Benign intermittent gastric outlet obstruction in an elderly: Endoscopic management and brief review

We describe the clinical scenario in an 80 year old female who presented with history of epigastric discomfort and postprandial fullness of three weeksduration without any alarming symptoms. On upper GI endoscopy she was found to have gastric polyp with a long stalk which was partially obstructing her pyloric ring giving rise to features of intermittent gastric outlet obstruction Polypectomy was done with complete relief of symptoms .She is following our clinic for last 6 months now. Although possibility of malignant etiology in gastric out let obstruction ranks high in the elderly some patients are lucky to have a benign cause as the index case. Report of the case and brief review ispresented.Key words:Inflammatory polyp, Gastric outlet obstruction

A Model of Noncommunicable Diseases Determinants in Iran; a Qualitative Study

Aims: Non-communicable diseases have become an emerging pandemic globally with disproportionately higher rates in developing countries. This study aimed to design a representative model of non-communicable diseases determinants in Iran according to the viewpoint of experts. Participants & Methods: The statistical population of this qualitative study was experts and academic member informants, who were worked at Kashan, Esfahan and Tehran Universities of Medical Sciences in March to June 2016. 20 participants were selected through purposeful sampling method. Experts were asked to explain their opinion regarding to the most effective factors of noncommunicable disease in developing countries. Findings: Social, environmental, and physiological factors, besides the life style were affecting factors on non-communicable diseases in developing countries. Conclusion: Social, environmental, and physiological factors, besides the life style are affecting factors on non-communicable diseases in developing countries

Physico-Chemical Characterization Of Sweet Chestnut (Castanea Sativa L.) Starch Grown In Temperate Climate Of Kashmir, India

Studies were conducted to characterize the chestnut starch for physico-chemical properties. Chemical composition of chestnut starch showed low levels of protein and ash indicating purity of starch. The results revealed low water and oil absorption capacity of chestnut starch. Starch showed high swelling power and low solubility index. Swelling power and solubility index of chestnut starch increased with increase in temperature (50–90 °C). The results revealed high initial, peak, setback, breakdown, and final viscosity but low paste development temperature. Transmittance (%) of the starch gel was low and decreased with increasing storage period. The chestnut starch gel showed increase in % water release (syneresis) with increase in time of storage but was less susceptible to repeated cycles of freezing and thawing. Starch was also characterized for granule morphology. Starch granules were of round and oval shapes, some granules showed irregular shape

Genetic Alterations of RET: Possible Implications and Clinical Correlations in Thyroid Carcinogenesis

Thyroid cancers are malignant tumors in the thyroid gland. DNA polymorphisms are playing a decisive role in unscrambling the genomic basis of tumor formation and development in cancer. Thyroid cancer is influenced in a polygenic and low-penetrance manner by RET gene polymorphisms and this part of the world (North India) has not recorded any study regarding RET alterations in this very cancer. We assessed RET G691S (rs1799939), L769L (rs1800861) and S904S (rs1800863) polymorphisms by restriction fragment length polymorphism (RFLP) in order to explain their potential role in the diagnosis and prognosis of Papillary thyroid cancer (PTC) and follicular thyroid cancer (FTC). In RET G691S polymorphism, the total dissemination of variant alleles (GA + AA) was 62.9% in cases as related to 44.5% in controls (P < 0.05). RET L769L variant alleles (TG + GG) was 70% in cases versus 88% in controls (P < 0.05). In RET S904S, occurrence of variant alleles (CG + GG) was 56% in cases versus 44% in controls (P < 0.05). G691S and L769L polymorphism advocate a “Dominant mode of inheritance”. The S904S polymorphism approves an “Additive mode of inheritance”. In conclusion, there was an over-representation of RET G691S/S904S polymorphisms and under-representation of L769L polymorphism in PTC and FTC patients. Additionally, our data suggest that some haplotypes (A T G, G T G and A T C) of RET may act as low penetrance alleles for predisposition of thyroid cancer

