A review on extraction, composition, structure, and biological activities of polysaccharides from different parts of Nelumbo nucifera.

Nelumbo nucifera (lotus plant) is an important member of the Nelumbonaceae family. This review summarizes the studies conducted on it since the past 15 years to provide an understanding on future areas of focus. Different parts of this plant, that is, leaves, roots, and seeds, have been used as food and for the treatment of various diseases. Polysaccharides have been extracted from different parts using different methods. The manuscript reviews the methods of extraction of polysaccharides used for leaves, roots, and seeds, along with their yield. Some methods can provide better yield while some provide better biological activity with low yield. The composition and structure of extracted polysaccharides have been determined in some studies. Although monosaccharide composition has been determined in various studies, too little information about the structure of polysaccharides from N. nucifera is available in the current literature. Different useful biological activities have been explored using in vivo and in vitro methods, which include antioxidant, antidiabetic, antitumor, anti-osteoporotic, immunomodulatory, and prebiotic activities. Antitumor activity from polysaccharides of lotus leaves is yet to be explored, besides lotus root has been underexplored as compared to other parts (leaves and seeds) according to our literature survey. Studies dedicated to the successful use of combination of extraction methods can be conducted in future. The plant provides a therapeutic as well as nutraceutical potential; however, antimicrobial activity and synergistic relationships of polysaccharides from different parts of the plant need further exploration.

Breast cancer knowledge and perception among healthcare professionals and senior medical students at Bolan Medical Complex Hospital Quetta, Pakistan.

OBJECTIVE: To assess knowledge and perception about different aspects of Breast Cancer among health care professionals at Bolan Medical Complex Hospital Quetta, Pakistan. METHODS: This cross-sectional study was carried out at Bolan Medical Complex Hospital Quetta from October to December 2017. A total of 312 health care workers including consultants (42), residents (85), medical officers (52), interns (45), nurses (48) and final year medical students (40) took part in the study. The study tool was a self-designed questionnaire with separate sections to assess the knowledge about risk factors, signs and symptoms, screening tools, breast self-examination (BSE), treatment and barriers in seeking medical advice. RESULTS: Participants had satisfactory knowledge about risk factors and signs of breast cancer but poor knowledge about association of breast cancer with menarche status, oral contraceptive pills and smoking. Majority was aware of mammography benefits and believed that breast cancer is curable with therapy. All perceived that cultural and socioeconomic barriers are the cause of late stage presentation. The nurses particularly were having misconceptions in knowledge about breast cancer risk factors and screening tools. CONCLUSIONS: The current study demonstrated that knowledge related to breast cancer was average and highlighted the need for provision of continuing medical education programmes to improve health practitioners' practice on cancer screening tools. Knowledge was particularly deficient regarding screening modalities and BSE method and timing. Special emphasis is needed to train nurses, so they could play an expanded role in breast cancer care.

Subserosal Leiomyoma with Intravenous Leiomyomatosis Extending into Inferior Vena Cava and Right-sided Cardiac Chambers.

Leiomyoma (fibroid) is the most common benign tumour of the uterus in reproductive age. Its treatment is easy and employs a surgical resection, usually without complications. However, it may show an atypical behaviour and result in intravenous leiomyomatosis (IVL) extending into the regional and systemic veins, thus reaching the heart; and may extend into the pulmonary arteries. The symptoms of IVL are non-specific, resulting in underdiagnosis and misdiagnosis of the disease entity and so the condition is underreported. Cross sectional imaging plays an important role in correct diagnosis of the condition, resulting in reduced morbidity and mortality of the patient and saving surgeons from unwanted complications. It typically originates from the uterus and may involve ovarian/uterine veins. We report a 45-year female who presented with right hypochondial pain for which she was diagnosed as cholelithiasis. She was also diagnosed with a left adnexal mass on ultrasonography (USG) for which she underwent a CECT abdomen and pelvis and was diagnosed as a case of subserosal fibroid with IVL extending into left gonadal vein, and inferior vena cava (IVC). Intracardiac extension was confirmed on 2-D echocardiography. This is first reported case of IVL from Balochistan, Pakistan.