Effect of triple drug antiretroviral therapy on CD4+ count in pregnant women with HIV and prevention of parent to child transmission

Background: India has moved from single drug Antiretroviral Therapy (ART) in 2002 to triple drug ART in 2013 to prevent parent to child transmission of HIV. The aim of the study was to know the effects of triple drug ART on maternal CD4+ count and prevention of HIV transmission to baby along with its adherence, side effects and pregnancy outcome.Methods: A prospective study wsas done in Safdarjung Hospital, New Delhi on 40 HIV positive pregnant women who received single dose combination of triple drug ART. CD4+ count, LFT and KFT were done before beginning of ART and repeated after 6 months of ART. The infants received nevirapine prophylaxis and HIV status was determined by DBS PCR at 6 weeks.Results: The median CD4+ count was 317 and 397 pre and post ART for 6 months respectively (p value<0.001. Low birth weight (LBW) was seen in 43.59% which was statistically significant but confounded as 76.4% of these babies were preterm. 23.08% of babies had an APGAR of < 7 at 1 minute, out of which 77.7% were preterm. Nine out of 39 infants (one had abortion) needed NICU admission. Only one baby (2.56%) was HIV positive who died at 4 months of age due to pneumonia. There was no defaulter and no statistically significant changes in LFT and KFT after 6 months of ART.Conclusions: Triple drug ART offers greater convenience improves fetomaternal outcome and minimize the risk of HIV transmission from mother to child

A simple 'paper smear' method for dry collection, transport and storage of cervical cytological specimens for rapid screening of HPV infection by PCR

Human papillomaviruses (HPVs) are major pathogens associated with the development of cancer of the uterine cervix, the most common malignant tumour of women world-wide. Reliable diagnosis of HPV infection, particularly the 'high-risk' types (16/18), may facilitate early identification of 'high-risk' populations for developing cervical cancer and may augment the sensitivity and specificity of primary cervical cancer screening programmes by complementing the conventional Pap test. A simple paper smear method has been developed for dry collection, transport and storage of cervical smears/scrapes at room temperature for subsequent detection of HPV DNA by PCR assay. Imprint biopsies, blood and fine-needle aspirates were also collected by this method. The cervical scrapes or other body fluids were smeared (within 0.5-1 cm diameter) and dried on to sterile small slides made of Whatman 3MM filter paper, and stored individually at room temperature or at 4°C. A small piece (2-3 mm) of the paper smear was punched or cut out with a sterile surgical blade, boiled in an eppendorf tube containing 50 µl of distilled water for 5 min and used directly for PCR amplification. The quality and quantity of DNA derived from paper smears and the results of PCR amplifications for HPV type 16, BRCA1 and p53 genes were identical to those obtained from the same samples following collection in PBS, storage (-70°C) and phenol-chloroform-based DNA extraction. DNA was stable in the paper smears for up to a year, whether stored at room temperature or at 4°C. This method is simple, rapid and cost-effective, and can be effectively employed for large-scale population screening, especially for regions where the specimens are to be transported from distant places to the laboratory

Bosonic field equations from an exact uncertainty principle

A Hamiltonian formalism is used to describe ensembles of fields in terms of two canonically conjugate functionals (one being the field probability density). The postulate that a classical ensemble is subject to nonclassical fluctuations of the field momentum density, of a strength determined solely by the field uncertainty, is shown to lead to a unique modification of the ensemble Hamiltonian. The modified equations of motion are equivalent to the quantum equations for a bosonic field, and thus this exact uncertainty principle provides a new approach to deriving and interpreting the properties of quantum ensembles. The examples of electromagnetic and gravitational fields are discussed. In the latter case the exact uncertainty approach specifies a unique operator ordering for the Wheeler-DeWitt and Ashtekar-Wheeler-DeWitt equations.Comment: 24 pages, extended version of part (B) of hep-th/0206235, to appear in J. Phys.

India after the 2014 general elections:BJP dominance and the crisis of the third party system

This article critically assesses claims that India has entered a new party system after the 2014 general elections, marked by renationalisation with the BJP as the new 'dominant' party.' To assess these claims, we examine the electoral rise of the BJP in the build-up to and since the 2014 general elections until the state assembly elections in December 2018. Overall, we argue that despite the emerging dominance of the BJP, a core feature of the third party system -a system of binodal interactions- has remained largely intact albeit in a somewhat weaker form. Furthermore, by comparing the post 2014 Indian party system with key electoral features of the first three party systems, we conclude that the rise of the BJP has thrown the third-party system into crisis, but does not yet define the consolidation of a new party system

Hubble Space Telescope STIS Observations of GRB 000301C: CCD Imaging and Near-Ultraviolet MAMA Spectroscopy

