In vivo analysis the effect of antibiotic growth promoters (AGPs), Oxytetracycline di-hydrate and Tylosin phosphate on the intestinal microflora in broiler chicken

Abstract The study was aimed to analyse the effects of antibiotic growth promoters (AGPs), Oxytetracycline di-hydrate and Tylosin phosphate on the intestinal microflora in broiler chicken. The AGPs were provided in different concentrations solely or in combinations for 42 days of rearing. Faecal samples were collected from the intestine (duodenum, jejunum and caeca) of broiler chicken on 14th, 28th and 42nd days of trial. Samples were cultured on different selective medium and bacterial identification was performed by different biochemical and molecular diagnostic tools. Results showed a significant effect of AGPs on the growth of pathogenic microorganisms such as Escherichia coli and Clostridium perfringens in the intestine. Interestingly, an impaired growth was observed for both bacterium showing a significant effect (P<0.05) of AGPs on E. coli and C. perfringens on day 14th, 28th, and 42nd. This effect was observed solely and in combination while using AGPs. Data further showed that the effect was more prominent in combination and with an increase concentration of AGPs. Remarkably, no impairment was seen on the growth of L. reuteri at different sites of intestine and duration (14th, 28th, and 42nd days). The results showed that the use of AGPs in diet has no harmful effect on beneficial bacteria, however, an impaired growth was seen on the harmful bacteria. It is suggested that a combination of AGPs (OXY-1.0+TP-0.5) is economical and have no harmful effect on the broiler chicken. The use of AGPs in a recommended dose and for a specific period of time are safe to use in poultry both as growth promoter and for the prevention of diseases.

Bilateral idiopathic temporal bone meningoencephaloceles - An unusual presentation

Meningoencephaloceles (MECs) occur due to herniation of brain tissue through a bony defect in the skull base. They can be spontaneous or acquired. These are secondary to trauma, infection or neoplasia. Adult-onset spontaneous or idiopathic MECs are rare. Temporal bone MECs can present with watery discharge from the ear, conductive hearing loss or symptoms of meningitis like headache, fever, vomiting or seizures. These symptoms mimic chronic suppurative or serous otitis media. Computed tomography scan and magnetic resonance imaging differentiate between them. Awareness of this disease entity is necessary for early detection to avoid complications. We report a case of bilateral idiopathic temporal bone MECs with a rare presentation of autophony as the chief complaint. The differentiating features on computed tomography scan and magnetic resonance imaging and the surgical management are discussed.

Effect of statin on progression of degenerative aortic root dilatation

Background

Aortic root dilatation (ARD) is the most common thoracic aortic aneurysm (TAA). Causes of TAA include congenital and heritable disorders, degenerative disorders, inflammatory and infectious etiologies (1.) Hypertension management and smoking cessation are the two most important risk factor modification strategies to prevent rapid progression (&gt;2 mm/year) of TAAs. Beta blockers and angiotensin receptor blockers are the preferred agents to treat HTN (5,6). Statin use is associated with a lower rate of progression of ascending arch and thoracoabdominal aortic aneurysms (2,3,4). However, their role in the progression of degenerative ARD remains unclear.

Purpose

To evaluate the association between statin use and progression of ARD.

Methods

A retrospective chart analysis was performed on 340 patients with a known diagnosis of degenerative ARD. Aortic root measurements were followed by serial transthoracic echocardiograms from the time of first diagnosis for a total of 10 years. The study population was dichotomized based on statin use. The mean change in ARD was calculated for each patient in millimeters. Baseline characteristics were compared between the groups. Multivariate adjusted linear regression models were used to estimate unit change in mean ARD change based on statin use.

Results

Patients in the statin group were older, more obese, with a higher prevalence of comorbidities and medication use compared to patients not on statin. Over a 10-year follow up, the mean increase in ARD was comparable for statin vs. non-statin users (0.83 mm vs. 0.73 mm, p=0.53). On a multivariate regression model adjusted for baseline demographics, risk factors and medication use, the statin group showed a 0.16 mm reduction in ARD compared to non-statin group but this decrease was not statistically significant (Table 1, p=0.47)

Conclusion

In patients with degenerative ARD on a pre-existing regimen of statin, there was no statistically significant change in ARD.

Funding Acknowledgement

Type of funding sources: None. Table 1

The dynamics of genome size and GC contents evolution in genus Nicotiana

Hybridization and Polyploidization are most common of the phenomenon observed in plants, especially in the genus Nicotiana leading to the duplication of genome. Although genomic changes associated with these events has been studied at various levels but the genome size and GC content variation is less understood because of absence of sufficient genomic data. In this study the flow cytometry technique was used to uncover the genome size and GC contents of 46 Nicotiana species and we compared the genomic changes associated with the hybridization events along evolutionary time scale. The genome size among Nicotiana species varied between 3.28 pg and 11.88 pg whereas GC contents varied between 37.22% and 51.25%. The tetraploid species in genus Nicotiana including section Polydiclae, Repandae, Nicotiana, Rustica and Sauveolentes revealed both up and downsizing in their genome sizes when compared to the sum of genomes of their ancestral species. The genome sizes of three homoploid hybrids were found near their ancestral species. Loss of large genome sequence was observed in the evolutionary more aged species (>10 Myr) as compared to the recently evolved one's (<0.2 Myr). The GC contents were found homogenous with a mean difference of 2.46% among the Nicotiana species. It is concluded that genome size change appeared in either direction whereas the GC contents were found more homogenous in genus Nicotiana.

Characterization of wheat-Thinopyrum bessarabicum genetic stock for stripe rust and Karnal bunt resistance

Utilization of modern breeding techniques for developing high yielding and uniform plant types ultimately narrowing the genetic makeup of most crops. Narrowed genetic makeup of these crops has made them vulnerable towards disease and insect epidemics. For sustainable crop production, genetic variability of these crops must be broadened against various biotic and abiotic stresses. One of the ways to widen genetic configuration of these crops is to identify novel additional sources of durable resistance. In this regard crops wild relatives are providing valuable sources of allelic diversity towards various biotic, abiotic stress tolerance and quality components. For incorporating novel variability from wild relative's wide hybridization technique has become a promising breeding method. For this purpose, wheat-Th. bessarabicum amphiploid, addition and translocation lines have been screened in field and screen house conditions to get novel sources of yellow rust and Karnal bunt resistant. Stripe rust screening under field conditions has revealed addition lines 4JJ and 6JJ as resistant to moderately resistant while addition lines 3JJ, 5JJ, 7JJ and translocation lines Tr-3, Tr-6 as moderately resistant wheat-Thinopyrum-bessarabicum genetic stock. Karnal bunt screening depicted addition lines 5JJ and 4JJ as highly resistant genetic stock. These genetic stocks may be used to introgression novel stripe rust and Karnal bunt resistance from the tertiary gene pool into susceptible wheat backgrounds.

