Chemico-pharmacological evaluation of the methanolic leaf extract of Catharanthus ovalis: GC-MS/MS, in vivo, in vitro, and in silico approaches

Introduction: Natural plant-based medicines have gained popularity recently as a major source of inventive, risk-free, and more potent secondary bioactive compounds with medicinal potential. Catharanthus ovalis is a perennial shrub containing various indole alkaloids cultivated extensively for local medical purposes. Methods: This research is conducted to identify the phytocompounds present in the leaves of C. ovalis and its central and peripheral analgesic, thrombolytic, and membrane-stabilizing activities through tail immersion, acetic acid-induced writhing, human blood clot lysis, and erythrocyte lysis by heat and hypotonic solution methods, respectively. Results and discussion: A total of 39 compounds were identified using GC-MS/MS techniques, including hexadecanoic acid, methyl ester (56.749%), methyl stearate (29.782%), carvacrol and its TBDMS derivative (12.586%), and 9-octadecenoic acid, methyl ester, (E)-] (9.297%) presented in high quantity. The highest tail immersion latency was observed for the 600 mg/kg extract of C. ovalis crude extract. Both 400 and 600 mg/kg doses of C. ovalis crude extract exhibited prominent peripheral analgesic activity. The maximum thrombolytic effect was observed by DCM soluble fraction extract by inhibiting 54.87% of the clot. However, the aqueous-soluble fraction of this extract manifested an excellent membrane-stabilizing effect by showing 73.98% and 87.51% hemolysis against heat- and hypotonic-induced hemolysis, respectively. Some of the compounds were identified as active agents against different receptors related to these diseases, which supported the findings of in vitro and in vivo tests. Conclusion: Further investigation needs to be conducted to specify and identify the exact mechanism of action of these compounds.

Method for Glucose and Fructose Quantitation in Beverages Using an Off-the-Shelf Glucose Test Strip

A method was developed for quantifying both glucose and fructose in solutions and grape juice using commercially available glucose test strips connected to a mini-potentiostat. The first step of this sensing approach involved exposing the sample solution to an Accu Chek Aviva glucose test strip, which allowed for the direct quantitation of glucose. To quantify fructose, the solution was exposed to glucose isomerase, which led to the conversion of glucose to fructose and vice versa until an equilibrium was reached. Once equilibrium was reached, the solution was exposed to another glucose test strip; the signal obtained was shown to be related to the total amounts of glucose and fructose in solution. Finally, fructose was quantified by subtracting the glucose concentration (from the initial measurement) from the total concentration of glucose and fructose (from the second measurement after the reaction with glucose isomerase). The method yielded a limit of detection of 0.047 g L-1 for glucose and 0.49 g L-1 for fructose. Importantly, this method was shown to work well for analyzing glucose and fructose concentration in grape juice, which contains >60 g L-1 glucose and fructose. Since the ratio of glucose and fructose concentration in ripe grapes is close to 1, this method can be used to aid in the determination of grape ripeness to guide harvesting times.

Generation of two iPSC lines (MHHi001-A-12 and MHHi001-A-13) carrying biallelic truncating mutations at the 3'-end of SRCAP using CRISPR/Cas9

Non-Floating Harbour Syndrome (FLHS) neurodevelopmental disorder (NDD) is a recently described disorder caused by mutations in certain regions of the SRCAP gene. We generated two iPSC lines that contain truncating mutation on both alleles at the 3'-end of SRCAP using CRISPR/Cas9 technology. Both cell lines are pluripotent, differentiate into the 3 germ layers and contain no genomic aberrations or off-target modifications. The cell lines form part of a human disease model to investigate the effects of truncating mutations in different regions of SRCAP.

The effect of smoking on union rates following corrective osteotomies around the knee: A systematic review and meta-analysis

BACKGROUND

Distal femur osteotomies (DFO) and high tibial osteotomies (HTO), are well-established treatment options for joint preservation in active patients with uni-compartmental osteoarthritis. Optimal outcomes are contingent on adequate preoperative evaluation of patient-specific factors. This systematic review and meta-analysis aims to explore the difference in union rates between smokers and non-smokers following corrective osteotomies around the knee.

METHODS

A systematic search of the MEDLINE and EMBASE databases was performed in accordance with the PRISMA guidelines to identify studies reporting smoking status in adults who developed delayed and/or non-union following HTO or DFO. Studies were pooled using a random effect model [Review Manager (RevMan) software, V.5.4] and heterogeneity was estimated using I2.

RESULTS

Data for meta-analysis was available for 1,406 osteotomies from 10 studies, performed in patients with mean age ranging from 38-54 years, and 65% were male. The union rate among non-smokers was 97.3% (1100/1131) compared with 89.5% (246/275) among smokers; OR 4.59 [95% CI 1.99 to 10.62], p-value < 0.001. Subgroup analysis revealed that the risk of non-union in smokers after opening wedge osteotomy was almost double (OR 4.8) that of closing wedge osteotomies (OR 2.9).

CONCLUSION

Smoking increases the risk of non-union during elective knee osteotomy surgery. Our findings also suggest that smokers have a better chance of achieving union with closing wedge osteotomy compared to open wedge osteotomy.

TB treatment using family members, treatment supporters and self-administered therapies in rural Papua New Guinea

SETTING

Papua New Guinea (PNG) has one of the world's highest TB incidence rates. It is difficult for patients to access TB care in remote provinces due to insufficient infrastructure and challenging terrain, making varied, targeted delivery models for treating TB necessary.

OBJECTIVE

To assess treatment outcomes using self-administered treatment (SAT), family-supported treatment and community-based directly observed therapy (DOT) via treatment supporter (TS) in the PNG context.

DESIGN

A retrospective, descriptive analysis of routinely collected data from 360 patients at two sites in 2019-2020. All patients were assigned a treatment model based on risk factors (adherence or default) and offered patient education and counselling (PEC), family counselling and transportation fees. End-of-treatment outcomes were assessed for each model.

RESULTS

Treatment success rates among drug-susceptible TB (DS-TB) were good overall: 91.1% for SAT, 81.4% for family-supported treatment and 77% for DOT patients. SAT was strongly associated with favourable outcomes (OR 5.7, 95% CI 1.7-19.3), as were PEC sessions (OR 4.3, 95% CI 2.5-7.2).

CONCLUSION

By considering risk factors when determining their treatment delivery model, strong outcomes were seen in all three groups. Multiple modes of treatment administration, tailored to individuals' needs and risk factors, is a feasible, effective, patient-centred care model for hard-to-reach, resource-limited settings.

Bovine Serum Albumin-Protected Gold Nanoclusters for Sensing of SARS-CoV-2 Antibodies and Virus

An approach to assess severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (and past infection) was developed. For virus detection, the SARS-CoV-2 virus nucleocapsid protein (NP) was targeted. To detect the NP, antibodies were immobilized on magnetic beads to capture the NPs, which were subsequently detected using rabbit anti-SARS-CoV-2 nucleocapsid antibodies and alkaline phosphatase (AP)-conjugated anti-rabbit antibodies. A similar approach was used to assess SARS-CoV-2-neutralizing antibody levels by capturing spike receptor-binding domain (RBD)-specific antibodies utilizing RBD protein-modified magnetic beads and detecting them using AP-conjugated anti-human IgG antibodies. The sensing mechanism for both assays is based on cysteamine etching-induced fluorescence quenching of bovine serum albumin-protected gold nanoclusters where cysteamine is generated in proportion to the amount of either SARS-CoV-2 virus or anti-SARS-CoV-2 receptor-binding domain-specific immunoglobulin antibodies (anti-RBD IgG antibodies). High sensitivity can be achieved in 5 h 15 min for the anti-RBD IgG antibody detection and 6 h 15 min for virus detection, although the assay can be run in "rapid" mode, which takes 1 h 45 min for the anti-RBD IgG antibody detection and 3 h 15 min for the virus. By spiking the anti-RBD IgG antibodies and virus in serum and saliva, we demonstrate that the assay can detect the anti-RBD IgG antibodies with a limit of detection (LOD) of 4.0 and 2.0 ng/mL in serum and saliva, respectively. For the virus, we can achieve an LOD of 8.5 × 10⁵ RNA copies/mL and 8.8 × 10⁵ RNA copies/mL in serum and saliva, respectively. Interestingly, this assay can be easily modified to detect myriad analytes of interest.

