Clinicopathological features and the value of differential Cytokeratin 7 and 20 expression in resolving diagnostic dilemmas of ovarian involvement by colorectal adenocarcinoma and vice-versa

The distinction between metastasis from a colorectal adenocarcinoma into the ovary and an ovarian adenocarcinoma is vital, but challenging at times, due to overlapping morphological features. Similarly, a distinction between an ovarian metastasis into the colorectum and a colorectal adenocarcinoma, although rare; is important and can be daunting. We report an analysis of 20 cases of ovarian involvement by metastatic colorectal adenocarcinomas and colorectal involvement by metastatic ovarian adenocarcinomas, including the value of differential expression of cytokeratins 7 & 20 by immunohistochemistry (IHC), in these cases. Nine cases (45%) were identified as colorectal adenocarcinomas metastatic to the ovary. On biopsy, all these cases showed a 'garland-like' tumor necrosis, with desmoplasia and predominantly exhibited a tubuloalveolar pattern (67% cases). On IHC, all 8 of 9 such cases, where staining for cytokeratin 20 was performed, displayed strong positivity and 7 cases, where staining for carcinoembryogenic antigen (CEA) was performed, revealed positivity for this marker (100%). Other 11 cases (55%) were ovarian adenocarcinomas, metastatic to the colorectum. These showed metachronous presentations, with the ovarian tumor preceding the colorectal tumor deposits. Morphologically, psammomatous calcification was noted in 73% of these cases, whereas 'garland-like' necrosis was absent in all. The chief morphological subtype was serous papillary cystadenocarcinoma (55% cases). On IHC, CK7 and CA 125 were positive in all 6 of 11 such cases, whereas CK 20 was negative in all these cases

An impact of reduction in point prevalence of tobacco use on cancer incidence- A challenge for global policy makers:A challenge for global policy makers

Worldwide 8.2 million people die from cancer & 2/3rd of them are from LMIC. Tobacco-related cancer (TRCs) accounts a major share. In India, 45% of male's and 20% of female's cancer is due to tobacco use. Nearly half of all cancers in men occur at sites associated with tobacco use( Farhood and et al., 2018 Mar) .11ObjectiveThis attempt to find out impact of tobacco prevalence on incidence rate of Tobacco related cancers across various states of India. This can help policy makers to understand and formulate control measures to curb the increasing trend of TRCs.MethodsAge standardised incidence rate of TRCs from Global Burden of Diseases, Injuries, and Risk Factors Study and tobacco prevalence from NFHS-4 data was observed. State-wise data harmonisation towards tobacco prevalence and cancer incidence was performed.ResultsReduction of tobacco consumption prevalence only 1% may decline incidence of lip, oral cavity and larynx cancer by 23.56 per 10 lac female populations and incidence of pharynx cancer by 25.31 per 10 lac male populations.ConclusionTobacco consumption contributes substantial AAR of TRCs among both sexes in most of the Indian states while, other factors need to be considered too. Hence, systematic, multi-sectorial coercive approach to curtail the burden related to TRCs is imperative

RISK FACTOR ASSESSMENT FOR ACNE VULGARIS IN HUMAN AND IMPLICATIONS FOR PUBLIC HEALTH INTERVENTIONS IN NORTH CENTRAL INDIA: A SURVEY-BASED STUDY

Background: Acne vulgaris is a very common dermatological problem of adolescence since the time immemorial. However, it is neither life threatening nor is a physical disability, but acne affects social and psychological functioning. Acne vulgaris is multifactorial, apart from basic factor of hormonal change and bacterial outbreak; there are several other factors that may influence the prevalence of acne.Methods: In the present study, populations were assessed for influence of various factors on acne prevalence. This cross-sectional study was a population based field study intending to discern the factors that influence the prevalence of acne in adolescents. The study carried out from April 2016 to October 2016 in north central India. For this survey, questionnaires were design to cover all the required information regarding occurrence of acne that include factors like gender, age, skin type, complexion, season of occurrence, dietary habit etc.Results: Acne vulgaris appears to be influenced by gender, age, seasonal variations, breakout area, complexion, skin types and dietary habits. Further, the influence of dietary habit on acne, by the consumption of dairy products or high-carbon diet has also been evaluated. Apart from depicting the vulnerable range of age (p=0.003288), sensitivity on various skin types (p=0.00039) and complexion (p=0.001355) on the basis of gender; This Field study on Acne Vulgaris, also reveals that the season has inordinate role in acne pervasiveness (p=0.115731).Conclusion: This study is helpful in categorizing the risk factors and evidencing the afflictions of acne in population thus, contributing health care planning. Â