Impact of nitrogen and phosphorus fertilizers on Cry1Ac protein contents in transgenic cotton

Application of different fertilizers to check the efficiency of expression of Bt (Bacillus thuringiensis) gene in one of the leading commercialized crops (cotton) against Lepidopteran species is of great concern. The expression of Cry protein level can be controlled by the improvement of nutrients levels. Therefore, the myth of response of Cry toxin to different combinations of NP fertilizers was explored in three Bt cotton cultivars. Combinations include three levels of nitrogen and three levels of phosphorus fertilizers. Immunostrips and Cry gene(s) specific primer based PCR (Polymerase Chain Reaction) analysis were used for the presence of Bt gene that unveiled the presence of Cry1Ac gene only. Further, the ELISA (enzyme-linked immunosorbent assay) kit was used to quantify the expression of Cry1Ac protein. Under various NP fertilizers rates, the level of toxin protein exhibited highly significant differences. The highest toxin level mean was found to be 2.3740 and 2.1732 µg/g under the treatment of N150P75 kg ha-1 combination while the lowest toxin level mean was found to be 0.9158 and 0.7641 µg/g at the N50P25 kg ha-1 level at 80 and 120 DAS (Days After Sowing), respectively. It was concluded from the research that the usage of NP fertilizers has a positive relation with the expression of Cry1Ac toxin in Bt cotton. We recommend using the N150P50 kg ha-1 level as the most economical and practicable fertilizer instead of the standard dose N100P50 kg ha-1 to get the desired level of Cry1Ac level for long lasting plant resistance (<1.5). The revised dose of fertilizer may help farmers to avoid the cross-resistance development in contradiction of insect pests.

Efficiency of exogenous zinc sulfate application reduced fruit drop and improved antioxidant activity of 'Kinnow' mandarin fruit

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Kinnow' mandarin (Citrus nobilis L.× Citrus deliciosa T.) is an important marketable fruit of the world. It is mainstay of citrus industry in Pakistan, having great export potential. But out of total production of the country only 10% of the produce meets the international quality standard for export. Pre-harvest fruit drop and poor fruit quality could be associated with various issues including the plant nutrition. Most of the farmers do not pay attention to the supply of micro nutrients which are already deficient in the soil. Furthermore, their mobility within plants is also a question. Zinc (Zn) is amongst those micronutrients which affect the quality and postharvest life of the fruit and its deficiency in Pakistani soils is already reported by many researchers. Therefore, this study was carried out to evaluate the influence of pre-harvest applications of zinc sulfate (ZnSO4; 0, 0.4%, 0.6% or 0.8%) on pre-harvest fruit drop, yield and fruit quality of 'Kinnow' mandarin at harvest. The treatments were applied during the month of October i.e. 4 months prior to harvest. The applied Zn sprays had significant effect on yield and quality of the "Kinnow" fruit. Amongst different foliar applications of ZnSO4applied four months before harvest, 0.6% ZnSO4 significantly reduced pre-harvest fruit drop (10.08%) as compared to untreated control trees (46.45%). Similarly, the maximum number of fruits harvested per tree (627), fruit weight (192.9 g), juice percentage (42.2%), total soluble solids (9.5 °Brix), ascorbic acid content (35.5 mg 100 g-1) and sugar contents (17.4) were also found significantly higher with 0.6% ZnSO4 treatment as compared to rest of treatments and control. Foliar application of 0.6% ZnSO4 also significantly improved total antioxidants (TAO) and total phenolic contents (TPC) in fruit. In conclusion, foliar spray of ZnSO4 (0.6%) four months prior to harvest reduced pre-harvest fruit drop, increase yield with improved quality of 'Kinnow' mandarin fruit.

Physicochemical features, functional characteristics, and health benefits of cottonseed oil: a review

Vegetable oils have their specific physicochemical properties due to which they are playing vital role in human nutritional diet for health benefits. Cottonseed oil is obtained from various species of cotton seeds that are famous to be grown mainly for their fiber quality. The most prominently used specie is Gossypium hirsutum. It is obvious that the seeds of different variety of cotton vary as grown in diverse agroclimatic conditions with respect to oil, fats and protein contents. Cottonseed oil is routinely used for cooking and food manufacturing products. Cottonseed oil obtained after proper extraction/processing steps from crude state to refined oil in a variety of ways. Cotton crop is considered for their dual-use purpose, for fiber quality and oil production to promote health benefits in the world. Keeping in view the above facts, this review clearly demonstrated an overview about physicochemical and functional properties of cottonseed oil to promote health benefits associated with the use of this oil. The overall characteristics and all concerned health benefits of CSO will further improve their usefulness is a compact way. We have summarized a brief multi-dimensional features of CSO in all aspects up to the best of our knowledge for the end researchers who can further research in the respective aspect.

Exogenous application of bio-stimulant and growth retardant improved the productivity of cotton cultivars under different planting arrangement

Optimum planting arrangement is an important attribute for efficient utilization of available resources and to obtain high yield of cotton. Application of plant growth promoter and retardant on cotton in improved planting density are the innovative techniques in the establishment of more productive cotton crop. Therefore, we planned a field study to assess the role of bio-stimulant and growth retardant in the resource utilization efficiency of cotton cultivars planted under variable row spacing at Agronomic Research Area Bahauddin Zakariya University and Usmania Agricultural Farm Shujabad during Kharif 2012. Experimental treatments consisted of cotton genotypes viz. CIM-573 and CIM-598, cultivated under conventional (75 cm), medium (50 cm) and ultra-narrow row spacing (25 cm) with foliar spray of bio-stimulant (moringa leaf extract) and growth retardant (mepiquate chloride), either sole or in combination, keeping distilled water as a control. Exogenously applied MLE alone and MLE + MC significantly enhanced the number of squares, flowers and green bolls per plant leading to higher cotton seed and lint yield of CIM 598 cultivar cultivated under conventional row spacing. While application of MC alone and MLE + MC produced maximum micronaire value, fiber strength and fiber uniformity ratio of CIM 573 cultivar cultivated under conventional row spacing. The results suggested that application of MLE is a possible approach to enhance the cotton productivity and the use of MC to enhance the fiber quality attributes under conventional row spacing.

170Lipoprotein subclasses associated with high-risk coronary atherosclerotic plaque: insights from the PROMISE clinical trial

Background

Greater than half of major adverse cardiovascular events (MACE) occur in individuals with non-obstructive coronary artery disease (CAD) and may be related to the presence of high-risk coronary atherosclerotic plaque (HRP). HRP can be detected by coronary computed tomographic angiography (CTA) and is associated with increased MACE risk. Biomarkers associated with HRP may therefore aid in risk stratification in individuals with chest pain and provide insight into the biology of HRP.

Purpose

To determine whether nuclear magnetic resonance (NMR)-measured lipoprotein particles are associated with HRP independent of risk factors.

