Disarming Dialogues during a visit to India

This article is based on the workshop - Disarming Dialogues: Reviving Humanities in Medical Education - conducted in November 2016 at the University of Chicago center in Delhi. \ud \ud The workshop is a collaboration between the Medical Humanities Group, University College of Medical Sciences, University of Delhi, and Bucksbaum Institute for Clinical Excellence, University of Chicago, Illinois

Identification of a repetitive sequence belonging to a PPE gene of Mycobacterium tuberculosis and its use in diagnosis of tuberculosis

A repetitive sequence specific to Mycobacterium tuberculosis was isolated from a gt11 library of M. tuberculosis by DNA-DNA hybridization using genomic DNA of M. tuberculosis as probe followed by subtractive hybridization with a cocktail of other mycobacterial DNA. This led to identification of CD192, a 1291 bp fragment of M. tuberculosis containing repetitive sequences, which produced positive hybridization signals with M. tuberculosis DNA within 30 min. Nucleotide sequencing revealed the presence of several direct and inverted repeats within the 1291 bp fragment that belonged to a PPE family gene (Rv0355) of M. tuberculosis. The use of CD192 as a DNA probe for the identification of M. tuberculosis in culture and clinical samples was investigated. The 1291 bp sequence was present in M. tuberculosis, Mycobacterium bovis and M. bovis BCG, but was not present in many of the other mycobacterial strains tested, including M. tuberculosis H37Ra. More than 300 clinical isolates of M. tuberculosis were probed with CD192, and the presence of the 1291 bp sequence was observed in all the clinical strains, including those lacking IS6110. The sequence displayed RFLP among the clinical isolates. A PCR assay was developed which detected M. tuberculosis with 100 % specificity from specimens of sputum, cerebrospinal fluid and pleural effusion from clinically diagnosed cases of tuberculosis

Incidental retained intrauterine Lippe’s loop in 65 years old woman: a rare case report

Intrauterine contraceptive devices are a widely used method of contraception. It is cheap, easy and an effective method. The first intrauterine device was Lippe’s loop which was double S shaped trapezoid loop introduced in 1962. Nowadays, third generation intrauterine devices are used which are effective for 5 and as well as 10 years. Here we presented a rare case of first generation of intrauterine device, that was, Lippe’s loop in a 65 year old lady which was found as an incidental finding. Intrauterine device insertion without the knowledge of women can lead to the forgotten device which can adversely affect the health of women

Vitamin A Administered with measles vaccine to nine-month-old infants does not reduce vaccine immunogenicity

After a report of reduced seroconversion to measles in infants, aged 6 mo, given vitamin A with their measles vaccination, serious concerns were raised regarding the safety of the WHO's recommendation that infants be supplemented with vitamin A at the time of measles immunization. To determine the impact of coadministered vitamin A on the antibody response to measles vaccine given to infants aged 9 mo, the more common age for immunization in developing countries, we conducted a randomized, double-blind, placebo-controlled trial in an urban slum community in Delhi. Infants (618) were randomly allocated to receive 30 mg vitamin A or a placebo with the measles immunization. Antibodies to measles were measured by ELISA in serum samples obtained at before (baseline) and 12 wk after immunization. Overall, the seroconversion rates did not differ between vitamin A (89.5%) and placebo (87.6%) groups. There were no significant differences in the geometric mean titers in the two groups (ratio of geometric means, 1.19; 95% confidence interval, 0.97-1.46). Among malnourished infants, the geometric mean titer was significantly greater in the vitamin A group compared to the placebo group (ratio of geometric means, 1.57; 95% confidence interval, 1.18-2.0), but seroconversion rates did not differ. There were no differences in seroconversion rates and geometric mean titers in the two study groups among the well-nourished children. These results indicate that 30 mg vitamin A does not reduce the immune response to the coadministered vaccine and, therefore, can be continued to be given safely in public health programs

Investigation of DNA damage response and apoptotic gene methylation pattern in sporadic breast tumors using high throughput quantitative DNA methylation analysis technology

<p>Abstract</p> <p>Background-</p> <p>Sporadic breast cancer like many other cancers is proposed to be a manifestation of abnormal genetic and epigenetic changes. For the past decade our laboratory has identified genes involved in DNA damage response (DDR), apoptosis and immunesurvelliance pathways to influence sporadic breast cancer risk in north Indian population. Further to enhance our knowledge at the epigenetic level, we performed DNA methylation study involving 17 gene promoter regions belonging to DNA damage response (DDR) and death receptor apoptotic pathway in 162 paired normal and cancerous breast tissues from 81 sporadic breast cancer patients, using a high throughput quantitative DNA methylation analysis technology.</p> <p>Results-</p> <p>The study identified five genes with statistically significant difference between normal and tumor tissues. Hypermethylation of <it>DR5 </it>(P = 0.001)<it>, DCR1 </it>(P = 0.00001)<it>, DCR2 </it>(P = 0.0000000005) and <it>BRCA2 </it>(P = 0.007) and hypomethylation of <it>DR4 </it>(P = 0.011) in sporadic breast tumor tissues suggested a weak/aberrant activation of the DDR/apoptotic pathway in breast tumorigenesis. Negative correlation was observed between methylation status and transcript expression levels for <it>TRAIL</it>, <it>DR4</it>, <it>CASP8</it>, <it>ATM</it>, <it>CHEK2</it>, <it>BRCA1 </it>and <it>BRCA2 </it>CpG sites. Categorization of the gene methylation with respect to the clinicopathological parameters showed an increase in aberrant methylation pattern in advanced tumors. These uncharacteristic methylation patterns corresponded with decreased death receptor apoptosis (P = 0.047) and DNA damage repair potential (P = 0.004) in advanced tumors. The observation of BRCA2 -26 G/A 5'UTR polymorphism concomitant with the presence of methylation in the promoter region was novel and emerged as a strong candidate for susceptibility to sporadic breast tumors.</p> <p>Conclusion-</p> <p>Our study indicates that methylation of DDR-apoptotic gene promoters in sporadic breast cancer is not a random phenomenon. Progressive epigenetic alterations in advancing tumors result in aberrant DDR-apoptotic pathway thereby promoting tumor development. We propose, since pathological epigenetic changes of the DDR-apoptotic genes are reversible modifications, these could further be targeted for therapeutic interventions.</p

GROUP COGNITIVE BEHAVIOUR THERAPY FOR ALCOHOLISM

ABSTRACT The purpose of the present study is to replicate the effectiveness of group cognitive behaviour therapy, which is known to be cost effective as well as emerging as an appropriate non-pharmacological intervention in India. Close homogeneous group of 15 alcoholics were formed and alcohol dependence scale (ADS) was administered on them before (baseline) and after (follow up) group cognitive behaviour therapy. Results showed the difference in scores on alcohol dependence scale for baseline and follow up assessment to be statistically significant; indicating that group cognitive behaviour therapy is an effective non-pharmacological treatment for alcoholism