Butterfly pattern hypopigmentation with antitubercular treatment

Standard short course chemotherapy is the key element of the DOTS strategy and these drugs cause different kinds of cutaneous adverse drug reactions that usually occur within 2 months of initiation of treatment in around 97% of the patients. We hereby report a case of a 16-year-old female patient who developed butterfly pattern hypopigmented rashes after 3 months of starting on category 1 antitubercular treatment (ATT). Other causes with similar picture were ruled out with additional investigations and the case was confirmed as ATT induced hypopigmented rash. WHO-UMC causality assessment showed a probable association

Using a Discrete Choice Experiment to Elicit the Demand for a Nutritious Food: Willingness-to-Pay for Orange Maize in Rural Zambia

Using a discrete choice experiment, this paper estimates the willingness to pay for biofortified orange maize in rural Zambia. The study design has five treatment arms, which enable an analysis of the impact of nutrition information, comparing the use of simulated radio versus community leaders in transmitting the nutrition message, on willingness to pay, and to account for possible novelty effects in the magnitude of premiums or discounts. The estimation strategy also takes into account lexicographic preferences of a subset of our respondents. The results suggest that (a) orange maize is well liked and can compete with white maize in the absence of a nutrition campaign, (b) there is a premium for orange maize with nutrition information, and (c) the mode of nutritional-message dissemination does not have a large impact on consumer acceptance, and (d) novelty effects do not translate into higher willingness to pay for orange maize.

Role of thalassemia screening in prevention and control of thalassemia - a 5 year experience

Background: Thalassemia is a commonest genetic blood disorder in India which can be prevented by antenatal screening and prenatal diagnosis. Aim of the study was to screen antenatal women and their spouses to detect “couples at risk” of thalassemia major births and offering them genetic counseling and option of prenatal diagnosis thereby preventing the birth of thalassemia major babies.Methods: Thalassemia screening for antenatal women was done by NESTROFT test and RBC Indices (MCV, MCH, and RBC count). Confirmation of diagnosis was done by HPLC test. Husbands of women testing positive on HPLC were also tested and couples at risk detected. They were counseled and referred for prenatal genetic diagnosis. Women carrying thalassemia major fetus were advised termination and those with normal and thalassemia minor fetus were advised to continue pregnancy.Results: A total of 93871 patients were screened and HPLC was done on 10983 patients. 7.07% had one or the other hemoglobinopathies and 5.8% had beta thalassemia trait. Among antenatal beta thalassemia trait was found in 5.02%, HbD in 0.36%, HbE in 0.58% and HbS 0.05%. Forty two “at risk couples” (both husband and wife thalassemia trait) were identified, 16 of these underwent prenatal diagnosis and 3 thalassemia major births were terminated.Conclusions: Lack of awareness, late registration, husbands not coming/turning up for their test and “at risk couples” opting out of prenatal diagnosis are the cause of thalassemia major births which can be prevented if awareness is generated amongst masses, screening and prenatal genetic diagnosis services are made widely available

Outcome of pregnancy in women with previous one cesarean section

Background: Worldwide rise in cesarean section (CS) rate during the last three decades has been the cause of alarm and needs an in-depth study. The purpose of this study was to determine the outcome of pregnancy in women with previous one cesarean section and maternal and perinatal complications. It also aimed at identifying the factors, which can influence the outcome of trial of labour (TOL).Methods: The prospective study was conducted in the department of Obstetrics and Gynaecology, Kamla Nehru hospital for mother and child, Indira Gandhi Medical College, Shimla, from June 2013 to May 2014 which included all women undergoing trial for vaginal birth after a previous cesarean who were more than 34 weeks, singleton viable fetus of appropriate size with cephalic presentation with inter delivery interval more than 18 months. Collected data was analysed by Student T-test and Chi-square test was used where required, for statistical analysis using Epi info 7 software. P value <0.05 was considered significant.Results: Out of 152 subjects given trial of labour, 107 (70.39%) subjects had successful VBAC and 45 (29.61%) had repeat emergency cesarean section. The maternal morbidity in emergency cesarean section group and vaginal delivered group was seen in 14 (31%), 8 (7.47%) subjects respectively. No significant perinatal morbidity was observed. VBAC rate was significantly more in women who had prior vaginal deliveries, especially in those with previous VBAC.Conclusions: In carefully selected cases, trial of labour (TOL) after a prior cesarean is safe and often successful. A prior vaginal delivery, particularly, a prior VBAC are associated with a higher rate of successful TOL