Methods

This study included 1755 stable symptomatic outpatients enrolled in the PROMISE trial who had coronary CTA performed. Thirty-seven lipoprotein particle parameters were measured in plasma using NMR. Principal components analysis was used to reduce the number of correlated lipoproteins into a smaller number of uncorrelated factors. HRP cases (N=277) were defined as presence of HRP features (positive remodeling, low CT attenuation or napkin-ring sign) with or without obstructive CAD; controls had no HRP and no obstructive CAD (N=1478). Multivariable logistic regression models adjusting for age, sex, diabetes, hypertension, BMI, smoking status and statin use were used to test for association of lipoprotein factors with HRP case/control status; lipoproteins loaded within significant factors (p<0.05) were tested individually. Finally, because event rates in PROMISE were too low, we used a separate study (CATHGEN, a study of individuals undergoing coronary angiography; N=8707) to test for association of lipoproteins with MACE using multivariable Cox proportional hazard models.

Results

HRP cases were less likely to be female than controls (36.8% vs. 56.6%) and were more likely to have diabetes (23.5% vs 19.6%), but were of similar age (60.1 vs 60.4 years [SD±8]) and with similar statin use (45.2% vs 44.4%). In multivariable models, two lipoprotein factors were associated with HRP: an HDL factor (OR 1.29 [95% CI, 1.10–1.52], p=0.002) and a triglyceride (TG) factor (OR 1.19 [1.03–1.36], p=0.01). Within these two factors, H6P (a large HDL subclass; OR 0.67 [0.54–0.82], p<0.001), HDL size (OR 0.78 [0.66–0.92], p=0.003) and small TG-rich lipoproteins (OR 1.22 [1.07–1.39], p=0.002) were associated with HRP. H6P (HR 1.1 [1.07–1.13], p<0.0001) and HDL size (HR 1.28 [1.24–1.32], p<0.0001) were also associated with time to death or MI in CATHGEN, but in the opposite direction.

Conclusions

In a cohort of low-risk patients from the PROMISE trial, large HDL and small TG particles were associated with CTA-defined HRP independent of risk factors. Large HDL particles were also associated with incident MACE in a separate high-risk cohort. The discordant direction of association of HDL subclasses with HRP and MACE is likely due to underlying HDL biology and requires further study.

Acknowledgement/Funding

The PROMISE trial was funded by the National Heart, Lung, and Blood Institute (grants R01HL098237, R01HL098236, R01HL98305, and R01HL098235)

Cholinergic neural activity directs retinal layer-specific angiogenesis and blood retinal barrier formation

Blood vessels in the central nervous system (CNS) develop unique features, but the contribution of CNS neurons to regulating those features is not fully understood. We report that inhibiting spontaneous cholinergic activity or reducing starburst amacrine cell numbers prevents invasion of endothelial cells into the deep layers of the retina and causes blood-retinal-barrier (BRB) dysfunction in mice. Vascular endothelial growth factor (VEGF), which drives angiogenesis, and Norrin, a Wnt ligand that induces BRB properties, are decreased after activity blockade. Exogenous VEGF restores vessel growth but not BRB function, whereas stabilizing beta-catenin in endothelial cells rescues BRB dysfunction but not vessel formation. We further identify that inhibiting cholinergic activity reduces angiogenesis during oxygen-induced retinopathy. Our findings demonstrate that neural activity lies upstream of VEGF and Norrin, coordinating angiogenesis and BRB formation. Neural activity originating from specific neural circuits may be a general mechanism for driving regional angiogenesis and barrier formation across CNS development.

During retinal development, waves of cholinergic neural activity play a role in retinal circuit development. Here, the authors show that this activity also contributes to layer-specific angiogenesis and formation of the blood-retinal barrier.

Role of pneumonectomy for lung cancer in current scenario: An Indian perspective

BACKGROUND

Surgical treatment for lung cancer has evolved from pneumonectomy to lobectomy/sleeve resection around the world. Although condemned for poor outcomes, pneumonectomy may still be required in a select group of patients in developing countries. With the better patient selection, optimization of medical comorbidities, better perioperative care; pneumonectomy may show better results. Thus, there is a need to reconsider the role of pneumonectomy in patients with locally advanced lung cancer in the current scenario.

PATIENTS AND METHODS

The aim of this study was to analyze the demographic and clinicopathologic profile of lung cancer patients and the role of pneumonectomy at a tertiary cancer center in India. The records of patients, who underwent surgery for lung cancer at our institute from January 2011 to April 2014, were analyzed retrospectively, and various parameters in pneumonectomy were compared to lobectomy patients.

RESULTS

Out of 48 patients undergoing major lung resections, nearly 80% patients were symptomatic at presentation and were mostly in advanced stages, thus requiring neoadjuvant chemotherapy in 45.8% cases and pneumonectomy in 41.6% patients. There was no difference in morbidity and mortality in pneumonectomy (25%, 5%) versus lobectomy (21.2%, 3.5%). Disease-free survival at 1, 2, and 3 years after pneumonectomy (71.8%, 51.4%, and 42.8%) was comparable to lobectomy (73.3%, 66.1%, and 55.6%). After neoadjuvant therapy, survival was not affected by the type of surgery.

CONCLUSIONS

In the Indian scenario, as the majority of lung cancer patients present at an advanced stage, pneumonectomy still plays a major role, and the acceptable postoperative outcome can be achieved with aggressive perioperative management.

Abstract P2-02-10: Circulating cells from the tumor microenvironment as liquid biopsy biomarkers alongside circulating tumor cells in metastatic breast cancer

Background: Metastasis is a multistep process that involves the shedding of tumor cells in the peripheral circulation. These Circulating Tumor Cells (CTCs) have prognostic implications in patients with metastatic breast cancer (MBC). Cancer Associated Fibroblasts (CAFs) are a major component of the breast tumor microenvironment. The reciprocal signaling between tumor cells and its microenvironment promotes carcinogenesis, invasion, and metastasis. Studies in mouse models have shown that metastatic cells can bring their own stromal components from the primary site to the site of metastasis, and that these cotraveling stromal cells provide an early growth advantage to the accompanying metastatic cancer cells. CAFs have not been identified in the peripheral circulation. Using a microfilter capture technique, we discovered non-tumor, non-immune cells in the blood of metastatic patients and identified these cells as circulating CAFs (cCAFs). The purpose of this study is to demonstrate the presence of cCAFs as a biomarker of metastasis simultaneously with CTCs in patients with MBC.

Materials and Methods: We identified 20 patients with MBC (Metastatic/MET Group) and 10 patients with cured breast cancer (Ductal carcinoma in situ or Stage I post definitive treatment with &gt;5 years of disease free survival i.e. Localized/LOC Group). A total of 7.5 ml of peripheral blood was obtained from each patient. The enumeration of CTCs and cCAFs was carried out by the microfilter capture technique. Identification of these cells was done by a triple immunofluorescence staining for pan-CK (cytokeratin), FAP (Fibroblast Activated Protein) and CD45. cCAFs were identified as CK-, FAP+, CD45- cells and CTCs as CK+, CD45- cells. Identification and confirmation of cCAF was also carried out in parallel samples by a simultaneous FAP/α-Smooth Muscle Actin staining.

