Key players of immunosuppression in epithelial malignancies: Tumor-infiltrating myeloid cells and γδ T cells.

BACKGROUND: The tumor microenvironment of solid tumors governs the differentiation of otherwise non-immunosuppressive macrophages and gamma delta (γδ) T cells into strong immunosuppressors while promoting suppressive abilities of known immunosuppressors such as myeloid-derived suppressor cells (MDSCs) upon infiltration into the tumor beds. RECENT FINDINGS: In epithelial malignancies, tumor-associated macrophages (TAMs), precursor monocytic MDSCs (M-MDSCs), and gamma delta (γδ) T cells often acquire strong immunosuppressive abilities that dampen spontaneous immune responses by tumor-infiltrating T cells and B lymphocytes against cancer. Both M-MDSCs and γδ T cells have been associated with worse prognosis for multiple epithelial cancers. CONCLUSION: Here we discuss recent discoveries on how tumor-associated macrophages and precursor M-MDSCs as well as tumor associated-γδ T cells acquire immunosuppressive abilities in the tumor beds, promote cancer metastasis, and perspectives on how possible novel interventions could restore the effective adaptive immune responses in epithelial cancers.

Recent Approaches on Molecular Markers, Treatment and Novel Drug Delivery System Used for the Management of Colorectal Cancer: A Comprehensive Review.

Colorectal cancer affects 1 in 25 females and 1 in 24 males, making it the third most frequent cancer with over 6,08,030 deaths worldwide, despite advancements in detection and treatments, including surgery, chemotherapeutics, radiotherapy, and immune therapeutics. Novel potential agents have increased survival in acute and chronic disease conditions, with a higher risk of side effects and cost. However, metastatic disease has an insignificant long-term diagnosis, and significant challenges remain due to last-stage diagnosis and treatment failure. Early detection, survival, and treatment efficacy are all improved by biomarkers. The advancement of cancer biomarkers' molecular pathology and genomics during the last three decades has improved therapy. Clinically useful prognostic biomarkers assist clinical judgment, for example, by predicting the success of EGFR-inhibiting antibodies in the presence of KRAS gene mutations. Few biomarkers are currently used in clinical settings, so further research is still needed. Nanocarriers, with materials like Carbon nanotubes and gold nanoparticles, provide targeted CRC drug delivery and diagnostics. Light-responsive drugs with gold and silica nanoparticles effectively target and destroy CRC cells. We evaluate the potential use of the long non-coding RNA (non-coding RNA) oncogene plasmacytoma variant translocation 1 (PVT1) as a diagnostic, prognostic, and therapeutic biomarker, along with the latest nanotech breakthroughs in CRC diagnosis and treatment.

Immature Teratoma: A Case Report of a Monster Tumor in the Pediatric Age Group.

Immature teratoma is a rare type of germ cell tumor containing embryonic tissues that may be malignant. It usually occurs in young women and affects the ovaries. Teratomas exhibit benign clinical behavior, but they can return as teratomas or with malignant components, and in a small subset of individuals, the prognosis may be deadly. We will discuss a case of a 9-year-old female child who presented with pain and a huge lump in the lower abdomen that was suggestive of an ovarian dermoid cyst or a germ cell tumor on computed tomography (CT) abdomen pelvis and underwent exploratory laparotomy and debulking surgery. Histopathology results indicated that she had a grade 3 immature teratoma. Postoperatively, the patient received 3 cycles of bleomycin, etoposide, and cisplatin (BEP) as adjuvant chemotherapy with a good response. She is currently under regular follow-up and has no evidence of recurrence or metastasis. This case illustrates the importance of early diagnosis and treatment of immature teratoma, which can be cured with surgery and chemotherapy. It also highlights the challenges of managing such a large tumor in a pediatric patient.

Groundwater hydrogeochemistry and non-carcinogenic health risk assessment in major river basins of Punjab, India.