PHARMACOLOGICAL STUDIES OF OCIMUM BASILICUM L.

Ocimum basilicum (O. basilicum) L. belongs to family Lamiaceae which comprises the most employed medicinal plants as a worldwide source of spices and also as a consolidated source of extracts. The phytochemical constituents of sweet basil essential oil have been investigated for several therapeutic importance from many regions of the world. They include terpenoids, alkaloids, flavonoids, tannins, saponin glycosides and ascorbic acid. These compounds have been reported to exhibit antibacterial and antifungal, antidyspepsia, anti-inflammatory, antioxidant, antiulcer, antiviral, insecticidal, wound-healing etc. activities. The plant parts of O. basilicum have been widely used in preparation traditional medicine. The plants also been used as a folk remedy to treat various ailments such as feverish illness, poor digestion, nausea, abdominal cramps, gastro-enteritis, migraine, insomnia, depression, gonorrhea, dysentery etc. Externally, they have been applied for the treatment of acne, loss of smell, insect stings, snake bites and skin infections. The present review is aimed to cover the pharmacological investigations on this important medicinal herb. Key Words: Ocimum basilicum, phytochemical constituents, antiinflammatory, antioxidant, antiviral, insecticida

Age-specifi c and sex-specifi c adult mortality risk in India in 2014: analysis of 0·27 million nationally surveyed deaths and demographic estimates from 597 districts

Background As child mortality decreases rapidly worldwide, premature adult mortality is becoming an increasingly important contributor to global mortality. Any possible worldwide reduction of premature adult mortality before the age of 70 years will depend on progress in India. Indian districts increasingly have responsibility for implementing public health programmes. We aimed to assess age-specifi c and sex-specifi c adult mortality risks in India at the district level. Methods We analysed data from fi ve national surveys of 0∙27 million adult deaths at an age of 15–69 years together with 2014 demographic data to estimate age-specifi c and sex-specifi c adult mortality risks for 597 districts. Cause of death data were drawn from the verbal autopsies in the Registrar General of India’s ongoing Million Death Study. Findings In 2014, about two-fi fths of India’s men aged 15–69 years lived in the 253 districts where the conditional probability of a man dying at these ages exceeded 50%, and more than a third of India’s women aged 15–69 years lived in the 222 districts where the conditional probability of a woman dying exceeded 40%. The probabilities of a man or woman dying by the age of 70 years in high-mortality districts was 62% and 54%, respectively, whereas the probability of a man or woman dying by the age of 70 years in low-mortality districts was 40% and 30%, respectively. The roughly 10-year survival gap between high-mortality and low-mortality districts was nearly as extreme as the survival gap between the entire Indian population and people living in high-income countries. Adult mortality risks at ages 15–69 years was highest in east India and lowest in west India, by contrast with the north–south divide for child mortality. Vascular disease, tuberculosis, malaria and other infections, and respiratory diseases accounted for about 60% of the absolute gap in adult mortality risk at ages 15–69 years between high-mortality and low-mortality districts. Most of the variation in adult mortality could not be explained by known determinants or risk factors for premature mortality. Interpretation India’s large variation in adult mortality by district, notably the higher death rates in eastern India, requires further aetiological research, particularly to explore whether high levels of adult mortality risks from infections and non-communicable diseases are a result of historical childhood malnutrition and infection. Such research can be complemented by an expanded coverage of known eff ective interventions to reduce adult mortality, especially in high-mortality district

Performance criteria for verbal autopsy-based systems to estimate national causes of death: development and application to the Indian Million Death Study.

