Concurrent cytologic and colposcopic evaluation of symptomatic cervical erosion

Background: Cervical cancer is amongst the leading causes of deaths due to cancer in developing countries. Moreover, preinvasive lesions of the cervix have a long latency period for conversion into malignancy and are also detectable by screening techniques. Hence, colposcopy in addition to cytology should be carried out wherever facility is available to ensure early detection and timely management.Methods: Simultaneous cytology and colposcopy was done for 80 women with symptomatic cervical erosion followed by a colposcopic directed biopsy in women with MRCI >3. Finally, correlation between cytology, colposcopy and histopathological results was done.Results: 65/80 women were biopsied. 12/80 women had MRCI >6 amongst which 10/80 were confirmed to have a high grade lesion on histopathology. 13/80 had lesser abnormalities (ASCUS and LSIL) amongst which 3/80 had CIN1 on histopathology. Only 2/80 had HSIL on cytology as compared to 8/80 on histopathology that had CIN 2/3. Lastly, only 1/80 had SCC on cytology compared to 2/80 on histopathology. The sensitivity, specificity, PPV and NPV of cytology and colposcopy for diagnosing cervical dysplasia was 46.1%, 83.5%, 35.2%, 88.8% and 84.6%, 86.5%, 55%, 96.6% respectively making colposcopy a better screening tool than cytology for evaluating cervical malignancy.Conclusions: Colposcopic examination should ideally be carried out in all women with symptomatic cervical erosion in addition to cytology. Moreover, suspicious areas should be biopsied even if cytology is normal to exclude malignancy.

Therapeutic Approaches to Aggressive Carcinomas Based on a Novel VEGF/Neuropilin Autocrine Pathway

Summary: Autocrine VEGF signaling in tumor cells contributes to de-differentiation and function of tumor initiating/stem cells. NRP2 is the nexus of a signaling pathway that promotes de-differentiation and sustains tumor initiating/stem sells. Anti-NRP2 therapy is worth pursuing, especially for high-grade cancers. Therapeutic Abs are available. This presentation was part of the retreat mini-symposium entitled: Biomarker Discovery and Targeted Therapeutics in Cancer

Dermatofibrosarcoma Protuberans of Scalp With Cervical Lymph Node Metastasis

Dermatofibrosarcoma protuberans (DFSP) is an uncommon, slow growing and locally aggressive tumor of the skin with a high rate of recurrence even after supposedly wide excision. The reports of regional lymph node metastasis and distant metastasis are very rare. Because of the extreme rarity of these cases with metastasis, the experience with management of such patients is very limited. A case of recurrent DFSP of scalp, with metastasis to the regional lymph nodes, in a 17-year-old boy is reported here. This is the second case of DFSP involving scalp and 16th case of DFSP of all sites metastasizing to the regional lymph nodes reported in literature. The patient was treated with wide excision of the lesion and ipsilateral radical neck dissection (including excision of overlying involved skin)

Evaluating the impact of comprehensive epilepsy education programme for school teachers in Chandigarh city, India

AbstractPurposeSchool teachers can play a key role in the first-aid management of school children experiencing a seizure. The teachers have a pivotal role in disseminating knowledge to the children of diseases experienced by them and developing positive attitudes among the children regarding the diseases. The present study investigated the knowledge and practices used by teachers to manage epileptic seizures. The study also tested an epilepsy intervention educational package to see whether it improved the knowledge and practices of the teachers regarding epilepsy.MethodsA total of 85 teachers in schools from Chandigarh, a city of northern India, participated in the study. At the start of the study the teachers completed a pre-tested, semi-structured questionnaire on the first-aid management of epileptic seizures. They were then presented with an intervention package that included audio-visual material on basic aspects of epilepsy. The teachers were then retested after the intervention (one immediately and another after three months from the intervention). A scoring system was devised to quantify the knowledge, attitude and skills of teachers.ResultsMore than 90% of the teachers had previously either heard or read about epilepsy. Nearly half of the teachers said that books and magazines were the most common source of their information, followed by the internet. A comparison of the knowledge, attitudes and skills about the first-aid management of epilepsy based on the before and after questionnaire scores showed significant improvements in the various domains (p<0.05).ConclusionThe epilepsy intervention educational package provided a positive, short term, impact on the knowledge and skills of teachers about epilepsy. There is a need for regular workshops to improve and reinforce the knowledge and skills of the teachers about health problems like epilepsy

Role of serum Cystatin C as a marker of early nephropathy in metabolic syndrome: a case control study

Background: The metabolic syndrome (MS) has become a significant public health problem and patients with MS are at higher risk for developing renal diseases. Serum Cystatin C suggested as a sensitive endogenous marker than creatinine for slight changes in GFR could be useful marker in MS.Methods: A total of 200 subjects were included. New International Diabetes Federation (IDF) definition of MS was used as inclusion criteria. Patients excluded were those with hypo/hyperthyroidism, on glucocorticoids, statins and fibrate, malignancy, cirrhosis, active liver disease and conditions affecting abdominal girth. Serum Cystatin C, insulin, creatinine, triglycerides, high density lipoproteins-cholesterol (HDL-C), fasting glucose, Urinary microalbumin and Urinary creatinine were estimated by standard method.eGFR and HOMA-IR (homeostasis model assessment of insulin resistance) were calculated. The primary outcome assessed was the occurrence of early nephropathy in MS and the secondary outcome included evaluation of early nephropathy by serum Cystatin C and eGFR. Appropriate statistical test was applied by using SPSS Version 21 software.Results: Fasting insulin levels and insulin resistance were significantly raised in MS cases. eGFR (MDRD) was lower in the MS cases (72.59±8.79mL/min/1.73m2) vs non-MS (130.34±40.75 mL/min/1.73m). Urinary microalbumin levels and serum cystatin C were significantly increased in MS and the cystatin c levels showed significant positive correlation with urinary microalbumin and negative correlation with eGFR.eGFR was found to be lower in the microalbuminuric than normoalbuminuric groups.Conclusions: Serum Cystatin C levels are higher in MS and can be useful, practical, non-invasive biomarker for evaluation of early renal involvement in MS.

