Mobility, Attitudes and HIV

BackgroundMany Indian truck drivers tend to have multiple sexual partners, owing to the migratory nature of their occupation. Consequently there is a greater risk for them to pass on Sexually Transmitted Infections (STIs) and HIV to their wives and other partners. This study endeavours to document the sexual behaviour and trends of condom usage, of truck drivers halting at Kalamboli Truck Terminal, Navi Mumbai.Method  This community based, cross sectional study was conducted by interviewing 300 male truck drivers using a pre-tested structured questionnaire. Data collected was compiled and analysed using Mean and Percentages.ResultsOf the 300 truck drivers interviewed, mean age of first sexual encounter was 19.4 years. 270 truck drivers had experienced sexual intercourse and 30 had not. Out of 270 sexually exposed truck drivers, 40.7% had sex with commercial sex workers (CSWs) only, 1.1% with other men only, 0.7% with Transsexuals only and 7.5% with other known females. 5.9% had sex with multiple categories. Premarital sex was reported in 70.25% truck drivers and 28.4% married truck drivers had extramarital sex. Of the Truck drivers having sex outside marriage, 53% used condoms regularly. Of the 47% truck drivers who reported irregular / no use of condoms, the main reasons given were “Did not like to use as it affects sexual pleasure” (40.8%) and ”Could not procure at spur of the moment” (36.7%).ConclusionOwing to the migratory nature of their occupation and high risk sexual behaviour, truck drivers form a high risk group for contracting and spreading HIV/AIDS and other STIs. Thus there is an urgent need for intensifying effective strategies to educate truck drivers and to change their perceptions regarding safe sex

Ingenuity Pathway Analysis indicates canonical signaling pathways involved in CCA.

<p>Homology noted with more commonly occurring solid tumors including melanoma and glioblastoma.</p

Mutation Profiling in Cholangiocarcinoma: Prognostic and Therapeutic Implications

<div><p>Background</p><p>Cholangiocarcinoma (CCA) is clinically heterogeneous; intra and extrahepatic CCA have diverse clinical presentations. Next generation sequencing (NGS) technology may identify the genetic differences between these entities and identify molecular subgroups for targeted therapeutics.</p><p>Methods</p><p>We describe successful NGS-based testing of 75 CCA patients along with the prognostic and therapeutic implications of findings. Mutation profiling was performed using either a) NGS panel of hotspot regions in 46 cancer-related genes using a 318-chip on Ion PGM Sequencer or b) Illumina HiSeq 2000 sequencing platform for 3,769 exons of 236 cancer-related genes plus 47 introns from 19 genes to an average depth of 1000X. Clinical data was abstracted and correlated with clinical outcome. Patients with targetable mutations were referred to appropriate clinical trials.</p><p>Results</p><p>There were significant differences between intrahepatic (n = 55) and extrahepatic CCA (n = 20) in regard to the nature and frequency of the genetic aberrations (GAs). <i>IDH1</i> and DNA repair gene alterations occurred more frequently in intrahepatic CCA, while <i>ERBB2</i> GAs occurred in the extrahepatic group. Commonly occurring GAs in intrahepatic CCA were <i>TP53</i> (35%), <i>KRAS</i> (24%), <i>ARID1A</i> (20%), <i>IDH1</i> (18%), <i>MCL1</i> (16%) and <i>PBRM1</i> (11%). Most frequent GAs in extrahepatic CCA (n = 20) were <i>TP53</i> (45%), <i>KRAS</i> (40%), <i>ERBB2</i> (25%), <i>SMAD4</i> (25%), <i>FBXW7</i> (15%) and <i>CDKN2A</i> (15%). In intrahepatic CCA, <i>KRAS</i>, <i>TP53</i> or <i>MAPK/mTOR</i> GAs were significantly associated with a worse prognosis while <i>FGFR</i> GAs correlated with a relatively indolent disease course. <i>IDH1</i> GAs did not have any prognostic significance. GAs in the chromatin modulating genes, <i>BAP1</i> and <i>PBRM1</i> were associated with bone metastases and worse survival in extrahepatic CCA. Radiologic responses and clinical benefit was noted with EGFR, FGFR, C-met, B-RAF and MEK inhibitors.</p><p>Conclusion</p><p>There are significant genetic differences between intra and extrahepatic CCA. NGS can potentially identify disease subsets with distinct prognostic and therapeutic implications.</p></div

Patient demographics and tumor characteristics.

<p>Patient demographics and tumor characteristics.</p

Relationship of Overall Survival with presence of <i>KRAS</i> mutation in cases of Intrahepatic CCA.

<p>Relationship of Overall Survival with presence of <i>KRAS</i> mutation in cases of Intrahepatic CCA.</p

Multivariate regression analysis for overall survival (OS) in patients with intrahepatic CCA.

<p>Multivariate regression analysis for overall survival (OS) in patients with intrahepatic CCA.</p