Outcomes in children treated for tuberculosis with the new dispersible fixed-dose combinations in Port Moresby

Setting

The new child-friendly fixed dose combinations (FDCs) were introduced at Port Moresby General Hospital, Papua New Guinea, in 2016 for the first-line treatment of children (aged <15 years) with tuberculosis (TB) who weighed <25 kg.

Objective

To describe the characteristics and outcomes for children treated with the new FDCs, and to identify risk factors for unfavourable treatment outcomes.

Design

This was a retrospective cohort study of all children treated for TB with the FDCs from August 2016 to August 2017.

Results

Of 713 children included, 488 (68%) were diagnosed with pulmonary TB. Only 6 (0.8%) TB cases were bacteriologically confirmed and human immunodeficiency virus (HIV) status was known in 50%. Treatment outcomes were favourable in 425 (60%) children. Of 288 children with unfavourable outcomes, there were 242 (84%) with loss to follow-up (LTFU) and 25 (8.4%) were known to have died. Children who were severely underweight (weight-for-age Z score <-3) on presentation were at greater risk of LTFU compared to children of normal weight on multivariable analysis (aRR 1.3, 95%CI 1.0-1.6, P < 0.05).

Conclusion

Alternative models of care to decrease LTFU during treatment are needed, including integration with nutritional support. Improving diagnosis through microbiological confirmation of TB and HIV are major challenges to be addressed.

Genome-wide identification of glutathione S-transferase gene family in pepper, its classification, and expression profiling under different anatomical and environmental conditions

Glutathione S-transferases (GSTs) compose a family of multifunctional enzymes involved in the numerous aspects of regulating plant growth, development, and stress response. An in silico genome-wide analysis of pepper (Capsicum annuum L.) was performed to identify eighty-five GST genes that were annotated according to their chromosomal location. Segmental duplication contributed more than tandem duplication for the expansion of GST gene family in pepper. All the identified members belong to ten different classes which are highly conserved among Arabidopsis, rice, tomato and potato counterparts indicating the pre-dicot-monocot split diversification of GST classes. Gene structure, protein domain, and motif organization were found to be notably conserved over the distinct phylogenetic groups, which demonstrated the evolutionary significant role of each class. Expression of most of the CaGST transcripts as well as the total pepper GST activity was found to be significantly up-regulated in response to cold, heat, drought, salinity and osmotic stress conditions. Presence of various hormone and stress-responsive cis-elements on most of the putative CaGST promoter regions could be directly correlated with the alteration of their transcripts. All these findings might provide opportunities for future functional validation of this important gene family in pepper.

Abstract P6-14-04: Not presented

This abstract was not presented at the conference.

Citation Format: Mohd Taib NA, Islam T, Su TT, Musthaffa S, Abdullah Din N, Rahman Z, Mohamed KNB, Kaur S, Filza J, Shaheera F, Ellsworth Beaumont C. Not presented [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-14-04.

Molecular evolution of SUN-domain containing proteins in diverse plant species and their expression profiling in response to developmental and perturbation stimuli

SUN (Sad1/UNC-84) domain-containing proteins are highly conserved throughout evolution. They are localized to the inner membrane of the nuclear envelope and are involved in nuclear migration and nucleoskeleton formation. In the present study, a genome-wide investigation was performed in three dicotyledonous (Arabidopsis thaliana, Glycine max and Medicago truncatula) and three monocotyledonous (Oryza sativa, Zea mays and Sorghum bicolor) plants. A total of 56 SUN proteins encoded by 30 genes were identified. Based on their length, transmembrane topology, conserved domains and phylogenetic relationships, they could be divided into two previously defined groups- Cter-SUN and mid-SUN proteins. Expression of these genes was analyzed in different developmental stages, tissues and various unfavorable conditions such as salinity, drought, and hormonal treatment. Analyses indicated that the expression of SUN1/2 transcripts are ubiquitous; that of SUN3/4 are development/tissue regulated, and SUN5 are inflorescence stage-specific. This study provides an initial framework for the characterization and functional validation of the plant SUN family.

