Kashmir, North India.Methods: A prospective hospital-based study, carried out in the Department of Pediatrics, G.B Pant Hospital Srinagar Kashmir India over the period from 2014 July to June 2015. A teaching, research and tertiary care hospital at Srinagar Kashmir North India. All the mothers who were having infants in the age group 0 to 6 months were included in study. Procedure of this variables recorded were modes of feeding, demographics, socioeconomic status, literacy level, mode of delivery, place of delivery etc.Results: A total of 600 mothers were included in study. Less than 35% of mothers were exclusively breast feeding their infants. Exclusive breast feeding was significantly high in babies born by normal vaginal delivery, more than 3 antenatal visits, mother knowing advantages of breast feeding and higher parental education.Conclusions: Exclusive breast feeding is very low (less than 35%) in this part of world and formula feeding is a major public health problem.

Assessment of immunization coverage in district Srinagar of Kashmir

Background: Immunization is till now most safe, cost effective and powerful intervention that has decreased the burden of vaccine preventable infectious diseases all over the world. The aim of this study was to estimate the immunization coverage among children aged 12-23 months in district Srinagar of Jammu and Kashmir.Methods: The study sample included 30 clusters from district Srinagar selected as per the 30×7 cluster sampling method.Results: It was found that fully immunized children were 87.14% and 12.26% of children were partially immunized and none was unimmunized. Regarding the individual vaccine coverage, it was highest for OPV1 (99.52%) followed by BCG and OPV0 (99.05%) and lowest for Hepatitis birth dose (95.24%). The dropout was found highest (6.22%) for OPV1-OPV3 and lowest (1.47%) for LPV1 - measles/MCV (1.47%).Conclusions: The immunization of district Srinagar is above 85% and this gives a positive hope for better future to reach coverage of 100%.

Ethnobotanical profiling of the medicinal flora of Kotli, Azad Jammu and Kashmir, Pakistan: Empirical reflections on multinomial logit specifications

OBJECTIVE@#To report the indigenous people's uses of plants from a multidimensional perspective in a remote area where strong ethnobotanical cultural practices prevail.@*METHODS@#An ethnobotanical survey was conducted in the field during 2014-2016. Ethnobotanical data were gathered from 182 informants through oral interviews and semi-structured questionnaires. The distribution of plants was explored using both descriptive and graphical methods. Further, a Multinomial Logit Specification was applied to find out the probability of the occurrence of diverse utilization of plants in multipurpose domains.@*RESULTS@#The study identified 202 plant species distributed among 71 families and 156 genera. Ethnobotanical data indicate that there are more medicinal (36.96%) uses of plants as compared to all other use categories. The output from the Multinomial Logit Specifications (MLS) model reveals that perennial and non-woody plants are exploited more for medicinal and food uses than annual and woody plants. In the context of ethnomedicinal uses, aerial plant parts particularly leaves are more extensively used for the preparation of herbal recipes as compared to underground parts.@*CONCLUSIONS@#The results of the study emphasize the need to create awareness among the local communities about the conservation status of plant species in order to maintain a sustainable resource of plant-derived materials into the future. The novel econometric approach employed in this study adds a new insightful methodology to the existing body of literature in the field of ethnobotany. We strongly recommend conservation measures, alongside phytochemical and pharmacological studies on the useful plant species identified in this study in order to ensure their sustainable and effective utilization.

Sero-prevalence of Hepatitis B and C virus among patients attending Dental clinics in Kashmir Valley

Introduction: Hepatitis B and C virus (HBV and HCV) infections are considered an occupational risk for dental professionals and other health care workers. It is a risk that includes the possibility of dental personnel getting HBV or HCV infection from an infected patient and the potential transmission of HBV to susceptible patients from infected dental personnel. There is dearth of consensus prevalence data on HBV & HCV infections among patients attending dental clinics in Kashmir Valley, and no prevalence study is available. The aim of this study to detect the presence of HBsAg and HCV antigen, and the relation of it‘s presence with other factors such as gender, age, social status, history of surgical operation and blood transfusion among patients attending dental clinics in Kashmir Valley. Materials and methods: Serum from 2000 patients who attended Government Dental College and Hospital, Srinagar was screened for detection HBV surface Ag and HCV Ag using the Rapid Card Diagnostic Test (SD Bioline rapid immunochromatographic test for antibody IgG). All rapid test positive samples were further tested at SMHS Hospital, Kaksarai, Srinagar by a third-generation Enzyme linked immune sorbent assay (ELISA). Data was analyzed by SPSS (Statistical Package of Social Science) software program version 16 and the prevalence and percentage of all variables were calculated. Chi-square test was applied to see difference by gender. Results: The overall sero-prevalence of HBV and HCV among dental patients was 4.4% and 4.3 % respectively. There was no statistical significant difference in prevalence of HCV and HBV in male and females. A high sero-positivity was prevalent in the age group of 51-60 years (12% for HBV and HCV respectively). Most of positive results were observed from District Anantnag especially villages Suhail Latoo, Mohammad Shafi, Humaira Nazir. Sero-prevalence of Hepatitis B and C virus among patients attending Dental clinics in Kashmir Valley. IAIM, 2017; 4(2): 53-59. Page 54 of Kokernag (77.3 % of total no. of serologically HBV positive cases and 82.6% of total no. of serologically HCV positive cases). There was a significantly high prevalence of dental procedures among cases as compared to controls (p < 0.001) for both HBV and HCV results. Conclusion: The sero frequency of hepatitis B and C is high among Kashmiri patients especially from rural population of South Kashmir attending Government Dental College and Hospital, Srinagar, dental malpractice being major source of cross infection.

