Micromorphological variations of trichomes in the genus Ocimum L.

Ocimum L. is an attractive fragrant ornamental plant with medicinal aromatic compounds. The study using digital microscopy revealed the distinct epidermal trichome morphology in five species of Ocimum including O. americanum L., O. basilicum L., O. gratissimum L., O. kilimandscharicum Gurke and O. tenuiflorum L. A distinguished variation in size, shape, type and abundance of trichomes on leaves and stem of all species are described and photographed. Both glandular and non-glandular trichomes scrutinized in all the species in which glandular type comprised capitate and peltate trichomes. On the stem, the longest glandular capitate trichome (GCT) and non-glandular trichome (NGT) were observed in O. tenuiflorum while O. basilicum possessed longest glandular peltate trichome (GPT). In case of foliar trichomes, the longest GCT observed on leaves of O. americanum; and O. basilicum showed the longest GPT and NGT. In the species, the septate or aseptate NGT possessed uni, bi or multicellular base with acute or broad apex. A distinguished variation in the number of cells in stalk and head of GT was observed in the study. Presence of silica bodies in peltate trichome of O. kilimandscharicum was noticed as the characteristic feature. Among the five species, the trichomes were abundant in O. kilimandscharicum; while O. basilicum showed sparse distribution. Trichomes with disrupted cells were also noted in O. americanum. Due to the presence of specific trichome characteristics, the efficient taxonomic key is prepared to identify the taxa at species level

Evaluation of functional outcome in patients treated with locking compression plate for distal femur fractures

Distal femur fractures are always a challenge to an orthopedic surgeon. They may be unstable and comminuted. Thin cortex, wide medullary canal, relative osteopenia and short distal segment adds to the complexity. The present study assessed the functional outcome of using locking compression plate fixation for fractures of distal end of femur in patients admitted to JMMC orthopedics department satisfying the inclusion and exclusion criteria from December 2017 to may 2019. Twenty cases were taken in this study. Serial follow up was done at 4, 8, 12, 24 weeks and functional outcome was assessed at the end of 24 weeks using NEERS criteria. 18 patients were treated with open reduction and internal fixation. 2 of the fractures were stabilized via MIPPO technique. No patients had implant failure and none of the cases were complicated by deep infection. 5 of the 20 patients had ‘Excellent’ Neers scores and 14 had ‘Good’ scores. Only one patient had ‘Fair’ score. Conclusion: Locking compression plate fixation is a safe procedure for supracondylar fractures of distal femur with good functional outcome.  It can be done on a routine basis with a minimum risk of complications.  Keywords: Functional Outcome, LCP, Open Reduction Internal Fixation, Prospective Study, Supracondylar Fracture

Management of bacillus Calmette-Guerin (BCG) refractory superficial bladder cancer: results with intravesical BCG and Interferon combination therapy

BCG is the most efficacious intravesical treatment for superficial bladder cancer. However, 30%-40% of tumors are refractory. BCG failure is an indication for cystectomy but several salvage intravesical (IVe) strategies have been proposed. Early results with reduced dose BCG in combination with IFN-a in patients are currently the most promising. We have adopted this approach and now report our preliminary results. This is the first report of this salvage therapy from Canada, the birthplace of IVe BCG therapy for superficial bladder cancer. The "O'Donnell protocol" of reduced dose IVe BCG plus IFN-a was followed in 12 patients with BCG refractory superficial transitional cell carcinoma. A retrospective review of the efficacy and toxicity of the treatment was conducted. One year from induction therapy with salvage BCG/IFN-a, 6 of the 12 (50%) of patients were tumor free. Of the six recurrences, 3(50%) did not respond to the IVe therapy and had residual/recurrent tumor at the first follow-up visit. Risk factors for treatment failure were identified. The combinative therapy was well tolerated with minimal toxicity compared to previous full dose BCG. Our 12 month data with reduced dose IVe BCG plus IFN-a salvage therapy for BCG refractory superficial TCC confirm previous reports of >50% complete response rates. We need longer follow up in a larger patient population to determine the durability of this promising therapy in patients who would otherwise undergo radical cystectomy

Clinical and Genomic Factors Associated with Greater Tumor Mutational Burden in Prostate Cancer

Tumor mutational burden (TMB) is a biomarker that predicts response to immune checkpoint inhibitor therapy. We currently lack a comprehensive understanding of how genomic and clinical factors correlate with TMB. We used a clinicogenomic database to assess independent predictors of TMB levels. The study included 2740 prostate cancer specimens from prostate gland (51.6%), lymph nodes (14.6%), and bone (10.4%). Androgen deprivation therapy use beyond 24 mo was weakly associated with high TMB (fold-change estimate [FCE] 1.14, 95% confidence interval [CI] 1.03–1.26; p = 0.009). In comparison to the prostate gland, metastases in the bladder (FCE 1.20, 95% CI 1.02–1.42; p = 0.029), liver (FCE 1.26, 95% CI 1.10–1.43; p < 0.001), and other locations (FCE 1.26, 95% CI 1.11–1.43; p < 0.001) were associated with high TMB. Microsatellite instability high (FCE 8.46, 95% CI 6.42–11.15; p < 0.001) and intermediate (FCE 1.77, 95% CI 1.46–2.14; p < 0.001) status were associated with greater TMB. Altered genes associated with greater TMB included MLH1 (FCE 1.81; p = 0.004), MSH2 (FCE 1.87; p < 0.001), MSH6 (FCE 1.92; p < 0.001), BRCA2 (FCE 1.69; p < 0.001), CDK12 (FCE 1.40; p < 0.001), MRE11 (FCE 2.28; p = 0.016), and PALB2 (FCE 2.08; p < 0.001). Our study demonstrates that TMB is relatively stable over lines of therapies and can be used to guide treatment at diagnosis or in later lines for patients with metastatic prostate cancer. Patient summary: The number of genetic mutations in a tumor (tumor mutational burden, TMB) may help in predicting a patient’s response to immunotherapy in advanced prostate cancer. We evaluated clinical and genetic factors that may affect TMB. We found that metastases in the bladder and liver are more likely to have high TMB than the primary tumor. Some individual genes are associated with high TMB. No prior treatment type was strongly associated with TMB, suggesting that TMB can be used to guide treatment at any time point.These data were presented at the American Society of Clinical Oncology 2023 Genitourinary Cancers Symposium