Improving Breast Health Literacy Through an Innovative Breast Cancer Awareness Campaign Using the Know Your Lemons (KYL) Materials in Malaysia

Background: Breast cancer (BC) is the most common cancer in Malaysia but has the worst survival in the Asia Pacific region. Main drivers identified in previous research include late-stage disease at presentation, poor adherence to treatment and sociocultural barriers. Factors affecting late presentations include lack of awareness on basic symptoms of BC and poor access to early detection. Although BC awareness campaigns have been done, Hadi et al., showed low BC awareness among university students in Malaysia. This is an evaluation of the “Show You Care, Be Aware” campaign that was done in University of Malaya, Kuala Lumpur in October 2017. The campaign was carried out using KYL materials through use of posters, awareness booths and public forums. The materials contain information on the normal breast, 12 symptoms of BC, information on breast self examination (BSE), screening and diagnostic (detection) pathways in Malay and English language. Aim: To evaluate the campaign effect on breast health literacy. Methods: A quasi-experimental research was conducted. The KYL materials were forward and backward translated by 2 native bilingual individuals. The context and content of the translation was ensured to be accurate and fitted into the KYL design. A total of 679 participants participated in the study. A self-designed questionnaire was used to assess effectiveness of the materials. Educational intervention sessions were provided in the form of KYL materials (leaflets, posters and banners) displayed in awareness booths in the campus. Discussion on leaflets and questions and answers, and practical demonstrations of BSE dummy were done. The questionnaire was administered through face to face interview. The data were analyzed via SPSS 20; descriptive and Wilcoxon matched paired signed rank test was performed. Results: 72% (n=492) of our participants were Malay, 19% (n=119) Chinese and 10% (n=68) Indians and others. Majority of our participants were female (94.2%), age 30 or below (61%), single (62.9%), had college or university education (85.7%). Most of our participants, 96.2% stated that the language used in the KYL materials were clear and understandable; 95.3% thought materials were attractive and 89.2% found them acceptable in Malaysian culture. 52.7% preferred Malay materials, 40.4% English and 6.5% in both Malay and English. The materials improved perceived knowledge on the process of detecting BC (96.5%). 92.8% agreed or strongly agreed that they felt more confident in recognizing the symptoms of BC themselves. There was an increase in self reported knowledge of BC; mean scores before and after exposure to KYL materials were 2.83 versus 4.30 respectively ( P < 0.001). Conclusion: Health education using KYL materials promoted breast cancer awareness, confidence in detecting symptoms and knowing processes of diagnosis among urban and educated Malaysians. Future research in lower educated and rural communities in Malaysia is warranted.

The Prevalence of Metabolic Syndrome Among Newly Diagnosed Malaysian Breast Cancer Patients

Background: The incidence of breast cancer has increased in South East Asian (SEA) women. Malaysia has the highest obesity rates in SEA. Malaysian Breast Cancer Survivorship Cohort (MyBCC) study is a hospital-based prospective cohort study that aims to study the association between lifestyle factors and overall survival and quality of life of Malaysian breast cancer patients. Metabolic syndrome (MS) is associated with increasing levels of inflammatory cytokines and leptin that can stimulate cell proliferation through various mechanisms, hence indicating both an increased risk of developing breast cancer and a poorer prognosis. However, there is very scarce information available on the presence of MS among the newly diagnosed breast cancer patients. This is an early report of the presence of MS in the MyBCC study. Aim: We aim to evaluate the presence of MS among newly diagnosed breast cancer patients and to determine the association of MS and sociodemographic factors. Methods: 370 newly diagnosed breast cancer patients were interviewed at baseline. The anthropometric data (waist circumference, hip circumference, body weight, body height and body fat percentage) and also blood for lipid profile and glucose profile were collected. The MS status of the patients was defined using a modified International Diabetes Federation worldwide definition; presence of central obesity (waist circumference ≥ 80 cm) and any of two or more of the following criteria: (i) raised triglyceride with ≥ 1.7 mmol/L, (ii) reduced HDL-cholesterol that < 1.3 mmol/L, (iii) diagnosed with hypertension and (iv) diagnosed with diabetes. Results: Among the 370 breast cancer patients, most were aged 51 years and above (258, 69.7%), were Chinese (180, 48.6%), had secondary school education level (168, 45.4%), had less than RM3500 household income (193, 52.2%) and were postmenopausal (250, 67.6%). Most of the patients were obese or overweight (268, 72.4%) and around half of the patients (190, 51.4%) had high body fat percentage. 140 patients had MS (37.8%). MS was significantly higher among patients aged 61 years and above (59, 42.1%) and 51 to 60 years (50, 35.7%) compared with 20 to 50 years of age group (31, 22.1%) ( P < 0.05). The patients with MS were significantly higher among Chinese ethnicity (57, 40.7%), unemployed (95, 70.4%), and postmenopausal (108, 77.1%) ( P < 0.05). Conclusion: The prevalence of MS is high in newly diagnosed Malaysian breast cancer patients. With longer follow-up, further analysis will be done to look at association with outcomes.