BACKGROUND: Verbal autopsy (VA) has been proposed to determine the cause of death (COD) distributions in settings where most deaths occur without medical attention or certification. We develop performance criteria for VA-based COD systems and apply these to the Registrar General of India's ongoing, nationally-representative Indian Million Death Study (MDS). METHODS: Performance criteria include a low ill-defined proportion of deaths before old age; reproducibility, including consistency of COD distributions with independent resampling; differences in COD distribution of hospital, home, urban or rural deaths; age-, sex- and time-specific plausibility of specific diseases; stability and repeatability of dual physician coding; and the ability of the mortality classification system to capture a wide range of conditions. RESULTS: The introduction of the MDS in India reduced the proportion of ill-defined deaths before age 70 years from 13% to 4%. The cause-specific mortality fractions (CSMFs) at ages 5 to 69 years for independently resampled deaths and the MDS were very similar across 19 disease categories. By contrast, CSMFs at these ages differed between hospital and home deaths and between urban and rural deaths. Thus, reliance mostly on urban or hospital data can distort national estimates of CODs. Age-, sex- and time-specific patterns for various diseases were plausible. Initial physician agreement on COD occurred about two-thirds of the time. The MDS COD classification system was able to capture more eligible records than alternative classification systems. By these metrics, the Indian MDS performs well for deaths prior to age 70 years. The key implication for low- and middle-income countries where medical certification of death remains uncommon is to implement COD surveys that randomly sample all deaths, use simple but high-quality field work with built-in resampling, and use electronic rather than paper systems to expedite field work and coding. CONCLUSIONS: Simple criteria can evaluate the performance of VA-based COD systems. Despite the misclassification of VA, the MDS demonstrates that national surveys of CODs using VA are an order of magnitude better than the limited COD data previously available

Childhood Cancer Mortality in India: Direct Estimates From a Nationally Representative Survey of Childhood Deaths.

PURPOSE: Although most children with cancer live in low- and middle-income countries, measurements of childhood cancer burden in such countries have been restricted to incidence rates from a few subnational cancer registries and mortality rates from vital statistics. We aimed to provide alternative burden estimates by using nationally representative longitudinal survey-derived mortality rates. METHODS: We examined cancer deaths in childhood (1 month to 14 years of age) in the Million Death Study, a cohort of > 27,000 pediatric deaths in India on the basis of enhanced verbal autopsies. All deaths potentially due to childhood cancer were identified. Two pediatric specialists independently categorized deaths as definite, probable, possible, or unlikely cancer related. From definite and probable deaths, we estimated national and regional mortality rates attributable to childhood malignancies. Data on symptoms and health care-seeking behavior were abstracted from closed-ended questions and caregiver narratives. RESULTS: Of 700 included deaths, 189 were classified as definite or possibly cancer related. The κ-statistic between reviewers was 0.75 (95% CI, 0.71 to 0.78). From these deaths, we estimated that in 2010, 13,700 were a result of childhood cancer in India, which led to a mortality rate of 37 (95% CI, 31 to 42) per million population per year, which exceeds many prior estimates of mortality and even some estimates of incidence. Disparities between mortality estimates were widest in northeast India and for brain tumors. A preponderance of male deaths was seen (male:female ratio, 1.6:1). CONCLUSION: The burden of childhood cancer in India is substantially higher than previously suggested. This information will aid advocacy for national strategies aimed at improving outcomes for Indian children with cancer

Trends in mouth cancer incidence in Mumbai, India (1995–2009): An age-period-cohort analysis

