Applications of Artificial Intelligence in the field of therapies focused on orofacial cleft repair and rehabilitation

<p>Orofacial clefts are common congenital malformations with genetic and environmental risk factors. The management of cleft lip and palate spreads over the course of the child’s development into adulthood. Currently Artificial Intelligence (AI) has gained much popularity in the dental field. AI is of much help in the multidisciplinary management of cleft lip and cleft palate repair starting right from the prenatal period itself. This review focuses on the available documentation in the literature that has thrown light on the recent applications of AI in cleft lip and palate cases.</p>

Cancer trends and burden among Armed Forces personnel, veterans and their families: Cancer registry data analysis from tertiary care hospital

Background

Cancer incidence is rising across the globe. The incidence and patterns of various cancers among Armed Forces Personnel and Veterans is not known. We did the analysis of registry data maintained at our hospital.

Methods

A retrospective analysis was performed of all patients registered at our hospital cancer registry between 01st January 2017 and 31st December 2019. Patients were registered with unique identification number. Baseline demographics and cancer subtype data were retrieved. Patients with histopathologically proven diagnosis and age ≥18 years were studied. Armed Forces Personnel (AFP) were defined as those who are in active service, and Veterans as those who had retired from service at the time of registration. Patients with Acute and Chronic Leukemias were excluded.

Results

New cases registered were 2023, 2856 and 3057 in year 2017, 2018, 2019 respectively. AFP, Veterans and dependents among them were 9.6%, 17.8%, and 72.6% respectively. Haryana, Uttar Pradesh and Rajasthan represented 55% of all cases with male to female ratio 1.14:1 and median age was 59 years. The median age among AFP was 39 years. Among AFP as well as veterans, Head and Neck cancer was the most common malignancy. Cancer incidence was significantly higher in adults >40 years as compared to <40 years.

Conclusion

Seven percent rise per year of new cases in this cohort is alarming. Tobacco-related cancers were the most common. There is an unmet need to establish a prospective centralized Cancer Registry to better understand the risk factors, outcomes of treatment and strengthen the policy matters.

Investigation of the one-step electrochemical deposition of graphene oxide-doped poly(3,4-ethylenedioxythiophene)-polyphenol oxidase as a dopamine sensor

In this paper, we fabricated poly(3,4-ethylenedioxythiophene) (PEDOT)-graphene oxide-polyphenol oxidase (PEDOT-GO-PPO) as a dopamine sensor. The morphology of PEDOT-GO-PPO was observed using scanning electron microscopy. Cyclic voltammetry was conducted to study the oxidation-reduction characteristics of dopamine. To optimize the pH, potential and limit of detection of dopamine, the amperometric technique was employed. The found limit of detection was 8 × 10-9 M, and the linear range was from 5 × 10-8 to 8.5 × 10-5 M. The Michaelis-Menten constant (K m) was calculated to be 70.34 μM, and the activation energy of the prepared electrode was 32.75 kJ mol-1. The electrode shows no significant change in the interference study. The modified electrode retains up to 80% of its original activity after 2 months. In the future, the biosensor can be used for the quantification of dopamine in human urine samples. The present modified electrode constitutes a tool for the electrochemical analysis of dopamine.

Clinicopathological Profile and 2 Year Relapse Rates of Non-Hodgkin's Lymphoma in Tertiary Care Center