Application of Database and Data Science Techniques in the Malaysian Breast Cancer Survivorship Cohort STUDY

Background: Breast cancer is one of the leading cause of mortality among women worldwide. The Breast Cancer Resource Centre (BCRC) of University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia, started the Malaysian Breast Cancer Survivorship Cohort (MyBCC) study in 2012. Aim: As a further enhancement of the research, the MyBCC database has been developed to conduct the survey in a convenient way, which aims to predict the factors influencing different survival rate among patients from multiethnic origin using data science techniques. Methods: The database comprised of life style related data of the patients including demographic factors, information on other illness, clinical factors, quality of life, psychosocial support, physical activity, work related questions, depression score, family background, type of medication consumed and financial status of the patients. This paper presents an approach to build an automated workflow using the MySQL database management system and PHP, integrated with R and HTML for web display. Results: A relational database comprising 816 breast cancer patients' data were developed for the MyBCC cohort study. This database serves as the backend for the MyBCC application where researchers can register new patients' records, update and view the information of recruited patients by using the system in a more commodious environment than before. Besides, the MyBCC database has been integrated with R programming tool by deploying the RMySQL package to perform audits. A few important analysis using plotly package, leveraging the integration of R with database are presented. Conclusion: In this paper, the development of the MyBCC database is presented, with the aim to automate the manual process of data entry, storage and analysis for performing audits for the breast cancer cohort study. The integration of database with R for automated analysis of data are also shown using examples of predictions that can be generated using functions in R. This fully automated workflow reduces the workload and time taken in performing manual predictions using data sources stored in flat files.

Linguistic and Psychometric Validity of the Malay BREAST-Q in Women Undergoing Breast Cancer Surgery in Malaysia

Background: BREAST-Q is a PROMs used to measure and assess patient satisfaction and quality of life before and after breast cancer surgery. BREAST-Q composed of 5 different modules and each module comprised of multiple scales. Each module has preoperative and postoperative versions to assess the impact of surgery. Four subscales with common items from the 5 modules: “satisfaction with the breast”, psychosocial, sexual and physical well-being were subjected to testing. Two other subscales, “satisfaction with overall outcomes” and “satisfaction with the care” were only validated linguistically. Currently, the BREAST-Q has already been translated into 25 languages. Linguistic and psychometric validation of BREAST-Q has not been performed in Malaysia. Aim: To translate the BREAST-Q into Malay language and perform psychometric validation. Methods: Translation of the English BREAST-Q to Malay language was done based on linguistic validation protocol provided by MAPI Research Trust. Content and face validation were performed to determine contextual accuracy, acceptability and understanding of the items. The finalised Malay BREAST-Q then underwent psychometric testing. Breast cancer patients (n=186) who were planned for breast cancer surgery were conveniently sampled at the breast clinic of UMMC between June 2015 to June 2016. Consented participants completed the questionnaire in the same visit following their diagnosis. Retest was done 2-3 weeks after the first questionnaire administration in 62 patients who were admitted for their surgery. Data were analyzed using SPSS and AMOS software. Results: Content experts (4 breast surgeons) agreed the items in BREAST-Q comprehensively measured the concept of interest and I-CVI for each item was 1.0. Participants agreed the questionnaire was comprehensive and easy to understand. The average time taken to complete the questionnaire was 15.3 minutes. Test–retest analysis showed good reproducibility with intraclass correlation coefficient (ICC) value of 0.71-0.98. Internal consistencies were good for all items in each subscale with Cronbach's alpha values of 0.83-0.95. The highest interitem correlation for each item with at least one other item in the construct ranged from 0.47 to 0.90. The lowest corrected item-total correlation (CITC) values ranged from 0.47 to 0.72. In exploratory factor analysis, the KMO values were excellent in all 4 subscales (0.76, 0.92, 0.91, and 0.86). Single factor was extracted in 3 subscales that explained more than 50% of the variance and 3 factors (breast pain, general pain, and discomfort) were extracted in “physical well-being” subscale that cumulatively explained more than 50% of the variance. Conclusion: The Malay BREAST-Q demonstrated good reliability, content and face validity, and excellent psychometric properties. Hence, we propose the use of the Malay BREAST-Q to measure patient reported outcomes among breast cancer patients in Malaysia undergoing breast cancer surgery.