We present Space Telescope Imaging Spectrograph observations of the optical transient (OT) counterpart of the γ-ray burster GRB 000301C obtained 5 days after the burst, on 2000 March 6. CCD clear-aperture imaging reveals a R ≃ 21.50 ± 0.15 source with no apparent host galaxy. An 8000 s, 1150 Å 18 on the line of sight to the OT. This measured redshift is conservatively a lower limit to the GRB redshift. However, as all other GRBs that have deep Hubble Space Telescope images appear to lie on the stellar field of a host galaxy, and as the large H I column density measured here and in later ground-based observations is unlikely on a random line of sight, we believe we are probably seeing absorption from H I in the host galaxy. In any case, this represents the largest direct redshift determination of a γ-ray burster to date. Our data are compatible with an OT spectrum represented by a power law with an intrinsic index α = 1.2 (f_ν ∝ ν^(-α)) and no extinction in the host galaxy, or with α = 0.5 and extinction by SMC-like dust in the OT rest frame with A_V = 0.15. The large N_(H I) and the lack of a detected host are similar to the situation for damped Lyα absorbers at z > 2

HST/STIS observations of GRB000301C: CCD imaging and NUV MAMA spectroscopy

We present HST/STIS observations of the optical counterpart (OT) of the gamma-ray burster GRB 000301C obtained on 2000 March 6, five days after the burst. CCD clear aperture imaging reveals a R ~ 21.50+/-0.15 source with no apparent host galaxy. An 8000 s, 1150 < lambda/A < 3300 NUV-MAMA prism spectrum shows a relatively flat continuum (in f_lambda) between 2800 and 3300 A, with a mean flux 8.7 (+0.8,-1.6)+/- 2.6 10^(-18) ergs/s/cm^2/A, and a sharp break centered at 2797+/-25 A. We interpret it as HI Lyman break at z = 2.067+/-0.025 indicating the presence of a cloud with a HI column density log(HI) > 18 on the line-of-sight to the OT. This value is conservatively a lower limit to the GRB redshift. However, the facts that large N(HI) system are usually considered as progenitors of present day galaxies and that other OTs are found associated with star forming galaxies strongly suggest that it is the GRB redshift. In any case, this represents the largest direct redshift determination of a gamma-ray burster to date. Our data are compatible with an OT spectrum represented by a power-law with an intrinsic index \alpha = 1.2((f_nu \propto nu^-alpha) and no extinction in the host galaxy or with alpha = 0.5 and extinction by a SMC-like dust in the OT rest-frame with A_V = 0.15. The large N(HI) and the lack of detected host is similar to the situation for damped Ly-alpha absorbers at z > 2.Comment: Replaced by final version. 10 p., 2 fig. Scheduled to appear in ApJ 555 n2 Jul 10, 2001. Minor changes, both redshift and mean near UV flux are revised with slightly larger values, due to a wrong offset sign in the wavelength calibratio

Transcription factor AP-1 in esophageal squamous cell carcinoma: Alterations in activity and expression during Human Papillomavirus infection

<p>Abstract</p> <p>Background</p> <p>Esophageal squamous cell carcinoma (ESCC) is a leading cause of cancer-related deaths in Jammu and Kashmir (J&K) region of India. A substantial proportion of esophageal carcinoma is associated with infection of high-risk HPV type 16 and HPV18, the oncogenic expression of which is controlled by host cell transcription factor Activator Protein-1 (AP-1). We, therefore, have investigated the role of DNA binding and expression pattern of AP-1 in esophageal cancer with or without HPV infection.</p> <p>Methods</p> <p>Seventy five histopathologically-confirmed esophageal cancer and an equal number of corresponding adjacent normal tissue biopsies from Kashmir were analyzed for HPV infection, DNA binding activity and expression of AP-1 family of proteins by PCR, gel shift assay and immunoblotting respectively.</p> <p>Results</p> <p>A high DNA binding activity and elevated expression of AP-1 proteins were observed in esophageal cancer, which differed between HPV positive (19%) and HPV negative (81%) carcinomas. While JunB, c-Fos and Fra-1 were the major contributors to AP-1 binding activity in HPV negative cases, Fra-1 was completely absent in HPV16 positive cancers. Comparison of AP-1 family proteins demonstrated high expression of JunD and c-Fos in HPV positive tumors, but interestingly, Fra-1 expression was extremely low or nil in these tumor tissues.</p> <p>Conclusion</p> <p>Differential AP-1 binding activity and expression of its specific proteins between HPV - positive and HPV - negative cases indicate that AP-1 may play an important role during HPV-induced esophageal carcinogenesis.</p

Telomerase activity as an adjunct to high-risk human papillomavirus types 16 and 18 and cytology screening in cervical cancer

