CCN3 Proteins as a diagnostic marker in osteosarcoma patients: A case control study.

BACKGROUND: Osteosarcoma is the most prevalent type of primary bone sarcoma and is the major cause of deaths associated with cancer in children and adolescents. Despite novel and innovative therapies, early diagnosis of the osteosarcoma is still critically needed. Our study aimed to analyse the CCN3 proteins as a diagnostic marker and correlate their expression level with the severity of primary osteosarcoma patients. METHODS: In this prospective case-control study, after ethical clearance and informed consent, a total of 35 cases with primary osteosarcoma and ten otherwise healthy controls were enroled according to our strict inclusion-exclusion criteria. Tissue samples were collected during biopsy procedures in suspected cases and in controls during bone grafting procedures. The CCN3 expression level was measured by the western blotting assay. The clinic-radiological examinations were done in cases and graded according to the AJCC classification. Comparisons of CCN3 expression were measured between cases and controls, followed by correlation of their expression level with severity/grade of osteosarcoma in cases. RESULTS: All the demographic parameters showed insignificant differences. The CCN3 protein expressions were significantly upregulated in tissue samples of osteosarcoma patients (cases) compared to controls. The mean difference (p<0.0001) in CCN3 protein expression between cases' and controls' bony tissues was significant but showed insignificant correlation with the different grades of osteosarcoma. CONCLUSIONS: The upregulated CCN3 protein expression in osteosarcoma tissue along with significant differential manifestation in accordance with different grades of osteosarcoma make CCN3 suitable for a potential diagnostic biomarker. However, the author recommends further extensive multi-centric collaborative studies to increase our study reliability and generalizability.

Blood Lead Levels in Occupationally Exposed Workers Involved in Battery Factories of Delhi-NCR Region: Effect on Vitamin D and Calcium Metabolism.

Workers involved in battery manufacturing or recycling factories are occupationally exposed to high concentrations of lead. In humans, lead can cause a wide range of biological effects depending upon the level and duration of exposure. The purpose of this study was to find out the blood lead levels (BLL) in occupationally exposed workers involved in battery industry in Delhi NCR region and to study whether lead affected the vitamin D (vit D) and calcium metabolism. For this study 100 occupationally lead-exposed battery workers (LEBW) and 100 non-lead exposed controls (NLEC) were recruited. BLL were measured using inductively coupled plasma optical emission spectrometer (ICP-OES) technique while ELISA was performed to quantify the serum vit D levels in the study subjects. Routine biochemical parameters were measured by chemistry autoanalyzers. Statistical analysis was done using appropriate statistical tools. Results showed that BLL were significantly higher in LEBW as compared to NLEC (p < 0.0001). Serum vitamin D, calcium and phosphorus levels were significantly decreased in battery workers as compared to controls (p < 0.005). Spearman's rank correlation analysis showed significant negative correlation of BLL with serum Vitamin D and calcium levels. Significant positive correlation was observed between BLL and duration of lead exposure. Weak negative correlation was also observed between BLL and vit D even after adjusting for smoking status. In conclusion, this study demonstrated that higher BLL significantly alters the vit D and calcium metabolism.

Correlation of Paraoxonase Status with Disease Activity Score and Systemic Inflammation in Rheumatoid Arthritic Patients.

INTRODUCTION: Despite, various preventive efforts on conventional cardiovascular disease (CVD) risk factors, the incidence of CVD in rheumatoid arthritis (RA) patients increases continuously. To solve this conundrum one needs more investigations. AIM: The present study was conducted to evaluate the plasma paraoxonase (PON) activity along with the markers of systemic inflammation, oxidative stress and disease activity score-28 (DAS28) in RA patients and clarify their role in determining the probability of RA patients to develop future CVD risk. MATERIALS AND METHODS: Plasma PON, total antioxidant activity (TAA), C-reactive protein (CRP), synovial interleukin-6 (IL-6) and erythrocyte malondialdehyde (MDA) levels were estimated in 40 RA patients aged 40-55 years aged and 40 age-matched healthy controls. The data obtained were compared statistically by using Student's t-test and Pearson correlation test. RESULTS: Besides dyslipidaemia, marked reduction in plasma PON and TAA (p< 0.05) were observed in RA patients as compared with that of healthy controls. Erythrocyte MDA, plasma CRP and synovial IL-6 levels were increased significantly (p<0.05) in RA patients. PON was negatively correlated with MDA (r = - 0.672; p < 0.001), CRP (r = -0.458; p<0.05), IL-6 (r = -0.426; p<0.05) and DAS28 (r = -0.598; p < 0.001), and positively correlated with HDL cholesterol (r = 0.648; p<0.001) and TAA (r = 0.608; p< 0.001) levels in RA patients. CONCLUSION: Alteration in PON activity might contribute to the progression of future CVD risk in RA patients, which may result from interplay of several confounding factors, such as inflammation, oxidative stress and dyslipidaemia. Furthermore, plasma PON activity, CRP and TAA levels could be considered as non-traditional factors to predict CVD risk. Thus, it is suggested that future drugs could be developed to target the non-traditional risk factors in RA patients.