The Indian Punjab state is drained by the four rivers, along with a well-connected network of canals, and is now dealing with a slew of water quality issues and problems. In this study, basin-wise hydrogeochemical modelling of 323 groundwater samples and identification of NO3- and F- enrichment pathways in aquifer systems of Punjab were studied using different plots and multivariate statistics. To evaluate the groundwater quality and human health risks, an entropy-based water quality index and Monte Carlo simulation were used, respectively. Spatial distribution of NO3- indicated that its very high values were prominent in parts of southwestern Punjab falling under LSRB, along with few pockets in eastern and northeastern Punjab falling under MSRB and GRB. High NO3- values (> 45.0 mg/L) were found in 15.0% of Ravi River Basin (RRB) groundwater samples, 22.86% of Beas River Basin (BRB), 23.52% of Middle Sutlej River Basin (MSRB), 36.9% of Lower Sutlej River Basin (LSRB), and 21.31% of Ghaggar River Basin (GRB). The spatial distribution of NO3- revealed elevated concentrations (> 100 mg/L) in the southwestern part of Punjab, particularly in LSRB and localized pockets in the eastern and northeastern areas of Punjab within MSRB and GRB. High F- concentration (> 1.5 mg/L) was observed in 15.12% and 21.31% groundwater samples of LSRB and GRB, respectively. Spatially southern parts falling under LSRB and GRB reflected high F- content (> 1.5 mg/L) in groundwater. In LSRB, evaporative and anthropogenic processes influence the groundwater quality. The results of interionic relationships and statistical analysis revealed that NO3- has anthropogenic origin and that is being aggravated by leaching, the evaporation processes, animal excreta, septic tanks and irrigation return flows in LSRB and GRB, while F- is geogenic in nature. Hazard index (HI) values in 14.63%, 22.2%, 24.6%, 49.58%, and 34.42% samples for adults and 21.95%, 27.7%, 42.0%, 72.3%, and 52.46% samples for children were higher than unity in RRB, BRB, MSRB, LSRB, and GRB, respectively. The basin-wise demarcation of various groundwater quality parameter and assessment of human health risk would be of significance for the management of water resources.

Telephonic intervention to combat non-adherence to oral iron-folic acid supplementation in pregnancy: A randomized controlled trial.

Introduction: Iron deficiency anemia is a public health problem globally attributing to high incidences of maternal and infant mortality and morbidity. Iron and folic acid supplementation (IFAS) is essential and provided free of cost by the public health sectors, however, a systematic review shows that the national-level adherence to oral Iron-Folic Acid Supplementation (IFAS) is less than half in pregnant women, and the significant obstacles to non-adherence are fear of side effects and forgetfulness. This trial was designed to mitigate the side effects and tackle forgetfulness with telephonic intervention. The objectives were to investigate the effectiveness of the telephonic intervention on oral IFAS adherence and hemoglobin and the reasons for non-adherence to oral IFAS, to find out the proportion of anemia in the study population, and to assess the effectiveness of the intervention on maternal and neonatal outcomes. Methods: Hospital-based open-label multi-centric parallel-group randomized controlled trial, used block randomization and allocated treatment in a 1:1 ratio recruited 286 anemic pregnant women between 14 and 24 weeks of gestation with hemoglobin level < 11 g/dl having smartphones at a secondary hospital and a tertiary hospital in Eastern India. The experimental group received telephonic intervention for one month via structured text reminders, WhatsApp audio messages, and phone calls. The standard course of treatment was given to the control group. Results: 286 women (n1 =143, n2 =143) were randomized, 36 had attrition leaving 250 for analysis (n1 =123, n2 =127), the experimental group experienced a 44.9 % and the control group 13.8 % increase in adherence (P < 0.001). The leading reasons for non-adherence were forgetfulness (24 %), nausea and vomiting (23.2 %), and constipation (18.8 %). Hemoglobin level increased by 0.8 g/dl (P < 0.001) in the experimental group and 0.2 g/dl (P < 0.807) in the control group. Conclusion: In addition to improving adherence to oral IFAS, telephonic intervention mitigates side effects and enhances hemoglobin in anemic pregnant women. The increase in adherence was threefold in the experimental group compared to a marginal rise in the control group. This study recommends the implementation of a telephonic intervention to promote adherence to oral IFAS among anemic pregnant women.

Apremilast Add-On Benefits Over Conventional Drugs (ABCD) in Unstable Non-segmental Vitiligo: A 12-Week Single-Center Randomized Controlled Trial.