Utilization of a Glucometer Test Strip and Enzymatic Reactions to Quantify Anti-SARS-CoV-2 Spike RBD IgG Antibody and SARS-CoV-2 Virus in Saliva and Serum

A sensor capable of quantifying both anti-SARS-CoV-2 spike receptor-binding domain (RBD) antibody levels and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus in saliva and serum was developed. This was accomplished by exploiting the enzymatic reaction of maltose and orthophosphate (PO43-) in the presence of maltose phosphorylase to generate an equivalent amount of glucose that was detected using a commercial glucometer test strip and a potentiostat. Important for this approach is the ability to generate PO43- in an amount that is directly related to the concentration of the analytes. RBD-modified magnetic microparticles were used to capture anti-SARS-CoV-2 spike RBD antibodies, while particles modified with anti-SARS-CoV-2 nucleocapsid antibodies were used to capture SARS-CoV-2 nucleocapsid protein from inactivated virus samples. A magnet was used to isolate and purify the magnetic microparticles (with analyte attached), and alkaline phosphatase-conjugated secondary antibodies were bound to the analytes attached to the respective magnetic microparticles. Finally, through enzymatic reactions, specific amounts of PO43- (and subsequently glucose) were generated in proportion to the analyte concentration, which was then quantified using a commercial glucometer test strip. Utilizing glucose test strips makes the sensor relatively inexpensive, with a cost per test of ∼US $7 and ∼US $12 for quantifying anti-SARS-CoV-2 spike RBD antibody and SARS-CoV-2, respectively. Our sensor exhibited a limit of detection of 0.42 ng/mL for anti-SARS-CoV-2 spike RBD antibody, which is sensitive enough to quantify typical concentrations of antibodies in COVID-19-infected or vaccinated individuals (>1 μg/mL). The limit of detection for the SARS-CoV-2 virus is 300 pfu/mL (5.4 × 106 RNA copies/mL), which exceeds the performance recommended by the WHO (500 pfu/mL). In addition, the sensor exhibited good selectivity when challenged with competing analytes and could be used to quantify analytes in saliva and serum matrices with an accuracy of >94% compared to RT-qPCR.

Procalcitonin versus C-Reactive Protein as a Biomarker for Prediction of Bacterial Infection in Children with Febrile Neutropenia in Acute Leukemia

Febrile neutropenia (FN) is a frequently occurring treatment-related complication with significant morbidity and mortality for childhood acute leukemia. Early diagnosis and assessment of severity are essential steps for early comprehensive treatment to reduce FN-related morbidity and mortality. Biomarkers like C-reactive protein (CRP) and procalcitonin (PCT) can be used to assess and predict the bacterial infection in children with febrile neutropenia. The objective of the study was to determine the role of procalcitonin and CRP as a biomarker for prediction of bacterial infection in children with FN in acute leukemia. This prospective observational study was conducted in the Department of Pediatric Hematology and Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from August 2020 to July 2021. Total 58 Children with acute leukemia aged 1 to <18 years with FN were analyzed in this study. A proper history and thorough physical examination were carried out. The blood sample was sent for biomarkers (Procalcitonin and CRP) within 24 hours of the onset of FN and other investigations, such as Complete blood count, Blood C/S, Urine R/E and C/S. Metabolic workup (SGPT, Serum Creatinine, Serum Electrolytes, Serum Ca+) was also done in every patient. Stool R/E & C/S, Chest X-ray, Wound swab for C/S were done when the patient presented with diarrhoea, cough, respiratory distress and focal sepsis respectively. In this study, the mean age of the patients was 6.62±4.07 years (1.10-16.0 years) and 34 patients (58.6%) were male. In 65.5% of patients, localizing signs of infection were not identified. Of the 58 patients, 12 patients (20.7%) showed positive blood culture and 2 patients (3.4%) showed positive urine culture. Klebsiella spp (41.0%) was the most frequent organism isolated followed by Acinetobacter (17.0%), Pseudomonas (17.0%) and E. coli (17.0%). The median PCT levels were significantly higher in patients with bacterial infection than patients without bacteremia (26.10μg/l versus 0.78μg/l, p=0.002) and PCT level >2μg/l was significantly associated with bacteremia. The median CRP levels in the bacteremia and without-bacteremia patients were 137.4mg/L and 54.17mg/L, respectively (p=0.036). In direct comparisons, PCT showed better overall performance than CRP with the AUC being 0.797 (95% CI 0.651-0.943) for PCT and 0.697 (95% CI 0.54-0.855) for CRP in predicting the bacterial infection. PCT and CRP both are useful biomarkers for the prediction of bacteremia, but PCT may be a superior early biomarker as compared to CRP to predict bacterial infection in children with febrile neutropenia in acute leukemia.

Effect of Hydrophobic Chain Length on the Antioxidation Properties of Alanyl Tyrosine Dipeptide-type Surfactants

The antioxidant (AOX) activities of alanyl tyrosine dipeptide-type surfactants with several chain lengths were investigated. The critical micelle concentration decreased exponentially with the carbon number of the hydrophobic chain of the surfactant. The antioxidative property was investigated using the 2,2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid ammonium salt) (ABTS) assay and the oxygen radical absorbance capacity (ORAC) assay. The AOX activity was found to be strongly dependent on the chain length in the monomer solution. Therefore, an increase in the molecular size negatively influenced the AOX ability of the tyrosine residue. However, it was almost independent of the chain length of the surfactant in the micellar solution. The micelle particles acted as a catalyst for the reduction of the radicals in the ORAC assay.

Immunohistochemical validation study of 15-gene biomarker panel predictive of benefit from adjuvant chemotherapy in resected non-small-cell lung cancer: analysis of JBR.10

Objective

There are no validated approaches to predict benefit from adjuvant chemotherapy for resected patients with non-small-cell lung cancer (NSCLC). The aim of this study was to translate a 15-gene mRNA expression profile published by Zhu et al, shown to be prognostic and predictive of benefit, into a readily applicable immunohistochemistry (IHC) panel.

Methods

For seven of the genes in the gene expression profile (GEP) for which suitable commercial antibodies were available, we semiquantitatively assessed the IHC expression and prognostic significance for 173 patients treated at the Saint John Regional Hospital (SJRH). Cut-offs for high and low expression were defined for each marker and applied to IHC scores from 291 of the 482 patients in JBR.10, including patients on both the adjuvant chemotherapy and observation arms. The prognostic and predictive value of these markers on overall survival (OS) or recurrence-free survival (RFS) was assessed by Cox regression models.

Results

In the SJRH cohort, in 62 patients with resected stage II–III NSCLC, the prognostic significance of IHC assays for four proteins were concordant with Zhu’s GEP results. Low FOSL2 (OS, HR=0.15; p=0.0001; RFS, HR=0.14; p<0.0001) and high STMN2 (RFS, HR=2.501; p=0.0197) were adverse prognostic factors. Low ATP1B1 and low TRIM14 expression trended toward worse OS and RFS. Validation of these markers with JBR.10 patients failed to show prognostic significance either individually or in combined risk classifications. Additionally, the interaction between these markers and chemotherapy treatment in predicting OS (FOSL2, p=0.52; STMN2 p=0.14; ATP1B1, p=0.33; TRIM14, p=0.81) or RFS (FOSL2, p=0.63; STMN2, p=0.12; ATP1B1, p=0.66; TRIM14, p=0.57) did not reach significance, individually or in combination panels.

Conclusions

Zhu’s GEP could not be translated into an IHC panel predictive of benefit from adjuvant chemotherapy. Future predictive biomarker analysis in the adjuvant NSCLC setting may need to focus on novel therapies.

