Obesity and diabetes are associated with increased breast cancer risk and worse disease progression once cancer is diagnosed; however, the exact etiology behind these observations remains to be fully elucidated. Due to the global obesity/diabetes pandemic, it is imperative to understand how these diseases promote and enhance breast cancer and other common cancers. In this study we demonstrate that hyperglycemia promotes breast cancer by altering leptin/IGF1R and AKT/mTOR signaling. To our knowledge, we show for the first time that in breast epithelial cells, hyperglycemia alone directly impacts leptin signaling. Hyperglycemia increased proliferation of both non-tumorigenic and malignant mammary epithelial cells. These observations coincided with increased leptin receptor and IGF1R receptor, as well as, increased levels of GRB2, pJAK2, pSTAT3, pIRS1/2, pAKT, and p-mTOR. Moreover, pJAK2 was almost completely colocalized with leptin receptor under high glucose conditions. These results demonstrate how hyperglycemia can potentially increase the risk of breast cancer in premalignant lesions and enhance cancer progression in malignant cells.
Gallbladder cancer is common in north India. It is also a well established fact that gall bladder cancer is frequently associated with gallstone disease in north India, similar to reports from the West. The magnitude of the problem of gallbladder cancer in south India and its link to gallstone disease is not clearly established. The aim of the study was to determine retrospectively, the characteristics of individuals with GBC in south India and to determine its association with gallstone disease. Retrospective data was obtained from records of proven cases of gallbladder cancer and patients undergoing cholecystectomy for gallstone disease between Jan 2001 and Dec 2010. Data retrieved included age, gender, and clinical presentation, findings on imaging, histology and details of management. The number of proven cases of gallbladder cancer each year ranged from 8 to 17. There were 38 men and 23 women. Male female ratio was 1.6:1. There were more men in the successive decades. Right upper quadrant pain (42 %) followed by jaundice (27 %) and a presence of a palpable mass (12 %) were the common clinical presentation. Pre-operative diagnosis of gall bladder cancer was possible in 80 %. Twelve patients had co-existing gallstones (19.6 %). Forty patients (50 %) had stage IV disease; only 6 patients had Stage I operable disease (9.8 %). During the same time 758 patients had cholecystectomy for gallstone disease. Only one patient had an incidental gall bladder cancer, who had an extended cholecystectomy. Gallbladder cancer is uncommon in south India and its association with gallstone is also low.
Gall bladder; Gallstones; Carcinoma
The establishment of a complete genomic sequence of silkworm, the model species of Lepidoptera, laid a foundation for its functional genomics. A more complete annotation of the genome will benefit functional and comparative studies and accelerate extensive industrial applications for this insect. To realize these goals, we embarked upon a large-scale full-length cDNA collection from 21 full-length cDNA libraries derived from 14 tissues of the domesticated silkworm and performed full sequencing by primer walking for 11,104 full-length cDNAs. The large average intron size was 1904 bp, resulting from a high accumulation of transposons. Using gene models predicted by GLEAN and published mRNAs, we identified 16,823 gene loci on the silkworm genome assembly. Orthology analysis of 153 species, including 11 insects, revealed that among three Lepidoptera including Monarch and Heliconius butterflies, the 403 largest silkworm-specific genes were composed mainly of protective immunity, hormone-related, and characteristic structural proteins. Analysis of testis-/ovary-specific genes revealed distinctive features of sexual dimorphism, including depletion of ovary-specific genes on the Z chromosome in contrast to an enrichment of testis-specific genes. More than 40% of genes expressed in specific tissues mapped in tissue-specific chromosomal clusters. The newly obtained FL-cDNA sequences enabled us to annotate the genome of this lepidopteran model insect more accurately, enhancing genomic and functional studies of Lepidoptera and comparative analyses with other insect orders, and yielding new insights into the evolution and organization of lepidopteran-specific genes.
Bombyx mori; large-scale full-length cDNA collection; tissue-specific genes; sexual dimorphism; gene cluster; silkworm
A 19-year-old male presented with recurrent episodes of pericardial effusion. On evaluation, he was diagnosed to have idiopathic chylous effusion. As there was persistent pericardial collection, chemical pericardiodesis was done. Following pericardiodesis, there was no recurrence of pericardial effusion. Chemical pericardiodesis may be an effective treatment option for recurrent, idiopathic chylopericardium.