Molecular Alterations and Expression Dynamics in the Etiopathogenesis of Thyroid Cancer

Thyroid carcinoma is the most prevalent endocrine malignancy and accounts for 2% of all human cancers. In the past decade, knowledge of genetic alterations of thyroid cancer (TC) has rapidly expanded, which has provided new insights into thyroid cancer etiology and has offered novel diagnostic tools and prognostic markers that enable improved and personalized management of thyroid cancer patients. Alterations in key signaling effectors seem to be the hallmark of distinct forms of thyroid neoplasia. Mutations or rearrangements in genes that encode Mitogen activated protein kinase (MAPK) pathway effectors seem to be required for transformation. Mutations in BRAF were the most recently identified MAPK effector in thyroid cancer. BRAF V600E is the most common alteration in sporadic papillary carcinoma. Three RAS proto-oncogenes (NRAS, HRAS & KRAS) are implicated in human thyroid tumorigenesis. High incidence of thyroid cancer worldwide indicates the importance of studying genetic alterations that lead to its carcinogenesis. BRAF and RAS alterations represent a novel indicator of the progression and aggressiveness of thyroid carcinogenesis. The GSα-adenylyl cyclase-cyclic AMP (cAMP) cascade is effected in thyroid cancer. Promoter hypermethylation of multiple genes especially TSHR has been identified to play a role in thyroid cancers, in particular showing a close association with BRAF mutational status. So, the main aim of the study was to elucidate the involvement of BRAF and RAS gene mutations along with BRAF expression and thyroid-stimulating hormone receptor (TSHR) hypermethylation in North Indian patients and investigate their association with clinicopathological characteristics

Prevalence of ultrasonography proved polycystic ovaries in North Indian women with type 2 diabetes mellitus

BACKGROUND: Polycystic ovaries (PCO) and their clinical expression (the polycystic ovary syndrome [PCOS]) as well as type 2 diabetes mellitus (T2DM) are common medical conditions linked through insulin resistance. We studied the prevalence of PCO and PCOS in women with diet and/or oral hypoglycemic treated T2DM and non-diabetic control women. DESIGN: Prospective study. METHODS: One hundred and five reproductive age group women with diet and /or oral hypoglycemic treated T2DM were the subjects of the study. Sixty age-matched non-diabetic women served as controls. Transabdominal ultrasonographic assessment of the ovaries was used to diagnose PCO. Clinical, biochemical and hormonal parameters were also noted. RESULTS: Ultrasonographic prevalence of PCO was higher in women with diabetes than in non-diabetic subjects (61.0% vs. 36.7%, P < 0.003) whereas that of PCOS was 37.1% in diabetic subjects and 25% in non-diabetic controls (P > 0.1). Diabetic women with PCO had diabetes of significantly longer duration than those without PCO (4.19±2.0 versus 2.9±1.6 yrs; p < 0.05). Among both diabetic and non-diabetic women, those with PCO had significantly higher plasma LH, LH/FSH ratio, total testosterone and androstenedione levels. CONCLUSION: This study demonstrates a higher prevalence of PCO in women with T2DM as compared to non-diabetic subjects

Duality in mathematical programming.

In this thesis entitled, “Duality in Mathematical Programming”, the emphasis is given on formulation and conceptualization of the concepts of second-order duality, second-order mixed duality, second-order symmetric duality in a variety of nondifferentiable nonlinear programming under suitable second-order convexity/second-order invexity and generalized second-order convexity / generalized second-order invexity. Throughout the thesis nondifferentiablity occurs due to square root function and support functions. A support function which is more general than square root of a positive definite quadratic form. This thesis also addresses second-order duality in variational problems under suitable second-order invexity/secondorder generalized invexity. The duality results obtained for the variational problems are shown to be a dynamic generalization for thesis of nonlinear programming problem.Digital copy of Thesis.University of Kashmir

