Inflammatory breast cancer clusters: A hypothesis

Reproduced with permission of Baishideng Publishing Group, World Journal of Clinical Oncology

Clinico-epidemiological Characteristics of Children with Infectious Meningitis at Nishtar Medical Hospital

Objective: This study aims to determine the common Clinico-epidemiological Characteristics of Patients suffering from infectious meningitis presenting at Nishtar medical university hospital Multan, Pakistan. Study design: Descriptive cross-sectional study Place and duration of study: Pediatric department, Nishtar Hospital Multan the duration of the study was February 01, 2016 to January 31, 2017. Method The study comprised of 172 patients. All the children of age 1 month to 12 years with suspected meningitis presenting to Pediatric Department Nishtar Hospital, Multan were included in our study. The patients who were critically ill or immune compromised were not included in the study. The cases in which the parents did not give consent were also excluded. The written informed consent was taken from the parents. All these cases were evaluated by detailed history, thorough physical examination and the necessary investigations. All the demographic data and other variables related to clinico-epidemiological features were measured and recorded using a specifically designed performa. The data were analyzed by using computer program SPSS 21 version. Result Of the 154 patients included in the final analysis, 98 (63.6%) were females and 56 (36.4%) males. The age ranged from 1 month to 12 years with a median of 31 months (6.00 - 72.50). Seventy-five percent of them were below 5 years. On the basis of investigations, bacterial meningitis was diagnosed in 91, viral meningitis in 27, tuberculous meningitis in 21 and cryptococcal meningitis in 15 patients. The most common clinical presentations of meningitis were fever, vomiting, headache, irritability, neck stiffness and altered level of consciousness. While the photophobia and fits were less common. The GCS score was more than 13 in 109 patients (70.8%) while less than eight GCS score was observed in 45 children (29.2%). Most of the complications were observed in the initial 36 hours of admission. The commonly observed complications were an altered level of sensorium, seizure, and shock. The minimum length of hospitalization was one day and the maximum was 36 days with median (IQR) of 12 days (4-15). The mortality was observed in 22 patients (14.3%) of Pediatric Medicine Department. Conclusion Meningitis is a highly morbific and fatal central nervous system infection in children population. It is associated with life-threatening complications and exhibits highly diverse clinical course with a very non-specific sign and symptoms. Younger children of rural areas are highly prone to fall a victim to this lethal disease. By vaccinating the children population against causative agents of meningitis, we can reduce the burden of disease. Keywords: Meningitis.  Children. Clinico-epidemiological features

Clinicopathological prognostic factors of oral squamous cell carcinoma: An experience of a tertiary care hospital

Locoregional recurrence accounts for majority of the treatment failures in oral cancer patients. Current study aimed to determine the predictors of recurrence and survival in patients with biopsy proven Squamous Cell Carcinoma (SCC) of the oral cavity. This study included 88 patients of squamous cell carcinoma treated at our institution from 2007 till 2013. Primary intervention was surgery in all patients with radiation and chemotherapy in selected patients. Primary end point was locoregional recurrence, distant metastasis and death. Out of 88 patients, 23 (26.1%) patients developed locoregional recurrence and 6 (6.8%) patients developed distant metastasis. Overall survival rate was 77.3%. Follow up ranged from 1 month to 63 months with mean of 17.8±16.2. On multivariate analysis, lymph node involvement and loco-regional recurrence were independent parameters related to decrease overall survival. Lymphovascular invasion, perineural spread, TNM stage and lymph node involvement had significant impact on recurrence

The glucose metabolite methylglyoxal inhibits expression of the glucose transport genes by inactivating the cell surface glucose sensors Rgt2 and Snf3 in yeast

