Breast Cancer: Management and Survivorship

Breast cancer is one of the most common in female population worldwide and comprises about 22.9% of all cancers. Despite the prognosis and survival rates of breast cancer patients and survivors are comparatively better than other cancers, but their net outcome can be revealed by other factors like tumor grade, secondary effects of chemotherapy like insomnia and health behaviors, this distressing may decrease patient’s life expectancy. In the backdrop of this, the need of the hour for the breast cancer survivors is to assess multifactoral nonpharmacological interventions and the management that includes physical exercise, psychological and complementary medicine, which could be cost effective, widely accessible and more promising for breast cancer patients and survivors apart from pharmacological interventions

Evaluation of Insulin receptor (INSR), Leptin receptor (LEPR) and β3-adrenergic receptor (ADRB3) gene polymorphisms in Diabetes Mellitus patients of Kashmir valley

The prevalence of type 2 diabetes mellitus has reached epidemic proportions worldwide. This complex disorder is characterized by defects in insulin secretion and insulin resistance. Type 2 diabetes is a consequence of complex interactions among multiple genetic variants and environmental risk factors. The genetic basis of type 2 diabetes is still poorly understood. The overarching aim of this study was to investigate various polymorphisms in Insulin receptor (INSR), leptin receptor (LEPR) and β3-adrenergic receptor (ADRB3) genes and evaluate their role in the incidence and progression of type 2 diabetes. Three single nucleotide polymorphisms (233, 234 and 276) in the exon 3 of INSR gene, a CTTTA pentanucleotide repeat Del/Ins polymorphism in the 3@ UTR of LEPR gene and a single nucleotide polymorphism (Trp64Arg) in the ADRB3 gene were analysed. The study comprised of 500 local subjects including 200 type 2 diabetes patients and 300 age and gender matched healthy controls. Restriction fragment length polymorphism and single stranded conformation polymorphism techniques were used for genotyping and the results were validated by direct sequencing assay. We observed that codon 233, 234 and 276 of INSR gene were monomorphic in our population thereby ruling out any possible association with type 2 diabetes. However we found an association of LEPR and ADRB3 gene polymorphisms with risk factors and severity of type 2 diabetes, such as obesity, abnormal lipid profile, hypertension, elevated HbA1c levels and serum creatinine levels. The frequency of Del allele was 89.7% and 59.3% in cases and controls respectively (p<0.001; odds ratio 6.0; 95% confidence interval 3.61 - 9.97). The wild allele (Del) in the LEPR gene showed a positive association with the disease as well as associated risk factors. The genotypes for Del/Ins polymorphism did not satisfy Hardy and Weinberg equilibrium (χ2=57.22). In ADRB3 gene, frequency of variant C (Arg) allele was observed to be 40% and 10.2% in cases and controls respectively (p<0.001; odds ratio 5.89; 95% confidence interval 3.69-9.39). Presence of C (Arg) allele was observed to be a risk factor, where as the wild T (Trp) allele exerted a protective effect against type 2 diabetes in our population. Presence of C allele was directly related to higher BMI, WHR, dyslipidemia and uncontrolled diabetes. Genotypes for Trp64Arg polymorphism were in Hardy and Weinberg equilibrium (χ2=0.48). The study signifies that Del allele in LEPR gene and Arg allele in ADRB3 are genotypic risk factors that confer susceptibility to type 2 Diabetes Mellitus in ethnic Kashmiri population

Cell Cycle and Factors Involved in Inhibition or Progression of Breast Cancer

Cell cycle progression is driven by the sequential activation of a family of cyclin-dependent kinases (CDKs), which phosphorylate and activate proteins that execute events critical to cell cycle progression. Cell cycle checkpoints are scrutiny points that display the order, integrity, and fidelity of the major proceedings of the cell cycle. These comprise development to the correct cell size, the replication, integrity of the chromosomes, and their precise separation at mitosis. Many of these mechanisms are prehistoric in origin and highly preserved and hence have been deeply well versed by studies in model organisms such as the yeasts as well as in higher organisms. These molecular mechanisms switch alternative cell fates with substantial impact on tumor suppression. In the present study, we have explained different checkpoint pathways and the consequences of their dysfunction on cell fate in cancer

Cancer Survivorship

This book is a marvelous compendium of eight articles that cover a wide range of topics, including breast cancer: management and survivorship, rectal cancer intersphincteric resection, head and neck cancer diagnosis and radiotherapy, synthetic peptides as antitumor agents, and recent advances in thyroid cancer. It has been a wonderful opportunity to co-edit this special edition. We are greatly appreciative of the work of all the contributors to the book, who brought with them tremendous diversity of perspectives and fields truly reflective of the complexity of the topic and who, through coming together in this project, serve as a nidus of the multidisciplinary collaboration in this field. Finally, we must acknowledge the thousands of cancer patients who have participated in the studies that have provided the information that has advanced the field so greatly in recent years