Results: cCAFs were detected in 17/20 (85%) MET patients but in only 2/10 (20%) LOC patients. CTCs were detected in 20/20 (100%) MET patients and in 8/10 (80%) LOC patients. The counts of CTCs and cCAFs in MET group ranged between 1-98 (median 13.5) and 0-117 (median 4), respectively. The counts of CTCs and cCAFs in the LOC group ranged between 1-14 (median 6) and 0-2 (median 0), respectively. For patients with exhibited cCAFs, 2/10 LOC and 5/17 MET patients had cCAFs counts of 2 or less. Although the sample size was small, patients exhibiting cCAFs (odds ratio=22.67, 95% CI: 3.14-163.63, p=0.002) were more likely to be in MET group than LOC group.

Conclusion: This is the first demonstration that CAFs, the predominant mesenchymal cell in the breast tumor microenvironment, are shed into the circulation and can be identified and enumerated as cCAFs in MBC patients along with CTCs. There was a clear difference in the numbers of CTCs and cCAFs levels between the MET and the LOC groups suggesting that CTCs and cCAFs are associated with advanced stage disease. While most patients, both in the LOC and MET group, exhibited CTCs, very few LOC patients exhibited cCAFs. We suggest that cCAFs could independently or along with CTCs serve as liquid biopsy biomarkers of metastasis. Validation of these findings in a larger cohort of patients will be presented during the meeting.

Citation Format: Parajuli R, Ao Z, Shah SH, Sengul TK, Lippman ME, Datar R, El-Ashry D. Circulating cells from the tumor microenvironment as liquid biopsy biomarkers alongside circulating tumor cells in metastatic breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-02-10.

Clinico-pathological findings of Clostridium perfringens type D enterotoxaemia in goats and its hemolytic activity in different erythrocytes

The present investigation was conducted to study the effects of experimental Clostridium perfringens type D enterotoxaemia in teddy goats. Clinical signs started to appear after 30 min of experimental infection like anorexia, diarrhea, dehydration, frothing and dyspnea. Gross lesions consisted of severe congestion in tissues of varying intensity with enlarged mesenteric lymph nodes while histological examination revealed edema of lungs, kidney, and lymph nodes and to some extent in brain along with hemorrhages in lungs and intestines. Clostridium perfringens type D carrying alpha and epsilon toxin genes were amplified with amplicon size about 247 bp and 665 bp, respectively. Human erythrocytes showed the highest hemolysis, 68%, followed by mice, 57%, against culture supernatants. The percentage of hemolysis was significantly higher at 37°C as compared to 25°C except for rabbit and dog.

Study of comparative effects of antioxidants on insulin sensitivity in type 2 diabetes mellitus

OBJECTIVES

This study intended to assess the effects of the antioxidants; Alpha Lipoic Acid (ALA), omega 3 fatty acids and vitamin E on the parameters of insulin sensitivity, oxidative stress, lipid metabolism and glycaemic control in patients of type 2 diabetes mellitus.

METHODS

This was a prospective, randomized, double blind, placebo controlled, single centred study. One hundred four patients with type 2 diabetes mellitus with insulin resistance were recruited for the study. They were given ALA, omega 3 fatty acids, vitamin E or placebo. Their weight, Body Mass Index (BMI) and Waist circumference were measured. The investigations which were fasting glucose and fasting total cholesterol. The insulin resistance was calculated on the basis of the BMI and the waist circumference.

RESULTS

In the intra group analysis at the baseline (V1) vs at the end of the treatment period (V5), we observed a significant decrease in the BMI, waist circumference and the total cholesterol in the three treatment groups. In the intergroup analysis at V5, ALA, omega 3 fatty acids and vitamin E showed a significant improvement in the total cholesterol as compared to the placebo and vitamin E showed the maximum improvement.

CONCLUSION

ALA, omega 3 fatty acids and vitamin E showed the improvement in insulin sensitivity. Since they differ in improving different parameters all of these three can be used as an add on therapy in patients with type 2 diabetes mellitus to improve their insulin sensitivity and lipid metabolism.

A Novel ABCA12 Mutation in Two Families with Congenital Ichthyosis

Autosomal recessive congenital ichthyosis (ARCI) is a rare genetically heterogeneous disorder characterized by hyperkeratosis in addition to dry, scaly skin. There are six genes currently known to be associated with the disease. Exome sequencing data for two affected individuals with ichthyosis from two apparently unrelated consanguineous Pakistani families was analysed. Potential candidate mutations were analysed in additional family members to determine if the putative mutation segregated with disease status. A novel mutation (c.G4676T, p.Gly1559Val) in ABCA12 occurred at a highly conserved residue, segregated with disease status in both families, and was not detected in 143 control chromosomes. Genotyping with microsatellite markers demonstrated a partial common haplotype in the two families, and a common founder mutation could not be excluded. Comparison to previously reported cases was consistent with the hypothesis that severe loss of function ABCA12 mutations are associated with Harlequin Ichthyosis and missense mutations are preferentially associated with milder phenotypes. In addition to identifying a possible founder mutation, this paper illustrates how advances in genome sequencing technologies could be utilised to rapidly elucidate the molecular basis of inherited skin diseases which can be caused by mutations in multiple disease genes.

Malaria burden in human population of Quetta, Pakistan

Malaria is a serious global health challenge, which is responsible for more than one million deaths a year. Malarial infection is more prevalent in developing countries including Pakistan. Significant efforts have been made to control malaria; however, due to socio-environmental factors, it remains a frequent problem in Quetta. The present study was undertaken to determine the malarial incidence, species prevalence, and its demographic evaluation in human population of Quetta, Pakistan. A total of 1831 subjects, comprising 1072 male and 759 female presenting symptoms of malaria, were included in this study. Blood samples from clinically suspected individuals were subjected to the standard immunochromatographic and malaria parasite smear analysis for malaria diagnosis. Out of 1831 subjects, 338 (18.45%) patients were positive for malarial parasite while the species prevalence was found as 276 (81.66%) and 62 (18.34%) for Plasmodium vivax, and Plasmodium falciparum, respectively. Furthermore, seasonal variations gradual increase in the prevalence rate. The age group of 21-30 years (30.47%) was found more prone to malaria. The suspected malaria cases were found more frequent in rural (72.1%) as compared to urban (27.9%). In addition, the malaria burden was high in urban area (22.89%) population as compared to the rural area (16.74%) population. It was observed that the highest disease occurrence was caused by P. vivax, which reflects a serious threat for public health. The current findings will be helpful to plan effective strategies to prevent and control malaria in this area.

Branched-chain amino acid levels are associated with improvement in insulin resistance with weight loss

AIMS/HYPOTHESIS

Insulin resistance (IR) improves with weight loss, but this response is heterogeneous. We hypothesised that metabolomic profiling would identify biomarkers predicting changes in IR with weight loss.

METHODS

Targeted mass spectrometry-based profiling of 60 metabolites, plus biochemical assays of NEFA, β-hydroxybutyrate, ketones, insulin and glucose were performed in baseline and 6 month plasma samples from 500 participants who had lost ≥4 kg during Phase I of the Weight Loss Maintenance (WLM) trial. Homeostatic model assessment of insulin resistance (HOMA-IR) and change in HOMA-IR with weight loss (∆HOMA-IR) were calculated. Principal components analysis (PCA) and mixed models adjusted for race, sex, baseline weight, and amount of weight loss were used; findings were validated in an independent cohort of patients (n = 22).