Effectiveness of Breast Care Nurse Led Video Orientation Programme on Information and Navigation for Newly Diagnosed Breast Cancer Patients at University Malaya Medical Center, Malaysia

Background: Advancement in medical treatment with wider treatment options have made breast cancer (BC) care more complex. Short consultation time with physicians, treatment complexities, patients' fears and poor coping skills at the time of diagnosis may affect patient´s decision that cause treatment delays and nonadherence. Main reasons for advance BC presentation in Malaysia are delay in taking treatment decision and poor breast health literacy on disease and treatment outcomes may contribute to nonadherence to treatments. To address this knowledge gap, a breast care nurse (BCN) led orientation video for new patients to navigate them through complex multimodal treatment processes. This audio-visual educational tool address multimodal treatments and its side effects and in addition navigating admission, discharge and follow-up, advice on diet and exercise to maintain a healthy life style during survivorship period was developed in layperson language in Malay, Mandarin and English. Aim: To assess the effectiveness of BCN led video orientation on the improvement of patient knowledge and satisfaction. Methods: A pilot study was carried out in 50 patients to assess the effectiveness of the video, and found that patients needed a face to face interaction to watch the video. Hence, a BCN led orientation was developed to use the video. A self-administered pre- and postsurvey on 246 newly diagnosed breast cancer patients in University Malaya Medical Center (UMMC) was performed to evaluate expectations, satisfactions and knowledge (a Likert scale response using items 4 number scale was used, 0 means “no knowledge” and 4 means “a great degree of knowledge”). The scoring was done before and after the video orientation was done. A Wilcoxon matched-paired signed-rank test was perform to analyze the changes in the scoring. Results: Among 247 patients, who received the BCN led video orientation program, 79.3% (n= 197) found that the video met or exceeded their expectations. 23.9% (n=59) and 56.3% (139) consecutively found the video very effective and effective in broadening their perspective on BC treatments. And 171 (69.2%) of them overall rated the video highly met their expectations. There were significant improvement in knowledge for treatment options for BC, mean scores (M=0.93 versus M=2.97) before and after watching the video ( P < 0.001). Similar findings were found in different types of operation for BC; procedure for admission in UMMC, information on chemotherapy; radiotherapy; hormone therapy and alternative medicine for BC. It also showed improved knowledge scores for healthy diet; physical activity after treatments and care of the arm after operation ( P < 0.001). Conclusion: Video-based information on treatments and navigating care through a BCN led service had effectively improved patients' knowledge and satisfaction. This approach can be used to educate cancer patients in a middle resource setting.

Serum 25(OH) Vitamin D Deficiency and Risk of Breast Cancer in Malaysia: A Case-Control Study

Background: Despite the emerging literature supporting the beneficial role of sufficient vitamin D level and its association with various cancers, current evidence on the vitamin D and the risk of getting breast cancer is still inconsistent. Furthermore, the study between vitamin D status and breast cancer risk among south east Asian women is limited. Aim: We aimed to investigate the association between vitamin D deficiency and the risk of getting breast cancer among Malaysian women. Methods: We conducted a retrospective nested case control study which consisted of Malaysian Breast Cancer Cohort Study (MyBCC) subjects as the cases and UMMC Mammogram Cohort Study subjects as the hospital control. We also used a secondary data from the Cohort Study on Clustering of Lifestyle Risk Factors and understanding its association with stress on health and well-being among school teachers in Malaysia (CLUSTer), as we only included the data from the schools in Kuala Lumpur as the population control. We measured and compared serum 25-hydroxyvitamin D (25(OH)D) between newly diagnosed breast cancer patients (n= 231), female without cancer who came for mammogram checkup (n= 462) and female teachers without cancer from schools in Kuala Lumpur (n=231). Vitamin D deficiency was defined as serum (25(OH)D) < 50 nmol/L. Results: Median serum (25(OH)D) for cases and controls were 42.43 nmol/L and 44.30 nmol/L, respectively. We examined the association between serum (25(OH)D) and breast cancer risk stratified by age < 50 and ≥ 50 years old. The crude ORs for breast cancer risk in cases and controls did not show statistically significant association with serum (25(OH)D) for both age groups ( P = 0.463 and P = 0.650, respectively). After adjustment for age, ethnicity, education level and BMI the ORs (95% CI) for breast cancer risk among both groups were 1.183 (0.591-2.366) ( P = 0.635) and 1.237 (0.801-1.911) ( P = 0.338) respectively for women with serum (25(OH)D) < 50 nmol/L. Conclusion: Our results suggest that there is lack of association between vitamin D deficiency and the risk of getting breast cancer in Malaysian women.

Recurrent unicystic maxillary ameloblastoma presenting as unilateral proptosis

Unicystic Ameloblastoma (UA) is a rare variant of ameloblastoma which is an odontogenic epithelial neoplasm, typically affecting mandibular ramus. Maxillary ameloblastoma is a rare entity with a more disastrous consequence. Although extremely rare, their highly recurrent and locally aggressive behavior can lead to invasion of vital structures surrounding maxilla (orbit, cranium) even after several years of conservative surgical management (limited resection, curettage). We report a case of 16-year-old girl presenting with proptosis of left eye, UA left maxilla, who was treated initially with limited resection (enucleation) and curettage and the lesion recurred after two years with a more aggressive behavior, causing destruction floor of orbit. To this date there are only 23 documented cases of orbital invasion and only three of the reports are in ophthalmic literature. The ophthalmologists need to be aware of this type of rare lesion presenting as proptosis.