The aim and objectives are to study clinicopathological profiles and 2-year relapse rates of Non-Hodgkin lymphoma,Material :This prospective observational study was conducted from Jan 2017 to May 2021. All newly diagnosed patients of NHL were enrolled and received a CHOP±R regimen for 6 cycles as per B-cell or T-cell lineage. The data was and analyzed using spss software. Observation: A total of 50 patients were enrolled and followed for 2 years. The median age of presentation was 44.62±15.92. Commonest clinical presentation was lymphadenopathy (46%), followed by B symptoms (32%). Commonest clinical sign was lymph node enlargement (52%). The commonest extranodal presentation was hepatomegaly (22%) and splenomegaly (22%). On peripheral blood smear, macrocytic hypochromic anemia (12%) was the commonest presentation. CT Scan showed, nodal involvement in 86% with generalized lymphadenopathy in (40%) cases. Extranodal involvement was seen in 50%. WB PET showed nodal involvement in (90%), and extranodal involvement in 70%. PET scan (90%) was a little more sensitive for detecting lymph node involvement over CT scan (86%). On lymph node biopsy, the most common subtype was B cell NHL (84.84%) and the commonest histopathological subtype was diffuse large cell B cell lymphoma. Biopsy from the extranodal site shown B cell NHL in (93.33%). The commonest histopathological subtype was DLBCL (18%). On marrow examination and biopsy, 88% were B cell type and the commonest type was DLBCL (62%). The commonest treatment-related toxicity was febrile neutropenia (44%). At 6 months, 30% were having clinical active disease and PET imaging revealed radiologic disease activity in 32 %. At 12 months, 14% were having clinical disease, and radiologic disease activity in 14%. At 18 months, 5% were having clinical disease, and radiologic disease activity in 10%. At 24 months, 14% were having clinical disease, and radiologic disease activity in 14%. At the end of the study period, 78 % were in remission, 10% cases in relapse, 6% cases had progressive disease and 6% of cases expired. Conclusion: This study found 02-year survival post standard chemotherapy in NHL cases was 88%. The relapse rate at 24 months was 14%. The B symptoms were seen less commonly, and bulky disease was noted in one-third of cases. The role of PET in diagnosing and follow up on these cases was good but it was comparable with CT scan.

Cancer in the Adolescent and Young Adults (AYA) and Children: A Comprehensive Analysis of the Epidemiology and Psychosocial Morbidity in the Indian Population

Aims  Adolescent and young adults (AYAs), children with cancer, and their guardians have unique psychosocial morbidities adversely effecting quality of life (QOL). This is measurable using patented tools. We analyzed epidemiological and clinicopathological patterns of solid organ cancers in this subgroup. We also assessed psychosocial morbidity and changes in QOL faced by them.

Methods  All patients aged 2 to 39 years, newly diagnosed with cancer from April 2017 to March 2019 were included. Clinical history, diagnosis, staging, treatment, outcomes, and follow-up were recorded. The National Comprehensive Cancer Network (NCCN) distress thermometer and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ C-30) were used to assess psychosocial morbidity of AYAs, children ≥ 12 years, and parents of children < 12 years. Pediatric Quality of Life Inventory (Peds QL) version 3.0 was used for children < 12 years. Data was analyzed using descriptive statistics.

Results  A total of 571 patients (512 AYAs, 59 children) were enrolled. Median age was 30 years with male predominance (58.1%). Most cases (98.6%) were absent from school or work. Carcinoma breast was the most common in females (29.3%) and non-Hodgkin lymphoma in males (12.6%). 91.06% had overall NCCN distress score ≥ 4. Also, 73.81 and 79.49% had “quite a bit” or “very much” responses on functional and symptom scales, respectively, in EORTC QLQ C-30 questionnaire. Peds QL version 3.0 revealed total score ranging from 276 to 523 for each patient.

Conclusion  AYAs and children with cancer are extremely vulnerable to psychological stress and morbidity. Use of well-established tools help in assessing their mental status and timely psychiatric referral can be initiated.

Epidemiological Study of Fingertip Injuries in a Tertiary Care Center in Kancheepuram District, India

Background and Aim: Although fingertip injuries are common, there is limited literature on its epidemiology. This study examines the clinical characteristics of fingertip injuries in adults treated at a tertiary medical hospital. The aim of the study is to investigate and examine the epidemiological variables impacting patients' fingertip injuries in a tertiary care hospital in Kancheepuram. Methods: An epidemiological study of patients with fingertip injuries managed at a tertiary hospital in Kancheepuram over a period of twelve months (March 2020-March 2021). The patients’ profile as well as the clinical presentation, management options and the outcome of care of the patients were documented and analyzed using descriptive statistics. Results: Fifty one fingertips patients were managed. The median age was 23.50 years, with 88% of male. 36 [70%] injuries involved accidents in their workplace. A total of 34 [66%] injuries occurred in the fingers of the right hand. The management offered included PSS (Primary Skin Suturing), V-Y flap, RHAF, Nail bed repair and K wire fixation. About 91.5 % of the patients reported a satisfactory outcome. Conclusion: In the workplace, right-handed males between the ages of 18 and 25 are more prone to have fingertip injuries. While proper diagnosis and adequate response are critical for a positive result in fingertip injuries, a safer environment and workplace would assist to alleviate the burden.