Background Apremilast is an oral phosphodiesterase-4 enzyme inhibitor that modulates the immune system by increasing intracellular cyclic adenosine monophosphate levels and inhibiting inflammatory cytokines synthesis. We aimed to compare the efficacy and safety of add-on apremilast in combination therapy with standard treatment in patients with unstable, non-segmental vitiligo. Methods The study was a 12-week randomized, controlled, parallel-group, open-labeled trial. The control group received standard treatment (n=15), and the intervention group received 30 mg apremilast twice daily in addition to standard treatment (n= 16). Time to the first sign of re-pigmentation, halt in progression, and change in vitiligo area scoring index (VASI) score is the primary outcomes. Normality was assessed, and appropriate parametric and nonparametric tests were undertaken. Results Thirty-seven participants were randomized into two groups, and analysis was done on thirty-one participants. Over the treatment duration of 12 weeks, the median time to observe the first sign of re-pigmentation was four weeks in the add-on apremilast group compared to seven weeks in the control group (p=0.018). The halt in progression was observed more in the add-on Apremilast group (93.75%) compared to the control group (66.66%) (p=0.08). The VASI score decreased by 1.24 in the add-on apremilast group and 0.05 in the control group (p= 0.754). Parameters including body surface area, dermatology life quality index, and body mass index reduced significantly, while the visual analog scale increased significantly in the add-on apremilast group. However, results were comparable between groups. Conclusions Treatment with add-on apremilast accelerated clinical improvement. It also reduced disease progression and improved the disease index among participants. However, add-on apremilast had a lower tolerability profile than the control group.

Yttrium Oxide Nanoparticle-Loaded, Self-Assembled Peptide Gel with Antibacterial, Anti-Inflammatory, and Proangiogenic Properties for Wound Healing.

Chronic wounds are a major healthcare challenge owing to their complex healing mechanism and number of impediments to the healing process, like infections, unregulated inflammation, impaired cellular functions, poor angiogenesis, and enhanced protease activity. Current topical care strategies, such as surgical debridement, absorption of exudates, drug-loaded hydrogels for infection and inflammation management, and exogenous supply of growth factors for angiogenesis and cell proliferation, slow the progression of wounds and reduce patient suffering but suffer from low overall cure rates. Therefore, we have developed a proteolytically stable, multifunctional nanoparticle loaded-peptide gel with inherent anti-inflammatory, antibacterial, and pro-angiogenic properties to provide a favorable wound healing milieu by restoring impaired cellular functions. We have fabricated a self-assembled, lauric acid-peptide conjugate gel, LA-LLys-DPhe-LLys-NH2, loaded with yttrium oxide (Y2O3) nanoparticles (NLG). Gel formed a nanofibrous structure, and nanoparticles were passively entrapped within the network. The surface morphology, stability, viscoelastic, and self-healing characteristics of gels were characterized. It showed a high stability against degradation by proteolytic enzymes and highly potent antibacterial activities against E. coli and S. aureus due to the presence of positively charged side chains of lysine in the peptide chain. It also exhibited an excellent antioxidant activity as well as ability to stimulate cell proliferation in murine fibroblast (L929) cells and human umbilical vein endothelial cells (HUVECs). The incorporation of nanoparticles promoted angiogenesis by upregulating pro-angiogenic genes, vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF2), and epidermal growth factor (EGFR), and the gel caused complete wound closure in cells. In summary, the Y2O3 nanoparticle-loaded lauric acid-peptide conjugate gel is able to elicit the desired tissue regeneration responses and, therefore, has a strong potential as a matrix for the treatment of chronic wounds.

Diagnostic and economic value of biomarker testing for targetable mutations in non-small-cell lung cancer: a literature review.

We aimed to assess the diagnostic and economic value of next-generation sequencing (NGS) versus single-gene testing, and of liquid biopsy (LBx) versus tissue biopsy (TBx) in non-small-cell lung cancer biomarker testing through literature review. Embase and MEDLINE were searched to identify relevant studies (n = 43) from 2015 to 2020 in adults with advanced non-small-cell lung cancer. For NGS versus single-gene testing, concordance was 70-99% and sensitivity was 86-100%. For LBx versus TBx, specificity was 43-100% and sensitivity was ≥60%. Turnaround times were longer for NGS versus single-gene testing (but not vs sequential testing) and faster for LBx versus TBx. NGS was cost-effective, and LBx reduced US per-patient costs. NGS versus single-gene testing and LBx versus TBx were concordant. NGS and LBx may be cost-effective for initial screening.