Graphene aerogel based multifunctional composites

Graphene oxide (GO) nanosheets can be assembled into multifunctional three-dimensional graphene aerogels (3D GAs) via hydrothermal assembly for sensing and energy storage applications. However, due to strong van der Waals forces, GO nanosheets often stack together, significantly compromising their performance. A well-designed and highly interconnected 3D GAs are still one of the biggest and most debated challenges in achieving multifunctional compressible materials. To address these issues, first, a novel two-step freezing method was demonstrated to synthesize a unique core-shell structured 3D graphene aerogel (3D GA). In this method, a dual temperature gradient was created to control the ice crystal growth, leading to the formation of a well-structured 3D GA with honeycomb-like densely packed core and sparsely packed shell. A high-performance multifunctional 3D GAs with carbon materials was prepared using a hydrothermal assisted two-step freezing method followed by natural drying to increase the structural stability and surface area of GAs by preventing the stack of graphene sheets during their assembly. The carbon materials significantly prevent the restacking of graphene sheets caused by van der walls forces and make available a space between graphene layers, facilitating a strong structure and superb electrical conductivity by facilitating an excellent pathway for electron transport. The GAs were applied in strain sensors to detect various human bio-signals. Furthermore, the GAs were used as free-standing electrodes to create flexible supercapacitors, demonstrating satisfactory electrochemical performances. Overall, we show that 3D graphene/nano carbon hybrid aerogels have excellent multifunctional properties for applications in flexible electronics and energy storage devices

Leptin in obesity and hypertension

Background: Obesity along with hypertension is the common risk factor for the development of cardiovascular disease. Leptin, an anti-obesity hormone, is currently considered to play a vital role in the development of hypertension in obesity. We aim to determine the leptin levels in hypertensive and normotensive participants and to find the correlation between leptin and hypertension in obese and non-obese hypertensive subjects. Material and methods: A total of 94 participants aged &gt; 18years of either gender were included in the study. The participants were divided into obese (n = 55) and non-obese (n = 39) groups with further subgroups based on presence or absence of hypertension. Height, weight and blood pressure were taken with standard methods. Leptin was determined using ELISA method and intra and inter-group comparisons were made. Results: The leptin levels were significantly higher in obese (p = 0.000), hypertensive (p = 0.048) and females (p = 0.001) compared to non-obese, normotensive and male participants. Furthermore, obese hypertensive participants were having higher leptin levels compared to obese normotensive participants but with no statistical significance (p = 0.14). Serum leptin levels positively correlated with serum LDL (p = 0.003), body mass index (BMI) (p = 0.000), serum uric acid (p = 0.034) and fasting plasma glucose (FPG) (p = 0.001). However, on correction for factors like BMI, and obesity, positive correlation persisted only for female gender (p = 0.048) and FPG (p = 0.029). Furthermore, BMI (p = 0.021) and FPG (p = 0.027) were found to be the independent risk factors for elevated leptin levels on multiple regression analysis. Conclusions: Our study concluded that serum leptin levels are higher in obesity and have a direct correlation with degree of obesity. However, our study does not support any direct correlation between serum leptin and hypertension

C242T polymorphism of p22 PHOX Gene and cerebrovascular disease in the Kashmiri Population.

Objectives: To study the p22 phox gene for polymorphism in patients with cerebrovascular disease. Study Design: Case control study. Material & Methods: 60 patients of hemorrhagic and ischemic stroke without any identifiable risk factor for stroke were compared with 40 healthy, age and sex matched controls for C242T polymorphism of p22 PHOX by detection of restriction fragment length polymorphism. Results: The TC+TT genotype frequencies in the CVA group and control group were 27.0% and 10%, respectively, and the prevalence of the TC+TT genotype was significantly higher in the CVA patients (χ2=18.759, P<0.001, OR 6.90, 95% CL 2.71 to 17.61). Analysis by CVA subtypes showed that the OR for the TC+TT genotype was higher in hemorrhagic than in those with ischemic stroke. Conclusions: The C242T polymorphism of the NADPH oxidase p22 PHOX gene is a novel pathogenetic risk factor for CVA

The effect of percutaneous coronary revascularization on plasma N-terminal pro-B-type natriuretic peptide levels in stable coronary artery disease

Background: This study was conducted to assess the effect of percutaneous coronary revascularization (PCR) on plasma NT-proBNP concentration in patients with chronic stable angina (CSA). Methods: This prospective open label interventional study included 22 patients with moderate to severe CSA, normal left ventricular (LV) systolic functions and critical (>90%) proximal stenosis in one of the three major epicardial coronary arteries. After stabilization of medications for 8 weeks, resting supine plasma NT-proBNP levels were measured and patients underwent PCR of the involved vessels. Eight weeks later, with medications unaltered; plasma NT-proBNP levels were repeated and compared with the baseline levels. LV systolic and diastolic functions were assessed before and after PCR. Results: The mean age of the patients was 61.27 ± 8.87 years. Out of 22 patients, 20 were male and 2 were female. PCR was performed on left anterior descending coronary artery (LAD) in 12 patients and in a non-LAD vessel in 10 patients. After 8 weeks of successful PCR, there was a significant overall reduction in mean plasma NT-proBNP levels (from 244.36 ± 218.99 to 168.68 ± 161.61 pg/mL, p = 0.016). The patients who underwent PCR of LAD demonstrated significantly reduced NT-pro-BNP levels after PCR (p = 0.009). In the non-LAD group, NT-proBNP levels also decreased, albeit insignificantly (p = 0.432). Reduction in NT-proBNP was independent of change in LV systolic functions. Conclusion: Successful PCR, by relieving myocardial ischemia, significantly reduced plasma NT-proBNP levels in majority of the patients with chronic stable angina secondary to critical epicardial coronary artery stenosis. Keywords: Coronary artery disease, Chronic stable angina, NT-ProBNP, Percutaneous coronary revascularizatio