Histopathological Analysis of Prostatic Adenocarcinoma and the Role of Immunohistochemistry in Distinction between Low Grade and High Grade Carcinomas

INTRODUCTION: Prostatic adenocarcinoma accounts for about 95% of malignancies of prostate gland. It is the most common malignant tumor among men. Incidence increases from 20% in men in their 50's to 70% in men between ages of 70's and 80's. The relative distribution of prostate cancer is different in each zone, 68% arises in the peripheral zone, 24% in transitional zone, and 8% in the central zone. Both genetic and environmental factors play a role in the origin of this disease. Long term androgen exposure and estrogen receptor β play an important role in the initiation of prostate cancer. Gleason's grading system is used to grade prostate cancers. Gleason's score ranges from 2-10. Serum prostate specific antigen is used to assist the diagnosis and management of prostate cancer. Immunohistochemical markers like cyclin D1, Ki-67 and ER-β are used to distinguish between low and high grade prostate adenocarcinomas. Alcian blue stain is used to demonstrate acid mucin production by tumor cells. AIMS AND OBJECTIVES: 1. To find out the age distribution of prostate carcinoma. 2. To distinguish between low grade and high grade prostate adenocarcinoma using Gleason's scoring method as well as immunohistochemical markers like Ki-67, cyclin D1, estrogen receptor -β. 3. To demonstrate the production of acid mucin by prostate cancer using histochemical stain like Alcian blue. 4. To correlate the level of serum prostate specific antigen with the grade of the tumor. MATERIALS AND METHODS: This is a study done in Thanjavur Medical College and Hospital from January 2015 to June 2017. Specimems obtained by transurethral resection of prostate from 50 cases were studied in the Department of Pathology. 1. Clinical details of patients like age, symptoms, location of the lesion within the prostate gland, serum PSA level were noted. 2. TURP specimens were fixed in 10% neutral buffered formalin, processed in a routine manner and sections were stained with hematoxylin and eosin. The sections were examined under light microscope and using modified Gleason's grading system. The prostate adenocarcinomas were grouped into low grade (score ≤6) and high grade tumors (score ≥7). 3. Immunohistochemistry was performed on whole tissue section using Cyclin D1, Ki67 and ER-b. 4.Also special stain like combined alcian blue -PAS was used to demonstrate the acid mucin production by prostate adenocarcinomas. RESULTS: Out of the 50 cases, 60% of the cases were between the age group of 70 - 80 years of age. Peripheral zone was involved by the tumor in all the 50 cases. There was a steep rise in the serum PSA level with increase in the Gleason's score. Mean serum PSA level in cases with low Gleason's score was 27.9 ng/mL .This was lower than serum PSA level of individuals with high Gleason score in whom it was 139.25 ng/mL. All 16 cases with high grade tumors (100%) showed cyclin D1 positivity. The mean expression of cyclin D1 was higher (35%) in high grade tumors than low grade tumors (16%). 94% of the high grade tumors showed Ki-67 expression when compared to low grade tumors where the expression of Ki-67 was found only in 29 % of the cases. ER-b expression was only 7% in high grade tumors when compared to the low grade tumors where the mean ER-b expression was 30.58%. 59% of the well differentiated tumors showed acid mucin production. None of the poorly differentiated tumors secreted acid mucin. CONCLUSION: Thus, a steep rise was found in the serum prostate specific antigen levels with increase in Gleason's score. Also a significant correlation was found between Gleason's score and cyclin D1, Ki-67 expression. The expression of these two markers was higher in high grade prostate adenocarcinomas. ER-β expression was higher in low grade tumors and its expression gets reduced with increase in Gleason's score. Acid mucin production by tumor cells gets reduced as the Gleason's score of the tumor increases

Requirements Engineering for Globally Distributed Teams using Scaled Agile Framework

As large organizations are striving to deliver software at a faster pace and to keep up with the latest trends, they are in a transformation stage of adopting to Scaled Agile Framework (SAFe). SAFe is a framework for implementing agile practices at enterprise level and it provides a roadmap for portfolios, programs and teams. Large organizations adopting to SAFe are facing challenges in coordinating, planning and managing requirements, as they work with globally distributed teams. The goal of this thesis was to improve the Requirements Engineering (RE) process using Scaled Agile Framework in globally distributed teams. The main research method used in this thesis was action research, an iterative approach which combines theory and practice. The empirical study was conducted in a large project that used SAFe and had eight globally distributed teams. In order to investigate the challenges faced by globally distributed teams, analysis of the existing literature and RE process flow in SAFe was important. It served as a good input to understand which good RE practices can be applied in the empirical study. The results of the study show that visually representing requirements as models and sharing domain and system knowledge through Community of Practice (CoP) reduced ambiguity in requirements. The good RE practice applied in SAFe, of working and improving collaboratively with the globally distributed teams helped in better coordination and managing of requirements. In addition to this, it was also essential to have SAFe training to develop clear and shared understanding of the framework and RE process. The lessons learned from the empirical study indicate that a well-organized PI planning is the key RE practice of SAFe in providing the big picture of requirements to all members in distributed teams. In addition, Community of Practice (CoP) can be a key RE practice of SAFe in sharing knowledge such as business domain, system knowledge, skills and techniques, and experiences

