Etiology and endoscopic profile of dysphagia in adults - Single center study at a tertiary care center in South India.

Background: Dysphagia is defined as difficulty in deglutition. It can be either structural or motility abnormality in the passage of food from the oral cavity to the stomach. Upper GI endoscopy is the most important tool to diagnose dysphagia and rule out premalignant and malignant lesions. The purpose of the study was to classify various causes of dysphagia. Methods: This prospective observational study was conducted on 206 patients with complaints of dysphagia. Detailed history, physical examination was done. Upper GI endoscopy was done in all cases, and biopsies were taken if required. Oropharyngeal and neurological dysphagia were excluded from the study. The statistical analysis was performed using Microsoft Excel. The mean, percentage and proportions were calculated. Results: Two hundred and six patients were included in the study. Out of 206 patients, 127 were females, and 79 were males. The mean age was 43.62 years. The commonest age group was 21- 40 years contributing 41.7% cases, followed by 41-60 years contributing to 30.8% cases. Benign etiology (n= 141) was more common than that of malignant (n= 65). The commonest benign etiology was reflux esophagitis (n =54) followed by esophageal candidiasis (n= 38). The commonest malignant etiology was adenocarcinoma of the esophagus (n= 38), followed by squamous cell carcinoma (n= 24). Conclusions: The upper GI endoscopy is effective and safe modality to diagnose dysphagia. Benign etiologies were more common among females, but malignant causes were more common among males. The incidence of esophageal malignancy increases with advanced age

Functional Annotation of Hypothetical Proteins Derived from Suppressive Subtraction Hybridization (SSH) Analysis Shows NPR1 (Non-Pathogenesis Related)-Like Activity

Fusarium wilt is considered the most devastating banana disease incited by Fusarium oxysporum f. sp. cubense (FOC). The present study addresses suppressive subtraction hybridization (SSH) analysis for differential gene expression in banana plant, mediated through FOC and its interaction with biocontrol agent Trichoderma asperellum (prr2). SSH analysis yielded a total of 300 clones. The resultant clones were sequenced and processed to obtain 22 contigs and 87 singleton sequences. BLAST2GO (Basic Local Alignment Search Tool 2 Gene Ontology) analysis was performed to assign known protein function. Initial functional annotation showed that contig 21 possesses p38-like endoribonuclease activity and duality in subcellular localization. To gain insights into its additional roles and precise functions, a sequential docking protocol was done to affirm its role in the defense pathway. Atomic contact energies revealed binding affinities in the order of miRNA > phytoalexins > polyubiquitin, emphasizing their role in the Musa defense pathway. Contig 21 and polyubiquitin showed an atomic contact energy value of −479.60 kJ/mol, and even higher atomic contact energies were observed for miRNA (−804.86, −482.28, −494.75 kJ/mol), demonstrating its high RNA-binding properties. Phytoalexin contig 21-interacting interfacial residues were identified as rigid (10)/non-rigid (2) based on Bi, N values, and B-factor per residue. Hence, based on these results, contig 21 was characterized as a NPR1 (non-pathogenesis-related protein) homolog that is involved in plant defense and systemic induced resistance

Pancreatic malignancy in the backdrop of chronic pancreatitis: How much to push the boundaries to achieve R0 resection

Tumors of the body and tail of the pancreas are often more aggressive than tumors of the head and would have often undergone metastatic spread to other organs at the time of diagnosis. Most patients with carcinoma of the body and tail of the pancreas present at a late stage. Surgery is only indicated in those patients in whom there is no evidence of metastatic spread. Surgery is often not possible in cancers of the body and tail of the pancreas if the tumor invades celiac artery. Controversy exists regarding the margin status impact of microscopic resection margin involvement (R1) after pancreaticoduodenectomy (PD) for PDAC. There are reports indicating the rate of R1 resections increases significantly after PD if pathological examination is standardized. In this report, we present the case of a 56-year-old female who had undergone lateral pancreaticojejunostomy for chronic pancreatitis 8 years ago, but has now developed malignancy of the body and tail of the pancreas involving multiple organs. This patient underwent en bloc resection involving: 1. distal pancreatectomy with jejunal loop (lateral pancreaticojejunostomy) resection; 2. splenectomy; 3. left nephrectomy; 4. total gastrectomy; and 5. segmental colectomy with reconstruction by esophagojejunostomy, jejunojejunostomy, and colocolic anastomosis. The infrequent occurrence of tumor in the distal gland and advanced tumor stage at the time of diagnosis have both combined to produce therapeutic nihilism/dilemma in the minds of many surgeons. This report highlights the decision on how much to the push limits for multi-organ resection (en bloc resection with distal pancreatectomy, gastrectomy, splenectomy, colectomy, nephrectomy) with the intent of achieving R0 status in spite of the complexity of surgery in selected patients

Ag-Decorated Vertically Aligned ZnO Nanorods for Non-Enzymatic Glucose Sensor Applications

The non-enzymatic glucose sensing response of pure and Ag-decorated vertically aligned ZnO nanorods grown on Si substrates was investigated. The simple low-temperature hydrothermal method was employed to synthesize the ZnO NRs on the Si substrates, and then Ag decoration was achieved by sputtering. The crystal structure and surface morphologies were characterized by X-ray diffraction, field-emission scanning electron microscopy (FESEM), and transmission electron microscopy (TEM). The Ag incorporation on the ZnO NR surfaces was confirmed using EDS mapping and spectra. Furthermore, the chemical states, the variation in oxygen vacancies, and the surface modifications of Ag@ZnO were investigated by XPS analysis. Both the glucose/ZnO/Si and glucose/Ag@ZnO/Si device structures were investigated for their non-enzymatic glucose sensing performances with different glucose concentrations. Based on EIS measurements and amperometric analysis, the Ag@ZnO-NR-based glucose sensor device exhibited a better sensing ability with excellent stability over time than pure ZnO NRs. The Ag@ZnO NR glucose sensor device recorded 2792 µA/(mM·cm2) sensitivity with a lowest detection limit of 1.29 µM