Telomerase a prognostic marker an therapeutic target

Malignant glioma is the most common and aggressive form of tumours and is usually refractory to therapy. Telomerase and its altered activity, distinguishing cancer cells, is an attractive molecular target in glioma therapeutics. The aim of this thesis was to silence telomerase at the genetic level with a view to highlight the changes caused in the cancer proteome and identify the potential downstream pathways controlled by telomerase in tumour progression and maintenance. A comprehensive proteomic study utilizing 2D-DIGE and MALDI-TOF were used to assess the effect of inhibiting two different regulatory mechanisms of telomerase in glioma. RNAi was used to target hTERT and Hsp90α. Inhibition of telomerase activity resulted in down regulation of various cytoskeletal proteins with correlative evidence of the involvement of telomerase in regulating the expression of vimentin. Vimentin plays an important role in tumour metastasis and is used as an indicator of glioma metastasis. Inhibition of telomerase via sihTERT results in the down regulation of vimentin expression in glioma cell lines in a grade specific manner. While, 9 of 12 glioblastoma tissues (grade IV) showed vimentin to be highly expressed, its expression was absent in lower grades and normal tissues. This suggests that vimentin can be potentially used as a glioma progressive marker. This is the first study to report the potential involvement of telomerase in the regulation of vimentin expression. This study also identified that combination therapy, comprising siRNA targeted towards telomerase regulatory mechanisms and the natural product Epigallocatechin-3-gallate (ECGC), results in decreased cell viability producing comparable results to that of other chemotherapeutic drugs

Fetomaternal outcome in sickle cell disease in a tertiary care centre

Background: Sickle cell disease is a hereditary haematological disorder prevalent in tribal regions of India. Sickle cell disease can increase complications during pregnancy and in turn negatively influence pregnancy outcomes. This study reports the analysis of tribal maternal admissions in the tertiary centre S.S.G. Hospital, Baroda, Gujarat. Hence this study was conducted to assess complications in pregnancy and maternal and perinatal outcome among women with Sickle cell disease.Methods: It was a retrospective observational study including all pregnant women with sickle cell disease after 20 weeks of gestation who delivered at S.S.G. Hospital, Baroda from August 2019 to August 2020.Results: There were 43 antenatal women with Sickle cell disease during the study period. There was increased risk of obstetric complications like gestational hypertension (11.62%), preeclampsia (9.3%), eclampsia (6.97%), HELLP syndrome (4.65%), intrauterine growth retardation (23.25%), and oligohydramnios (11.62%). Medical complications observed were mainly anaemia (53.48%), vaso-occlusive crisis (18.16%), acute chest syndrome (4.65%) and infections like urinary tract infection (6.97%) and pneumonia (4.65%). The incidence of low birth weight babies (56.94%), low APGAR score (11.62%) and neonatal ICU admissions (23.25%) was high. 6.5% cases of maternal mortality and 4.65% cases of perinatal mortality was observed.Conclusions: Pregnancy in Sickle cell disease is associated with an increased maternal morbidity and high perinatal mortality due to obstetric and medical complications

Correlation of disability with anxiety and depression in patients with chronic non-specific neck pain: a cross-sectional observational study

Background: Neck Pain is a prevalent musculoskeletal condition usually associated with disability. Psychological illnesses like anxiety and depression are commonly seen in chronic pain. The purpose of this study was to evaluate the relationship between anxiety, and depression with disability in patients with chronic non-specific neck pain.Methods: 87 patients with chronic non-specific neck pain were recruited in this cross-sectional study. The disability was evaluated with neck disability index, anxiety with the generalized anxiety disorder scale (GAD-7), and depression with patient health questionnaire (PHQ9).Results: Out of 87, 60 were females and 27 were male. For correlation, Spearman’s test was applied for the outcome measures. There was a moderate positive correlation found between disability and anxiety (r=0.55) and between neck pain and depression (r=0.63).Conclusions: There is a moderate positive correlation between self-reported disability and anxiety (GAD7) and also between self-reported disability and depression (PHQ9) in patients with chronic non-specific neck pain.