Genome-wide dissection and expression profiling of unique glyoxalase III genes in soybean reveal the differential pattern of transcriptional regulation

Reactive carbonyl species, such as methylglyoxal and glyoxal are very toxic in nature and can inactivate various cellular macromolecules such as DNA, RNA, and protein by forming advanced glycation end products. Conventional glyoxalase pathway with two enzymes- glyoxalase I and glyoxalase II, detoxify MG into D-lactate with the help of reduced glutathione. However, DJ-1/PfpI domain(s) containing DJ-1/ Hsp31 proteins do the same in a single step, and thus termed as "glyoxalase III". A comprehensive genome-wide analysis of soybean identified eleven putative glyoxalase III proteins with DJ-1/PfpI domain encoded by seven genes. Most of these proteins are predicted to be mitochondria and chloroplast localized. In spite of similar function, a differential evolution pattern was observed between Hsp31 and DJ-1 proteins. Expression of GmDJ-1A, GmDJ-1B, and GmDJ-1D2 transcripts was found to be constitutive in different tissues and developmental stages. Transcript profiling revealed the strong substrate-specific upregulation of GmDJ-1 genes in response to exogenous methylglyoxal exposure. Out of seven genes, GmDJ-1D1 and GmDJ-1D2 showed maximum upregulation against salinity, dehydration, and oxidative stresses. Moreover, GmDJ-1D2 showed functional glyoxalase III enzyme activity by utilizing MG as a substrate. Overall, this study identifies some novel tissue-specific and abiotic stress-responsive GmDJ-1 genes that could be investigated further.

Phacoemulsification after Deep Anterior Lamellar Keratoplasty

Purpose.

To evaluate the results of phacoemulsification and intraocular lens implantation after deep anterior lamellar keratoplasty (DALK).

Methods.

Retrospective, consecutive, noncomparative, single-surgeon series.

Results.

Sixteen eyes of 16 patients were included (mean age: 51 years). Five eyes had phacoemulsification because of cataract, and 11 eyes for myopic refractive lens exchange. No intraoperative or postoperative complications were noted. Mean spherical equivalent (SE) improved from −8.69 D (SD 3.74) to −0.97 D (SD 1.13). Mean preoperative defocus equivalent (DE) improved from 10.32 D (SD 4.04) to 2.57 D (SD 0.92). Mean preoperative best spectacle-corrected visual acuity improved from 0.48 logMAR (SD 0.60) to 0.13 D (SD 0.005). Mean postoperative uncorrected visual acuity was 0.675 logMAR (SD 0.252). Safety index was 2.33, efficacy index was 0.70, and endothelial cell loss was not significant.

Conclusions.

Phacoemulsification can provide safe and predictable visual rehabilitation for cataract and refractive errors resulting after DALK.

Genome-wide identification and expression analysis of glutathione S-transferase gene family in tomato: Gaining an insight to their physiological and stress-specific roles

Glutathione S-transferase (GST) refers to one of the major detoxifying enzymes that plays an important role in different abiotic and biotic stress modulation pathways of plant. The present study aimed to a comprehensive genome-wide functional characterization of GST genes and proteins in tomato (Solanum lycopersicum L.). The whole genome sequence analysis revealed the presence of 90 GST genes in tomato, the largest GST gene family reported till date. Eight segmental duplicated gene pairs might contribute significantly to the expansion of SlGST gene family. Based on phylogenetic analysis of tomato, rice, and Arabidopsis GST proteins, GST family members could be further divided into ten classes. Members of each orthologous class showed high conservancy among themselves. Tau and lambda are the major classes of tomato; while tau and phi are the major classes for rice and Arabidopsis. Chromosomal localization revealed highly uneven distribution of SlGST genes in 13 different chromosomes, where chromosome 9 possessed the highest number of genes. Based on publicly available microarray data, expression analysis of 30 available SlGST genes exhibited a differential pattern in all the analyzed tissues and developmental stages. Moreover, most of the members showed highly induced expression in response to multiple biotic and abiotic stress inducers that could be harmonized with the increase in total GST enzyme activity under several stress conditions. Activity of tomato GST could be enhanced further by using some positive modulators (safeners) that have been predicted through molecular docking of SlGSTU5 and ligands. Moreover, tomato GST proteins are predicted to interact with a lot of other glutathione synthesizing and utilizing enzymes such as glutathione peroxidase, glutathione reductase, glutathione synthetase and γ-glutamyltransferase. This comprehensive genome-wide analysis and expression profiling would provide a rational platform and possibility to explore the versatile role of GST genes in crop engineering.