Health problems in adolescent girls

Background: Adolescents form precious human resources in every country, constitutes large number of populations. Adolescence is a period of rapid physical growth, sexual and psychological changes. The aim of the study is to assess the health problems in Adolescent girls and to take measures to prevent and treat their health problems. Methods: This prospective study was conducted from October 2014 to September 2016 in Hindu Rao hospital, North DMC medical college. Patients attending to gynecological outpatient department included in this study. The Statical analysis was done by using Microsoft excel. Results: Majority of patients in our study belongs to 15 to 19 years. Menstrual dysfunction (67.7%) is the most common complaint followed by leucorrhea (14.1%) and infections (10.6%). Conclusions: Adolescence girls presented with various gynaecological problems in our study. Setting up adolescent friendly clinics and privacy to discuss their problems is desirable for early diagnosis and management

A centrosome clustering protein, KIFC1, predicts aggressive disease course in serous ovarian adenocarcinomas

Background Amplified centrosomes are widely recognized as a hallmark of cancer. Although supernumerary centrosomes would be expected to compromise cell viability by yielding multipolar spindles that results in death-inducing aneuploidy, cancer cells suppress multipolarity by clustering their extra centrosomes. Thus, cancer cells, with the aid of clustering mechanisms, maintain pseudobipolar spindle phenotypes that are associated with low-grade aneuploidy, an edge to their survival. KIFC1, a nonessential minus end-directed motor of the kinesin-14 family, is a centrosome clustering molecule, essential for viability of extra centrosome-bearing cancer cells. Given that ovarian cancers robustly display amplified centrosomes, we examined the overexpression of KIFC1 in human ovarian tumors. Results We found that in clinical epithelial ovarian cancer (EOC) samples, an expression level of KIFC1 was significantly higher when compared to normal tissues. KIFC1 expression also increased with tumor grade. Our In silico analyses showed that higher KIFC1 expression was associated with poor overall survival (OS) in serous ovarian adenocarcinoma (SOC) patients suggesting that an aggressive disease course in ovarian adenocarcinoma patients can be attributed to high KIFC1 levels. Also, gene expression levels of KIFC1 in high-grade serous ovarian carcinoma (HGSOC) highly correlated with expression of genes driving centrosome amplification (CA), as examined in publically-available databases. The pathway analysis results indicated that the genes overexpressed in KIFC1 high group were associated with processes like regulation of the cell cycle and cell proliferation. In addition, when we performed gene set enrichment analysis (GSEA) for identifying the gene ontologies associated to KIFC1 high group, we found that the first 100 genes enriched in KIFC1 high group were from centrosome components, mitotic cell cycle, and microtubule-based processes. Results from in vitro experiments on well-established in vitro models of HGSOC (OVSAHO, KURAMOCHI), OVCAR3 and SKOV3) revealed that they display robust centrosome amplification and expression levels of KIFC1 was directly associated (inversely correlated) to the status of multipolar mitosis. This association of KIFC1 and centrosome amplification with HGSOC might be able to explain the increased aggressiveness in this disease. Conclusion These findings compellingly underscore that KIFC1 can be a biomarker that predicts an aggressive disease course in ovarian adenocarcinomas

Rampant Centrosome Amplification Underlies more Aggressive Disease Course of Triple Negative Breast Cancers

Centrosome amplification (CA), a cell-biological trait, characterizes pre-neoplastic and pre-invasive lesions and is associated with tumor aggressiveness. Recent studies suggest that CA leads to malignant transformation and promotes invasion in mammary epithelial cells. Triple negative breast cancer (TNBC), a histologically-aggressive subtype shows high recurrence, metastases, and mortality rates. Since TNBC and non- TNBC follow variable kinetics of metastatic progression, they constitute a novel test bed to explore if severity and nature of CA can distinguish them apart. We quantitatively assessed structural and numerical centrosomal aberrations for each patient sample in a large-cohort of grade-matched TNBC (n = 30) and non-TNBC (n = 98) cases employing multi-color confocal imaging. Our data establish differences in incidence and severity of CA between TNBC and non-TNBC cell lines and clinical specimens. We found strong correlation between CA and aggressiveness markers associated with metastasis in 20 pairs of grade-matched TNBC and non-TNBC specimens (p \u3c 0.02). Time-lapse imaging of MDA-MB-231 cells harboring amplified centrosomes demonstrated enhanced migratory ability. Our study bridges a vital knowledge gap by pinpointing that CA underlies breast cancer aggressiveness. This previously unrecognized organellar inequality at the centrosome level may allow early-risk prediction and explain higher tumor aggressiveness and mortality rates in TNBC patients

Effects of glenohumeral corticosteroid injection on stiffness following arthroscopic rotator cuff repair: a prospective, multicentric, case-control study with 18-month follow-up

Background This study aimed to analyze the efficacy of single-dose corticosteroid injection (CSI) administered at 6 weeks postoperative to treat stiffness following arthroscopic rotator cuff repair (ARCR). Methods In this prospective, multicentric, case-control study, post-ARCR stiffness at 6 weeks was treated with either a single dose of intra-articular CSI (CSI group) or physical therapy with oral analgesics (non-CSI group). Pain intensity according to visual analog scale (VAS), functional outcome using the Constant Murley Shoulder Score, time to return to activities of daily living (ADLs), and retear rate were recorded at 6 weeks, 9 weeks, 12 weeks, 6 months, 12 months, and 18 months postoperatively in both groups. Results A total of 149 patients (54.5%) in the CSI group and 124 patients (45.5%) in the non-CSI group were included in this study. Pain and function were significantly better in the CSI group at 9-week, 12-week, and 6-month (P<0.001) follow-up, whereas they were not significantly different when the groups were compared at 12- and 18-month follow-up. The mean duration to return to ADLs was significantly shorter (P<0.001) in the CSI group. The incidence of retears was not significantly different (P=0.36) between groups at the end of 18 months of follow-up. Conclusions Single-dose intra-articular CSI administered at 6 weeks postoperative to treat post-ARCR stiffness significantly improved pain, function, and duration of return to ADLs without increasing the risk of retears compared to patients who did not receive intra-articular CSI. Level of evidence III

Prognostic Role of Androgen Receptor in Triple Negative Breast Cancer: A Multi-Institutional Study

Background: Androgen Receptor (AR) has emerged as a potential therapeutic target for AR-positive triple-negative breast cancer (TNBC). However, conflicting reports regarding AR’s prognostic role in TNBC are putting its usefulness in question. Some studies conclude that AR positivity indicates a good prognosis in TNBC whereas others suggest the opposite, and some show that AR status has no significant bearing on the patients’ prognosis. Methods: We evaluated the prognostic value of AR in resected primary tumors from TNBC patients from six international cohorts {US (n=420), UK (n=239), Norway (n=104), Ireland (n=222), Nigeria (n=180), and India (n=242); total n=1407}. All TNBC samples were stained with the same anti-AR antibody using the same immunohistochemistry protocol, and samples with ≥1% of AR-positive nuclei were deemed AR-positive TNBCs. Results: AR status shows population-specific patterns of association with patients’ overall survival after controlling for age, grade, population, and chemotherapy. We found AR-positive status to be a marker of good prognosis in US and Nigerian cohorts, a marker of poor prognosis in Norway, Ireland and Indian cohorts, and neutral in UK cohort. Conclusion: AR status, on its own, is not a reliable prognostic marker. More research to investigate molecular subtype composition among the different cohorts is warranted