RESULTS

Mean weight loss was 8.67 ± 4.28 kg; mean ∆HOMA-IR was -0.80 ± 1.73, range -28.9 to 4.82). Baseline PCA-derived factor 3 (branched chain amino acids [BCAAs] and associated catabolites) correlated with baseline HOMA-IR (r = 0.50, p < 0.0001) and independently associated with ∆HOMA-IR (p < 0.0001). ∆HOMA-IR increased in a linear fashion with increasing baseline factor 3 quartiles. Amount of weight loss was only modestly correlated with ∆HOMA-IR (r = 0.24). These findings were validated in the independent cohort, with a factor composed of BCAAs and related metabolites predicting ∆HOMA-IR (p = 0.007).

CONCLUSIONS/INTERPRETATION

A cluster of metabolites comprising BCAAs and related analytes predicts improvement in HOMA-IR independent of the amount of weight lost. These results may help identify individuals most likely to benefit from moderate weight loss and elucidate novel mechanisms of IR in obesity.

Ab initio energetics of lanthanum substitution in ferroelectric bismuth titanate

Using first principles calculations and atomistic thermodynamics the bulk and defect properties of orthorhombic bismuth titanate (Bi₄Ti₃O₁₂) and bismuth lanthanum titanate (Bi₃.₂₅La₀.₇₅Ti₃O₁₂) have been investigated. Heats of formation, valid chemical conditions for synthesis, lanthanum substitution energies and oxygen and bismuth vacancy formation energies have been computed. The study improves our understanding of how native point defects and substitutional impurities influence the ferroelectric properties of these layered perovskite materials. It is found that lanthanum incorporation could occur on either of the two distinct bismuth sites in the structure and that the effect of substitution is to increase the formation energy of nearby native oxygen vacancies. The results provide direct atomistic evidence over a range of chemical conditions supporting the suggestion that lanthanum incorporation reduces the oxygen vacancy concentration. Oxygen vacancies contribute to ferroelectric fatigue by interacting strongly with domain walls, and therefore a decrease in their concentration is beneficial. The conditions that favor the greatest reduction in oxygen vacancy concentration are described.

First-principles density functional study of polarization-strain coupling in bismuth titanate

The influence of uniaxial and biaxial strain (± 3%) on the spontaneous polarization of orthorhombic bismuth titanate (Bi(4)Ti(3)O(12)) is investigated using a first-principles density functional approach. Born effective charges are obtained using linear response theory. In unstrained bismuth titanate the calculated principal component of polarization along the a axis (P(a)) is 0.46 C m(-2), which is close to the experimental measurement of 0.50 C m(-2). Uniaxial strain along this axis is more effective than along the c axis in improving this component of polarization, by up to 17% for a tensile strain of 3%. Compressive strain along the c axis also enhances P(a) but to a lesser degree. Biaxial strain has a more significant effect on P(a) than uniaxial strain. A simultaneous uniform tensile strain of 3% along the a and b axes enhances the principal component of polarization by 39% while a similar strain along the c and b axes produces an enhancement of 8%. These effects are explained in terms of the off-centre displacements of ions and have implications for device applications of bismuth titanate which use epitaxially strained thin-film heterostructures.

Insulin resistance is associated with a metabolic profile of altered protein metabolism in Chinese and Asian-Indian men

AIMS/HYPOTHESIS

Insulin resistance (IR) is associated with obesity, but can also develop in individuals with normal body weight. We employed comprehensive profiling methods to identify metabolic events associated with IR, while controlling for obesity.

METHODS

We selected 263 non-obese (BMI approximately 24 kg/m2) Asian-Indian and Chinese men from a large cross-sectional study carried out in Singapore. Individuals taking medication for diabetes or hyperlipidaemia were excluded. Participants were separated into lower and upper tertiles of IR based on HOMA indices of < or =1.06 or > or =1.93, respectively. MS-based metabolic profiling of acylcarnitines, amino acids and organic acids was combined with hormonal and cytokine profiling in all participants.

RESULTS

After controlling for BMI, commonly accepted risk factors for IR, including circulating fatty acids and inflammatory cytokines, did not discriminate the upper and lower quartiles of insulin sensitivity in either Asian- Indian or Chinese men. Instead, IR was correlated with increased levels of alanine, proline, valine, leucine/isoleucine, phenylalanine, tyrosine, glutamate/glutamine and ornithine, and a cluster of branched-chain and related amino acids identified by principal components analysis. These changes were not due to increased protein intake by individuals in the upper quartile of IR. Increased abdominal adiposity and leptin, and decreased adiponectin and IGF-binding protein 1 were also correlated with IR.

CONCLUSIONS/INTERPRETATION

These findings demonstrate that perturbations in amino acid homeostasis, but not inflammatory markers or NEFAs, are associated with IR in individuals of relatively low body mass.

Polymorphisms of the tumor suppressor gene LSAMP are associated with left main coronary artery disease

Previous association mapping on chromosome 3q13-21 detected evidence for association at the limbic system-associated membrane protein (LSAMP) gene in individuals with late-onset coronary artery disease (CAD). LSAMP has never been implicated in the pathogenesis of CAD. We sought to thoroughly characterize the association and the gene. Non-redundant single nucleotide polymorphisms (SNPs) across the gene were examined in an initial dataset (168 cases with late-onset CAD, 149 controls). Stratification analysis on left main CAD (N = 102) revealed stronger association, which was further validated in a validation dataset (141 cases with left main CAD, 215 controls), a third control dataset (N = 255), and a family-based dataset (N = 2954). A haplotype residing in a novel alternative transcript of the LSAMP gene was significant in all independent case-control datasets (p = 0.0001 to 0.0205) and highly significant in the joint analysis (p = 0.00004). Lower expression of the novel alternative transcript was associated with the risk haplotype (p = 0.0002) and atherosclerosis burden in human aortas (p = 0.0001). Furthermore, silencing LSAMP expression in human aortic smooth muscle cells (SMCs) substantially augmented SMC proliferation (p<0.01). Therefore, the risk conferred by the LSAMP haplotype appears to be mediated by LSAMP down-regulation, which may promote SMC proliferation in the arterial wall and progression of atherosclerosis.

Molecular characterization of Ephedra species found in Pakistan

Ephedra, also known as "ma huang", is a dioecious, drought- and frost-resistant, perennial, evergreen shrub with compelling medicinal value. The genus is represented by 42 species around the world, 9 of which were provisionally reported from Pakistan. Species of the genus have a controversial taxonomy due to their overlapping morphological features. Conventional tools alone are not sufficient for characterizing the species. The objective of present study was to assess the genetic variability present in different biotypes of Ephedra growing in Pakistan using molecular markers. A total of six genotypes collected from diverse geographic zones of Pakistan were used. The DNA of all genotypes was amplified using nine randomly amplified polymorphic DNA (RAPD) primers to study genetic variability at the molecular level. The dissimilarity coefficient matrix based on the data of 9 RAPD primers was used to construct a dendrogram which was then used to group the genotypes in clusters. Based on the dendrogram and dissimilarity coefficient matrix, the RAPD markers used here revealed a moderate to high level of genetic polymorphism (6 to 49%) among the genotypes. It was found that the collection of genotype accessions from Swat Valley in northwestern Pakistan was most distantly related to the other five collections. More molecular markers including functional genes and ribosomal spacer regions are suggested to find a better estimate of the genetic diversity present in Ephedra growing in Pakistan. The information provided here is useful for identifying valuable Ephedra variants which will be used for medicinal purposes and earning foreign currency.