Assessing the impact of religion and family in shaping UAE national women’s choice of, and engagement with their careers

National women in the Gulf Cooperative Council (GCC) countries are highly educated yet their work participation remains low when compared to the rest of the world. This thesis aims to assess the impact of religion and family in the shaping of national women’s careers in the GCC workforce, in particular the United Arab Emirates (UAE). This aim is fulfilled by conducting three interlinked research projects; a systematic literature review, a qualitative study and finally, a quantitative study. The first research project comprises a systematic review of the literature that identifies the barriers and enablers to the participation and advancement of female national managers in the GCC workforce. The synthesis of articles reveals findings at the societal, organizational, family and individual levels. At the societal level, barriers and enablers are identified as those influenced by socio-cultural and religious norms and practices. These norms and practices influence how organizations (public and private) engage with their employees, and families engage with their individual members. In the second research project, I choose to narrow the scope of my research from six GCC countries to one country, the UAE. I explore the influence of family on the experiences of ten senior female UAE national managers at key work decision stages; I employ semi-structured interviews and, based on their experiences, the findings reveal that the family has influence at both the role entry and role participation stages. No data were available for the role exit stage. Furthermore, the experiences are different for women from extended versus nuclear families. In the third research project I choose to focus on the factors that support and impact on the experiences of UAE national women during their career life cycle. The findings indicate that overall there are no differences between the experiences of women from nuclear families versus extended; however, there are differences between the model and the UAE sample, both at the overall level and individual age stages. My second research project; a qualitative study provides three contributions to knowledge. Firstly, I extend the understanding of work related decisions, taking into account family influences. However, in the UAE, based on my research, the outcome will primarily be in favour of family due to the influence of socio-cultural and religious norms and practices. I propose that the conceptual framework be extended by adding the component of religion to it when considering the context of the UAE. Secondly, I propose a modification to the framework enabling it to be used in the UAE context. Thirdly, no previous empirical research has been conducted using this framework, with the result that the data from my research contribute empirically. With respect to contribution to practice, this qualitative study identifies the need for enhanced recruitment strategies for women and more gender friendly policies and practices to ensure the effectiveness of Emiratization within both the public and private sectors. The evidence from my third research project; a quantitative study contributes theoretically as my research demonstrates that the O’Neil and Bilimoria (2005) three phase women’s career development model does not fit in the UAE context. The research also contributes from a practical perspective as it identifies the need to improve the development of networking, communication and leadership skills for women and the implementation of comprehensive flexible working practices for women

Interrogating Practices of Gender, Religion and Nationalism in the Representation of Muslim Women in Bollywood: Contexts of Change, Sites of Continuity

Through a discourse analysis of four commercially successful Bollywood films between 2012-2013, this paper investigates Bollywood’s role in creation of hierarchical identities in the Indian society wherein Muslims occupy the position of the inferior ‘other’ to the superior Hindu ‘self’. Focusing on Muslim heroines, the paper demonstrates that the selected narratives attempt to move away from the older binary identity narratives of Muslim women such as nation vs. religion and hyper-sexualised courtesan vs. subservient veiled women, towards identity narratives borne out of Muslim women’s choice of education, career and life partner, political participation, and embodied practices. However, in comparison to signs of change the sites of continuity are strongly embedded in the religious-nationalistic meta-narrative that drives the paradigms of Indian femininity/ womanhood. To conclude, the nature of the recent deployment of Muslim heroines in Bollywood reinforce the hierarchy between the genders (male-female), between the communities (Hindu-Muslim) and between nations (India- Pakistan)

Retrospective study of histopathological pattern of endometrium in abnormal uterine bleeding

Background: Abnormal uterine bleeding (AUB) is a common gynaecological complaint associated with considerable morbidity. It significantly affects the patient’s family personal and social life. The aim of this study was to analyse the histopathological patterns of endometrium in patients presenting with AUB.Methods: This is a retrospective study conducted in the teaching hospital in the department of obstetrics and gynecology along with the pathology department. All patients with AUB were included in the study. This study of 138 samples both from hysterectomy specimens and endometrial biopsy were included.Results: The specimen obtained for examination of the endometrial samples 86 comprised from dilatation and curettage and rest 52 samples were obtained from hysterectomy specimens. Most common histopathological pattern was found to be proliferative endometrium, followed by disordered proliferative endometrium and atropic endometrium.Conclusions: Study of the histopathological pattern of the endometrial biopsies can be included in the initial evaluation of women with AUB when the cause of bleeding is not known along with ultrasound examination, then using it as the last modality for diagnostic and therapeutic purposes, irrespective of age group

