(Analysis of the proliferating cell nuclear antigen(PCNA) and Ki-67 as proliferating cell markers) Expressions in colorectal carcinoma at HUSM and its relationship with the duke staging system

Proliferating cell nuclear antigen (PCNA) and Ki-67 are the two important molecules expressed by the proliferating cells. They are important during the DNA synthesis. We applied the antibodies (using DAKO EPOS system) against these two proteins to a series of 54 cases of colorectal adenocarcinoma of various Dukes' stages in order to observe the degree of expressions and their relationship with Dukes' stage. Our study showed, regardless of the Dukes' stage almost all cases are strongly expressed PCNA. However we failed to demonstrate the expression of Ki-67. We conclude that expression of PCNA is strong in colorectal carcinoma but the degree of expression has no relationship with the Dukes' stage. Expression of Ki-67 is probably best seen if we use fresh tissue rather than formalin fixed paraffin embedded tissue

Immunohistochemical studies on the expression of cea, c-erbb-2 and cathepsin din tissue sections and fine needle aspirates of benign breast lesions

The diagnosis of breast lesions in histopathology relies heavily on the morphology of the epithelial cells. This study aim at looking on the immunohistological expression of well-known prognostic markers ofbreast carcinoma i.e. CEA, c-erbB-2 and Cathepsin D on the epithelial cells of benign breast lesions in tissue sections and fine needle aspiration smears. Being strongly positive in malignant breast lesions, it is expected that the markers will be less positive or totally negative in beni~ epithelial cells. 91 cases of benign breast leSions composed of 46 cases of fibroadenoma, 18 cases of fibrocystic change, 10 ~ of sclerosing adenosis, 9 cases of epithelial hyperplasia, 7 cases of papilloma and 1 case of lactating adenoma were identified in tissue sections. CEA was positive in 11 of the cases (12%) and Cathepsin D was positive in 20 cases (22%). Complete ring of epimembranous cytoplasmic C-erb-B2 expression was absent in all the cases, therefore it is considered that all cases were negative for c .. erb-B2 expression. 13 cases (14%) comprising of9 fibroadenoma, 2 fibrocystic change and 2 epithelial hyperplasia showed incomplete ring of epimembranous staining by c-erb-B2. It appeare4 that CEA and c-erbB-2 expression is low in benign breast lesion and the expression is specific in the epithelial cells. However, CEA at the same time also showed strong positivity to the adjacent myoepithelial cells and this may give a higher result of positivity in such cases. For Cathepsin D expression, on top of showing strong positivity for myoepithelial cells and epithelial cells, it showed a non-specific positivity in the surrounding stromal cells. These findings indicate that c-erbB .. 2 and CEA rather than Cathepsin D are more likely to give a better distinguishing expression when comparing benign and malignant breast lesion in tissue sections. In 46 cases of fibroadenoma studied, CEA was positive in 10 cases (21. 7%) and Cathepsin Din 9 cases (19.6%). In 18 cases offibrocystic change studied, none showed expression for CEA and cerbB- 2 ; and 3 cases were positive for Cathepsin D. The same pattern is observed in sclerosing adenosis and papilloma cases studied. CEA and c .. erbB-2 were not expressed in 10 cases of sclerosing adenosis and 7 cases of papilloma. Cathepsin D was positive in 3 cases of sclerosing adenosis and 2 cases of papilloma Sl.cases of fine needle aspirates of benign breast lesion were also studied. 28·c~ compnsitig of 21 fibroadenoma, 4 benign proliferative lesion, 2 fibrocystic change and 1 non-specific · inflammatory lesion were subjected to CEA staining while another 23 cases ·comprising .of 18 . fibroadenoma, 3 beriign proliferative lesion, 1 :fibrocystic change and 1 non-specific inflammatory lesion were subjected to c-erbB-2 staining. For the CEA staining, 6· cases (21%) comprising of 5 fibroadenoma and 1 :fibrocystic change were positive. C-erbB-2 expression is only seen in one case ( 4%) out of 23 cases subjected to the staining and that single case was a fibroadenoma In the study of the fine needle aspirate, c-erbB-2 appears to be less expressed compare to CEA. · In conclusion, it can be seen that c-erbB-2 marker is significantly less expressed or not expressed at all compare to CEA in both tissue sections as well as in fine needle aspiration smears. Therefore c-erbB-2 marker is a potential tool that can be used to differentiate benign from malignant breast lesions. Cathepsin D due to its non-specific staining and increased background staining m.ake it unsuitable for usage to distinguish benign :from malignant breast lesions

Effect Of Spray-dried Ethanolic Extract of Andrographis Paniculata (Burm. F.) Nees On Streptozotocin-induced Diabetic Female Rats.