Telomerase is a ribonucleoprotein comprising an RNA template, the telomerase-associated protein and its catalytic subunit, human telomerase reverse transcriptase (hTERT). Telomerase activation is a critical step in cellular immortalisation and development of cancer. Enhanced telomerase activity has been demonstrated in cervical cancer. In the present study telomerase activity and hTERT mRNA expression were evaluated and correlated with the presence of human papillomavirus (HPV) infection and cytological changes in the cervical lesions. Telomerase activity was assayed by telomeric repeat amplification protocol, hTERT mRNA expression by reverse transcriptase polymerase chain reaction and presence of high risk HPV (HR-HPV) infection by polymerase chain reaction. Out of 154 cervical samples of different cytology, 90 (58.44%) were positive for HR-HPV types 16/18, while among 55 normal cervical scrapes, 10 (18.18%) were HPV DNA positive. All 59 invasive cancer samples showed a very high telomerase activity. Among dysplasia, seven (63.6%) mild dysplasia, 18 (100%) of moderate, 20 (100%) of severe dysplasia and 6 (100%) carcinoma in situ (CIS) samples were positive with mild to moderate to high to very high telomerase activity respectively. Seven (12.7%) samples of apparently normal cervical scrapes were weakly positive for telomerase activity. We observed a good correlation (P<0.001) between telomerase activity and HR-HPV 16/18 positivity with a sensitivity of 88.1% for HPV and 100% for telomerase activity. It is suggested that telomerase activity may be used as an adjunct to cytology and HPV DNA testing in triaging women with cervical lesions

Hubble Space Telescope STIS Observations of GRB 000301C: CCD Imaging and Near-Ultraviolet MAMA Spectroscopy

We present Space Telescope Imaging Spectrograph observations of the optical transient (OT) counterpart of the γ-ray burster GRB 000301C obtained 5 days after the burst, on 2000 March 6. CCD clear-aperture imaging reveals a R ≃ 21.50 ± 0.15 source with no apparent host galaxy. An 8000 s, 1150 Å 18 on the line of sight to the OT. This measured redshift is conservatively a lower limit to the GRB redshift. However, as all other GRBs that have deep Hubble Space Telescope images appear to lie on the stellar field of a host galaxy, and as the large H I column density measured here and in later ground-based observations is unlikely on a random line of sight, we believe we are probably seeing absorption from H I in the host galaxy. In any case, this represents the largest direct redshift determination of a γ-ray burster to date. Our data are compatible with an OT spectrum represented by a power law with an intrinsic index α = 1.2 (f_ν ∝ ν^(-α)) and no extinction in the host galaxy, or with α = 0.5 and extinction by SMC-like dust in the OT rest frame with A_V = 0.15. The large N_(H I) and the lack of a detected host are similar to the situation for damped Lyα absorbers at z > 2

Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial

Background: Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplatelet therapy (combined aspirin, clopidogrel, and dipyridamole) with that of guideline-based antiplatelet therapy. Methods: We did an international, prospective, randomised, open-label, blinded-endpoint trial in adult participants with ischaemic stroke or transient ischaemic attack (TIA) within 48 h of onset. Participants were assigned in a 1:1 ratio using computer randomisation to receive loading doses and then 30 days of intensive antiplatelet therapy (combined aspirin 75 mg, clopidogrel 75 mg, and dipyridamole 200 mg twice daily) or guideline-based therapy (comprising either clopidogrel alone or combined aspirin and dipyridamole). Randomisation was stratified by country and index event, and minimised with prognostic baseline factors, medication use, time to randomisation, stroke-related factors, and thrombolysis. The ordinal primary outcome was the combined incidence and severity of any recurrent stroke (ischaemic or haemorrhagic; assessed using the modified Rankin Scale) or TIA within 90 days, as assessed by central telephone follow-up with masking to treatment assignment, and analysed by intention to treat. This trial is registered with the ISRCTN registry, number ISRCTN47823388. Findings: 3096 participants (1556 in the intensive antiplatelet therapy group, 1540 in the guideline antiplatelet therapy group) were recruited from 106 hospitals in four countries between April 7, 2009, and March 18, 2016. The trial was stopped early on the recommendation of the data monitoring committee. The incidence and severity of recurrent stroke or TIA did not differ between intensive and guideline therapy (93 [6%] participants vs 105 [7%]; adjusted common odds ratio [cOR] 0·90, 95% CI 0·67–1·20, p=0·47). By contrast, intensive antiplatelet therapy was associated with more, and more severe, bleeding (adjusted cOR 2·54, 95% CI 2·05–3·16, p<0·0001). Interpretation: Among patients with recent cerebral ischaemia, intensive antiplatelet therapy did not reduce the incidence and severity of recurrent stroke or TIA, but did significantly increase the risk of major bleeding. Triple antiplatelet therapy should not be used in routine clinical practice