Methylglyoxal (MG) is a cytotoxic by-product of glycolysis. MG has inhibitory effect on the growth of cells ranging from microorganisms to higher eukaryotes, but its molecular targets are largely unknown. The yeast cell-surface glucose sensors Rgt2 and Snf3 function as glucose receptors that sense extracellular glucose and generate a signal for induction of expression of genes encoding glucose transporters (HXTs). Here we provide evidence that these glucose sensors are primary targets of MG in yeast. MG inhibits the growth of glucose-fermenting yeast cells by inducing endocytosis and degradation of the glucose sensors. However, the glucose sensors with mutations at their putative ubiquitin-acceptor lysine residues are resistant to MG-induced degradation. These results suggest that the glucose sensors are inactivated through ubiquitin-mediated endocytosis and degraded in the presence of MG. In addition, the inhibitory effect of MG on the glucose sensors is greatly enhanced in cells lacking Glo1, a key component of the MG detoxification system. Thus the stability of these glucose sensors seems to be critically regulated by intracellular MG levels. Taken together, these findings suggest that MG attenuates glycolysis by promoting degradation of the cell-surface glucose sensors and thus identify MG as a potential glycolytic inhibitor

Hepatocellular carcinoma with extrahepatic blood supply from right renal artery

Extrahepatic blood supply is seen in around 17-27% of hepatocellular carcinoma lesions. Evidence suggests that this extrahepatic supply most commonly originates from a right intercostal artery (70-83%) followed by left intercostal, omental and right renal arteries. Thus a comprehensive knowledge of variations in standard vascular anatomy and cognisance of factors influencing or predicting extrahepatic blood supply in HCC is instrumental in ensuring the success of surgical and interventional procedures. We present the unusual case of a 66-year-old male with HCC in Segment I of the liver with aberrant blood supply from the right renal artery in the absence of any risk factors for extrahepatic circulation. He successfully underwent transarterial chemoembolization. There was no evidence of residual disease on repeat imaging

Synthesis and Characterization of Edible Films from Garlic(Allium sativum) Husk Components

455-461Garlic husks are waste biomass and unutilized sources of essential compounds like lignin, pectin, cellulose, hemicellulose, lignocellulose and dietary fibre. Pectin was extracted from garlic husk using ammonium oxalate solution. Lignin is a complex biopolymer consisting of p-coumaryl alcohol, sinapyl alcohol, and coniferyl alcohol. Lignin was extracted from garlic husk using alkali pulping method; the sample was subjected to 10% (w/w) NaOH solution in a pressurized condition at high temperature. The extracted lignin was characterized using Fourier Transform Infrared Spectroscopy (FTIR). Transmittance ratios in FTIR Spectra of extracted lignin were similar to those of the commercial lignin. The edible film was prepared by solution casting method where the film was casted from the solution of pectin and lignin. The physical and chemical properties of the film like moisture content, color, solubility of the film, antimicrobial activity, water vapour transmission rate, pectin and lignin were characterized. The lowest water vapour permeability of the film is 17.48 ± 0.12 g/h m2. Whiteness index and 'L' value of film decreased from film 1 to film 4. An inhibition zone was formed against the Bacillus cereus proving the antimicrobial activity of the lignin extracted from garlic husk

Worldwide network for blood and marrow transplantation recommendations for establishing a hematopoietic stem cell transplantation program in countries with limited resources, part II: Clinical, technical, and socioeconomic considerations

The development of hematopoietic stem cell transplantation (HSCT) programs can face significant challenges in most developing countries because such endeavors must compete with other government health care priorities, including the delivery of basic services. Although this is may be a limiting factor, these countries should prioritize development of the needed expertise to offer state-of-the-art treatments, including transplantation, by providing financial, technological, legal, ethical, and other needed support. This would prove beneficial in providing successful programs customized to the needs of their population and potentially provide long-term cost savings by circumventing the need for their citizens to seek care abroad. The costs of establishing an HSCT program and the costs of the HSCT procedure itself can be substantial barriers in developing countries. In addition, socioeconomic factors intrinsic to specific countries can influence access to HSCT, patient eligibility for HSCT, and timely utilization of HSCT center capabilities. This report describes recommendations from the Worldwide Network for Blood and Marrow Transplantation for establishing HSCT programs, with a specific focus on developing countries, and identifies challenges and opportunities for providing this specialized procedure in resource-constrained settings