A Rapid Spectrofluorometric Method for the Determination of Aluminum at Nano-trace Levels in Some Real, Environmental, Biological, Hemodialysis, Food, Pharmaceutical, and Soil Samples Using 2',3,4',5,7-Pentahydroxyflavone

A very simple and non-extractive spectrofluorometric method for the swift determination of aluminum at nano-trace levels using 2',3,4',5,7-pentahydroxyflavone (morin) has been developed. Morin reacts in a slightly acidic (0.005 - 0.025 M H₂SO₄) solution with aluminum in 20% ethanol to produce a highly fluorescent complex in aqueous solution, which has excitation and emission wavelengths of λ_ex = 270 and λ_em = 565 nm, respectively. Linear calibration graphs were obtained for 0.01 - 800 μg L^-1 of Al, providing a detection limit of 1 ng L^-1. The limit of quantification of the reaction system was 10 ng L^-1. The stoichiometric composition of chelate is 3:2 (Al:morin). The developed method was successfully used in the determination of aluminum in several Standard Reference Materials (SRM) as well as in some water, biological, hemodialysis solutions, food, pharmaceutical, soil sample, and complex synthetic mixtures. The results of the proposed method for biological and food analysis were found to be in excellent agreement with those obtained by AAS. The results of the proposed method for hemodialysis solutions were analogous with those obtained using the method described in British Pharmacopoeia within 95% confidence limits.

Realizing ecosystem-safe hydropower from dams

For clean hydropower generation while sustaining ecosystems, minimizing harmful impacts and balancing multiple water needs is an integral component. One particularly harmful effect not managed explicitly by hydropower operations is thermal destabilization of downstream waters. To demonstrate that the thermal destabilization by hydropower dams can be managed while maximizing energy production, we modelled thermal change in downstream waters as a function of decision variables for hydropower operation (reservoir level, powered/spillway release, storage), forecast reservoir inflow and air temperature for a dam site with in situ thermal measurements. For data-limited regions, remote sensing-based temperature estimation algorithm was established using thermal infrared band of Landsat ETM+ over multiple dams. The model for water temperature change was used to impose additional constraints of tolerable downstream cooling or warming (1-6 °C of change) on multi-objective optimization to maximize hydropower. A reservoir release policy adaptive to thermally optimum levels for aquatic species was derived. The novel concept was implemented for Detroit dam in Oregon (USA). Resulting benefits to hydropower generation strongly correlated with allowable flexibility in temperature constraints. Wet years were able to satisfy stringent temperature constraints and produce substantial hydropower benefits, while dry years, in contrast, were challenging to adhere to the upstream thermal regime.

FRI0438 POST-CHIKUNGUNYA CHRONIC ARTHRITIS - SHARING OF BANGLADESH EXPERIENCE OVER ONE YEAR FOLLOW UP OF 60 PATIENTS

Background:

Chikungunya virus (CHIKV) infection is an emerging disease which is responsible for several epidemics around the world1. Systematic review and meta-analysis had shown that approximately 25% of cases of Chikungunya(CHIK) would develop CHIK-Chronic Inflammatory Rheumatism and 14% would develop persistent arthritis (or spondylitis)2.

Objectives:

To describe the frequency of the clinical patterns of chronic arthritis & to characterize the clinical symptoms in a Bangladeshi cohort of CHIK patients 12months post-infection.

Methods:

In 2017, a Chikungunya outbreak occurred in Dhaka, Bangladesh, during which a prospective cohort of CHIK patients with confirmed diagnosis was constituted. A longitudinal follow up of 60 patients from an initial cohort of 142 patients, attending the out-patient department of Rheumatology, BSMMU, was done. Patients having arthritis/ arthralgia or both lasting more than 3 months were considered as chronic cases. Their baseline and follow-up symptoms at 3m, 6m and 12months were evaluated. Functional status was assessed with the Bengali Version Health Assessment Questionnaire (HAQ).

Results:

Of the initial 142 patients enrolled in the study, 135(95.1%) had CHIKV-IgM and 29(20.4%) had IgG positive. Patients that followed up in-person were predominantly adult (age 43.73 ± 11.09 years) and female 34 (56.7%). The majority of the patients 35 (58.3%) had undifferentiated arthritis. After three months, 8 (16.3%) had oligoarthralgia, 26 (53.1%) had polyarthralgia and 8 (16.3%) had polyarthralgia with oligoarthritis. At the end of one year, 13 (21.7%) patients underwent complete remission. Among the 47 patients, 21 had joint involvement where 11(52.4%) had polyarthralgia, 5(23.8%) had polyarthralgia with oligoarthritis, 5 (23%) had oligoarthralgia and 4 (19%) had monoarthralgia. Among the 47 patients, mild, moderate and severe functional disability was present in 89.4%, 6.4% and 4.3% patients respectively.

Conclusion:

After one year of follow up, one-third of the patients remained symptomatic. Polyarthralgia was the predominant clinical feature. Mild functional disability was also observed in a significant number of patients.

References:

[1]Ali Ou Alla S, Combe B. Arthritis after infection with Chikungunya virus. Best Pract Res Clin Rheumatol. 2011;25(3):337-46.

[2]Rodríguez-Morales AJet al.Prevalence of Post-Chikungunya Infection Chronic Inflammatory Arthritis: A Systematic Review and Meta-Analysis.Arthritis. Care. Res. 68(12), 1849-1858 (2016).

Table 1.

Socio-demographic and clinical pattern of patients with Chronic CHK arthritis (n=60)

Variablesn(%)Age (in years)Mean ±SD43.73 ±11.1SexFemale34 (56.7)Male26 (43.3)First joint involvementGeneralized34 (56.7)Ankle12 (20.0)Knee6 (10.0)Wrist5 (8.3)Others (MTP, shoulder, neck and axial plane)3 (5.0)Clinical patternUndifferentiated35(58.3)Spondyloarthritis10 (16.7)Rheumatoid Arthritis7 (11.7)Pre-existing Spondyloarthritis6(10.2)Pre-existing Rheumatoid Arthritis1(1.7)Pre-existing Osteo-arthritis Arthritis1(1.7)Table 2.

Joint involvement of patients with Chronic CHIK arthritis

Joint characteristics3 m (n=49)6 m (n=36)1yr (n=21)f(%)f(%)f(%)Type of involvement in persistent painJoint only33 (55.0)28 (46.7)20 (33.3)Both joint & soft-tissue16 (26.7)8 (13.3)1 (1.7)Joint involvementMonoarthralgia1 (2.0)5 (13.9)4 (19.0)Oligoarthralgia8 (16.3)6 (16.7)5 (23.0)Polyarthralgia26 (53.1)18 (50.0)11 (52.4)Monoarthritis1 (2.0)0(0.0)0(0.0)Oligoarthritis6 (12.2)3 (8.3)0(0.0)Polyarthritis7 (14.3)9 (11.1)1 (4.8)Oligoarthralgia & monoarthritis1 (2.0)0 (0.0)0 (0.0)Polyarthralgia & monoarthritis0 (0.0)1 (2.8)0 (0.0)Polyarthralgia & oligoarthritis8 (16.3)4 (11.1)5 (23.8)Polyarthralgia & Polyarthritis1 (2.0)0 (0.0)0 (0)

Disclosure of Interests:

None declared

Synthesis of glycoimmunogen Tn-Thr-PS A1 via hydrazone bond and stability optimization of PS A1 monosaccharide mimics under vaccine development conditions

Previously, our group constructed several immunogens utilizing oxime linkage to conjugate a T-cell stimulatory zwitterionic polysaccharide PS A1 and tumor associated carbohydrate antigens (TACAs) in acetate buffer. Here, a semi-synthetic immunogen was synthesized using hydrazone conjugation between PS A1 and a glycopeptide hydrazide (α-d-GalNAc-l-Thr-NH-NH2) with an excellent loading in PBS buffer. To get robust immune response, the retention of zwitterionic character of PS A1 under vaccine construction conditions is essential. In this regard, the stability of embedded pyruvate acetal moiety in tetrasaccharide repeating unit of PS A1 can validate the retention of the dual charges. Therefore, rather than utilizing this highly immunogenic PS A1 fully, stability studies were performed with synthetic 1-thiophenyl-4,6-O-pyruvate acetal-d-galactopyranose in varying acetate buffer pHs and time intervals. Furthermore, 1-propyl-d-galactofuranose was synthesized to mimick the d-Galf of PS A1 to examine regioselective hydrazone and oxime formation with α-d-GalNAc-l-Thr-NH-NH2 and α-d-GalNAc-ONH2 moieties respectively.