Obesity Potentiates the Risk of Drug-Induced Long QT Syndrome - Preliminary Evidence from WNIN/Ob Spontaneously Obese Rat

Drug-induced long QT syndrome (DI-LQTS) is fatal and known to have a higher incidence in women rather than in men. Multiple risk factors potentiate the incidence of DI-LQTS, but the actual contribution of obesity remains largely unexplored. Correspondingly, the present study is aimed to evaluate the susceptibility of DI-LQTS in WNIN/Ob rat in comparison with its lean counterpart using 3-lead electrocardiography. Four- and eight-month-old female WNIN/Ob and their lean controls were used for the experimentation. Non-invasive blood pressure measurement and total body electric conductivity (TOBEC) analysis were carried out. After the baseline evaluations, animals were anesthetized with Ketamine (50 mg/kg). Haloperidol (12.5 mg/kg single dose) was administered intraperitoneally and ECG was taken at 0, 10, 20, 30, 60 min, and 24 h time points. Myocardial lystes were used to assess the BNP, protein carbonylation, and hydroxyproline content. Adiposity, as assessed by TOBEC, is higher in obese rats with elevated mean arterial blood pressure. Baseline-corrected QT interval (QTc) is significantly higher in the obese rat with a wider QRS complex. The incidence of PVC and VT are more intense in the obese rat. Haloperidol-induced QT prolongation in obese rats was rapidly induced than in lean, which was observed to remain till 24 h in obese groups while normalized in lean controls. Higher levels of BNP, protein carbonylation, hydroxyproline content, and relative heart weights indicated the presence of cardiac hypertrophy. The study provides preliminary evidence that obesity can be a potential risk factor for DI-LQTS with faster onset and longer subsistence.

COVID-19, Cancer, and Congregation: An Observational Study from a Tertiary Care Hospital in New Delhi

Objective Indian data on cancer patients with coronavirus disease 2019 (COVID-19) infection and its outcome are limited. Infectivity and outcome among cancer patients staying in large congregations are not known. We conducted this study to address this lacuna in literature.

Methods This was a retrospective–prospective, observational study of hospitalized cancer patients with proven COVID-19 infection, conducted at tertiary care hospital in New Delhi after ethical approval. We analyzed clinical, laboratorial parameters, and outcomes in these patients.

Results All 32 admitted male patients became COVID-19 positive and 10 (31%) patients were symptomatic. Median age was 37.5 years (range: 16–64). Sixteen health-care workers (HCWs) were working in the cancer ward (paramedical staff: 4, nurses: 6, residents: 4, and consultants: 2). Among HCWs, two nursing staff and three paramedical staff contracted asymptomatic COVID-19. Eighteen (56%) and 14 (44%) patients were on curative and palliative treatment, respectively. Leukopenia (total leukocyte count <4,000/μL) was seen in 37.5% of cases. Grades 4, 3, 2, and 1 neutropenia were present in 12.5% of patents. Two (6.25%) patients had features of critical COVID-19. Eight (25%) patients received treatment with hydroxychloroquine + azithromycin. Five patients died. Three patients had features of progressive disease with poor performance status. One critical COVID patient survived and one succumbed to COVID-19. Patients shared a common dining room, sanitation area.

Conclusion Seventy percent of cancer patients were asymptomatic. Cancer patients living in congregation areas are susceptible to COVID-19 with 3% mortality rate. Recent chemotherapy and associated cytopenias may not increase the risk in cancer patients with COVID-19 treated with curative intent. Palliative intended patients are at increased risk of death. N-95, personal protective equipment, and adherence to infection control measures should be encouraged.