Serum lipids in the GENECARD study of coronary artery disease identify quantitative trait loci and phenotypic subsets on chromosomes 3q and 5q

Coronary artery disease (CAD) and dyslipidemia have strong genetic components. Heterogeneity complicates evaluating genetics of complex diseases such as CAD; incorporating disease-related phenotypes may help reduce heterogeneity. We hypothesized that incorporating lipoproteins in a study of CAD would increase the power to map genes, narrow linkage peaks, identify phenotypic subsets, and elucidate the contribution of established risk factors to genetic results. We performed ordered subset analysis (OSA) and quantitative trait linkage (QTL) using serum lipoproteins and microsatellite markers in 346 families with early-onset CAD. OSA defined homogeneous subsets and calculated lod scores across a chromosome after ranking families by mean lipoprotein values. QTL used variance components analysis. We found significantly increased linkage to chromosome 3q13 (LOD 5.10, p = 0.008) in families with higher HDL cholesterol, lower LDL and total cholesterol, lower triglycerides, and fewer CAD risk factors, possibly due to a concentrated non-lipoprotein-related genetic effect. OSA identified linkage on chromosome 5q34 in families with higher cholesterol, possibly representing a hereditary lipoprotein phenotype. Multiple QTLs were identified, with the strongest for: total cholesterol on chromosome 5q14 (LOD 4.3); LDL on 20p12 (LOD 3.97); HDL on 3p14 (LOD 1.65); triglycerides on 18q22 (LOD 1.43); and HDL/TC ratio on 3q27-28 (LOD 2.06). Our findings suggest the presence of etiologic heterogeneity in families with early-onset CAD, potentially due to differential effects of lipoprotein phenotypes. Candidate genes are under investigation.

Influence of gender on outcomes after intra-arterial thrombolysis for acute ischemic stroke

Recent data suggest that women obtain greater benefit than men from IV fibrinolysis for acute ischemic stroke. It is unknown whether this gender-thrombolysis advantage extends to those treated with intra-arterial (IA) thrombolysis. The authors evaluated the independent effect of gender among ischemic stroke patients treated with IA fibrinolysis and found no differences in short-term clinical and angiographic outcomes between men and women who received IA thrombolysis for acute ischemic stroke.

Environmental monitoring of benzene and toluene produced in indoor air due to combustion of solid biomass fuels

Exposure to benzene and toluene from the combustion of solid biomass fuels is one of the important causes of morbidity and mortality in developing countries. In this study, we assessed the exposure of cooks to benzene and toluene from biomass fuel combustion in 55 rural homes. The GC-MS was used for quantification while a personnel sampler was used for environmental monitoring. The benzene exposure differed significantly (p < 0.0001) across different types of indoor kitchen fuel combinations. The geometrical mean (GM) of benzene exposure for cooks during cooking hours in an indoor kitchen using mixed fuel was 75.3 microg/m3 (with partition) and 63.206 microg/m3 (without partition), while the exposure was 11.7 microg/m3 for open type. The benzene exposure was significantly higher (p < 0.05) in an indoor kitchen with respect to open type using mixed fuels. Concentration of benzene (114.1 microg/m3) for cooks in an indoor kitchen with partition using dung fuel was significantly higher in comparison to non-cooks (5.1 microg/m3) for open type. Benzene exposure was not significantly different for kitchen with ventilation (31.2 microg/m3) and without ventilation (45.0 microg/m3) using wood fuel. However, this value was significantly (p < 0.05) lower than in indoor kitchens with or without partition. An almost similar trend was observed for toluene but the difference was statistically non-significant. This study may be helpful in developing a regional exposure database and in the facilitation of health risk assessment due to volatile organic pollutants in our day-to-day environment.

A correlation of secondary aerosol (nitrate and sulfate) with respirable particulate matter (RPM) in ambient air at different traffic junctions of Vadodara city

The correlation study of secondary aerosol (nitrate and sulfate) with RPM in ambient air at different traffic junctions of Vadodara city is reported. RPM was analyzed using Ion Chromatography technique and measured the level of nitrate and sulfate in ambient air. The correlation studies of these particulates with RPM have been established. The average concentration of sulfate and nitrate in ambient air was found 35.74 microg/m3 and 24.22 microg/m3, which ranged of 5.33-84.69 and 1.93-77.86 microg/m3 respectively. The correlation of RPM and SO4 (r = 0.813, P<0.01), RPM-NO3 (r = 0.5549, P<0.01) and SO4-NO3 (r = 0.6133, P<0.01) were found significant. The presence of sulfate and nitrate in RPM is 8.25% and 5.60% . The pH of water extract of RPM averaged 6.81, which ranged 6.17-7.28. Regression analysis result showed that the relationship between RPM-SO4 was significantly (R2=0.66215) correlated. This indicate that probably the secondary aerosols such as nitrate and sulfate in excess may cause irritation and increasing lung disease.

Gas chromatographic–mass spectroscopic determination of benzene in indoor air during the use of biomass fuels in cooking time

A gas chromatography-mass spectroscopic method in electron ionization (EI) mode with MS/MS ion preparation using helium at flow rate 1 ml min(-1) as carrier gas on DB-5 capillary column (30 m x 0.25 mm i.d. film thickness 0.25 microm) has been developed for the determination of benzene in indoor air. The detection limit for benzene was 0.002 microg ml(-1) with S/N: 4 (S: 66, N: 14). The benzene concentration for cooks during cooking time in indoor kitchen using dung fuel was 114.1 microg m(-3) while it was 6.6 microg m(-3) for open type kitchen. The benzene concentration was significantly higher (p < 0.01) in indoor kitchen with respect to open type kitchen using dung fuels. The wood fuel produces 36.5 microg m(-3) of benzene in indoor kitchen. The concentration of benzene in indoor kitchen using wood fuel was significantly (p < 0.01) lower in comparison to dung fuel. This method may be helpful for environmental analytical chemist dealing with GC-MS in confirmation and quantification of benzene in environmental samples with health risk exposure assessment.

An experience with sixty cases of haematological malignancies; a clinico haematological correlation

BACKGROUND

Haematological malignancies are not uncommon in our area. Due to inadequate diagnostic facilities and lack of health education they are diagnosed at an advanced stage when treatment is either impossible or very difficult. In our study, sixty patients with haematological malignancies were studied from 1-1-1999 to 1-1-2001, at Ayub Teaching Hospital. Abbottabad.