Abstract P4-07-05: A novel, first in class Notch transcriptional inhibitor, CB-103 has activity on luminal breast cancer stem cells in combination with fulvestrant

The Notch signaling pathway plays a central role in cellular differentiation, growth and stem cell maintenance. Expression and activation of Notch pathway receptors and ligands have differential outcomes depending on the tissue, localization and cell type. When Notch pathway is aberrantly activated by genetic lesions, it can be a major driver for Notch-dependent cancers and can cause resistance to standard of care treatment. We and others have shown that in Estrogen Receptor (ER)-positive breast cancers, estrogen deprivation caused by endocrine therapy results in Notch1 and Notch4 activation. In turn, Notch1 stimulated ER-dependent transcription in the absence of estrogen, causing endocrine resistance. Combinations of Notch inhibitors and endocrine therapy are effective in preclinical models of ER-positive breast cancer and have shown promising signals in early clinical trials.

Cellestia's lead development candidate CB-103 is a small molecule, first-in-class, oral pan-Notch inhibitor. CB-103 selectively blocks Notch pathway activation-related gene transcription through binding to a Notch specific protein in the transcription factor complex. The blockade occurs by protein-protein interaction inhibition with a binding site critical for the assembly of the Notch transcription complex. This is a unique mode of action, which allows blocking Notch signaling regardless of the genetic lesions which have activated the pathway.

We have performed mammosphere assays to test the potency and efficacy of this compound on stem cell ability to form sphere. We used two different doses of CB-103; either alone or in combination with a fixed dose of Fulvestrant (30nM), a SERD, in our mammosphere assays. Two different ER+ luminal,endocrine resistant cell lines were tested and compared with their parental controls. From our data, it's apparent that there is a synergistic effect when using CB-103 in combination with Fulvestrant. It's also evident that the efficacy of CB-103 is maximal maximizes at the lowest concentration tested in our assays. The combination was effective in 3 out of 4 models. However, the effect of CB-103 on MCF7-TAMR either as a single agent or in combination was not statistically significant.

Cellestia has received regulatory approval to start clinical development with CB-103 in a first-in-human study Phase l – lla study investigating safety (Ph l) and preliminary single agent efficacy (Ph lla) of CB-103 in patients with advanced solid cancers and haematological malignancies. Our data support the notion of testing this agent in ER-positive breast cancer in combination with SERDs.

Citation Format: Majumder S, Crabtree J, Hossain F, Murone M, Lehal R, Miele L. A novel, first in class Notch transcriptional inhibitor, CB-103 has activity on luminal breast cancer stem cells in combination with fulvestrant [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 P4-07-05.

Abstract P6-22-01: Repurposing sulindac sulfide as a notch inhibitor to target cancer stem-like cells in triple negative breast cancer

Triple negative breast cancer (TNBC) is a heterogeneous group of clinically aggressive breast cancers. TNBC patients have a high risk of recurrence and metastasis, and current treatment options remain limited. There is strong evidence supporting the involvement of Notch signaling in TNBC progression. Expression of Notch1 and its ligand Jagged1 correlate with poor prognosis. Emerging evidence suggests that cancer stem-like cells (CSCs) that escape chemo or radiation therapy in TNBC are often Notch-dependent. At the same time, there is evidence that active tumor immunity predicts good response to neo-adjuvant chemotherapy in TNBC. Notch inhibitors, including Gamma Secretase Inhibitors (GSIs) are quite effective in preclinical models of TNBC, where they eliminate CSCs resistant to chemotherapy. However, the success of GSIs in clinical trials is limited by their intestinal toxicity and adverse immunological effects. CD4 and CD8 T-cells, necessary to adaptive tumor immunity, require Notch1 for activation. Our overarching goal is to replace GSIs with agents that lack their systemic toxicity and adverse immunological effects. We identified Sulindac Sulfide (SS), the active metabolite of FDA-approved NSAID Sulindac, as a potential candidate to replace GSI. SS has Gamma Secretase Modifier (GSM) activity. We confirmed that SS inhibits Notch1 cleavage in TNBC cells. SS significantly inhibited mammosphere growth in all human and murine TNBC models we tested: 1) human MDA-MB-231 cells; 2) murine TNBC model C0321, from targeted conditional knockout of Lunatic Fringe (LFng-/-); and 3) Two TNBC patient-derived xenograft models, 2K1 and 4IC. In contrast, SS did not inhibit Notch expression or cleavage in murine T cells. In C0321 tumors, which recapitulate human mesenchymal TNBC, we found that SS had remarkable single-agent anti-tumor activity and virtually eliminated Notch1 expression in tumors. SS caused an increase in intra-tumoral CD11c+ dendritic cells, but decreased CD4 cells, which in this model are largely PD-1 positive (exhausted). CD8 cells were modestly increased. SS did not affect the number of tumor infiltrating macrophages or myeloid-derived suppressor cells (MDSC). However, SS blocked the immunosuppressive function of bone marrow-derived MDSC. We are currently investigating the mechanisms of this anti-tumor activity. Our data support further investigation of SS for the treatment of TNBC, with standard of care or with immunotherapy agents. Repurposing an FDA-approved, safe agent for the treatment of TNBC would be significantly easier and more cost-effective than developing unproven investigational agents.

Citation Format: Hossain F, Ucar D, Majumder S, Xu K, Ran Y, Minter L, Xi Y, Burow M, Golde T, Osborne B, Miele L. Repurposing sulindac sulfide as a notch inhibitor to target cancer stem-like cells in triple negative breast cancer [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 P6-22-01.

Solubilization of Genistein in Phospholipid Vesicles and Their Atioxidant Capacity

Water-insoluble genistein was solubilized in aqueous medium by using phospholipid vesicles composed of 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) and 1,2-dioleoyl-sn-glycerophosphocholine (DOPC) with 0-30% cholesterol. For each vesicle, the maximum solubilization amount of genistein was investigated by X-ray scattering measurement. In addition, the antioxidant capacity of the solubilized genistein was evaluated by the ABTS assay. Genistein was found to be solubilized by 10-20% and 40-50% of the vesicle concentrations of pure DPPC and DOPC respectively. The maximum solubilization amount of genistein decreased to 0-10% and 20-30% when 30% of cholesterol is present in the respective vesicles. Cholesterol is solubilized in a hydrophobic core whereas genistein is solubilized in the polar head region or in the polar-apolar interface. The overlapping of solubilizing sites affected the solubilization of genistein when cholesterol was present in the vesicles. Moreover, the lamellar interval was largely affected by cholesterol in compared to the little impact of genistein because the later can indirectly affect the acyl chains. Genistein solubilized in DOPC showed the same degree of antioxidant capacity as that of vesicle-free genistein system. On the other hand, genistein solubilized in DPPC had lower antioxidant activity than the former systems. The distinction of antioxidant activity at different systems probably related to the difference of accessibility of ABTS radical cation to solubilized genistein through different vesicles. Finally, cholesterol-free DOPC vesicles were found to be the best solubilizer for genistein among the investigated systems.