In a previous study, Chung, Legge & Cheung (2004) showed that training using repeated presentation of trigrams (sequences of three random letters) resulted in an increase in the size of the visual span (number of letters recognized in a glance) and reading speed in the normal periphery. In this study, we asked whether we could optimize the benefit of trigram training on reading speed by using trigrams more specific to the reading task (i.e. trigrams frequently used in the English language) and presenting them according to their frequencies of occurrence in normal English usage and observers’ performance. Averaged across seven observers, our training paradigm (four days of training) increased the size of the visual span by 6.44 bits, with an accompanied 63.6% increase in the maximum reading speed, compared with the values before training. However, these benefits were not statistically different from those of Chung et al (2004) using a random-trigram training paradigm. Our findings confirm the possibility of increasing the size of the visual span and reading speed in the normal periphery with perceptual learning, and suggest that the benefits of training on letter recognition and maximum reading speed may not be linked to the types of letter strings presented during training.
A 45-year-old female known to suffer from rheumatic heart disease (RHD), presented with breathlessness of 1 year duration. Two-dimensional echocardiography revealed significant mitral and aortic valve disease mandating double valve replacement. In addition, an unusual finding in the form of a well-defined, densely calcified intramyocardial left ventricular mass was noted on echocardiography. The nature and extent of the mass was assessed by additional imaging modalities. Patient underwent excision of the mass followed by double valve replacement. Histopathology was consistent with cardiac calcific amorphous tumour (CAT). An unusual occurrence of CAT in a patient with RHD is presented herein. This rare tumour has not been previously described in patients with RHD.
Introduction: India is on the verge of being the diabetic capital of the world, owing to the increasing prevalence of diabetes in India. The aim of this study was to find the association between anthropometry and dyslipidaemia, with a particular reference to the triacylglycerol levels, besides suggesting a better anthropometric variable.
Method: A group of eighty diabetic patients took part in the study. The Waist Circumference (WC), the waist to hip ratio, the serum triacylglycerol (TAG) levels and the glycated haemoglobin (HbA1c) levels were measured and studied.
Results: We found out that there was a significant association between the WC and the TAG levels (p-value = 0.030), between high TAG levels and high HbA1c values (p-value = 0.038) with greater accuracy, in favour of the waist circumference.
Conclusion: This depicted the fact that a simple measuring tape which is used in measuring the WC, could prove to be a useful and a cost-effective diagnostic approach for monitoring the metabolic complications of type 2 DM.
Diabetes mellitus; Waist circumference; Dyslipidaemia; Waist to hip ratio; Triacylglycerol; HbA1c
Liposarcomas are common tumors arising in the retroperitoneum. However, a primary mesenteric liposarcoma is a rare entity and less than 50 cases have been reported so far. Further, a liposarcoma arising in the transverse mesocolon is very unusual, and cases of multiple primary tumors arising from the transverse mesocolon are extremely rare. We want to report a case of a multiple primary mesenteric liposarcoma arising from the transverse mesocolon in a 63-year-old female who was successfully treated by surgery. Because a primary mesenteric liposarcoma is a rare entity, it should be considered with the differential diagnosis of an abdominal mesenchymal tumor. It can be diagnosed preoperatively by using contrast enhanced computed tomography and magnetic resonance imaging. The treatment for such a liposarcoma is surgical resection with sufficient surgical margin; the role of adjuvant therapy has yet to be defined.
Liposarcoma; Mesentric; Transverse magacolon; Diagnosis
The success of any genomic study depends primarily on the quality of the starting material, like genomic DNA (gDNA). The integrity of the extracted gDNA affects the downstream applications like microarray hybridization and next generation sequencing library construction. Since these are expensive and time consuming applications, a quality control (QC) of the genomic DNA has become highly recommended. The integrity of gDNA has traditionally been analyzed using agarose gel electrophoresis, which is manual, cumbersome and can involve exposure to hazardous chemicals like ethidium bromide. The new Agilent gDNA ScreenTape has been developed for the electrophoretic separation, sizing and quantification of large DNA samples (up to >60000 bp). This ready-to-use device, which runs on the Agilent 2200 TapeStation instrument, provides a reproducible QC method for analyzing the integrity and quantity of genomic DNA combined with the convenience of an automated system. With minimal sample preparation, automated loading and a variable throughput system, digital results can be presented as gel image, data table and in an electropherogram view. The ability to overlap and compare electropherograms within the software enables the discrimination of sample quality across different degradation states, sample types and concentrations. We present data that shows the Genomic DNA ScreenTape can easily verify the integrity of gDNA starting material with high sensitivity, precision and accuracy.