A novel setup for wafer curvature measurement at very high heating rates

The curvature evolution of a thin film layer stack containing a top Al layer is measured during temperature cycles with very high heating rates. The temperature cycles are generated by means of programmable electrical power pulses applied to miniaturized polysilicon heater systems embedded inside a semiconductor chip and the curvature is measured by a fast wafer curvature measurement setup. Fast temperature cycles with heating duration of 100 ms are created to heat the specimen up to 270 °C providing an average heating rate of 2500 K/s. As a second approach, curvature measurement utilizing laser scanning Doppler vibrometry is also demonstrated which verifies the results obtained from the fast wafer curvature measurement setup. Film stresses calculated from the measured curvature values compare well to literature results, indicating that the new method can be used to measure curvature during fast temperature cycling.

Outcomes of Category I and II regimens in mono- and polyresistant tuberculosis cases in the Philippines

SETTING

National Tuberculosis Programme, the Philippines.

OBJECTIVE

To compare treatment outcomes of Category I and Category II regimens among mono- and/or polyresistant tuberculosis (TB) cases under programme conditions.

DESIGN

Retrospective cohort analysis of pulmonary TB patients from two data sets from the National Drug Resistance Survey and the Programmatic Management of Drug-resistant Tuberculosis by linking drug resistance patterns with treatment outcomes.

RESULTS

Of 288 Category I patients, 193 were isoniazid (INH) resistant, 42 were either ethambutol (EMB) or streptomycin (SM) resistant, and 53 were resistant to a combination of two or all three TB drugs. Of 138 Category II patients, 92 were INH-resistant, 9 were either EMB- or SM-resistant, and 37 were poly-resistant. Respectively 206 (87.7%) and 41 (77.4%) mono- and poly-resistant patients treated with the Category I regimen achieved significantly higher successful treatment outcomes, in comparison to respectively 60 (59.4%) and 15 (40.5%) mono- and poly-resistant patients treated with the Category II regimen.

CONCLUSION

The Category II regimen produced poor outcomes, whereas the Category I regimen achieved a treatment success rate of more than 85% among new patients with the same drug resistance patterns. The poor outcomes of the Category II regimen could be attributed to other factors such as patient behaviour and comorbidities, rather than drug resistance.

Genome-wide identification and expression analysis of glutathione S-transferase gene family in tomato: Gaining an insight to their physiological and stress-specific roles

Glutathione S-transferase (GST) refers to one of the major detoxifying enzymes that plays an important role in different abiotic and biotic stress modulation pathways of plant. The present study aimed to a comprehensive genome-wide functional characterization of GST genes and proteins in tomato (Solanum lycopersicum L.). The whole genome sequence analysis revealed the presence of 90 GST genes in tomato, the largest GST gene family reported till date. Eight segmental duplicated gene pairs might contribute significantly to the expansion of SlGST gene family. Based on phylogenetic analysis of tomato, rice, and Arabidopsis GST proteins, GST family members could be further divided into ten classes. Members of each orthologous class showed high conservancy among themselves. Tau and lambda are the major classes of tomato; while tau and phi are the major classes for rice and Arabidopsis. Chromosomal localization revealed highly uneven distribution of SlGST genes in 13 different chromosomes, where chromosome 9 possessed the highest number of genes. Based on publicly available microarray data, expression analysis of 30 available SlGST genes exhibited a differential pattern in all the analyzed tissues and developmental stages. Moreover, most of the members showed highly induced expression in response to multiple biotic and abiotic stress inducers that could be harmonized with the increase in total GST enzyme activity under several stress conditions. Activity of tomato GST could be enhanced further by using some positive modulators (safeners) that have been predicted through molecular docking of SlGSTU5 and ligands. Moreover, tomato GST proteins are predicted to interact with a lot of other glutathione synthesizing and utilizing enzymes such as glutathione peroxidase, glutathione reductase, glutathione synthetase and γ-glutamyltransferase. This comprehensive genome-wide analysis and expression profiling would provide a rational platform and possibility to explore the versatile role of GST genes in crop engineering.