Hydrological model using ground- and satellite-based data for river flow simulation towards supporting water resource management in the Red River Basin, Vietnam

The Red River basin (RRB) exhibits substantial variation of water resource seasonally and annually. Sustainable water resource management in the RRB has been challenging due to the lack of in situ hydrological measurement data over the basin-wide scale. To address this issue, this study aimed to perform the setting up, calibration, and validation of the variable infiltration capacity (VIC) hydrological model forced with ground- and satellite-based datasets at a high spatial resolution of 0.1° for simulating the daily river flow of the Red River system in the RRB during the period of 2005-2014. By using the finely resolved land cover characterization with 15 types of land cover and leaf area index - the most important feature of vegetation that significantly influences the simulation of hydrological variables provided by the spatially distributed satellite remote sensing data, this study would not only address the poor data availability over the RRB but also enhance the accuracy of model simulation. The simulation results generally indicated that the calibrated VIC model could satisfactorily capture the river flow dynamics of the Red River system in the RRB. The VIC model's underestimated river flow compared to the observed data during the dry season for the downstream stations was likely due to the operation of the large man-made reservoirs and dams in the upstream catchments of the RRB that not represented by the VIC model. The findings also suggested that for further improving the VIC model performance, the use of more spatially representative meteorological data provided by satellite remote sensing should be considered in future studies.

Abstract P6-07-06: Targeting cancer stem-like cells metabolism via non-canonical notch signaling pathways in triple negative breast cancer

Triple negative breast cancer (TNBC) is a heterogeneous group of clinically aggressive diseases. TNBC patients have high risk of recurrence and metastasis, and current treatment options remain limited. Cancer stem-like cells (CSCs) have been linked to cancer initiation, progression and chemotherapy resistance. Therefore CSC-targeted therapies are keenly sought. There is strong evidence for the involvement of Notch signaling in TNBC. Notch1 is highly expressed in Basal-like 1 (BL1) and especially Mesenchymal-Stem-Like (MSL) TNBCs. Expression of Notch1 and its ligand Jagged1 correlate with poor prognosis. Moreover, strong evidence supports key roles of different Notch paralogs in breast CSCs. Here, we demonstrate that Notch activation by Jagged1-expressing stromal cells enhances transcription of the anti-apoptotic gene cIAP-2 (BIRC3), a known NF-κB target. This event is dependent on recruitment to the cIAP-2 promoter of NF-κB subunits, IKKα and Notch1. Short term exposure of MDA-MB-231 cells (MSL, PTEN wild-type), but not MDA-MB-468 cells (BL1, PTEN-null) to recombinant Jagged1 leads to AKT phosphorylation. This is suppressed by AKT inhibitors, IKK inhibitors, and dual mTORC1/2 inhibitors but not an mTORC1-selective inhibitor. These observations support a model where canonical and non-canonical mechanisms downstream of Notch1 trigger AKT phosphorylation and NF-κB activation in PTEN wild type TNBC cells. Rapid AKT phosphorylation downstream of Notch1 requires mTORC2, PI3K and IKKα, and contributes to NF-κB activation. This suggests a bidirectional crosstalk between the IKKα and AKT arms of this Jagged1-activated pathway. Importantly, we find co-localization of Notch1 with Mitochondria in MDA-MB-231 cells by confocal microscopy and Western blot of isolated mitochondrial fractions. We demonstrate that recombinant Jagged1 increases metabolism of TNBC cells. Knockdown of Notch1 or IKKα by siRNA decreases mitochondrial respiration and glycolysis. CSCs derived from MDA-MB-231 cells have increased Notch1, p-AKT, and oxidative metabolism compared to non-stem cells. AKT inhibition or IKK inhibition decreases both mitochondrial respiration and glycolysis of TNBC derived CSCs. Pharmacological inhibition of Notch cleavage by gamma secretase inhibitor (PF-03084014) in combination with AKT inhibitor (MK-2206) or IKK inhibitor (Bay11-7082) blocks CD90hi or CD44+CD24low sorted secondary mammospheres formation. Notably, we find similar results in TNBC patient derived xenograft (PDX) models. These data suggest that combination treatments affecting the intersection of Notch, NF-kB and AKT pathways have potential therapeutic importance in targeting CSCs in TNBC cases with high Notch1 expression.

Citation Format: Hossain F, Sorrentino C, Ucar Bilyeu AD, Matossian M, Crabtree J, Pannuti A, Burow M, Golde T, Osborne B, Miele L. Targeting cancer stem-like cells metabolism via non-canonical notch signaling pathways in triple negative breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-07-06.

A highly sensitive and selective spectrofluorimetric method for the determination of manganese at nanotrace levels in some real, environmental, biological, soil, food and pharmaceutical samples using 2-(α-pyridyl)-thioquinaldinamide

A very simple, ultra-sensitive and highly selective non-extractive spectrofluorimetric method is presented for the determination of manganese at nano-trace levels using 2-(α-pyridyl)-thioquinaldinamide (PTQA). PTQA has been proposed as a new analytical reagent for the direct non-extractive spectrofluorimetric determination of manganese(vii). This novel fluorimetric reagent, PTQA becomes oxidized in a slightly acidic (0.0125-0.05 M H2SO4) solution with manganese(vii) in absolute ethanol to produce a highly fluorescent oxidized product (λ ex = 319 nm; λ em = 373 nm). Constant and maximum fluorescence intensities were observed over a wide range of acidity (0.0125-0.05 M H2SO4) for the period between 5 min and 24 h. Linear calibration graphs were obtained for 0.01-800 μg L-1 of Mn, having a detection limit of 1 ng L-1; the quantification limit of the reaction system was found to be 10 ng L-1 and the RSD was 0-2%. A large excess of over 60 cations, anions and complexing agents do not interfere in the determination. The developed method was successfully used in the determination of manganese in several standard reference materials (alloys, steels, hair and sediments) as well as in some environmental waters (potable and polluted), biological samples (human blood, urine and hair), soil samples, food samples (vegetables, fruits, tea, rice, and wheat), fertilizer samples and pharmaceutical samples (multivitamin-mineral tablets and syrup), solutions containing both manganese(ii) and manganese(vii) speciation and complex synthetic mixtures. The results of the proposed method for assessing biological, food and vegetables samples were comparable with AAS and ICP-MS and were found to be in excellent agreement.

Contamination and ecological risk assessment of trace elements in sediments of the rivers of Sundarban mangrove forest, Bangladesh

In this study, total concentrations of 16 trace elements (Al, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Cd, Sb, Hg, Pb, Th and U) in sediments of the rivers of the Sundarban mangrove forest, after the catastrophic oil spill accident in the Sela river of Sundarban, were determined. The overall mean concentrations of V, Cr, Fe and Cd in surface sediments of the Sundarban are remarkably higher than available literature data of those elements. Trace element contamination assessment, using different environmental contamination indices, reveals that As, Sb, Th and U are low to moderately contaminated while Cd is moderately to severely contaminated in the sediments of this area. The multivariate statistical analyses were applied to reveal the origin and behavior of the elements during their transport in the mangrove ecosystem. High Cr, Ni, Cu and As concentrations suggest the risk of potentially adverse biological effects in the ecosystem.

Early performance-based and patient-reported outcomes of a contemporary taper fit bone-conserving short stem femoral component in total hip arthroplasty

Aims

The aim of this study was to compare early functional and health related quality of life outcomes (HRQoL) in patients who have undergone total hip arthroplasty (THA) using a bone conserving short stem femoral component and those in whom a conventional length uncemented component was used. Outcome was assessed using a validated performance based outcome instrument as well as patient reported outcome measures (PROMs).

Patients and Methods

We prospectively analysed 33 patients whose THA involved a contemporary proximally porous coated tapered short stem femoral component and 53 patients with a standard conventional femoral component, at a minimum follow-up of two years. The mean follow-up was 31.4 months (24 to 39). Patients with poor proximal femoral bone quality were excluded. The mean age of the patients was 66.6 years (59 to 77) and the mean body mass index was 30.2 kg/m2 (24.1 to 41.0). Outcome was assessed using the Oxford Hip Score (OHS) and the University College Hospital (UCH) hip score which is a validated performance based instrument. HRQoL was assessed using the EuroQol 5D (EQ-5D).