AbstractIntroductionDespite tobacco control and health promotion efforts, the incidence rates of mouth cancer are increasing across most regions in India. Analysing the influence of age, time period and birth cohort on these secular trends can point towards underlying factors and help identify high-risk populations for improved cancer control programmes.MethodsWe evaluated secular changes in mouth cancer incidence among men and women aged 25–74 years in Mumbai between 1995 and 2009 by calculating age-specific and age-standardized incidence rates (ASR). We estimated the age-adjusted linear trend for annual percent change (EAPC) using the drift parameter, and conducted an age–period–cohort (APC) analysis to quantify recent time trends and to evaluate the significance of birth cohort and calendar period effects.ResultsOver the 15-year period, age-standardized incidence rates of mouth cancer in men in Mumbai increased by 2.7% annually (95% CI:1.9 to 3.4), p<0.0001) while rates among women decreased (EAPC=−0.01% (95% CI:−0.02 to −0.002), p=0.03). APC analysis revealed significant non-linear positive period and cohort effects in men, with higher effects among younger men (25–49 years). Non-significant increasing trends were observed in younger women (25–49 years).ConclusionsAPC analyses from the Mumbai cancer registry indicate a significant linear increase of mouth cancer incidence from 1995 to 2009 in men, which was driven by younger men aged 25–49 years, and a non-significant upward trend in similarly aged younger women. Health promotion efforts should more effectively target younger cohorts

Cohort Profile: Indian Study of Healthy Ageing (ISHA-Barshi).

Key Features: - The Indian Study of Healthy Ageing (ISHA) examines the burden, causes and consequences of chronic diseases in an Indian adult population of ∼220 000. Once completed, ISHA will be the largest blood-based prospective study in South Asia. Expansion to sites in Varanasi, Guwahati, Sangrur and Mullanpur will further strengthen the study. - Recruitment began in 2015 in Barshi, Maharashtra state, India. Enumeration, including basic baseline data collection, has been completed for all participants. Further detailed data collection, through questionnaires, physical measurements and blood sampling, is complete for ∼39 000 participants and ongoing. Active follow-up and linkage to health-related datasets (for death, cancer and hospitalization) provide data on fatal and non-fatal disease events. - At baseline among the ∼39 000 participants, 53% were women, and mean (standard deviation: SD) age was 46 (11). Tobacco smoking and alcohol drinking are relatively uncommon, but tobacco chewing is prevalent (67% of men and 14% of women ever chewed tobacco). The population is relatively lean, with a mean (SD) body mass index of 23.2 (4.1) kg/m2. Self-reported, previously diagnosed chronic diseases were uncommon (hypertension: 6%; diabetes: 3%; cardiovascular disease: 1%; cancer: <1%). Depressive symptoms were common (at least one reported by 58%). - Data-sharing regulations are in place; specific proposals for future collaboration are welcomed

The MOBI-Kids Study Protocol: Challenges in Assessing Childhood and Adolescent Exposure to Electromagnetic Fields from Wireless Telecommunication Technologies and Possible Association with Brain Tumor Risk

The rapid increase in mobile phone use in young people has generated concern about possible health effects of exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF). MOBI-Kids, a multinational case-control study, investigates the potential effects of childhood and adolescent exposure to EMF from mobile communications technologies on brain tumor risk in 14 countries. The study, which aims to include approximately 1,000 brain tumor cases aged 10-24 years and two individually matched controls for each case, follows a common protocol and builds upon the methodological experience of the INTERPHONE study. The design and conduct of a study on EMF exposure and brain tumor risk in young people in a large number of countries is complex and poses methodological challenges. This manuscript discusses the design of MOBI-Kids and describes the challenges and approaches chosen to address them, including: (1) the choice of controls operated for suspected appendicitis, to reduce potential selection bias related to low response rates among population controls; (2) investigating a young study population spanning a relatively wide age range; (3) conducting a large, multinational epidemiological study, while adhering to increasingly stricter ethics requirements; (4) investigating a rare and potentially fatal disease; and (5) assessing exposure to EMF from communication technologies. Our experience in thus far developing and implementing the study protocol indicates that MOBI-Kids is feasible and will generate results that will contribute to the understanding of potential brain tumor risks associated with use of mobile phones and other wireless communications technologies among young people