Worldwide network for blood and marrow transplantation (WBMT) recommendations for establishing a hematopoietic stem cell transplantation program in countries with limited resources (Part II): Clinical, technical and socio-economic considerations

The development of hematopoietic stem cell transplantation (HSCT) programs can face significant challenges in most developing countries because such endeavors must compete with other government health care priorities, including the delivery of basic services. While this is may be a limiting factor, these countries should prioritize development of the needed expertise to offer state of the art treatments including transplantation, by providing financial, technological, legal, ethical and other needed support. This would prove beneficial in providing successful programs customized to the needs of their population, and potentially provide long-term cost-savings by circumventing the need for their citizens to seek care abroad. Costs of establishing HSCT program and the costs of the HSCT procedure itself can be substantial barriers in developing countries. Additionally, socioeconomic factors intrinsic to specific countries can influence access to HSCT, patient eligibility for HSCT and timely utilization of HSCT center capabilities. This report describes recommendations from the Worldwide Network for Blood and Marrow Transplantation (WBMT) for establishing HSCT programs with a specific focus on developing countries, and identifies challenges and opportunities for providing this specialized procedure in the resource constrained setting

Determining the Quantitative Principles of T Cell Response to Antigenic Disparity in Stem Cell Transplantation

Alloreactivity compromising clinical outcomes in stem cell transplantation is observed despite HLA matching of donors and recipients. This has its origin in the variation between the exomes of the two, which provides the basis for minor histocompatibility antigens (mHA). The mHA presented on the HLA class I and II molecules and the ensuing T cell response to these antigens results in graft vs. host disease. In this paper, results of a whole exome sequencing study are presented, with resulting alloreactive polymorphic peptides and their HLA class I and HLA class II (DRB1) binding affinity quantified. Large libraries of potentially alloreactive recipient peptides binding both sets of molecules were identified, with HLA-DRB1 generally presenting a greater number of peptides. These results are used to develop a quantitative framework to understand the immunobiology of transplantation. A tensor-based approach is used to derive the equations needed to determine the alloreactive donor T cell response from the mHA-HLA binding affinity and protein expression data. This approach may be used in future studies to simulate the magnitude of expected donor T cell response and determine the risk for alloreactive complications in HLA matched or mismatched hematopoietic cell and solid organ transplantation

Prognostic value of lymphocyte vascular density and e-cadherin in inflammatory breast cancer

Background: We recently evaluated four laboratory assays, vascular endothelial growth factor D (VEGF-D), E-cadherin, lymphatic vessel density (LVD) measured by podoplanin, and intra-lymphatic tumor emboli (ILTE), which showed notable differences between inflammatory breast cancer (IBC) and non-inflammatory locally advanced breast cancer (LABC). In this study we investigated the potential of the three most quantitatively measured markers, E-cadherin, LVD and VEGF-D, to predict survival in the IBC patients. Materials and Methods: This study involved the 100 cases identified in the Inflammatory Breast Cancer Registry (IBCR) whose tumors were previously evaluated for the four assays noted above. Living patients were recontacted and survival data were available for up to 17 years. Overall survival (OS) was analyzed through the Kaplan-Meier method stratified by E-cadherin, LVD, VEGF-D, and response to chemotherapy. The differences in OS curves were compared using the log-rank test. Results: The median OS for patients with high LVD was 6.63 years (95% CI: 4.06 to 10.14), compared to median at 10 years not reached in those with low LVD (p = 0.03). There was a trend towards a longer median OS in patients with high E-cadherin (10.14, 95% CI: 6.63 to 11.67), compared with those with low E-cadherin (6.26, 95% CI: 3.42 to undeterminable). VEGF-D levels showed no correlation with survival. Conclusion: Low LVD significantly predicts better survival. High E-cadherin expression, as with non-IBC breast cancer and several other malignancies, tends to be associated with a better prognosis