CREATIVE MARKETING STRATEGY AND EFFECTIVE EXECUTION ON PERFORMANCE IN PAKISTAN

ABSTRACT The purpose of the current research is to determine the influence of creative marketing strategies and effective execution on business unit performance. Moreover, strategic orientation and environmental uncertainty are used as moderating variables. Data are collected from 368 key informants working in Fast-Moving Consumer Goods (FMCG), banking, pharmaceutical, chemical, insurance, and engineering industries using a multi-stage random sampling technique. Factor analysis and multiple hierarchal regressions are used to test the study hypotheses. The results indicate that creative marketing strategy and effective execution are positively associated with business performance. Moreover, environmental uncertainty and strategic orientation play a moderating role in the above relationships

Bi-directional Causality Between Remittances and Poverty: An Empirical Evidence From Pakistan.

This study explores the two-way causality between poverty and remittances in Pakistan. The empirical evidence is based upon ARDL double bound approach for the long run relationship between remittances and poverty and VECM was used for direction and magnitude of causation. Furthermore, variance decomposition and Impulse response functions were used to capture the standard deviation shocks. Poverty (head count ratio) and remittances to GDP ratio were used from 1973-2006 for analysis purpose. In the study two equations were used interchangeably as dependent variable. It was found by using the Narayan (2005) test criteria for small sample there is co-integration found between poverty and remittances. The relationship is further supported by long run and short run analysis by ECM. Poverty and remittances are inversely and significantly related in the short run and long run by the estimates of ECM. VECM confirms the results by providing the short run and long run significant estimates. The results are also corroborated with variance decomposition and impulse response function. It could be concluded from the results that remittances are playing a vital role after the foreign direct investment. It is also found that due to altruistic behavior, inflow of remittances is increasing due to the poverty and it provides safety nets to poor and ultimately helping to reduces poverty. Key Words: Remittances, Poverty, ARDL, VECM and co-integration JEL classification: O11,O1

Perspectives from the ground: Governing informality of water in Metro Manila

Although privatisation in Metro Manila has resulted in increased access to piped connections and reduced pilferage, the urban poor pay more for low-quality water and access it through small-scale providers including cooperatives and syndicates. While forming cooperatives can represent efforts of urban poor communities to claim legality, the selling of water to neighbours or offering protections for pilfering by local providers illustrates everyday illegality. Governing logics of the postcolonial state and concessionaires shape these Janus-faced survival practices of urban poor communities. These unwritten shared understandings, or informal institutions, operate within porous spaces of legality and illegality and remain at the mercy of the state, which can criminalise them. Moreover, while living in an informal settlement precludes access to individual piped connections from concessionaires, living on a resettlement site does not ensure access either, indicating that city planning directly impacts water access and supply. These realities suggest a relational reading of informality, linking the state and concessionaires from the top down with negotiated access to water from the bottom up, which may explain persisting inequities

English Language Competency and Outsourced Call Centers in Bangladesh

This paper attempts to investigate whether or not the English competency of Customer Service Representatives (CSRs) is hindering the growth and development of outsourced call centers in Bangladesh. It also looks into the problems being faced by call centers in hiring English competent CSRs. A limited appraisal of the English communication training of the CSRs offered by Call Centre Training Institutes is also within the purview of the paper. With this purpose 33 supervisors of different call centers, who are in charge of monitoring the CSRs, have been interviewed with a questionnaire comprised of both close and open ended questions. The result shows there is scarcity of skilled English communicators which is one of the major barriers in the growth and development of the call centers. However, factors like product knowledge, intercultural communication skills, service personality are also crucial as they are integral for successful transaction and addressing them will pave the way for the progress of the industry. The result also implicitly indicates that mainstream education system in Bangladesh is still unable to produce competent English communicators. The findings of the study reveal that the current shortage of skilled manpower can further become more acute when call center industry grows in line with the expectation of the government. It is also revealed that the call center training institutes are incapable of delivering the kind of training required for the aspirant CSRs. This study pinpoints the necessity of future research in several directions to ensure a balance between the demand and supply of native like fluent English communicators for call center Industry in Bangladesh

Relationship among Economic Growth and other Macroeconomic Variables: A Study of Pakistan

This study is investigating the short run and long run relationship among major macroeconomic variables and economic growth for the economy of Pakistan during 2000 - 2015. Autoregressive distributed lag (ARDL) model and bounds test have been applied to estimate the short run and long run relationship between GDP and  other major macroeconomic variables like,  labour force, rate of capital formation, money supply, inflation rate, trade rate, foreign direct investment (FDI) and unemployment. ARDL model indicates significant relationship between labour force, FDI and unemployment economic growth, in the long run, at 1% and 5% level. Keywords: Macroeconomic variables; capital formation; money supply; inflation; trade; FDI; unemployment; economic growth; ARDL model. JEL Code: O1; O4; F43. DOI: 10.7176/JRDM/54-07 Publication date: April 30th 201