The objective of this study was to evaluate the effect of commercially prepared spray-dried ethanolic extract ol Andrographis paniculafa (AP) on streptozotocin (STZ)-induced diabetic female rats. METHODOLOGY: Rats with regular estrous cycle (EC) prior to STZ induction were randomly divided into five groups. The normal (nondiabetic) and diabetic controlgroups were given vehicle [0.2 ml of 2o/o carboxyl methyl cellulose (CMC) by gavagingl daily for 6 weeks. Other diabetic groups were treated with 50, 100 and 200 mg/kg/day of AP extracts respectively. The rats' body weight (BW), fasting blood glucose and insulin level were measured; and daily, EC evaluation was perfo;.ry1e.d1 throughout the 6-week study period. At the end.olthe experiment, rats were sacrificed and their P4fprpases were removed for histological examination."RESU LTS':, The survival rates and estrous cycle,'$f''AP-treatbd diabetic animals were found to be improved compared to nontreated animals

Synchrotron FTIR imaging of OH in quartz mylonites

Previous measurements of water in deformed quartzites using conventional Fourier transform infrared spectroscopy (FTIR) instruments have shown that water contents of larger grains vary from one grain to another. However, the non-equilibrium variations in water content between neighboring grains and within quartz grains cannot be interrogated further without greater measurement resolution, nor can water contents be measured in finely recrystallized grains without including absorption bands due to fluid inclusions, films, and secondary minerals at grain boundaries.Synchrotron infrared (IR) radiation coupled to a FTIR spectrometer has allowed us to distinguish and measure OH bands due to fluid inclusions, hydrogen point defects, and secondary hydrous mineral inclusions through an aperture of 10 µm for specimens > 40 µm thick. Doubly polished infrared (IR) plates can be prepared with thicknesses down to 4–8 µm, but measurement of small OH bands is currently limited by strong interference fringes for samples < 25 µm thick, precluding measurements of water within individual, finely recrystallized grains. By translating specimens under the 10 µm IR beam by steps of 10 to 50 µm, using a software-controlled x − y stage, spectra have been collected over specimen areas of nearly 4.5 mm2. This technique allowed us to separate and quantify broad OH bands due to fluid inclusions in quartz and OH bands due to micas and map their distributions in quartzites from the Moine Thrust (Scotland) and Main Central Thrust (Himalayas).Mylonitic quartzites deformed under greenschist facies conditions in the footwall to the Moine Thrust (MT) exhibit a large and variable 3400 cm−1 OH absorption band due to molecular water, and maps of water content corresponding to fluid inclusions show that inclusion densities correlate with deformation and recrystallization microstructures. Quartz grains of mylonitic orthogneisses and paragneisses deformed under amphibolite conditions in the hanging wall to the Main Central Thrust (MCT) exhibit smaller broad OH bands, and spectra are dominated by sharp bands at 3595 to 3379 cm−1 due to hydrogen point defects that appear to have uniform, equilibrium concentrations in the driest samples. The broad OH band at 3400 cm−1 in these rocks is much less common. The variable water concentrations of MT quartzites and lack of detectable water in highly sheared MCT mylonites challenge our understanding of quartz rheology. However, where water absorption bands can be detected and compared with deformation microstructures, OH concentration maps provide information on the histories of deformation and recovery, evidence for the introduction and loss of fluid inclusions, and water weakening processes

An examination of the relationship of governance structure and performance: Evidence from banking companies in Bangladesh

Corporate governance has become increasingly important in developed and developing countries just after a series of corporate scandals and failures in a number of countries. Corporate governance structure is often viewed as a means of corporate success despite prior studies reveal mixed, somewhere conflicting and ambiguous, and somewhere no relationship between governance structure and performance. This study empirically investigates the relationship between corporate governance mechanisms and financial performance of listed banking companies in Bangladesh by using two multiple regression models. The study reveals that a good number of companies do not comply with the regulatory requirements indicating remarkable shortfall in corporate governance practice. The companies are run by the professional managers having no duality and no ownership interest for which they are compensated by high remuneration to curb agency conflict. Apart from some inconsistent relationship between some corporate variables, the corporate governance mechanisms do not appear to have significant relationship with financial performances. The findings reveal an insignificant negative impact or somewhere no impact of independent directors and non-independent non-executive directors on the level of performance that strongly support the concept that the managers are essentially worthy of trust and earn returns for the owners as claimed by stewardship theory. The study provides support for the view that while much emphasis on corporate governance mechanisms is necessary to safeguard the interest of stakeholders; corporate governance on its own, as a set of codes or standards for corporate conformance, cannot make a company successful. Companies need to balance corporate governance mechanisms with performance by adopting strategic decision and risk management with the efficient utilization of the organization’s resources

Effect of different machining parameters on the surface roughness of aluminium alloys based on Si and Mg content

Aluminium-based alloys are considered lengthily for many applications in engineering areas due to their good mechanical properties. Machining these alloys had attracted the attention of many researchers on how to improve the machining, especially when high manufacturing rate is demanded. Usually, machining these materials poses some difficulties such as burr formation, roughness of the surface, continuous chip formation and build-up edge on cutting edge. In this study, AA6061T6, LM6 and AA5083 aluminium-based alloys were considered to research the optimum drilling parameters with the aim to address the earlier started challenges. Drillings were carried out by using a MAHO three-axis CNC drilling machine with an HSS drilling bit at three different spindle speeds and feed rates. From the results, it was established that each aluminium alloy has different surface roughnesses and this surface roughness decreases as spindle speeds increased. A minimum build-up edge was achieved for AA5083 and AA6061T6 alloys. However, a relatively high BUE was noticed in LM6

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe