Cancer biomarker development from basic science to clinical practice

The amount of published literature on biomarkers has exponentially increased over the last two decades. Cancer biomarkers are molecules that are either part of tumour cells or secreted by tumour cells. Biomarkers can be used for diagnosing cancer (tumour versus normal and differentiation of subtypes), prognosticating patients (progression free survival and overall survival) and predicting response to therapy. However, very few biomarkers are currently used in clinical practice compared to the unprecedented discovery rate. Some of the examples are: carcino-embryonic antigen (CEA) for colon cancer; prostate specific antigen (PSA) for prostate; and estrogen receptor (ER), progesterone receptor (PR) and HER2 for breast cancer. Cancer biomarkers passes through a series of phases before they are used in clinical practice. First phase in biomarker development is identification of biomarkers which involve discovery, demonstration and qualification. This is followed by validation phase, which includes verification, prioritisation and initial validation. More large-scale and outcome-oriented validation studies expedite the clinical translation of biomarkers by providing a strong ‘evidence base’. The final phase in biomarker development is the routine clinical use of biomarker. In summary, careful identification of biomarkers and then validation in well-designed retrospective and prospective studies is a systematic strategy for developing clinically useful biomarkers

Comprehensive experimental performance analysis of DSR, AODV and DSDV routing protocol for different metrics values with predefined constraints

A Mobile Adhoc Network is a multi-hop self-configuring network without any fixed infrastructure. Due to mobility of nodes, dynamic topology and highly dynamic environment, designing and implementing stable routing in Mobile Ad-hoc Networking is a major challenge and a critical issue. This paper analyses the performance analysis of on demand routing protocol, Dynamic Source Routing (DSR), Adhoc on Demand Distance Vector Routing (AODV) and table driven protocol, Destination-Sequenced Distance Vectoring (DSDV) using a network simulator NS2. Different types of test scenario have designed with fixed number of nodes but varying mobility. Different performance metric values like, throughput, delay, normalized network load, end to end delay, dropped packets, packets delivery ratio have been observed. The experimental results have been analysed and recommendation based on the obtained results has been proposed about the significance of each protocol in different scenarios and situations. The simulation results show that both protocols are good in performance in their own categories. We believe that findings of this paper will help the researcher to find the best protocol under predefined condition with varied mobility. We believe that this research will help the researcher to identify and further investigate any particular metrics value of AODV, DSR and DSDV

Comparative Study of the Attitudes of Rural and Urban Punjabi Society towards Caste Stereotypes in Punjabi Language

This study compares attitudes of rural/urban population of Punjab (Pakistan) towards caste-stereotypes in Punjabi language. The data were collected from District Vehari of southern Punjab including its two adjacent sub-divisions Burewla and Mailsi through questionnaire and interviews; and analyzed using SPSS. The results reveal that there is considerable difference among the attitudes of urban/rural population regarding beliefs and foundations of the caste-stereotypes and their impacts on social life. Besides, people living in rural areas are more prone to using caste-stereotypes than their urban counterparts. Similar trend is observed in the effect of caste-stereotypes on their social relations. DOI: 10.5901/mjss.2015.v6n1s1p62

The Usefulness of Morphology in Diagnosing various Malignancies on Bone Marrow Examination in Adults- A Single Centre Study

Introduction: Bone marrow is the site of involvement of various neoplasms. The objective of this study was to determine the incidence of various malignancies (Haematological and non-Haematological) in adults diagnosed on morphological examination of bone marrow. Materials and Methods: It was a single-centre, retrospective study conducted at the Department of Pathology, Fauji Foundation Hospital, Rawalpindi from January 2012 to December 2018. All patients above 15 years of age diagnosed as having Haematological or Non-Haematological malignancy involving bone marrow were included in the study. Data was analyzed using SPSS version 17. Results: A total of 275 adult patients had malignancies involving bone marrow; 233 (84.7%) were females and 42 (15.3%) were males.  Out of 275 patients, 50 (18.1%) patients had Acute Myeloid Leukaemia, 45 (16.3 %) had Chronic Myeloid Leukaemia (CML), 41 (14.9 %) having Non-Hodgkin lymphoma (NHL), 32 (11.6 %) having Acute Lymphoblastic Leukaemia (ALL), 31 (11.2 %) having Chronic Lymphocytic Leukaemia (CLL) and 27 (9.8 %) having Plasma cell Myeloma. Metastatic infiltrates were seen in 16 (5.8 %) patients. Myeloproliferative neoplasms (MPN) in 6 (2.1%), Essential Thrombocythaemia in 5 (1.8 %), Polycythaemia vera in 4 (1.4%), Primary myelofibrosis in 2 (0.7 %), Hodgkins Lymphoma in 2 (0.7 %), and Plasma Cell Leukaemia in 1 (0.3 %) patient were seen. Thirteen (4.7%) patients of Acute leukaemia and 6 (2.1%) patients of MPN required further testing by Immunophenotyping/Cytogenetics for a conclusive diagnosis. Conclusion: Leukaemias were the most common malignancies involving bone marrow, followed by Non-Hodgkin Lymphomas, Plasma cell myeloma and Metastatic infiltrates. Morphology by light microscopy remains the single most useful tool for the diagnosis of malignancies, especially in under-resourced centres

Out-of-Pocket Expenditure on Delivery Care in Public and Private Health Sectors – A Study in a Rural District of Pakistan

Pakistan witnessed a significant improvement in maternal health outcomes during the past two decades. However, persistent urban-rural and socio-economic inequalities exist in access to maternal healthcare services across the country. The objective of this study was to estimate out-of-pocket expenditure (OOPE) on delivery care by women in the public and private health sectors in RajanPur district. This was a cross-sectional study conducted, among 368 randomly selected mothers who had childbirths from 1st October to 31st December 2020. The study applied multi-stage random sampling technique to select the study participants. The results showed that about two-thirds of mothers preferred public hospitals for most recent delivery. The percentage of cesarean deliveries conducted in private hospitals (43.8%) was 4.7 times higher than in public hospitals (9.3%). About 99% of mothers incurred OOPE during delivery care, and the mean OOPE incurred during delivery care was PKR 2840 (US$17.75) in public hospitals and PKR 25596 (US$159.9) in private hospitals. OOPE on cesarean delivery in private hospitals (PKR 39654.7, US$247.8) was 2.5 times higher than the public hospitals (PKR16111.9, US$100.69), whereas OOPE incurred on normal delivery care in private hospitals (PKR14339, US$89.62) was 9.5 times higher than OOPE in public hospitals(PKR 1501.4, US$9.38).To conclude, the findings and recommendations drawn from the research would provide some insights to health policymakers and planners in developing an integrated and viable maternal healthcare program in Pakistan

Enteric coating of ibuprofen tablets (200 mg) using an aqueous dispersion system

Ibuprofen is a propionic acid derivative that belongs to the class NSAIDs. Major adverse reactions associated with Ibuprofen are related to GIT and include peptic and mucosal ulcers, dyspepsia, severe gastric pain and bleeding, that results in excessive treatment failure. The goal of this study was to develop enteric coated ibuprofen tablets in order to avoid gastric mucosal irritation, diffusion of drug across mucosal lining and to let active ingredient be absorbed easily in small intestine. The formulation was developed and manufactured through the direct compression process, the simplest, easiest and most economical method of manufacturing. Enteric coating was done using an Opadry white subcoating and an aqueous coating dispersion of Acryl-Eze. Enteric coated formulation was subjected to disintegration and dissolution tests by placing in 0.1 M hydrochloric acid for 2 h and then 1 h in phosphate buffer with a pH of 6.8. About 0.04% of drug was released in the acidic phase and 99.05% in the basic medium. These results reflect that ibuprofen can be successfully enteric coated in order to prevent its release in the stomach and facilitate rapid release of the drug in the duodenum, due to the presence of superdisintegrant. Formulating this enteric coated tablets could increase patient compliance by decreasing adverse drug reactions (ADR S) associated with Ibuprofen therapy.Ibuprofeno é um derivado do ácido propiônico, que pertence à classe dos fármacos não-esteróides (AINES). As principais reações adversas associadas com o ibuprofeno se referem àquelas do trato gastrintestinal (TGI), como úlceras pépticas e da mucosa, dispepsia, dor gástrica grave e sangramento, que resultam em muitas falhas de tratamento. O objetivo do estudo foi desenvolver comprimidos revestidos de ibuprofeno que impeçam a irritação da mucosa gástrica, difusão do fármaco através da mucosa e permitam, facilmente, a absorção do princípio ativo do intestino delgado. A formulação foi desenvolvida e manufaturada por meio de processo de compressão direta, método mais simples e econômico de preparação. O revestimento entérico foi efetuado utilizando-se subrevestimento com Opadry branco e revestimento por dispersão aquosa de Acryl-Eze. A formulação de revestimento para liberação entérica foi submetida a testes de desintegração e de dissolução, em ácido clorídrico 0,1 M, por 2 h, e, então, a h, em tampão fosfato pH 6,8. Cerca de 0,04% do fármaco foi liberado na fase ácida e 99,05%, no meio básico. Estes resultados refletem o fato de que o ibuprofeno pode ser revestido com sucesso, a fim de impedir sua liberação no estômago e facilitar a rápida liberação do fármaco no duodeno, devido à presença de superdesintegrante. A formulação de tais comprimidos aumentaria a adesão do paciente pela diminuição das reações adversas (RAs), associadas à terapia com ibuprofeno

Polymorphic noncoding region of GNRH1 gene in male patients with impaired fertility

Impaired male fertility is a multifactorial pathological condition and genetic contribution is up to 20%. Gonadotropin Releasing Hormone 1 (GNRH1) is associated with maturation of spermatozoa. We aimed to study genetic sequence of GNRH1 gene in azoospermia males. We collected 50 clinically diagnosed infertile males after the informed consent. DNA was extracted and primers were designed to amplify the exonic and exon/intron boundaries of exon 1 and exon 2 region of GNRH1 gene. The amplicons were sequenced and analyzed using bioninformatic tools. We have identified sequence variations at c.1325-131del.A, c.1325+40 T>G, c.1325+34T>G, c.1325+124 Ins. A, c.1325+126 Ins. A, c.1325+181T>G, c.1325+264 Ins.G and c.1325+269 Ins. A positions. Human Splicing Finder predicted that c.1325-131del.A, c.1325+34T>G, c.1325+124 Ins. A, c.1325+264 Ins.G and c.1325+269 Ins. A have impact on the splicing while c.1325+40 T>G, c.1325+126 Ins. A and c.1325+181T>G have relation with the splicing. The c.1325+40 reported in literature as rs2709608 but has no association with the male infertility. The c.1325+181T>G We could not find other variations in the literature therefore suggested to be novel. Our study suggests that intronic region of GNRH1 gene a highly variable in Pakistani infertile male patients and suggests to explore its correlation with the disease on a large scale

Patient's Feedback Platform for Quality of Services via “Free Text Analysis” in Healthcare Industry

Data analysis of social media posting continues to offer a huge variety of information about the health situation faced by an individual. Social networking or social media websites provide us a wealth of information generated by users in a variety of domains, that generated information are unstructured and unlabeled and are not captured in an exceedingly systematic manner, as info generated is not humanly possible to process due to its size. One traditional way of collecting patients experience is by conducting surveys and questionnaires, as these methods ask fixed questions and are expensive to administer. In this paper, a patient feedback platform (PFP) using free text sentiment analysis is developed to computationally identify and categorize the polarity expressed in a piece of text. Six machine learning latest algorithms have been used as key evaluation for evaluating accuracy of the developed (PFP) model. Results achieved have shown 88 % accuracy on the basis of which it is recommended that developed (PFP) patient feedback platform could be used to improve E-health care services indeed