Ethnobotanical profiling of the medicinal flora of Kotli, Azad Jammu and Kashmir, Pakistan: Empirical reflections on multinomial logit specifications

Objective To report the indigenous people's uses of plants from a multidimensional perspective in a remote area where strong ethnobotanical cultural practices prevail. Methods An ethnobotanical survey was conducted in the field during 2014–2016. Ethnobotanical data were gathered from 182 informants through oral interviews and semi-structured questionnaires. The distribution of plants was explored using both descriptive and graphical methods. Further, a Multinomial Logit Specification was applied to find out the probability of the occurrence of diverse utilization of plants in multipurpose domains. Results The study identified 202 plant species distributed among 71 families and 156 genera. Ethnobotanical data indicate that there are more medicinal (36.96%) uses of plants as compared to all other use categories. The output from the Multinomial Logit Specifications (MLS) model reveals that perennial and non-woody plants are exploited more for medicinal and food uses than annual and woody plants. In the context of ethnomedicinal uses, aerial plant parts particularly leaves are more extensively used for the preparation of herbal recipes as compared to underground parts. Conclusions The results of the study emphasize the need to create awareness among the local communities about the conservation status of plant species in order to maintain a sustainable resource of plant-derived materials into the future. The novel econometric approach employed in this study adds a new insightful methodology to the existing body of literature in the field of ethnobotany. We strongly recommend conservation measures, alongside phytochemical and pharmacological studies on the useful plant species identified in this study in order to ensure their sustainable and effective utilization.

p15(Ink4b) Loss of Expression by Promoter Hypermethylation Adds to Leukemogenesis and Confers a Poor Prognosis in Acute Promyelocytic Leukemia Patients / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The p15(Ink4b) gene exerts its influence as an inhibitor of cyclin-dependent kinases and is frequently associated with hematological malignancies. Inactivation of this gene through DNA methylation has been found to be the most prevalent epigenetic alteration reported, with a high frequency in all French-American-British subtypes of acute myeloid leukemias, including acute promyelocytic leukemia (APL). In this study,we investigated the prognostic significance of p15 gene promoter hypermethylation and its expression in APL patients of Kashmir (North India). MATERIALS AND METHODS: p15 gene promoter hypermethylation was conducted by methylation-specific polymerase chain reaction, while its subsequent expression analysis was carried out by semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS: Of the 37 patients, 16 (43.2%) were found to have methylated p15 genes. Of these 16 cases, seven (43.8%) were methylated partially and nine (56.2%) were found to have complete methylation. Moreover, nine of the 37 patients (24.3%) who presented with leukocytosis at their baseline had complete p15 gene methylation as well (p < 0.05). Semiquantitative RT-PCR showed a complete loss of p15 expression in nine patients with complete methylation coupled with leukocytosis (p=0.031), while seven patients with partial methylation showed decreased p15 expression. Six patients relapsed during the maintenance phase of treatment and were found to have a completely methylated p15 gene and no p15 mRNA. CONCLUSION: Complete methylation and loss of p15 gene expression causes susceptibility to relapse and decreased survival in APL patients. Thus, p15 promoter hypermethylation is a prospective prognostic indicator and a reliable clinical aid in assessment of patients with APL.

p15(Ink4b) Loss of Expression by Promoter Hypermethylation Adds to Leukemogenesis and Confers a Poor Prognosis in Acute Promyelocytic Leukemia Patients / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The p15(Ink4b) gene exerts its influence as an inhibitor of cyclin-dependent kinases and is frequently associated with hematological malignancies. Inactivation of this gene through DNA methylation has been found to be the most prevalent epigenetic alteration reported, with a high frequency in all French-American-British subtypes of acute myeloid leukemias, including acute promyelocytic leukemia (APL). In this study,we investigated the prognostic significance of p15 gene promoter hypermethylation and its expression in APL patients of Kashmir (North India). MATERIALS AND METHODS: p15 gene promoter hypermethylation was conducted by methylation-specific polymerase chain reaction, while its subsequent expression analysis was carried out by semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS: Of the 37 patients, 16 (43.2%) were found to have methylated p15 genes. Of these 16 cases, seven (43.8%) were methylated partially and nine (56.2%) were found to have complete methylation. Moreover, nine of the 37 patients (24.3%) who presented with leukocytosis at their baseline had complete p15 gene methylation as well (p < 0.05). Semiquantitative RT-PCR showed a complete loss of p15 expression in nine patients with complete methylation coupled with leukocytosis (p=0.031), while seven patients with partial methylation showed decreased p15 expression. Six patients relapsed during the maintenance phase of treatment and were found to have a completely methylated p15 gene and no p15 mRNA. CONCLUSION: Complete methylation and loss of p15 gene expression causes susceptibility to relapse and decreased survival in APL patients. Thus, p15 promoter hypermethylation is a prospective prognostic indicator and a reliable clinical aid in assessment of patients with APL.