Rapid adoption of new sequencing technologies means that sample QC in this workflow not only needs to have high throughput capability, but flexibility is also critical. The Agilent 2200 TapeStation system meets this demand by providing a simple to use automated electrophoresis platform with truly variable throughput capabilities, from a single sample up to a 96-well plate. The D1K ScreenTape assay on the 2200 TapeStation enables analysis of DNA fragments between 35 and 1000bp, suiting NGS library preparation QC and quantification. This study is an assessment of the performance the D1K ScreenTape assay in high-throughput DNA analysis using the 96-well sample plate capability. Sizing and quantification were assessed for accuracy and precision on a foil-sealed 96-well plate over typical and extended run times. The study concluded that the D1K ScreenTape assay is suited for accurate sizing and quantification of DNA fragments in high-throughput applications.
An experimental work was reported to estimate the increase in distillate yield for a compound parabolic concentrator-concentric tubular solar still (CPC-CTSS). The CPC dramatically increases the heating of the saline water. A novel idea was proposed to study the characteristic features of CPC for desalination to produce a large quantity of distillate yield. A rectangular basin of dimension 2 m × 0.025 m × 0.02 m was fabricated of copper and was placed at the focus of the CPC. This basin is covered by two cylindrical glass tubes of length 2 m with two different diameters of 0.02 m and 0.03 m. The experimental study was operated with two modes: without and with air flow between inner and outer tubes. The rate of air flow was fixed throughout the experiment at 4.5 m/s. On the basis of performance results, the water collection rate was 1445 ml/day without air flow and 2020 ml/day with air flow and the efficiencies were 16.2% and 18.9%, respectively.
The experimental study was operated with two modes: without and with air flow between inner and outer tubes. The rate of air flow was fixed throughout the experiment at 4.5 m/s.
On the basis of performance results, the water collection rate was 1445 ml/day without air flow and 2020 ml/day with air flow and the efficiencies were 16.2% and 18.9%, respectively.
Compound Parabolic Concentrator; Desalination; Tubular Solar Still
Introduction: Methicillin-Resistant Staphylococcus aureus (MRSA) has become a major public health problem in both hospitals and communities. Panton – Valentine Leucocidin (PVL) has been reported to be an important marker for the highly pathogenic community acquired S. aureus infections. A rapid detection of these MRSA is very important for its treatment. The specific detection of MRSA is always a problem due to the prevalence of methicillin resistance among the coagulase negative Staphylococci. Hence, this study was done to develop a rapid triplex PCR for the detection of PVL positive MRSA and for the simultaneous differentiation of MRSA from Coagulase Negative Staphylococci (CoNS).
Materials and Methods: We developed a triplex PCR for the specific detection of PVL positive Community Acquired (CA) – MRSA and for its simultaneous differentiation from the coagulase negative Staphylococci. We used PCR for targeting the fem A gene which is specific for S. aureus, mecA which is specific for methicillin-resistance and luk - PV which is specific for the PVL toxin. The method was evaluated with a total of 100 clinical isolates of Staphylococcus spp.
Results: The triplex PCR was successfully standardized by using the reference strains and it was evaluated by using clinical strains. The method was found to be rapid, highly sensitive (100%), specific (99%) and cost effective.
Conclusion: Triplex PCR can be used as a diagnostic tool for the detection of the highly pathogenic strains of CA-MRSA.
PVL MRSA; MRCoNS; Triplex PCR; femA; mecA
Congenital cholesteatoma is a rare entity. It may originate at various sites in the temporal bone, for example, in the petrous apex, the cerebellopontine angle, the middle ear cavity, the mastoid process or in the external auditory canal. The least common site being the mastoid process. Most common presentation is a retrotympanic pearly white mass with no previous history of ear discharge, perforation or any ear surgery. It can lead to various complications, both intracranial and extracranial, some of which may be life threatening. Bezold’s abscess is an extracranial complication which is usually seen in children following acute otitis media with mastoiditis. Here we present a rare case of a 60 year old patient with congenital cholesteatoma complicating to Bezold’s abscess. After necessary investigations patient underwent surgery for complete removal of cholesteatoma and the abscess drainage.