Alcohol Used as Disinfectant before Venipuncture does not Lead to Sample Haemolysis or Sample Dilution.

INTRODUCTION: Sample haemolysis is often the leading cause of sample rejections in clinical laboratory. Isopropyl alcohol or ethyl alcohol, used as disinfectant during sample collection is often considered an important cause of sample haemolysis or sample dilution; although there is a paucity of scientific documentation verifying the same. AIM: To verify whether avoidance to wipe out alcohol from the venipuncture site, before sample collection leads to sample haemolysis; or leads to sample dilution. MATERIALS AND METHODS: This was a prospective randomized study, where every second patient coming to the phlebotomist during the study period, in the age group of 20 to 50 years, was considered for the study. A total of 60 patients were considered for the study. For unbiased comparison sample were collected from both left upper limb (alcohol dry) and right upper limb (alcohol wet) of all the patients. Visual inspection for haemolysis was done, and serum potassium (K), Calcium (Ca), Lactate Dehydrogenase (LDH), Aspartate transaminase (AST), Alanine transaminase (ALT), Alkaline phosphatase (ALKP) and Glucose were estimated in both the set. Also experiences of patients in both limb collections were considered. RESULTS: On visual inspection none of the sample was haemolysed. 51.67% of the patients experienced same level of discomfort in both limbs (alcohol dry and alcohol wet) during venipuncture. While 28.3% experienced burning sensation in alcohol wet limb, another 20% experienced a more soothing sensation in the alcohol wet limb during venipuncture. There is no statistically significant difference in the measured value of serum K, LDH, Ca, AST, ALT and ALKP and Glucose between the two sets of sample - alcohol dry and alcohol wet. CONCLUSION: The study concludes that avoidance to wipe alcohol before venipuncture does not lead to sample haemolysis or sample dilution. Also most patient experienced same or more soothing sensation in alcohol wet limb. Therefore sample can be collected without a waiting period for alcohol to dry off, thereby preventing haemoconcentration and decreasing sample collection time.

Triple negative breast cancer in people of North East India: critical insights gained at a regional cancer centre.

BACKGROUND: Breast cancer is a heterogeneous disease comprising of distinct biological subtypes with many targeted prognostic biomarkers having therapeutic implications. However, no specific targeted therapy for triple negative breast cancer has been discovered to date and hence further research is needed. AIM: The aim and objectives of the present study were to examine the prevalence of triple negative breast cancer (TNBC) in North-East India and to compare the clinicopathological parameters in two study groups defined by immunohistochemistry (IHC) -"TNBC" and "Others". MATERIALS AND METHODS: We carried out a retrospective study in a cohort of 972 patients diagnosed with invasive breast carcinoma in the Department of Pathology, Dr. B. Borooah Cancer Institute, a Regional Cancer Centre for treatment and research, Guwahati, for a period of 3 years and 10 months from January 2010 to October 2013. Based on IHC findings, patients were divided into two groups - "TNBC" and "Others". All relevant clinicopathological parameters were compared in both. TNBC were defined as those that were estrogen receptor (ER), progesterone receptor (PR), and HER2/neu negative while those positive for any of these markers were defined as "Others". RESULTS: In this study, out of total 972 cases 31.9% (310 cases) were defined as TNBC and 662 cases (68.1%) as "Others" based on IHC markers. Compared to the "Others" category, TNBC presented at an early age (mean 40 years), were associated with high grade large tumours and high rate of node positivity, IDC NOS being the most common histological subtype in TNBC. CONCLUSIONS: TNBC accounts for a significant portion of breast cancers in this part of India and commonly present at younger age and tend to be large high grade tumours.