Plain language summary Patients with lung cancer with specific genetic mutations can benefit from medications that are specific to those mutations, known as targetable mutations. There are many methods to test for specific genetic mutations in patients with lung cancer. To detect genetic mutations, doctors can test the blood or urine, or they can test biopsy tissue; a small piece of the tumor removed from the lung. These tests can either look for mutations in one specific gene at a time, or they can use technology that reads the entire DNA sequence to observe multiple genes at once. In this review, we examined scientific reports to answer important questions about using genetic testing to find targetable mutations in patients with lung cancer. How accurate are different genetic tests? How fast can doctors get results from different genetic tests? How much do different genetic tests cost? We found that reading the entire DNA sequence was as accurate as testing one specific gene. Reading the entire DNA sequence takes more time than testing one specific gene, but it might reduce overall costs. Testing blood or urine was not as accurate as testing tissue, but it took less time for doctors to receive genetic test results and reduced costs.

Predictors of Infarction in Tuberculous Meningitis in Indian Patients.

BACKGROUND: Stroke is a devastating complication of tuberculous meningitis (TBM) and is an important determinant of its outcome. We propose a model which would help to predict development of infarction or cerebrovascular events in patients of TBM. METHODS: A prospective study with n=129 patients of TBM were evaluated for predictors and outcomes of stroke. A diagnostic grid was formulated with clinical, laboratory and radiology as parameters to predict the vascular outcomes. All patients were followed up for mortality and disability on the basis of modified rankin score (mRS). MRI & CSF cytokines TNF-alpha, IFN- gamma & IL-6,8, 10 were measured at baseline and 3 months. The diagnosis of TBM included definite, probable & possible types and stage I & II with early and late onset of symptoms respectively. RESULTS: The mortality was 16.2% and 19.4% of all patients developed stroke. The mean GCS, barthel index and mRS at admission was 57.03± 9.5,10.2±2.3 & 3.3±0.03 respectively mild to moderate infection and functional limitation. Barthel index (BI) happened to be a strong predictor [F=32.6, p=0.001, t=15.5, ßeta coefficient =0.002] followed by biomarker TNF-α [F=18.9, p=0.02, t= -2.07, ßeta coefficient=-0.04]. N=25 patients developed stroke with TNF-α, IL-6, IFN -γ showing statistically significant increase in all the stroke affected TBM (95% CI; 4.5 to 1.2; p=0.003). At 3 months, it was observed that mRS was statistically significant between stage I & II (95% CI; 5.4 to 2.1; p=0.04). CONCLUSIONS: Our data revealed that 19.4% patients developed vascular events during the hospital stay or follow up. We recruited late onset TBM as compared to early onset. BI, TNF-α, IL6 are most potent predictors of stroke post TBM.

Contamination of rice crop with potentially toxic elements and associated human health risks-a review.

Production of rice, a major staple food crop, should be maintained both quantitatively and qualitatively to assure global food security. In recent decades, various natural (biogeochemical weathering of rocks) and anthropogenic (increased application of agrochemicals, solid and liquid waste discharges from domestic and industrial areas, vehicular pollution, etc.) activities have deteriorated soil and water resources by contributing potentially toxic elements (PTEs) to the environment. Shortage of land resources and requirements of the ever-increasing human population has led to increasing global trend of rice cultivation in contaminated soils, causing accumulation of various PTEs such as arsenic (As), mercury (Hg), cobalt (Co), cadmium (Cd), copper (Cu), lead (Pb), and nickel (Ni) in rice crop, especially in the grains. Rice plants uptake and accumulate PTEs leading to their entry into the food chain. Consumption of rice contaminated with PTEs disturbs the human metabolism as PTEs interfere with different physiological/molecular mechanisms causing various health problems such as weak bones; skin problems; respiratory, cardiovascular, endocrine, nervous, reproductive, and hepatic disorders; and cancer. Possible non-carcinogenic and carcinogenic health risks have been determined in some studies by following the guidelines provided by various governmental or non-governmental agencies. Considering these facts, the present study was conducted to give a broader perspective on rice contamination with various potentially toxic elements, their bioconcentration in rice, associated health risks in human beings, and strategies for bioremediation of soil and water resources to eliminate PTEs.