Results

There were no major peri-operative complications. There was no difference in the mean post-operative OHS, EQ-5D or function subscale of the UCH hip scores between the two groups. The mean pre-operative OHS and EQ-5D scores improved significantly (all p <  0.001). The mean functional component of the UCH hip score at final follow-up was 42.5 and 40.6 in the short stem and conventional stem groups, respectively. There was no statistically significant difference between the groups (p = 0.42). A total of seven patients (21.2%) in the short stem group and nine (16.98%) in the conventional group achieved a ceiling effect using the OHS; none did using the function subscale of the UCH hip score.

Conclusion

The proximally porous coated tapered short stem femoral component achieves comparable short-term functional outcomes when compared with a conventional longer stem uncemented femoral component when THA is undertaken in patients with good bone quality. Cite this article: Bone Joint J 2017;99-B(4 Supple B):49–55.

Integrated groundwater resource management in Indus Basin using satellite gravimetry and physical modeling tools

Reliable and frequent information on groundwater behavior and dynamics is very important for effective groundwater resource management at appropriate spatial scales. This information is rarely available in developing countries and thus poses a challenge for groundwater managers. The in situ data and groundwater modeling tools are limited in their ability to cover large domains. Remote sensing technology can now be used to continuously collect information on hydrological cycle in a cost-effective way. This study evaluates the effectiveness of a remote sensing integrated physical modeling approach for groundwater management in Indus Basin. The Gravity Recovery and Climate Experiment Satellite (GRACE)-based gravity anomalies from 2003 to 2010 were processed to generate monthly groundwater storage changes using the Variable Infiltration Capacity (VIC) hydrologic model. The groundwater storage is the key parameter of interest for groundwater resource management. The spatial and temporal patterns in groundwater storage (GWS) are useful for devising the appropriate groundwater management strategies. GRACE-estimated GWS information with large-scale coverage is valuable for basin-scale monitoring and decision making. This frequently available information is found useful for the identification of groundwater recharge areas, groundwater storage depletion, and pinpointing of the areas where groundwater sustainability is at risk. The GWS anomalies were found to favorably agree with groundwater model simulations from Visual MODFLOW and in situ data. Mostly, a moderate to severe GWS depletion is observed causing a vulnerable situation to the sustainability of this groundwater resource. For the sustainable groundwater management, the region needs to implement groundwater policies and adopt water conservation techniques.

Abstract P5-07-06: A novel non-canonical Notch1-IKKα-mTORC2-AKT pathway maintains survival in triple negative breast cancer cells and cancer stem-like cells

Triple negative breast cancer (TNBC) is a heterogeneous group of clinically aggressive breast cancers. TNBC patients have high risk of recurrence and metastasis, and current treatment options remain limited. There is strong evidence for the involvement of Notch signaling in TNBC and in breast cancer stem-like cells (CSCs). Notch1 is highly expressed in Basal-like 1 (BL1) and especially Mesenchymal-Stem-Like (MSL) TNBCs. Expression of Notch1 and its ligand Jagged1 correlate with poor prognosis. Treatment of TNBC with dual mTORC1/2 inhibitors leads to resistance through activation of Notch1. Expression of Notch1 protein correlates with pAKT and nuclear NF-κB in TNBC. Here, we demonstrate that Notch1 promotes cell survival in MDA-MB-231 cells, representative of MSL TNBC, in part by activating NF-κB. Notch activation by Jagged1-expressing stromal cells enhances transcription of the anti-apoptotic gene cIAP-2 (BIRC3), a known NF-κB target. This event is dependent on recruitment to the cIAP-2 promoter of NF-κB subunits, IKKα and Notch1. Short term exposure of MDA-MB-231 cells (MSL, PTEN wild-type), but not MDA-MB-468 cells (BL1, PTEN-null) to recombinant Jagged1 leads to rapid AKT phosphorylation. This is suppressed by dual mTORC1/2 inhibitors, AKT inhibitors and IKKα inhibitors but not Everolimus (mTORC1-selective inhibitor). Rapid AKT phosphorylation downstream of Notch1 requires mTORC2, PI3K and IKKα, and contributes to NF-κB activation. These observations support a model where canonical and non-canonical mechanisms downstream of Notch1 trigger rapid AKT phosphorylation and NF-κB activation in PTEN wild-type TNBC cells. Both arms of this pathway require IKKα. CSCs derived from MDA-MB-231 cells have increased Notch1, pAKT and pIKKα expression. Combined pharmacological inhibition of Notch and AKT or Notch and IKKα completely blocks secondary mammosphere formation. These data and published literature suggest that: 1) IKKα connects the Notch and mTORC2/AKT pathways in some TNBC subtypes; 2) IKKα is also required for nuclear Notch1-mediated NF-kB activation and may be a critical node in the Notch signaling network; 3) A feedback mechanism may exist in some TNBC cells between mTORC2/AKT and Notch1; 4) The non-canonical Notch-IKKα-AKT pathway has a potential therapeutic role in targeting CSCs of selected TNBC subtypes.

Citation Format: Hossain F, Peng Y, Pannuti A, Backus K, Golde T, Osborne B, Miele L. A novel non-canonical Notch1-IKKα-mTORC2-AKT pathway maintains survival in triple negative breast cancer cells and cancer stem-like cells [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-07-06.

Outcome of intraoperative use of mitomycin C combined with conjunctival auto graft in recurrent pterygium

Background and objectives: Recurrent pterygium is an important ocular problem in our country. There are different modalities of treatment for recurrent pterygium. The present study was undertaken to determine the effect of intraoperative mitomycin C along with conjunctival auto graft to prevent recurrence of pterygium.Methods: Patients with recurrent pterygium attending a tertiary care hospital in Dhaka from January 2013 to June 2015 were included in the study. Cases were randomized into two groups. Group 1 had pterygium surgery with conjunctival auto graft and Group 2 had auto graft and intraoperative mitomycin C (0.02%). All cases were followed up for one year to assess recurrence of pterygium.Results: A total of 54 recurrent pterygia cases were included in the study. The age of study population was 25 to 65 years. The recurrence rate of pterygium after 12 months was 77.7% in group 1 and none in group 2. No major postoperative complication was observed.Conclusion: The study demonstrated that the use of intraoperative mitomycin C along with conjunctival auto graft had significant effect in preventing the recurrence of pterygium.IMC J Med Sci 2016; 10(2): 49-52

Abundance of Satellite Data Presents Opportunity, Challenge

Globalizing Societal Application of Scientific Research and Observations from Remote Sensing: The Path Forward; Tacoma, Washington, 23–25 June 2015

Data for All: Using Satellite Observations for Social Good

The satellite and science communities must engage with stakeholders to identify priorities and capabilities, enabling the most beneficial use of abundant satellite sensing data.

Measuring function after hip and knee surgery: the evidence to support performance-based functional outcome tasks

Accurate, reproducible outcome measures are essential for the evaluation of any orthopaedic procedure, in both clinical practice and research. Commonly used patient-reported outcome measures (PROMs) have drawbacks such as 'floor' and 'ceiling' effects, limitations of worldwide adaptability and an inability to distinguish pain from function. They are also unable to measure the true outcome of an intervention rather than a patient's perception of that outcome. Performance-based functional outcome tools may address these problems. It is important that both clinicians and researchers are aware of these measures when dealing with high-demand patients, using a new intervention or implant, or testing a new rehabilitation protocol. This article provides an overview of some of the clinically-validated performance-based functional outcome tools used in the assessment of patients undergoing hip and knee surgery.