A Trusted Model for Secure Cloud Environment

Cloud computing is an emerging technology that gives a tremendous changes in IT industry. It has ultimate features like multitenancy, elasticity, pay-per-use, self provision etc. But the customers are still hesitant to adopt cloud computing due to security and privacy. In this paper we propose a trust model which secures client’s information from both insiders and outsiders. In this model calculation of trust is based on their compliance report which has been promised in service level agreement

Fetomaternal outcome in pregnancy with oligohydramnios: a prospective study

Background: Oligohydramnios is defined as amniotic fluid index 30 weeks.Results: The most common risk factor associated with oligohydramnios was hypertensive disorder of pregnancy (35%) followed by intra uterine growth restriction (31%), preterm rupture of membranes (17%), post-datism (5%) and about 12% were due to idiopathic causes. Among cases majority were primigravida (43%). Lower segment caesarean section was done in 86 cases (43%), and main indication was fetal distress. There was no maternal mortality in the study. NICU admission for low birth weight (26%), pre-maturity (20%), meconium aspiration syndrome (8%), congenital anomalies (8%). Among congenital anomalies, posterior urethral valve had highest incidence (50%) followed by renal agenesis (25%). The neonatal mortality was 5%.Conclusions: Oligohydramnios adversely affects the perinatal outcome. Therefore, it requires meticulous assessment, prompt detection, timely management and treating underlying condition. However, a favourable outcome can be expected by good antenatal and intrapartum surveillance and neonatal care

STUDY ON KAP OF OCULAR COMPLICATIONS DUE TO DIABETES AMONG TYPE II DIABETICS VISITING A TERTIARY TEACHING HOSPITAL

Introduction: Diabetes mellitus is a major public health problem worldwide. Diabetic patients are at risk of developing blindness from diabetic retinopathy. While occurrence of diabetic retinopathy cannot be prevented, its complications can be minimized. This requires awareness of the sight-threatening potential of diabetes and the need for regular eye examinations. Aim: To study the knowledge of ocular complications of diabetes, among type II diabetics visiting a tertiary level hospital. Settings and Design: This was a prospective study in a tertiary care teaching hospital. Methods and Material: This was a questionnaire based study on 350 type II diabetics. All patients were interviewed by the same investigator. Statistical analysis used: The data was analysed using chi square test. Results: With increase in the duration of illness, the awareness about diabetic retinopathy is more. Even though the awareness of the disease increased with increasing duration of the disease, 51.4% of the diabetics did not know how diabetes can affect the eye, 49.7% of diabetics did not know if diabetic retinopathy can be treated and 67.4% had not heard of any treatment modality for diabetic retinopathy. This shows that lack of knowledge about the disease was significant. Conclusions: Prevention of non-communicable disease through increased awareness needs to be the thrust of the effort in resource poor contexts, where the treatment can be prohibitively costly. These measures would help to bring about more awareness and understanding about the disease among the patients and therefore prevent sight-threatening complications by timely intervention and management

Study of feto-maternal outcome in patients with intra uterine fetal death

Background: Intra Uterine Fetal Death (IUFD) is an important issue in modern obstetrics. This study has been undertaken to find out the incidence of IUFD, socio-demographic factors, probable etiological factors, mode of delivery, its outcome and complications if any.Methods: This retrospective observational study was carried out at a tertiary care hospital. Data was collected from case papers of patients who have delivered beyond 20 weeks and/or baby weighing more than 500 grams and having IUFD prior to onset of labor or during labor with singleton pregnancy.Results: Incidence of IUFD was 17.2 per 1000 births. Majority of the patients 93 (48.1%) were in age group of 26-30 years, 115 (59.5%) came as an emergency and 94 (48.7%) were primi gravida. Majority 89 (46.1%) patients had not taken any antenatal visit. IUFD occurred due to unexplained etiology, pre-eclampsia-eclampsia, anemia, uncontrolled diabetes, jaundice, antepartum haemorrhage and congenital malformation in 77 (39.9%), 51 (26.4%), 10 (5.1%), 7 (3.6%), 4 (2%), 29 (15%) and 2 (1%) respectively. Vaginal delivery occurred in 151 (78.2%). Majority of dead babies 111 (57.5%) were male, 71 (36.7%) were weighing 1kg or less and 92 (47.6%) were macerated. Emotional upset, DIC, PPH and ARF occurred in 193 (100%), 21 (10.8%), 15 (7.7%) and 1 (0.5%) respectively.Conclusions: Majority of patients were unregistered and had not taken antenatal care or had inadequate antenatal care. Pre-eclampsia-eclampsia, APH, anemia and diabetes were the leading cause of IUFD along with unknown causes. A significant proportion of IUFD can be prevented by health education regarding adequate antenatal care, warning signs and institutional deliveries