Congenital cholesteatoma; Bezold’s abscess; Cortical mastoidectomy
Furcation invasions represent one of the most demanding therapeutic challenges in periodontics. This investigation assessed and compared the clinical efficacy of hydroxyapatite bone graft material when used alone and with collagen membrane in the treatment of grade II furcation defects.
Materials and Methods:
Ten patients with comparable bilateral furcation defects in relation to mandibular first molars were selected and treated in a split-mouth design. After the hygiene phase of therapy was completed, the groups were selected randomly either for treatment with hydroxyapatite bone graft (Periobone G) alone or with a combination of bone graft and guided tissue regeneration (GTR) membrane (Periocol). Clinical parameters like plaque index, gingival index, vertical probing depth, horizontal probing depth, clinical attachment level, position of marginal gingiva, and the amount of bone fill were used at baseline and at 3 and 6 months postoperatively.
At 6 months, both surgical procedures resulted in statistically significant reduction in vertical and horizontal probing depths and gain in the clinical attachment level.
The use of combination technique yielded superior results compared to sites treated with bone graft alone. However, the difference was not statistically significant.
Collagen; furcation defects; guided tissue regeneration; hydroxyapatite; surgical flaps
Cysts of the skin are one of the commonly excised specimens in the surgical outpatient department. A majority of them being clinically diagnosed as sebaceous cysts, their true nature is only discernible on histopathological examination. Closer examination of the type of keratinization involved will throw light into the exact nature of the cyst. Trichilemmal or Pilar cyst is one such entity, which presents in both a non-neoplastic and neoplastic form.
The present retrospective observational study was undertaken to find out the incidence of these cysts in surgical pathology practice in a rural hospital and to enlist the various morphological forms that these cysts may take.
Materials and Methods:
The histopathology files were reviewed for a period of 6 years for cases coded as pilar cyst.
A total of eight cases (5.75%) were identified, which showed features of trichilemmal differentiation. A single case each of proliferating trichilemmal cyst and malignant proliferating trichilemmal tumors were noted. Most of the cases were seen among females on the scalp.
Trichilemmal tumor is an uncommon histopathological entity. Many of these lesions may be mistakenly diagnosed due to lack of recognition of the unique type of keratinization.
Malignant pilar tumor; Pilarcyst; Proliferating pilar tumor; Proliferating trichilemmal cyst
The concept of fibroosseous lesions of bone has evolved over the last several decades and now includes two major entities: fibrous dysplasia and ossifying fibroma. Peripheral cemento-ossifying fibroma is a relatively rare tumour classified between fibroosseous lesions. It predominantly affects adolescents and young adults, with peak prevalence between 10 and 19 yrs. The cemento-ossifying fibroma is a central neoplasm of bone as well as periodontium which has caused considerable controversy because of confusion regarding terminology and the criteria for its diagnosis. The cemento-ossifying fibroma is odontogenic in origin, whereas ossifying fibroma is of bony origin. Lesions histologically similar to peripheral ossifying fibroma have been given various names in existing literature. Therefore, we present and discuss in this paper a series of cases of peripheral cemento-ossifying fibroma emphasizing the differential diagnosis.
A 32-year-old man, diagnosed with catatonic schizophrenia, was treated with risperidone and lorazepam in the general hospital psychiatry setup. He developed signs of intestinal obstruction, which was diagnosed as paralytic ileus and was treated conservatively along with stopping the offending drug. Risperidone is said to be devoid of anticholinergic side effects, but prevalence of these varies from 7% to 13% in patients receiving treatment for schizophrenia. Constipation has been reported but fatal adverse effect like paralytic ileus with risperidone is rarely reported. Timely diagnosis can save the need for surgical interventions and fatal complications. This predisposition in schizophrenia could be due to neurodevelopmentally shared abnormality of brain and gut nervous system.
Antipsychotic agents; intestinal pseudo-obstruction; risperidone; schizophrenia
Hospital-acquired hypernatremia (HAH) is a frequent concern in critical care, which carries high mortality.
To study the risk factors for HAH in settings that practice a preventive protocol.
Settings and Design:
Two tertiary-care hospitals. Prospective observational study design.