Antifungal activity of Syzygium samarangense leaf extracts against Candida

Candida species are opportunistic human fungal pathogens that cause acute and chronic infections against which only few antifungal agents are available. Here we have elucidated the antifungal effect of Syzygium samarangense leaf extracts (SSLE). Antifungal activity of SSLE was studied against Candida albicans, C. krusei, C. parapsilosis, C. glabrata, C. auris and C. tropicalis. Following experiments were performed: minimum fungicidal concentration (MFC) determination, agar well disc diffusion assays, fungal morphology analysis using scanning electron microscope (SEM), ex vivo fungal survival assays on porcine tongue and skin and in vivo fungal survival assays using Drosophila melanogaster fly model. Results demonstrated MFC of SSLE ranges between 100 and 125 mg ml^-1 . SEM images showed cell wall degradation of C. albicans when treated with SSLE. Around 75% decrease in C. albicans viability was observed when infected porcine tongue and skin were treated using SSLE. The C. albicans infected D. melanogaster when fed with SSLE showed significant decrease (around 80%) of fungal count than the infected control. Furthermore, agar plate disc diffusion assays demonstrated that the antifungal activity of SSLE could be due to chalcone, which is one of the active constituents in SSLE. Our study demonstrated that SSLE could be used for the topical treatment of Candida infections.

Segmentation Analysis Techniques and Identifying Stress Ratio of Human Lumbar Spine Using ANSYS

The Finite Element Method [FEM] used to replicate the products and systems. In this method, the abnormality estimation of the spine has developed and presented in this paper. Spine injury found on vertebrae L1–L5 and its corresponding inter-vertebral disk. Different types of filters used to eliminate obtained noise, starting the MRI image at different levels. The noiseless image was segmented using differing Edge Detection Algorithm (EDA) such as Canny Edge Detection Algorithm (CEDA), Prewitt, Sobel, and Robert from the applied segmentation algorithm the best EDA identified and the 3D model for lumbar spine was created. After the segmentation algorithm, the FEA method utilized for examining images of the 3D human lumbar spine on different loads. The experiment conducted with the stress–strain relationship and Modal Analysis on Natural Frequency (NF) calculated. The entire analysis accomplished by real-time simulation software called ANSYS.

Antibacterial and anticancer activity of hydrothermally-synthesized zinc oxide nanomaterials using natural extracts of neem, pepper and turmeric as solvent media

A novel and simple wet chemical hydrothermal synthesis method was employed in the preparation of zinc oxide (ZnO) nanoparticles using neem (N), pepper (P) and turmeric (T) extracts as solvent media. The structural and optical properties as well as the antibacterial and anticancer properties of all the samples (ZnO, N/ZnO, P/ZnO, T/ZnO and NPT/ZnO) were characterized and analyzed. Solvent media was found to have an effect on both the size and the morphology of the nanoparticles, which in turn effected their optical and cytotoxic properties. The colony forming unit (CFU) assays were done for E. coli, S. aureus and S. typhi in which T/ZnO (∼2) and P/ZnO (∼3) showed a remarkable effect on S. aureus for 100 μg ml−1 and nearly zero for 150 μg/ml. The zone of inhibition (ZoI) was measured for S. agalactiae, S. dysgalactiae and S. pyogenes.The results showed that S. dysgalactiae is more sensitive to N/ZnO.Finally, the anticancer properties of these compounds towardsprostate cancer cells was investigated. Among the active compounds T ZnO showed the highest activity with low IC50 value (37.751 μg/ml) followed by P ZnO (45.68 μg ml−1).