High soluble interleukin-2 receptor values in Indian paediatric & adult controls - Need for population-specific threshold in the diagnosis of haemophagocytic lymphohistiocytosis.

Background & objectives: Elevated soluble interleukin-2 receptor (sIL2R) is a diagnostic criterion for haemophagocytic lymphohistiocytosis (HLH). International guidelines propose a 2400 U/ml cut-off or individual laboratory-defined cut-off. However, sIL2R normal values are so far not known in Indians. So, this study was undertaken to measure sIL2R in healthy children and adults to establish age-related reference values. Methods: Healthy controls and cases (participants with persistent fever, organomegaly, cytopenias and biochemical markers of HLH) were prospectively enrolled. Serum sIL2R was measured by double-sandwich enzyme immunoassay in a standardization batch to determine the optimum cut-off value using receiver operator characteristic curve and was subsequently validated. Results: One hundred and forty six age- and sex-matched children (80 controls and 66 suspected HLH cases) and 55 adults (49 controls and 6 suspected HLH cases) were prospectively enrolled. The optimal sIL2R cut-off ≥23 ng/ml was defined as raised sIL2R in the standardization batch. No controls had sIL2R ≥23 ng/ml in the validation batch. In healthy controls, median sIL2R (interquartile range) decreased with increasing age from 9.0 ng/ml (6.6-13.4) below five years of age to 3.2 ng/ml (2.8-5.1) in adults. Proposed upper limit of normal value for sIL2R is 17.4 ng/ml in less than five year, 12.2 ng/ml in 5-9 yr, 6.7 ng/ml in 10-17 yr and 5.2 ng/ml in ≥18 yr. sIL2R accuracy to diagnose HLH marginally improved with age-appropriate cut-off. Interpretation & conclusions: Paediatric controls in India showed higher sIL2R levels than most studies conducted in other countries, except for some reports in Chinese and Russian populations. Age-appropriate reference values of sIL2R in a specific population may be considered to determine elevated sIL2R as a marker of HLH.

Vimentin as a potential therapeutic target in sorafenib resistant HepG2, a HCC model cell line.

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) is the most common liver cancer with high mortality rate in patients suffering from liver diseases. The drug of choice used in advanced-stage of HCC is sorafenib. However, adaptive resistance has been observed in HCC patients undergoing long-term sorafenib treatment, lowering its effectiveness. Hence, it is important to overcome drug resistance to improve overall management of HCC. Here, we have identified a candidate biomarker for sorafenib resistance in a HCC model cell line, HepG2. METHODS: Initially, comparative proteomic profiling of parental HepG2 [HepG2 (P)] and sorafenib-resistant HepG2 [HepG2 (R)] cells was performed via MALDI (matrix-assisted laser desorption/ionization) which revealed the deregulation of vimentin in HepG2 (R) cells. Gene and protein level expression of vimentin was also observed through quantitative real-time polymerase chain reaction (qRT PCR) and fluorescence-activated cell sorting (FACS), respectively. Furthermore, withaferin A was used to study regulation of vimentin expression and its significance in sorafenib resistance. RESULTS: Both gene and protein level of vimentin expression was found to be downregulated in HepG2 (R) in comparison to HepG2 (P). Interestingly, the study demonstrated that withaferin A further lowered the expression of vimentin in HepG2 (R) cells in a dose-dependent manner. Also, inhibition of vimentin lowered ABCG2 expression and decreased cell viability in parental as well as sorafenib resistant HepG2 cells. CONCLUSION: Hence, our study for the first time highlighted the probable therapeutic potential of vimentin in sorafenib resistant HepG2, a HCC model cell line.

Vascular Endothelial Growth Factor as Predictive Biomarker for Stroke Severity and Outcome; An Evaluation of a New Clinical Module in Acute Ischemic Stroke.