CT evaluation of malignant PNS mass and histopathological correlation

<p><strong>Background:</strong> Computed tomography (CT) is the gold standard for exact delineation of paranasal sinus(PNS) disease. There are many radiologically important diseases of paranasal sinuses.<strong> </strong></p><p><strong>Objective:</strong> to evaluate the malignant PNS mass by computed tomographic image and the findings of this modality were compared with histopathological result.</p><p><strong>Methods:</strong> It was a cross sectional type of study and carried out with suspected PNS mass having patients during January 2009 to Octo­ber 2010.</p><p><strong>Results:</strong> The mean age of the patients was 35.95 ± 18.24 and common complaints of the patients were nasal obstruction (73.7%) and maximum 53.9% patients had PNS mass in maxillary sinuses. Out of 76 cases 21.1 % found malignant mass on CT and after histopathology 19. 7% had malignant mass. Out of all cases 14 were diagnosed as malig­nant PNS mass by CT scan and confirmed by histopathological evaluation and they were true positive. Two cases were diagnosed as malignant PNS mass by CT scan but not confirmed by histopathological findings and they were false positive. Of 60 cases, which were diagnosed by CT scan, one was confirmed as malignant and 59 were benign by histopa­thology. They were false negative and true negative respectively. Sensitivity of CT scan to diagnose malignant PNS mass was 93.3%, specificity 96.7%, positive predictive value 87.5%, negative predictive value 98.3% and accuracy 96.1 %.<strong> </strong></p><p><strong>Conclusion:</strong> CT scan of the malignant para nasal sinus mass provides more information and better image quality and CT diagnosis correlate well with the findings of histopathology.</p>

The development of a phosphite-mediated fertilization and weed control system for rice

Fertilizers and herbicides are two vital components of modern agriculture. The imminent danger of phosphate reserve depletion and multiple herbicide tolerance casts doubt on agricultural sustainability in the future. Phosphite, a reduced form of phosphorus, has been proposed as an alternative fertilizer and herbicide that would address the above problems to a considerable extent. To assess the suitability of a phosphite-based fertilization and weed control system for rice, we engineered rice plants with a codon-optimized ptxD gene from Pseudomonas stutzeri. Ectopic expression of this gene led to improved root growth, physiology and overall phenotype in addition to normal yield in transgenic plants in the presence of phosphite. Phosphite functioned as a translocative, non-selective, pre- and post-emergent herbicide. Phosphite use as a dual fertilizer and herbicide may mitigate the overuse of phosphorus fertilizers and reduce eutrophication and the development of herbicide resistance, which in turn will improve the sustainability of agriculture.

Genome-wide analysis and expression profiling of glyoxalase gene families in soybean (Glycine max) indicate their development and abiotic stress specific response

BACKGROUND

Glyoxalase pathway consists of two enzymes, glyoxalase I (GLYI) and glyoxalase II (GLYII) which detoxifies a highly cytotoxic metabolite methylglyoxal (MG) to its non-toxic form. MG may form advanced glycation end products with various cellular macro-molecules such as proteins, DNA and RNA; that ultimately lead to their inactivation. Role of glyoxalase enzymes has been extensively investigated in various plant species which showed their crucial role in salinity, drought and heavy metal stress tolerance. Previously genome-wide analysis of glyoxalase genes has been conducted in model plants Arabidopsis and rice, but no such study was performed in any legume species.

RESULTS

In the present study, a comprehensive genome database analysis of soybean was performed and identified a total of putative 41 GLYI and 23 GLYII proteins encoded by 24 and 12 genes, respectively. Detailed analysis of these identified members was conducted including their nomenclature and classification, chromosomal distribution and duplication, exon-intron organization, and protein domain(s) and motifs identification. Expression profiling of these genes has been performed in different tissues and developmental stages as well as under salinity and drought stresses using publicly available RNAseq and microarray data. The study revealed that GmGLYI-7 and GmGLYII-8 have been expressed intensively in all the developmental stages and tissues; while GmGLYI-6, GmGLYI-9, GmGLYI-20, GmGLYII-5 and GmGLYII-10 were highly abiotic stress responsive members.

CONCLUSIONS

The present study identifies the largest family of glyoxalase proteins to date with 41 GmGLYI and 23 GmGLYII members in soybean. Detailed analysis of GmGLYI and GmGLYII genes strongly indicates the genome-wide segmental and tandem duplication of the glyoxalase members. Moreover, this study provides a strong basis about the biological role and function of GmGLYI and GmGLYII members in soybean growth, development and stress physiology.

ID: 57: PRE-GESTATIONAL DIABETES AND PREECLAMPSIA IN BANGLADESHI PATIENTS: A RETROSPECTIVE STUDY

Objective

Preeclampsia (PreE) is one of considerable public health threat particularly in developing countries globally affecting approximately 8% of all pregnancies. PreE is a pregnancy-specific condition that increases maternal and infant mortality and morbidity, but the etiology remains unknown. Despite numerous basic, clinical, and epidemiologic studies that have been conducted over the past half century, knowledge of the etiology and pathogenesis of preeclampsia remains elusive. It is diagnosed by new onset increased blood pressure and proteinuria during second or third trimester of gestation; key features of the preeclampsia category include a cut-off blood pressure of 140/90 mm Hg or higher and absolute requirement of proteinuria. Approximately 20% of the diabetic pregnant women develop preE. The mechanisms contributing to this effect is not well characterized. In a recent study, we have shown that hyperglycemia impairs cytotrophoblast (CTB) function via stress signaling. Several researchers demonstrate a direct link between preE and diabetes. The objective of the study was to evaluate potential linkage between the risk of developing preE and the presence of diabetes in pregnant patients in Bangladesh.