Fetal Ultrasound Image Evaluation of Chromosomal Anomaly Detection and Classification Using Conditional Rooted Neural Network (CRNN)

In this work, a computerized scheme of Chromosomal anomaly recognition and classification of Chromosomal abnormality such as Trisomy (T) T-13, T-18 and T-21 (Patau, Edwards and Down syndrome) based on Conditionally Rooted neural network (CRNN) with wavelet Filter. CRNN is used to estimate the chromosomal anomaly features separation from fetal provisions. The clear template of feature estimation from the first-trimester fetus of ultrasound images will be used to train the CRNN Neural Network. The software has successfully identified and classified the region of chromosomal anomaly. The evaluations show that our CRNN technique can attain good denoising and classification performance in comparison with existing methods. In this experiment, the results indicate that our proposed method can detect and classify the trisomy factors measurement from the US image regions precisely and robustly against speckle noise. The classification of Fetus US image datasets was done using CRNN classifier, and the accuracy of classification was found to be Highly efficient resolution for Chromosomal anomaly detection.

Non-Linear Filtering Technique Used for Testing the Human Lumbar Spine FEA Model

In this paper, the objective is to generate a mesh model of a spine that simulates numerically the biomedical properties of two vertebrae (L4 and L5) of human spine and an inter vertebrae disc using Finite Element Analysis (FEA) technique. Here, different types of non-linear filters and different edge detection techniques are used to segment the edges and the results are compared. The result shows that median filter obtains improved segmented output results in terms of edge length density, average magnitude, final threshold, initial position, and fine-tuned image. The behaviour of spine FEA model is analysed in terms of various parameters like equivalent elastic strain, total deformation, maximum principal elastic strain, minimum principal elastic strain, shear elastic strain, normal elastic strain, and minimum and maximum principal stress, equivalent stress, shear stress and normal stress. These parameters are used to analyse the human spine model under different conditions and different angles using ANSYS simulation tool. Further, MATLAB is carried out to implement various filters and edge detectors on proposed spine model.

The integration of transabdominal ultrasound simulators into an ultrasound curriculum

Introduction

Simulation is increasingly used throughout medicine. Within ultrasound, simulators are more established for learning transvaginal and interventional procedures. The use of modern high-fidelity transabdominal simulators is increasing, particularly in centres with large trainee numbers. There is no current literature on the value of these simulators in gaining competence in abdominal ultrasound. The aim was to investigate the impact of a new ultrasound curriculum, incorporating transabdominal simulators into the first year of training in a UK radiology academy.

Methods

The simulator group included 13 trainees. The preceding cohort of 15 trainees was the control group. After 10 months, a clinical assessment was performed to assess whether the new curriculum resulted in improved ultrasound skills. Questionnaires were designed to explore the acceptability of simulation training and whether it had any impact on confidence levels.

Results

Trainees who had received simulator-enriched training scored higher in an objective clinical ultrasound assessment, which was statistically significant (p = 0.0463). End confidence scores for obtaining diagnostic images and demonstrating pathology were also higher in the simulation group. All trainees stated that transabdominal simulator training was useful in early training.

Conclusions

This initial study shows that embedded into a curriculum, transabdominal ultrasound simulators are an acceptable training method that can result in improved ultrasound skills and higher confidence levels. Using simulators early in training could allow trainees to master the basics, improve their confidence, enabling them to get more educational value from clinical ultrasound experience while reducing the impact of training on service provision.

Antiobesity potential of Piperonal: promising modulation of body composition, lipid profiles and obesogenic marker expression in HFD-induced obese rats

Background

Black pepper or Piper nigrum is a well-known spice, rich in a variety of bioactive compounds, and widely used in many cuisines across the world. In the Indian traditional systems of medicine, it is used to treat gastric and respiratory ailments. The purpose of this investigation is to study the antihyperlipidemic and antiobesity effects of piperonal in high-fat diet (HFD)-induced obese rats.

Methods

Piperonal, an active constituent of Piper nigrum seeds, was isolated and confirmed by HPLC, ¹H and ¹³C NMR spectroscopy. Male SD rats were fed on HFD for 22 weeks; Piperonal was supplemented from the 16th week as mentioned in the experimental design. Changes in body weight and body composition were measured by TOBEC, bone mineral composition and density were measured by DXA, and adipose tissue distribution was measured by 7 T–MRI. Plasma levels of glucose, insulin, insulin resistance and lipid profiles of plasma, liver and kidney, adipocyte hormones and liver antioxidants were evaluated using standard kit methods. Expression levels of adipogenic and lipogenic genes, such as PPAR-γ, FAS, Fab-4, UCP-2, SREBP-1c, ACC, HMG-COA and TNF-α were measured by RT-PCR. Histopathological examination of adipose and liver tissues was also carried out in experimental rats.