BACKGROUND: The need to study prognosis after incidence of acute ischemic stroke (AIS) has fueled researchers to identify predictors apart from neurological, functional, or disability measures. The purpose of this study was to test and validate a newly developed clinico-biomarker assessment module in AIS and also to investigate the role of serum vascular endothelial growth factor (VEGF) after AIS. MATERIALS AND METHODS: A randomized controlled study with sample size of 250 patients suffering from AIS within 2 weeks of the index event were conducted and followed up for a period of three months. Age, gender, stroke subtype, previous stroke history, dysarthria, stroke localization, wakeup strokes, and Glasgow Coma Scale (GCS) were dichotomized as present or absent using the National Institute of Health Stroke Scale (NIHSS) which consists of four subcategories. The additional serum VEGF was scored between 1 and 4 (0-200 = 1, 200-300 = 2, 300-400 = 3, and 400-500 = 4). All these were summed under a clinical biomarker (CB) module with highest score of 30. RESULTS: The mean VEGF in 125 patients was 378.4 + 98.9 pg/ml, indicating a moderately high increase with a score of 3 on CB module. Multiple regression analysis revealed that the CB model was fit to predict prognosis and severity [R2 = 0.86, F (23.4, 6);P = 0.001], with NIHSS subscore, prestroke status, and VEGF being very strong predictors. When only the clinical module was tested on all 250 patients, it was found that the NIHSS subscore, time to stroke onset and prestroke functional status were the most common [R2 = 0.79; F (45,9);P = 0.005]. CONCLUSION: This study demonstrates that VEGF is highly upregulated in AIS with severe disability as compared to healthy controls. This biomarker is a strong predictor of severity and functionality when combined with clinical variables three months post the ishemic event.

Appraisal of heavy metal contents in groundwater and associated health hazards posed to human population of Ropar wetland, Punjab, India and its environs.

Heavy metals are well recognised for their toxicity and pose human health risks even at very low levels. In the present work, groundwater from Ropar wetland, Punjab, India and its environs (18 sites), were analysed for physico-chemical parameters, water quality indices, heavy metal contents (cadmium, cobalt, chromium, copper, lead and zinc) and possible health risks posed to adults and children during summer and winter seasons. Groundwater was slightly-alkaline, non-saline and hard which may be suitable for irrigation purposes. Among 18 samples, 7 and 9 samples in summer; 8 and 18 samples in winter exceeded BIS acceptable limits (mg L-1) of 0.003 and 0.05 for cadmium and chromium, respectively. Mean non-cancer hazard quotients for cobalt (5.09-7.63) were >1. Mean hazard indices for cumulative risks posed by all heavy metals (6.00-10.11) were also >1. These results indicated higher risk of non-cancerous health problems in residents of the study area. Chromium was found to pose significant possible cancer risk (1.20-2.99 cases/1000 persons). Children were more prone to health problems than adults due to their lower body weight with greater risk in winters, which may be attributed to higher contamination of heavy metals in groundwater after leaching during monsoons. The results of water quality analysis and risk assessment indicated that the groundwater suffered from significant contamination and if used for long-term without pre-treatment, may pose serious health risks to human population via drinking water and irrigation of agricultural fields due to bioconcentration of heavy metals in food crops cultivated in those fields.

Correlation of E-cadherin Immunohistochemical Expression with Histopathological Grading of Oral Squamous Cell Carcinoma.

OBJECTIVES: The current research was undertaken with an aim to correlate the expression of E-cadherin with histopathological grading in oral squamous cell carcinoma (OSCC) patients. Further, the objectives of the study were to evaluate the qualitative and quantitative expressions of E-cadherin in OSCC and to correlate the number of tumor cells of OSCC, immunopositive for E-cadherin with histopathological grading of OSCC. MATERIALS AND METHODS: Immunoexpression of E-cadherin antibody was evaluated in previously diagnosed, paraffin-embedded sections of 20 tissues each of well-differentiated and moderately differentiated OSCC, 17 tissues of poorly differentiated OSCC, and 10 tissues of normal oral mucosa; Chi-square test, analysis of variance, and Tukey's honestly significant difference test were employed for statistical analysis. RESULTS: E-cadherin immunoreactivity was inversely correlated to the loss of cell differentiation. There was a significant decrease in expression of E-cadherin (P < 0.0001) in advanced cases of OSCC. Furthermore, there was a significant reduction in intensity of E-cadherin expression with advancing histological grades of OSCC. CONCLUSION: From the present study, it is concluded that the reduced expression of E-cadherin may be a reliable indicator of increase in the invasiveness of OSCCs.