Turner’s Syndrome in Adulthood and Cytogenetics

Aims: Turner’s syndrome is a chronic disease of chromosomal aberration. The purpose of the study was to find out the accurate identification of cell line, which is critical for cytogenetic studies, genetic counseling, phenotypic studies carried out with few reconstructive procedures to plan future sexual and reproductive life. Methods: This study design was a prospective hospital based clinical study. In this study, ninety six patients were studied with secondary sex characters with relevant ultrasonogram findings and hormonal assay who underwent karyotyping in Bangabandhu Sheikh Mujib Medical University, Dhaka for a study period of ten years from October 1997 to October 2007. Results: Among 96 patients, 62.5 % of the patients were from 15-18 years. Four girls who were less than 15 years came with Turner’s and testicular stigmata. Twenty women aged more than 26 years presented with coital problems.  Around 72.9% had no secondary sexual character, 20.83% had normal female type of secondary sex character, and 6.25% had virilizing type of secondary sexual character. Karyotyping of the cases revealed 72.9% (n = 70) had 45XO pattern, which belong to the Turner's stigmata and correlated well with the hormone profile. Whereas, 20.83% (n = 20) had 46XX pattern and 6.25% (n = 6) had 46XY pattern with testicular feminization syndrome with inguinal testis. Conclusions: About 60% of cases were in the 15-18 years age group. Most of the patients presented with no secondary sexual characteristics. 45XO chromosomal pattern was the most common presenting in 72.9% cases. DOI: http://dx.doi.org/10.3126/njog.v9i2.11744 

Ultrasound guided fine needle aspiration cytology: a sensitive diagnostic tool for diagnosis of intra-abdominal lesions

Ultrasound guided fine needle aspiration cytology is widely accepted as a safe diagnostic procedure in various neoplastic and non-plastic disorders. This study was conducted to determine the usefulness and diagnostic accuracy of ultrasound guided fine needle aspiration cytology in the diagnosis of intraabdominal lesions. This cross sectional study was conducted in the Department of Radiology and Imaging, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh during the period of June 2007 to June 2009. A total 78 patients with intra abdominal lesions were included in this study. Fifty nine (75.6%) were males and 19 (24.4%) were females. Out of total aspirates 29 (37.2%) were categorized as benign, 41 (52.6%) were malignant and 8 (10.3%) were non-representative, as it contained only blood. Most of the benign lesions were liver abscess 19 (24.4%). A diagnosis of primary malignancy was established in 26 (33.3%) and that of secondary in 15 (19.2%). The results showed a sensitivity of 89.7%. Ultrasound guided fine needle aspiration cytology is a sensitive diagnostic tool in a wide spectrum of intra-abdominal neoplastic and non-neoplastic disorders. It is a simple, safe, rapidand inexpensive technique.

Proteinuria is an independent risk factor for ischemic stroke among diabetic patients

This study was done to assess the relationship between proteinuria and ischemic stroke in subjects with diabetes mellitus, and to determine whether proteinuria is an independent risk factor for stroke. This comparative study was conducted in Mymensingh Medical College Hospital from January 2009 to June 2010. It was done to establish the relationship between proteinuria (Microalbuminuria) and ischemic stroke among diabetic patients. Other risk factors were also assessed. Patients were divided in Group A - diabetic patients with ischemic stroke (n=50) and Group B diabetic patients without stroke (n=50). Mean age of the Group A & B were 60.16±8.33 and 57.19±7.73 years (p=0.068). Mean Blood sugar (2 hours after Break Fast) was 14.68±4.32mmol/L in Group A and 14.75±4.02mmol/L in Group B (p>0.05). Albumin Creatinine ratio was abnormal in 84.0% in Group A and 22.0% in Group A (p=0.001) [Odds ratio (95%CI) = 18.61 (6.78-51.09)]. Logistic regression analysis has also shown that microalbuminuria (ACR) is an independent risk factor for ischemic stroke (p=0.001), [Odds ratio (95%CI) = 19.811(5.915-66.348)]. In diabetic patients increased urinary protein is a risk factor for stroke. Estimation of urinary protein (Microalbuminuria) may be used as a predictor for ischemic stroke in patients with diabetes.

True hermaphrodite - a rare case for hysterectomy

One apparently healthy male patient reported at the Urology outpatient department, Bangabandhu Sheikh Mujib Medical University, Bangladesh, with the history of cyclical bleeding per urethra. He started bleeding from the age of 10. The bleeding lasted for 2-3 days. He also had cyclical lower abdominal pain, which remained unexplained. Menstruation occurred every 3-4 months. Left testis was normal but there was a separate soft palpable mass from its lower pole. Chromosomal analysis showed translocation of X and Y chromosome 45(t X/Y). Ultrasonography revealed normal kidneys with well-filled urinary bladder that appeared regular in outline. Left testis was normal in size, measuring about 2.73 × 1.72 cm. Its echotexture was finely homogenous with no evidence of collection or mass. There was a multiloculated cystic mass in the right half of scrotum. Right testis was not visualised along the line of descent. Surprisingly, uterus was found to be present and normal in size and anteverted in position. Fluid collection was noted in the uterine cavity. No ovarian outline was noted. FSH level was almost four times the normal level for males (31.74 IU). The LH level was slightly raised (16.17 IU). The testosterone, Estradiol and Prolactin level were within normal male range, being 3.5 microgram/L, 24 pg/L, and 13.54 microgram/L respectively. Semen analysis revealed azoospermia but the amount of semen was normal. After discussion with the patient, a total abdominal hysterectomy with right-sided salpingo-oophorectomy and left salpingectomy was performed under general anaesthesia. True hermaphrodites must be distinguished from a false one, they have both male and female gonadal tissue, false hermaphrodites are unisexual, but their sex organs resemble those of the opposite sex. This particular patient raised great interest because true hermaphrodites are rare. Attempts were made to make his life normal as a male. If he had the opportunity to have easy access to medical treatment, would he be raised as a female? Controversies are paramount. In this patient, subsequent surgery was done by urologists to correct the chordee and the hypospadias. The overall life of this patient is still a dilemma to us. It was a rare case of hysterectomy done, from the gynaecologist's point of view.

Are leg length and hip offset comparable after hip resurfacing and cementless total hip arthroplasty?

INTRODUCTION

The purpose of this study was to determine if hip resurfacing arthroplasty (HRA) and cementless total hip arthroplasty (THA) were comparable in correcting leg length and hip offset in patients with primary osteoarthritis.

METHODS

A retrospective analysis was performed of 80 patients who underwent either HRA or cementless THA for primary osteoarthritis (40 in each group) between 2006 and 2008. Standardised anteroposterior radiographs taken pre-operatively and at one year following surgery were used to calculate the total offset and leg length in both hips.

RESULTS

At one year following surgery, no leg length discrepancy was identified in either group. A difference of 0.39 cm (p=0.046) remained between the mean total offset of the operated hip and the contralateral non-operated hip in the HRA group. No difference in offset was observed between the two hips after surgery in the THA group (p=0.875).

CONCLUSIONS

Leg length is restored by HRA and THA. A difference remains in offset after HRA although we attribute this to intentional medialisation of the acetabular cup.

Role of VIA in cervical cancer screening in low-resource countries

Cervical cancer is one of the few highly preventable cancers. The early detection and removal of precancerous cervical lesions effectively abolish the development of invasive cervical cancer. The Pap test has been the standard screening test in the Western world for the last five decades. Visual inspection of cervix with acetic acid (VIA) is currently more popular method of cervical cancer of screening test in low resource countries. Cervical cancer incidence and mortality have been reduced dramatically as a result of successful screening in many countries. Cancer cervix can be prevented through both primary prevention using human papilloma virus (HPV) vaccine and early detection using screening techniques. Several screening modalities are now available for early detection of cervical cancer and its precursor lesions. They all differ with regard to their test characteristics, feasibility and economic considerations. This review has different aspects of these screening modalities and provides different options considering mass application. In developed countries, Pap smear cytology is used for cervical cancer screening. But in low-resource country, like Bangladesh, it is too expensive and is not feasible. VIA, a non-cytological test is a simple and inexpensive test which can be provided by trained paramedical personnel with a short training. So VIA can be done in low-resource countries for screening of cervical cancer as an alternative to Pap smear cytology.