Results

HFD substantially induced body weight, fat%, adipocyte size, circulatory and tissue lipid profiles. It elevated the plasma levels of insulin, insulin resistance and leptin but decreased the levels of adiponectin, BMC and BMD. Increased expression of PPAR-γ, FAS, Fab-4, UCP-2, SREBP-1c, ACC, and TNF-α was noticed in HFD-fed rats. However, supplementation of piperonal (20, 30 and 40 mg/kg b.wt) for 42 days considerably and dose-dependently attenuated the HFD-induced alterations, with the maximum therapeutic activity being noticed at 40 mg/kg b.wt.

Conclusions

Piperonal significantly attenuated HFD-induced body weight and biochemical changes through modulation of key lipid metabolizing and obesogenic genes. Our findings demonstrate the efficacy of piperonal as a potent antiobesity agent, provide scientific evidence for its traditional use and suggest the possible mechanism of action.

Obesity-alleviating potential of asiatic acid and its effects on ACC1, UCP2, and CPT1 mRNA expression in high fat diet-induced obese Sprague-Dawley rats

The present study evaluated the effects of asiatic acid (AA), a pentacyclic triterpenoid from Centella asiatica on lipid metabolism parameters in a rat model of obesity induced using a high fat diet (HFD) for 42 days. AA (20 mg/kg body weight [BW]) was administered orally once daily for 42 days, and an orlistat-treated group of rats (10 mg/kg BW) was included for comparison. Changes in BW, blood glucose levels, insulin resistance and leptin, adiponectin, amylase, and lipase levels in the blood; lipid profiles of plasma; liver antioxidants levels; and acetyl CoA carboxylase(ACC), uncoupling protein-2 (UCP2), and carnitine palmitoyltransferase-1 (CPT1) mRNA expression were observed in the experimental rats. Our results revealed that AA (20 mg/kg BW), similar to orlistat, reduced the increase in BW; increased bone mineral contents and bone mineral densities; reduced blood glucose levels, insulin resistance, leptin, plasma lipid levels; increased adiponectin, amylase, lipase levels in the blood; showed antioxidant activity; and altered mRNA expression of lipid metabolism-related genes, including ACC, UCP 2, and CPT 1, in the HFD-fed rats. From these results, we concluded that AA possesses significant anti-obesity potential through the suppression of BW gain, lipid lowering action, development of insulin and leptin sensitivity, antioxidant activity, and increased mRNA expression of lipid metabolism-related genes.

COMPARATIVE STUDY OF BONE HEALING FOLLOWING BONE CUTS USING SURGICAL BURS AND MICROSAWS

Bone cuts on the tibia of 6 healthy dogs were studied using surgical burs and microsaws arranged in two groups by random selection to assess the speed of cutting, precision and bone healing. Bone cuts in Group A were made with surgical burs of 1.6 mm diameter using micromotor at 40,000 revolutions per minute (RPM) whereas in Group B they were created using Stryker microsaws of 0.75 mm width at the speed of 40,000 RPM. In each group, the dogs were sacrificed at the end of 8, 12 and 16 weeks and a section of the tibia containing the fracture site was removed to assess healing histopathologically. Based on clinical, radiological and histopathological examination, the results of this study indicate that microsaws have their best use in osteotomy procedures in terms of precision and thermal injury to bone whereas ostectomy procedures are more convenient with surgical burs.