Integrins in prostate cancer progression

Integrins, which are transmembrane receptors for extracellular matrix proteins, play a key role in cell survival, proliferation, migration, gene expression, and activation of growth factor receptors. Their functions and expression are deregulated in several types of cancer, including prostate cancer. In this article, we review the role of integrins in prostate cancer progression and their potential as therapeutic targets

The alpha6beta4 integrin promotes resistance to ferroptosis

Increases in lipid peroxidation can cause ferroptosis, a form of cell death triggered by inhibition of glutathione peroxidase 4 (GPX4), which catalyzes the reduction of lipid peroxides and is a target of ferroptosis inducers, such as erastin. The alpha6beta4 integrin protects adherent epithelial and carcinoma cells from ferroptosis induced by erastin. In addition, extracellular matrix (ECM) detachment is a physiologic trigger of ferroptosis, which is evaded by alpha6beta4. The mechanism that enables alpha6beta4 to evade ferroptosis involves its ability to protect changes in membrane lipids that are proferroptotic. Specifically, alpha6beta4-mediated activation of Src and STAT3 suppresses expression of ACSL4, an enzyme that enriches membranes with long polyunsaturated fatty acids and is required for ferroptosis. Adherent cells lacking alpha6beta4 require an inducer, such as erastin, to undergo ferroptosis because they sustain GPX4 expression, despite their increase in ACSL4. In contrast, ECM detachment of cells lacking alpha6beta4 is sufficient to trigger ferroptosis because GPX4 is suppressed. This causal link between alpha6beta4 and ferroptosis has implications for cancer biology and therapy

Qualitative palmar dermatoglyphic patterns in cases of idiopathic generalized epilepsy

Background: Genetic etiology has been proposed for both idiopathic epilepsy and dermatoglyphics. Hence, the present study has been undertaken to find out the existence of any correlation between dermatoglyphics and idiopathic generalized epilepsy.Objective of current study wasto find out an association, if any, between dermatoglyphic patterns of hands in idiopathic generalized epilepsy of both sexes.Methods:The study was conducted in the department of anatomy and department of neurology, Himalayan institute of medical sciences, Swami Ram Nagar, Dehradun. Fingertip patterns (whorls, loops, arches) and Main line (A, B, C, D) terminations were analysed by utilizing finger and palmar prints.Results:The present study showed a significant decrease in whorls and an increase in arches in both the hands of male and female IGE patients. Loops were increased in both hands of female patients. Main line D was mostly confined to sectors 11, 9 and 7 in both sexes among the cases and controls. Main line C terminated quite often in sectors 9 & 7 in males and females of the case series. Main line B terminated most frequently in sectors 5'' & 7 in control and case groups. Main line A terminated most frequently in sector 5' in males and females.  Conclusion: Therefore, we can conclude and hypothesize merely by observing decrease in the whorl and increase in the arch patterns in the fingerprints (as observed in the present study) that persons with high risk of idiopathic generalized epilepsy can be identified early and preventive measures can be taken against serious complications.

Effect of crack propagation path on mesh stiffness of spur gears

Gear mesh stiffness is an important indicator for condition monitoring of gears as its value has been found to decrease with initiation of crack. In the current study, the effect of crack propagation path on mesh stiffness has been investigated. Elliptical cracks with different values of semi major and semi minor axes have been considered with same values of crack lengths along these paths. ANSYS 19 software along with FRANC 3D has been used to model the gears with cracks induced. Structural analysis has been performed through Mechanical APDL. The values of mesh stiffness have been found to vary significantly with change in path of crack progression

Neuropilin-2 promotes branching morphogenesis in the mouse mammary gland

Although the neuropilins were characterized as semaphorin receptors that regulate axon guidance, they also function as vascular endothelial growth factor (VEGF) receptors and contribute to the development of other tissues. Here, we assessed the role of NRP2 in mouse mammary gland development based on our observation that NRP2 is expressed preferentially in the terminal end buds of developing glands. A floxed NRP2 mouse was bred with an MMTV-Cre strain to generate a mammary gland-specific knockout of NRP2. MMTV-Cre;NRP2(loxP/loxP) mice exhibited significant defects in branching morphogenesis and ductal outgrowth compared with either littermate MMTV-Cre;NRP2(+/loxP) or MMTV-Cre mice. Mechanistic insight into this morphological defect was obtained from a mouse mammary cell line in which we observed that VEGF(165), an NRP2 ligand, induces branching morphogenesis in 3D cultures and that branching is dependent upon NRP2 as shown using shRNAs and a function-blocking antibody. Epithelial cells in the mouse mammary gland express VEGF, supporting the hypothesis that this NRP2 ligand contributes to mammary gland morphogenesis. Importantly, we demonstrate that VEGF and NRP2 activate focal adhesion kinase (FAK) and promote FAK-dependent branching morphogenesis in vitro. The significance of this mechanism is substantiated by our finding that FAK activation is diminished significantly in developing MMTV-Cre;NRP2(loxP/loxP) mammary glands compared with control glands. Together, our data reveal a VEGF/NRP2/FAK signaling axis that is important for branching morphogenesis and mammary gland development. In a broader context, our data support an emerging hypothesis that directional outgrowth and branching morphogenesis in a variety of tissues are influenced by signals that were identified initially for their role in axon guidance