METHODS

Patients were interviewed in detail, a thorough physical examination and blood tests including haemoglobin estimation, total and differential leukocyte count, platelets count, reticulocyte count and blood film examination was done on each patient. Bone marrow examination for routine giemsa staining and cytochemistry was also done in each case. Trephine biopsy was done in selected cases.

RESULTS

About 35.9% patients had acute myeloid leukemia, while 19.15% patients had acute lymphoblastic leukemia. Non Hodgkin's lymphoma was seen in 15.39% cases. Among chronic leukemias, chronic lymphocytic leukemia outnumbered chronic myeloid leukemia (13.91% against 10.76%). Multiple myeloma was seen in 4.61% patients while a single patient had Hodgkin's disease. Male to female ratio in haematological malignancies was 1.4:1 and majority of the patients (66.66) belonged to two districts (i.e. Mansehra and Abbottabad). Low grade fever, progressive pallor, weakness and body aches were the commonest symptoms (70% cases) while pallor was the frequently observed sign. Medium age for acute myeloid and acute lymphoblastic leukemia was 26 years and 7 years respectively. For chronic myeloid and chronic lymphocytic leukemia it was 22 years and 56 years respectively. In case of non Hodgkin's lymphoma it was 22.5 years.

CONCLUSION

In our study acute myeloid leukemia was the commonest type of haematological malignancy. Males were affected more than the females. Majority of the patients belonged to districts Mansehra and Abbottabad. Non specific symptoms like low grade fever, progressive pallor and bodyaches were the commonest symptoms while pallor was the most frequently observed sign.

Susceptibility patterns of Escherichia coli: prevalence of multidrug-resistant isolates and extended spectrum beta-lactamase phenotype

OBJECTIVE

To study Escherichia coli (E. coli) susceptibility, prevalence of multidrug-resistant isolates and possible role of extended spectrum beta-lactamases (ESBL) in E. coli resistance.

SETTING

Department of Medicine, Shifa College of Medicine, Islamabad.

METHODS

Three hundred and seventy eight E. coli isolates from different sources were identified during six-month period. Susceptibility to various antibiotics was checked using standard methods. Multidrug-resistant isolates were separated. Isolates resistant to cefpodoxime and aztreonam were considered as ESBL phenotype, indicating ESBL production.

RESULTS

Most of isolates were resistant to ampicillin and trimethoprim/sulfamethoxazole. Overall resistance to ciprofloxacin, ceftriaxone, cefotaxime and cefpodoxime was 49%, 34%, 36% and 38% respectively. Resistance to fourth generation cephalosporins was lower. Almost all Isolates were sensitive to amikacin, imipenem and tazobactam. Aztreonam resistance was found in 25% isolates. Similar pattern was observed for urinary E. coli isolates; 45% E. coli isolates were found to be multidrug-resistant. Nitrofurantoin showed low-level resistance both to multidrug-resistant as well as urinary isolates. Resistance to both cefpodoxime and aztreonam was found in 25% isolates suggesting ESBL production.

CONCLUSION

E. coli resistance in Pakistan is much higher than reported from western literature. Multidrug-resistant isolates, including third generation cephalosporins and quinolones, are very common. ESBL production may contribute to this high level resistance against beta-lactams.

Comparison of aztreonam against other antibiotics used in urinary tract infections

BACKGROUND

Urinary tract infection is a very common problem in adults as well as in children. There is always need for the right antibiotic to be chosen for treatment.

METHODS

This study was conducted at Microbiology section in Pathology department of Ayub Medical College, Abbottabad, Pakistan. In this study the aztronam which is only effective against gram negative bacilli has been compared with other conventionally used antibiotics, ampicillin, cotrimoxazole, minocyclin, pipemedic acid, nalidixic acid, norfloxacin, ciprofloxacin, gentamicin and ceftriaxon.

RESULTS

Total gram negative isolates were 342. Out of this 76.6% (262) were E. coli, klebsiella pneumoniae 14.3% (49), proteus species 5.2%(18) and pseudomonas aeruginosa were 3.8% (13). The aztreonam showed 78% sensitivity against gram negative bacilli which is better than norfloxacin which showed 62.2% sensitivity.

Detection of beta-thalassaemia trait: a study of fifty families

BACKGROUND

This study was carried out to detect beta-thalassaemia trait in the siblings of beta thalassaemia major children by Hemoglobin (Hb) electrophoresis.

METHODS

Subjects were divided into two groups. Group 1 was the patients group comprising 100-subjects siblings of beta-thalassaemia major children and Group 2 was the control group with 25-subjects.

RESULTS

It was observed that 58% of the siblings of beta-thalassaemia major children had beta-thalassaemia trait. Even in the control group 2 subjects had beta thalassaemia trait, which shows that thalassaemia gene is very common in Hazara division of Pakistan.

Transjugular intrahepatic portosystemic stent-shunt insufficiency and the role of diabetes mellitus

BACKGROUND/AIMS

Maintenance of long-term patency of transjugular intrahepatic portosystemic stent-shunts (TIPSS) has proved problematic. Various prognostic variables have been assessed as predictors, but the role of diabetes mellitus, which induces vascular endothelial cell dysfunction, has not been assessed.

METHODS

We analysed the records of 248 patients who underwent TIPSS between July 1991 and July 1997, followed-up through to August 1998. Patients with at least one shunt assessment by portography and available blood glucose levels were eligible (177 patients; median follow-up, 15.0 months). Fourteen patients had a pre-procedural diagnosis of diabetes (one insulin dependent, seven oral hypoglycaemic treated and six diet controlled). In another 14 patients, diabetes was diagnosed at TIPSS insertion, giving a 28/177 (15.8%) prevalence of diabetes in our patients. Fifty-nine patients were excluded from the final analysis (including five diabetics), as they either died or had early shunt insufficiency (within 1 month of stent placement), leaving 118 patients (including 23 diabetics) to be included in the final analysis.

RESULTS

Mean age, sex distribution, median follow-up (months) and pre-shunt portal pressure gradient were comparable in the two groups (diabetics versus non-diabetics). Child-Pugh classes A and B were more common in the diabetic group (P < 0.01), and the mean inserted stent diameter was larger in the diabetic group (P < 0.05). The presence of diabetes was associated with a higher incidence of delayed shunt insufficiency (P = 0.02), but there was no evidence of an association between presence of diabetes and variceal haemorrhage post TIPSS. Kaplan-Meier analyses revealed earlier insufficiency in diabetic patients compared with those without diabetes (P = 0.04). Age, gender and presence of diabetes are included in the final logistic regression model. Individuals who have diabetes are more likely to experience shunt insufficiency independent of age and gender.

CONCLUSIONS

Diabetes mellitus is common in patients undergoing TIPSS and is associated independently with increased incidence of primary delayed shunt insufficiency.

Breast carcinoma in Pakistani females: a morphological study of 572 breast specimens

OBJECTIVE

To study the morphological features in breast carcinoma which have proven prognostic value.

METHODS AND SETTING

A retrospective analysis of 572 mastectomy specimens received over a period of three years at the department of pathology, The Aga Khan University Hospital.