Zonal management of arsenic contaminated ground water in Northwestern Bangladesh

This paper used ordinary kriging to spatially map arsenic contamination in shallow aquifers of Northwestern Bangladesh (total area approximately 35,000 km(2)). The Northwestern region was selected because it represents a relatively safer source of large-scale and affordable water supply for the rest of Bangladesh currently faced with extensive arsenic contamination in drinking water (such as the Southern regions). Hence, the work appropriately explored sustainability issues by building upon a previously published study (Hossain et al., 2007; Water Resources Management, vol. 21: 1245-1261) where a more general nation-wide assessment afforded by kriging was identified. The arsenic database for reference comprised the nation-wide survey (of 3534 drinking wells) completed in 1999 by the British Geological Survey (BGS) in collaboration with the Department of Public Health Engineering (DPHE) of Bangladesh. Randomly sampled networks of zones from this reference database were used to develop an empirical variogram and develop maps of zonal arsenic concentration for the Northwestern region. The remaining non-sampled zones from the reference database were used to assess the accuracy of the kriged maps. Two additional criteria were explored: (1) the ability of geostatistical interpolators such as kriging to extrapolate information on spatial structure of arsenic contamination beyond small-scale exploratory domains; (2) the impact of a priori knowledge of anisotropic variability on the effectiveness of geostatistically based management. On the average, the kriging method was found to have a 90% probability of successful prediction of safe zones according to the WHO safe limit of 10ppb while for the Bangladesh safe limit of 50ppb, the safe zone prediction probability was 97%. Compared to the previous study by Hossain et al. (2007) over the rest of the contaminated country side, the probability of successful detection of safe zones in the Northwest is observed to be about 25% higher. An a priori knowledge of anisotropy was found to have inconclusive impact on the effectiveness of kriging. It was, however, hypothesized that a preferential sampling strategy that honored anisotropy could be necessary to reach a more definitive conclusion in regards to this issue.

Application and evaluation of two nutrient algorithms of Hydrological Simulation Program Fortran in Wolf River watershed

This study performs a comparison of two nutrient algorithms of Hydrological Simulation Program Fortran, PQUAL/IQUAL and AGCHEM. Watershed nutrient models with, PQUAL/IQUAL and AGCHEM, were developed and calibrated separately with observed data in the Wolf River watershed. Compared to AGCHEM modules, the PQUAL/IQUAL algorithm was found to have several disadvantages. Examples are: (i) it is a simple loading estimation algorithm, and cannot represent the soil nutrient processes; and (ii) the interactions of modeled nutrient species in the soil cannot be simulated. The AGCHEM modules are capable of explicitly representing the comprehensive nutrient processes in the soil such as fertilization, atmospheric deposition, manure application, plant uptake process, and the transformation processes. Therefore, AGCHEM modules afford the ability to evaluate the alternative management practice and model the interactions between nutrient species. However, our modeling results indicated that the inclusion of AGCHEM modules do not significantly improve the nutrient modeling performance but rather take much more time in model development. The nutrient algorithms selection for total maximum daily loads development depends on the data availability, required modeling accuracy, and available time for model development.

Health and socioeconomic effects of groundwater arsenic contamination in rural Bangladesh: new evidence from field surveys

This report discusses the health and socioeconomic problems that have recently emerged in the Bangladesh countryside because of arsenic contamination of the groundwater. A survey found that men in rural households are generally found to be more susceptible to arsenicosis than women. The survey also indicated that villagers with lower annual income are more likely to experience arsenicosis. About 60 percent of the respondents indicated a willingness to pay up to a dollar of their monthly income for safe water. More than 70 percent of women were found to be willing to walk for five minutes to collect safe water. Awareness campaigns conducted over the last decade seem to have been effective for villagers. Overall, findings from the survey paint a picture of a gradually evolving social and health scenario in rural Bangladesh that health officials must heed to safeguard the public health of the rural public.

Modeling nutrient dynamics under critical flow conditions in three tributaries of St. Louis Bay

Previous research results indicated that dry weather condition has complicated impacts on nitrogen dynamics; monitored and modeling data showed both increased and decreased levels. In order to facilitate the total maximum daily loads (TMDLs) development at three tributaries of St. Louis Bay estuary, the nitrogen dynamics were investigated for two designed critical flow conditions by integrating Hydrological Simulation Program Fortran (HSPF), Environmental Fluid Dynamics Code (EFDC), and Water Quality Analysis Simulation Program (WASP). The total amount of precipitation during the dry year corresponded to a flow condition with return period of 50 years, and 10-year return period for wet year. The dry year contributed more total nitrogen (TN) loads per unit flow volume. At the upstream tributaries, the computed peak reach-averaged TN concentrations were significantly higher for dry weather simulation than wet conditions, whereas at the near-bay tributary, there were no significant differences in the peak TN concentrations. Hence, for the upstream tributaries, the nitrogen TMDL calculation should be based on dry weather condition since the decision-makers are more concerned about the worse scenario.

Assessment of water quality conditions in the St. Louis Bay watershed

The water quality data from 14 sampling stations in the St. Louis Bay watershed were analyzed to evaluate the water quality conditions. The differences in water quality parameters between base and storm flow events were compared to identify the pollutant sources. The results indicated that fecal coliform was the primary cause for water quality impairment of the study area. The overall water quality conditions were good in terms of dissolved oxygen, eutrophication, and total suspended solid (TSS). The dominant sources of bio-chemical oxygen demand (BOD) could be from the failing septic system; the majority of the water samples exceeding Mississippi Department of Environmental Quality (MDEQ) target levels were from base flow events. Different from BOD, the majority of the water samples exceeding the water quality criteria and MDEQ target levels were from the storm events for fecal coliform, chemical oxygen demand, total organic carbon, TKN, NO(3), NH(3), chlorophyll a, and TSS. Based on cluster analysis, the sampling stations were classified into two major categories: upstream and near-coast stations. The major differences between upstream and near-coast stations are elevation, soil texture, and impacts of human activity. The results from this research would provide useful information for total maximum daily load calculation, development of a computational watershed model, and development of best management practices for the St. Louis Bay watershed and similar study area.

Satellite-based Flood Modeling Using TRMM-based Rainfall Products

Increasingly available and a virtually uninterrupted supply of satellite-estimated rainfall data is gradually becoming a cost-effective source of input for flood prediction under a variety of circumstances. However, most real-time and quasi-global satellite rainfall products are currently available at spatial scales ranging from 0.25° to 0.50° and hence, are considered somewhat coarse for dynamic hydrologic modeling of basin-scale flood events. This study assesses the question: what are the hydrologic implications of uncertainty of satellite rainfall data at the coarse scale? We investigated this question on the 970 km² Upper Cumberland river basin of Kentucky. The satellite rainfall product assessed was NASA's Tropical Rainfall Measuring Mission (TRMM) Multi-satellite Precipitation Analysis (TMPA) product called 3B41RT that is available in pseudo real time with a latency of 6-10 hours. We observed that bias adjustment of satellite rainfall data can improve application in flood prediction to some extent with the trade-off of more false alarms in peak flow. However, a more rational and regime-based adjustment procedure needs to be identified before the use of satellite data can be institutionalized among flood modelers.

Watershed modeling of dissolved oxygen and biochemical oxygen demand using a hydrological simulation Fortran program

Several inland water bodies in the St. Louis Bay watershed have been identified as being potentially impaired due to low level of dissolved oxygen (DO). In order to calculate the total maximum daily loads (TMDL), a standard watershed model supported by U.S. Environmental Protection Agency, Hydrological Simulation Program Fortran (HSPF), was used to simulate water temperature, DO, and bio-chemical oxygen demand (BOD). Both point and non-point sources of BOD were included in watershed modeling. The developed model was calibrated at two time periods: 1978 to 1986 and 2000 to 2001 with simulated DO closely matched the observed data and captured the seasonal variations. The model represented the general trend and average condition of observed BOD. Water temperature and BOD decay are the major factors that affect DO simulation, whereas nutrient processes, including nitrification, denitrification, and phytoplankton cycle, have slight impacts. The calibrated water quality model provides a representative linkage between the sources of BOD and in-stream DO\BOD concentrations. The developed input parameters in this research could be extended to similar coastal watersheds for TMDL determination and Best Management Practice (BMP) evaluation.