Complete nucleotide sequence analysis of the oncogene "Meq" from serotype 1 Marek's disease virus isolates from India

1. A study was undertaken to characterise the oncogene Meq at the molecular level for three serotype 1 Marek's disease virus (MDV) field isolates from vaccinated poultry flocks which had encountered a Marek's disease outbreak in the southern part of India. The isolates were named Ind/TN/11/01, Ind/KA/12/02 and Ind/TN/12/03. The oncogene Meq was amplified by PCR and sequenced. 2. The isolates were shown to have a homology for the Meq gene of 99.1-99.8% with various isolates from China and 98.5-99.2% with isolates from Europe and the USA. Alignment analysis of the nucleotide sequences showed that nucleotide mutations at 5 different positions in the Meq gene displayed perfect regularity in MDVs circulating in the southern part of India, which could be considered as features of field MDVs recently prevalent in this area. 3. In addition, the mutation in the Meq gene at positions 251, 260 and 437 was unique and coincides with very virulent strains from China GX0101, GXY2 and a Hungarian strain ATE. The mutation at positions 283 and 300 was unique and coincides with the very virulent strain ATE of Hungary. There were also single nucleotide mutations at positions 155 (A-T), 369 (A-C), 462 (C-A) and 548 (C-T) observed in the isolate Ind/TN/12/03. 4. Phylogenetic analysis of Meq sequences revealed that field MDVs in this area evolved independently but have similarities with very virulent strains from China, and that Meq has more similarities with the very virulent Hungarian strain.

Ameliorative potential of gingerol: Promising modulation of inflammatory factors and lipid marker enzymes expressions in HFD induced obesity in rats

Obesity, generally linked to hyperlipidemia, has been occurring of late with distressing alarm and has now become a global phenomenon casting a huge economic burden on the health care system of countries around the world. The present study investigated the effects of gingerol over 30 days on the changes in HFD-induced obese rats in marker enzymes of lipid metabolism such as fatty-acid synthase (FAS), Acetyl CoA Carboxylase (ACC), Carnitine Palmitoyl Transferase-1(CPT-1), HMG co-A Reductase (HMGR), Lecithin Choline Acyl Transferase (LCAT) and Lipoprotein Lipase (LPL) and inflammatory markers (TNF-α and IL-6). The rats were treated orally with gingerol (75 mg kg(-1)) once daily for 30 days with a lorcaserin-treated group (10 mg kg(-1)) included for comparison. Changes in body weight, glucose, insulin resistance and expressions of lipid marker enzymes and inflammatory markers in tissues were observed in experimental rats. The administration of gingerol resulted in a significant reduction in body weight gain, glucose and insulin levels, and insulin resistance, which altered the activity, expressions of lipid marker enzymes and inflammatory markers. It showed that gingerol had significantly altered these parameters when compared with HFD control rats. This study confirms that gingerol prevents HFD-induced hyperlipidemia by modulating the expression of enzymes important to cholesterol metabolism.

Eight Year Survival Analysis of Patients with Triple Negative Breast Cancer in India

BACKGROUND

Triple-negative breast cancer (TNBC) often presents as an interval cancer with short survival upon metastasis and thus represents an important clinical challenge. The present study investigated the clinicopathologic characteristics and long term survival outcome of early and locally advanced TNBC.

MATERIALS AND METHODS

Medical records were reviewed retrospectively for 148 consecutive confirmed cases of TNBC treated in a single unit at our centre. Demographic profile, tumor type, histopathology details, treatment and follow-up information was recorded and immunohistochemistry was performed.

RESULTS

Age group >50 years was associated with tumors of clinical stage 3 (53.8%), pathological stage 3 (46.2%), pathological grade 3 (45.7%), presence of extracapsular extension (ECE, 48.5%) and lymphovascular invasion (LVI, 64.9%). Locally advanced breast cancers (LABCs) were characterized by pathological stage 3 (96.2%), presence of ECE (100%) and absence of LVI (46.7%) as compared to early breast cancers (EBCs) which had higher incidence of lower stage tumors (100%), absence of ECE (82%) and presence of LVI (91.9%; p-value <0.001. Better relapse free survival was observed in patients with no axillary involvement (69%; p-value <0.001) and absence of ECE (64%; p-value <0.001). Improved overall survival was seen in patients with EBC (90%; p-value 0.008), clear axilla (86%; p-value <0.001), absence of ECE (87%; p-value <0.001) and negative lymph nodes (90%; p-value 0.006).