Methods

This is a cross-sectional study of 351 pregnant women performed to evaluate the prevalence of PreE with respect to different risk factors such as previous pregnancy, presence of Antiphospholipid antibodies, pre-existing diabetes (before this pregnancy), multiple gestation / singleton, family history of preE in first degree relative (mother, sister and daughters; most commonly mother), maternal age of 40 or greater. The study was conducted in selected hospitals of Dhaka city, Bangladesh during December 2013 to December 2015.

Results

The key study findings revealed that the overall rate of development of PreE in Bangladeshi pre-gestational diabetic patients is 22.6 percent. We gave special emphasis on the occurrence of PreE in pre-gestational diabetic patients. Among 351 respondents, 145 Patients (25.5%) with either DM prior to pregnancy or developing gestational diabetes or without diabetes were older (age >35 years) pregnant women (13.1%). Prevalence of PreE is 25.5 (n=145) and 19.6 (n=199) percent among those who developed pre-gestational diabetes and without diabetes prior to pregnancy. Of the respondents 17.2 percent have both systolic and diastolic hypertension those who developed DM prior to this pregnancy and 13 percent among those who does not developed DM prior to this pregnancy. Occurrence of abortion was up to 3 percentage before this pregnancy 45 percentage who developed DM prior to this pregnancy and 35 percent who does not have diabetes among the respondents.

Conclusions

There is an association has been found between the risk of developing preE and the presence of diabetes in pregnant patients in Bangladesh.

Western Pacific Regional Green Light Committee: progress and way forward

•

The Western Pacific Regional Green Light Committee (rGLC WPR) was established in 2011 to promote scale-up of programmatic management of drug-resistant tuberculosis (PMDT).

•

rGLC WPR has generated greater awareness of regional challenges and has encouraged local solutions to regional problems.

•

PMDT should be part and parcel of routine TB programme activity.

•

Challenges and bottlenecks have varied according to the different stages of PMDT implementation, requiring different types of technical assistance.

•

Regional initiatives should be dynamic and responsive to the needs of countries.

The Western Pacific Regional Green Light Committee (rGLC WPR) was established in 2011 to promote the rational scale-up of programmatic management of drug-resistant tuberculosis (PMDT). We reflect on its achievements, consider the challenges faced, and explore its potential future role. Achievements include the supervision and support of national PMDT action plans, increased local ownership, contextualized guidance, and a strong focus on regional capacity building, as well as a greater awareness of regional challenges. Future rGLC activities should include (1) advocacy for high-level political commitment; (2) monitoring, evaluation, and supervision; (3) technical support and contextualized guidance; and (4) training, capacity building, and operational research. Regional activities require close collaboration with both national and global efforts, and should be an important component of the new Global Drug-resistant TB Initiative.

Market size and sales pattern of tuberculosis drugs in the Philippines

OBJECTIVES

To identify the availability, types and quantity of anti-tuberculosis drugs in the public and private sectors from 2007 to 2011 in the Philippines.

METHODS

Analysis of the procurement of and sales data on anti-tuberculosis drugs from both the public and private sectors from 2007 to 2011.

RESULTS

Publicly procured anti-tuberculosis drugs were sufficient to treat all reported new tuberculosis (TB) cases from 2007 to 2011 in the Philippines. Nevertheless, the volume of anti-tuberculosis drugs in the private sector would have sufficed for the intensive phase of treatment for an additional 250 000 TB patients annually, assuming compliance with national treatment guidelines. Fixed-dose combination drugs comprised the main bulk (81%) of private market sales, while sales of loose drugs decreased over the years. Combining public and private sales in 2011, 484 725 new TB patients, i.e., 2.4 times the number of notified cases, could have been placed on treatment and treated for at least the intensive phase. Key second-line drugs are not available in the private market, making it impossible to design an adequate treatment regimen for multidrug-resistant TB (MDR-TB) in the private sector.

CONCLUSION

An enormous quantity of anti-tuberculosis drugs was channelled through the private market outside the purview of the Philippine National Tuberculosis Control Program, suggesting significant out-of-pocket expenditure, severe underreporting of TB cases and/or misuse of drugs due to overdiagnosis and overtreatment.