K*(892)(0) and phi(1020) production in Pb-Pb collisions at root s(NN)=2.76 TeV

The yields of the K*(892)(0) and phi(1020) resonances are measured in Pb-Pb collisions at root s(NN) = 2.76 TeV through their hadronic decays using the ALICE detector. The measurements are performed in multiple centrality intervals at mid-rapidity (vertical bar y vertical bar < 0.5) in the transverse-momentum ranges 0.3 < p(T) < 5 GeV/c for the K*(892)(0) and 0.5 < p(T) < 5 GeV/c for the phi(1020). The yields of K*(892)(0) are suppressed in central Pb-Pb collisions with respect to pp and peripheral Pb-Pb collisions (perhaps due to rescattering of its decay products in the hadronic medium), while the longer-lived phi(1020) meson is not suppressed. These particles are also used as probes to study the mechanisms of particle production. The shape of the pT distribution of the phi(1020) meson, but not its yield, is reproduced fairly well by hydrodynamic models for central Pb-Pb collisions. In central Pb-Pb collisions at low and intermediate p(T), the p/phi(1020) ratio is flat in p(T), while the p/pi and phi(1020)/pi ratios show a pronounced increase and have similar shapes to each other. These results indicate that the shapes of the p(T) distributions of these particles in central Pb-Pb collisions are determined predominantly by the particle masses and radial flow. Finally, phi(1020) production in Pb-Pb collisions is enhanced, with respect to the yield in pp collisions and the yield of charged pions, by an amount similar to the Lambda and Xi

Multiplicity dependence of the average transverse momentum in pp, p–Pb, and Pb–Pb collisions at the LHC

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Vascular Dysfunction Induced in Offspring by Maternal Dietary Fat Involves Altered Arterial Polyunsaturated Fatty Acid Biosynthesis

Nutrition during development affects risk of future cardiovascular disease. Relatively little is known about whether the amount and type of fat in the maternal diet affect vascular function in the offspring. To investigate this, pregnant and lactating rats were fed either 7%(w/w) or 21%(w/w) fat enriched in either18:2n-6, trans fatty acids, saturated fatty acids, or fish oil. Their offspring were fed 4%(w/w) soybean oil from weaning until day 77. Type and amount of maternal dietary fat altered acetylcholine (ACh)-mediated vaso-relaxation in offspring aortae and mesenteric arteries, contingent on sex. Amount, but not type, of maternal dietary fat altered phenylephrine (Pe)-induced vasoconstriction in these arteries. Maternal 21% fat diet decreased 20:4n-6 concentration in offspring aortae. We investigated the role of Δ6 and Δ5 desaturases, showing that their inhibition in aortae and mesenteric arteries reduced vasoconstriction, but not vaso-relaxation, and the synthesis of specific pro-constriction eicosanoids. Removal of the aortic endothelium did not alter the effect of inhibition of Δ6 and Δ5 desaturases on Pe-mediated vasoconstriction. Thus arterial smooth muscle 20:4n-6 biosynthesis de novo appears to be important for Pe-mediated vasoconstriction. Next we studied genes encoding these desaturases, finding that maternal 21% fat reduced Fads2 mRNA expression and increased Fads1 in offspring aortae, indicating dysregulation of 20:4n-6 biosynthesis. Methylation at CpG −394 bp 5′ to the Fads2 transcription start site predicted its expression. This locus was hypermethylated in offspring of dams fed 21% fat. Pe treatment of aortae for 10 minutes increased Fads2, but not Fads1, mRNA expression (76%; P<0.05). This suggests that Fads2 may be an immediate early gene in the response of aortae to Pe. Thus both amount and type of maternal dietary fat induce altered regulation of vascular tone in offspring though differential effects on vaso-relaxation, and persistent changes in vasoconstriction via epigenetic processes controlling arterial polyunsaturated fatty acid biosynthesis