Materials and Methods:
Patients aged >18 years admitted for an acute medical illness with normal serum sodium and need for intensive care >48 h formed the study population. Details of the basic panel of investigations on admission, daily electrolytes and renal function test, sodium content of all intake, free water intake (oral, enteral and intravenous) and fluid balance every 24 h were recorded. Individuals with serum Na 140-142 meq/l received 500 ml of free water every 24 h, and those with 143-145 meq/l received 1000 ml free water every 24 h.
Statistical Analysis Used:
Risk factors associated with HAH was analysed by multiple logistic regression.
Among 670 study participants, 64 (9.5%) developed HAH. The median duration of hypernatremia was 3 days. A total 60 of 64 participants with HAH had features of renal concentrating defect during hypernatremia. Age >60 years (P = 0.02), acute kidney injury (AKI) on admission (P = 0.01), mechanical ventilation (P = 0.01), need for ionotropes (P = 0.03), worsening Sequential Organ Failure Assessment (SOFA) score after admission (P < 0.001), enteral tube feeds (P = 0.002), negative fluid balance (P = 0.02) and mannitol use (P < 0.001) were the risk factors for HAH. Mortality rate was 34.3% among hypernatremic patients.
The study suggests that administration of free water to prevent HAH should be more meticulously complied with in patients who are elderly, present with AKI, suffer multi-organ dysfunction, require mechanical ventilation, receive enteral feeds and drugs like mannitol or ionotropes.
Critical care; hospital; hypernatremia; mortality
There has been a significant increase in general awareness about Sexually transmitted diseases (STD's) among the general public. However, rates of partner notification and treatment which are an integral part of STD awareness is still questionable.
Methodology and Results:
We analyzed the statistics for prevalence of partner notification (which is about 52%) as well as the possible reasons for non-compliance. An overview of various ways of partner notification has been given as patient delivered partner medication (PDPM) and patient based partner referral (PBPR) of which PDPM is the most acceptable and effective method worldwide.
Partner notification; patient based partner referral; patient delivered partner medication
The in vitro antibacterial and antibiofilm activity of chlorogenic acid against clinical isolates of Stenotrophomonas maltophilia was investigated through disk diffusion, minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), time-kill and biofilm assays. A total of 9 clinical S. maltophilia isolates including one isolate resistant to trimethoprim/sulfamethoxazole (TMP/SMX) were tested. The inhibition zone sizes for the isolates ranged from 17 to 29 mm, while the MIC and MBC values ranged from 8 to 16 μg mL−1 and 16 to 32 μg mL−1. Chlorogenic acid appeared to be strongly bactericidal at 4x MIC, with a 2-log reduction in viable bacteria at 10 h. In vitro antibiofilm testing showed a 4-fold reduction in biofilm viability at 4x MIC compared to 1x MIC values (0.085 < 0.397 A 490 nm) of chlorogenic acid. The data from this study support the notion that the chlorogenic acid has promising in vitro antibacterial and antibiofilm activities against S. maltophilia.
Previous studies that pooled Indian populations from a wide variety of geographical locations, have obtained contradictory conclusions about the processes of the establishment of the Varna caste system and its genetic impact on the origins and demographic histories of Indian populations. To further investigate these questions we took advantage that both Y chromosome and caste designation are paternally inherited, and genotyped 1,680 Y chromosomes representing 12 tribal and 19 non-tribal (caste) endogamous populations from the predominantly Dravidian-speaking Tamil Nadu state in the southernmost part of India. Tribes and castes were both characterized by an overwhelming proportion of putatively Indian autochthonous Y-chromosomal haplogroups (H-M69, F-M89, R1a1-M17, L1-M27, R2-M124, and C5-M356; 81% combined) with a shared genetic heritage dating back to the late Pleistocene (10–30 Kya), suggesting that more recent Holocene migrations from western Eurasia contributed <20% of the male lineages. We found strong evidence for genetic structure, associated primarily with the current mode of subsistence. Coalescence analysis suggested that the social stratification was established 4–6 Kya and there was little admixture during the last 3 Kya, implying a minimal genetic impact of the Varna (caste) system from the historically-documented Brahmin migrations into the area. In contrast, the overall Y-chromosomal patterns, the time depth of population diversifications and the period of differentiation were best explained by the emergence of agricultural technology in South Asia. These results highlight the utility of detailed local genetic studies within India, without prior assumptions about the importance of Varna rank status for population grouping, to obtain new insights into the relative influences of past demographic events for the population structure of the whole of modern India.