RESULTS

A total of 572 mastectomy specimens were analyzed which were received over a period of three years. Most of the patients were in the 5th and 6th decades of life. The mean age at diagnosis was 48 years. The most common tumour was infiltrating ductal carcinoma (81%). Tumour size was > 2 cms. in 80% of the cases. According to Modified Bloom and Richardson system most of the tumours were in grade II (65%) followed by grade III (24%). The number of cases with > 3 lymph node metastasis was significantly higher (70%) in tumours of > 2 cms size. High grade tumours also showed increased number of lymph node involvement.

CONCLUSION

In Pakistani females breast carcinoma occurs at a younger age group. They are of large size at the time of presentation and show more frequent axillary lymph node metastasis. Infiltrating ductal carcinoma is the most common type of tumour with predominance of high grade lesions.

Association of Epstein Barr Virus (EBV) with nasopharyngeal carcinoma (NPC)

AIM

To observe the frequency of nasopharyngeal carcinoma (NPC) and its association with Epstein Barr Virus (EBV) infection.

SETTING

This study included consecutive cases of nasopharyngeal carcinoma, which were diagnosed in the Department of Pathology at the Aga Khan University Hospital, Karachi in the period of two years (1996-97).

METHODS

These tumors were initially evaluated on H&E stained sections. The tumors showing evidence of keratinization were excluded from the study. The Epstein Barr Virus was detected with the help of Polymerase chain reaction in formalin fixed, paraffin embedded tissue sections.

RESULTS

During the study period, seventeen cases of nasopharyngeal carcinoma were diagnosed which comprised 0.3% of all malignant tumors. The age ranged from 5 years to 70 years with male to female ratio of 2.4:1. The NPC was more prevalent in adults (71%) as compared to children (29%) under 15 years. Six cases (35%) exhibited positive signal for Epstein Barr Virus.

CONCLUSION

Nasopharyngeal carcinoma is an infrequent tumor. The prevalence of Epstein Barr virus infection in nasopharyngeal carcinoma is quite low as compared to other regions of the world.

Morphological pattern of testicular tumors

OBJECTIVE

To find out the mode of presentation, age distribution and the prevalence of various histological subtypes of testicular tumors.

METHOD

All consecutive cases of testicular tumors diagnosed in the department of pathology, the Aga Khan University Hospital, Karachi, during the period of eight years (1991-98) were included in this study. Relevant clinical details such as age, clinical presentation and side of involvement of the testis were also recorded, where available.

RESULTS

During the span of eight years (1991-98), 170 cases of testicular tumors were diagnosed at the Aga Khan University Hospital, Karachi. Most of the tumors were diagnosed in the third and fourth decade of life. Scrotal mass or swelling was the predominant mode of presentation. There was a slight predominance of right-sided testicular tumors. Germ cell tumors constituted 83.5% of all malignant testicular neoplasms. Amongst these seminoma was the most common (36.5%) tumor followed by mixed germ cell tumors (28.82%). Yolk-sac tumor was the commonest testicular neoplasm in children while lymphoma was the predominant neoplasm in the elderly population.

CONCLUSION

The overall relative frequency of testicular malignancy in this series correlated with that reported in the international literature.

Frequency of malignant solid tumors in children

OBJECTIVE

To find out the frequency of malignant solid tumors in children (< 15 years).

SETTING

All cases of pediatric malignant solid tumors which were diagnosed in the section of histopathology at the Aga Khan University Hospital, Karachi during the period of two years.

METHODS

These tumors were initially evaluated on H&E stained sections and special stains were also performed whenever indicated. The undifferentiated tumors were evaluated immunohistochemically by using a panel of antibodies on sections from routinely processed, formalin fixed, paraffin embedded tissue blocks.

RESULTS

Of two hundred and fifty three (253) consecutive cases of paediatric malignant solid tumors, lymphoma (26.1%) was the most common tumor followed by central nervous system tumors (16.6%), osteosarcoma (7.5%), rhabdomyosarcoma (6.7%), neuroblastoma (5.1%), Wilm's tumor (5.1%), Ewing's sarcoma (4.7%), retinoblastoma (4.7%), germ cell tumor (4.4%) and primitive neuroectodermal tumor (4%) in order of frequency. In seven cases (2.8%), the nature of lesion remained undetermined even after immunohistochemical staining. Rest of malignant tumors (12.3%) included the rare entities like synovial sarcoma, nasopharyngeal carcinoma, leiomyosarcoma, malignant schwannoma and thyroid carcinoma, etc.

CONCLUSION

Lymphoma was the most frequent Paediatric tumor. The frequency of childhood central nervous system tumors was quite high as compared to the other series from different regions of Pakistan.

Childhood non-Hodgkin's lymphoma: an immunophenotypic analysis

OBJECTIVE

To observe the frequency of histological subtypes of childhood non-Hodgkin's lymphoma and its immunohistochemical profile.

SETTING

All cases of non-Hodgkin's lymphoma diagnosed in children (< 15 years) in the section of histopathology at the Aga Khan University Hospital Karachi during the period of three years.

METHODS

These consecutive cases were evaluated on H&E stained sections and then immunohistochemistry analysis of these tumors was performed by employing Peroxidase Anti-Peroxidase (PAP) technique.

RESULTS

The present series included 61 cases of non-Hodgkin's lymphoma. NHL was more common in males as compared to females with male to female ratio of 5.8:1. High grade NHL comprised 87% of childhood lymphoma. The mode of presentation in majority of NHL (57%) was extranodal. Burkitt's lymphoma (33%) was the most prevalent histological subtypes, followed by lymphoblastic (28%), diffuse large cell (15%), diffuse mix small and large cell (13%), small non cleaved Non-Burkitt's (7%) and immunoblastic (4%). Immunophenotypic analysis of the childhood Non-Hodgkin's lymphoma revealed that 67% of the Non-Hodgkin's lymphoma are B-cell type while 33%, are those of T-cell lineage.

CONCLUSION

NHL was more common in males. Majority of NHL in children were high grade tumors. Burkitt's lymphoma was the most frequent histological subtype. T-cell NHL comprised a significant portion of childhood lymphomas.

Nocturnal sweating and temperature in depression

OBJECTIVE

Patients with depression may have altered thermoregulation, such as high nocturnal core temperatures, decreased daytime sweating and subjective complaints of nocturnal sweating. We sought to compare nocturnal sweating in depressed patients and non-depressed controls, and to assess the impact of REM sleep on sweat rates.

METHOD

Nocturnal sweat rate, nocturnal temperature and REM sleep were measured during the night in 9 controls and 8 depressed subjects; 7 depressed patients were assessed during recovery.

RESULTS

The nocturnal temperature was significantly higher in depressed patients compared to controls, and decreased significantly with recovery. The nocturnal sweat rates of depressed patients did not differ significantly from those of controls, but decreased significantly with recovery. Analyses of sweat rates before, during and after REM sleep indicated a trend for the entire sample to show a decrease in sweat rates during REM.

CONCLUSION

The nocturnal sweating rates in the depressed patients suggest that impaired sweating is not the cause of the high nocturnal temperature commonly found in depressed patients.