CONCLUSIONS

TNBCs are aggressive tumors which show poor long term survival. Patients with TNBC benefit from chemotherapy, thus better and less toxic treatment options are needed. Identification of newer targets and development of targeted therapies are the need of the hour.

An Overview of Management of Root Fractures

Crown or root fractures are the most commonly encountered emergencies in the dental clinic. Root fractures occur in fewer than eight percent of the traumatic injuries to permanent teeth. They are broadly classified as horizontal and vertical root fractures. Correct diagnosis of root fractures is essential to ensure a proper treatment plan and hence, the best possible prognosis. Indication of the type of treatment to be used depends primarily on the level of the fracture line. Therefore, a clinician must also have a thorough knowledge of the various treatment approaches to devise a treatment plan accordingly. Various treatment strategies have been proposed, each with their own advantages and disadvantages. Hence, this literature review presents an overview of the various types of root fractures and their management.Kathmandu University Medical Journal Vol.12(3) 2014; 222-230

Synthesis, growth and spectral, optical and thermal characterization studies on L-Tryptophan p-nitrophenol (LTPN) single crystals for NLO applications

The novel nonlinear optical single crystal of L-Tryptophan p-nitrophenol (LTPN) has been successfully synthesized by taking the appropriate amount of L-Tryptophan and p-nitrophenol. The single crystals have been grown by slow evaporation solution growth technique. The single crystal XRD studies confirmed that the grown crystal belongs to the monoclinic system. The various functional groups presented in the crystal were confirmed by FT-IR and (1)H NMR spectroscopic studies. The absorptions of the grown crystals were analyzed using UV-Vis-NIR spectral studies. The thermal analysis was performed to study the thermal stability of the grown crystals. The second harmonic generation behavior of L-Tryptophan p-nitrophenol crystal was tested by Kurtz-Perry powder technique.

Medulloblastoma: A common pediatric tumor: Prognostic factors and predictors of outcome

BACKGROUND

Medulloblastoma is a common malignancy in the pediatric population, accounting for 25% of all childhood brain tumors and relatively uncommon in adults. This review was to investigate treatment outcome and prognostic factors after treatment of medulloblastoma.

MATERIALS AND METHODS

A total of 53 patients with histological confirmed medulloblastoma cases treated at our institute between 2006 and 2012 were included in the study. Demographic variables, clinical variables, radiological findings and treatment details with respect to age, sex, signs and symptoms, location of tumor, extent of surgical resection, histopathology type, radiotherapy dose, follow-up period and outcomes were recorded. Survival was analyzed by using these parameters.

RESULTS

Thirty-one (58.5%) patients were pediatric (<14 years), and 22 (41.5%) patients were adults (≥14 years). Duration of symptoms were <3 months in 19 (36%) and more than 3 months in 34 (64%) patients. Tumor resection was performed in all patients with gross total resection in 8 (15%) patients, near total resection in 34 (64%) patients and subtotal resection in 11 (21%) patients. All patients underwent postoperative craniospinal irradiation (CSI) delivering a median craniospinal dose of 36 Gy with additional boosts to the posterior fossa up to 54 Gy. Median overall survival was 50 months for the total group whereas 36 months for pediatric age group and 70 months for adult group. Desmoplastic histology showed an improved outcome compared with other histologies with a median survival of 71 months compared with that of classical medulloblastoma histology being 36 months and other histologies shown a median survival of 34 only.

CONCLUSIONS

Treatment of medulloblastoma with surgery and CSI yields long survival rates in both children and adults. Adult age group and desmoplastic histology were associated with a favorable outcome.

Acute intravascular hemolysis and methemoglobinemia following naphthalene ball poisoning

Naphthalene (C10H8) is a natural component of fossil fuels such as petroleum, diesel and coal. The common consumer products made from naphthalene are moth repellents, in the form of mothballs or crystals, and toilet deodorant blocks. Major toxic effects of naphthalene are due to precipitation of acute intravascular hemolysis. Very few cases of naphthalene poisoning and its effects have been reported from India. We report a case of accidental naphthalene poisoning, who presented with intravascular hemolysis and methemoglobinemia.