Prevention of Malignant Transformation of Oral Leukoplakia and Oral Lichen Planus Using Laser: An Observational Study

Objectives: The present observational study was conducted with an aim to evaluate the efficacy of diode laser in management of homogenous oral leukoplakia (OL) and reticular oral lichen planus (OLP), so that these potentially malignant disorders can be limited and further malignant transformation can be prevented. Further the assessment of associated postoperative complications after laser therapy was also carried out. Study Design: Present study was carried out using diode laser 810nm on 60 subjects, of whom 30 subjects were of homogenous OL and 30 subjects were of reticular OLP aged between 20 ­ 60 years, the diagnosis of which was histopathologically confirmed. Results: Of the 60 subjects none complained of pain during and immediately after surgery with no bleeding at any stage of the procedure. By the end of 3rd day post operative most subjects reported no pain and swelling and very few subjects had negligible pain and swelling when evaluated. On subsequent follow-up of 1,2 and 4 week(s) none of the subject reported of pain, swelling or bleeding and it was noted that all the areas treated with laser had healed without scarring with no signs of recurrence. Fibrosis was seen in two male patients and one female patient treated for OL and OLP respectively. Conclusion: Patient compliance and contentment without any postoperative complications were observed to be of high degree in the present study. Thus diode laser can be considered as a best alternative to conventional surgical treatment modality in managing OL and OLP and preventing its further transformation.

Estimation of arsenic, manganese and iron in mustard seeds, maize grains, groundwater and associated human health risks in Ropar wetland, Punjab, India, and its adjoining areas.

Present study was conducted to estimate the bioconcentration of total arsenic (t-As), manganese (Mn) and iron (Fe) in mustard seeds and maize grains cultivated in agricultural fields of Ropar wetland and its surroundings. Possible health risks posed to residents of study area via daily dietary intake of inorganic arsenic (i-As), manganese and iron via consumption of mustard seeds, maize grains and groundwater were also assessed. i-As content was determined form t-As using relevant conversion factor (i-As = t-As in groundwater and i-As = 70% t-As in food crops). Mustard seeds acted as accumulator of arsenic as mean bioconcentration factor (BCF) was > 1 for 66.67% of the samples. BCFs of t-As, Mn and Fe for mustard seeds and maize grains varied logarithmically with their respective concentrations in soil samples, except BCF for Mn in mustard seeds, which followed a linear model. Hazard quotient and hazard index values of i-As, Mn and Fe were found to be > 1 for mustard seeds and groundwater samples. Possible cancer risk was determined for i-As in mustard seeds, maize grains and groundwater samples > 1.00E-06. These results indicated that daily dietary intake of mustard seeds, maize grains and groundwater contaminated with i-As, Mn and Fe is highly unsafe as it may cause a high possibility of appearance of cancerous and non-cancerous health problems in human population of study area.

PRISMA and AMSTAR show systematic reviews on health literacy and cancer screening are of good quality.

OBJECTIVES: The objectives of this study were to evaluate the reporting and methodological quality of systematic reviews (SRs) on health literacy and cancer screening and to investigate factors that may influence overall quality. STUDY DESIGN AND SETTING: We reviewed SRs published between 2009 and 2017. We calculated indices to represent the included SRs' adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and A Measurement Tool to Assess Systematic Reviews (AMSTAR). To assess possible determinants of SRs' quality, we regressed the index scores on year and region of publication, journal impact factor, authors' reported use of PRISMA, and presence of funding statements. RESULTS: We included 19 SRs, and median index scores were 0.86 for PRISMA (interquartile range [IQR] = 0.11; range = 0.32-1.00) and 0.67 for AMSTAR (IQR = 0.30; range = 0.22-1.00). Methodological and reporting problems pertained to protocol registration or publication, number of raters used, gray literature searches, excluded article lists, and unintegrated discussions of risk of bias and efficacy. Only journal impact factor was statistically significantly associated (positively) with PRISMA and AMSTAR index scores. CONCLUSION: The quality of SRs on health literacy and cancer screening was generally good. Systematic reviewers should register or publish their protocols, include PRISMA and AMSTAR checklists when submitting SRs to journals, and self-evaluate their SRs before submission.

Heavy metal contamination in soil, food crops and associated health risks for residents of Ropar wetland, Punjab, India and its environs.

In the present study, an assessment of heavy metal content in soil and food crops (wheat, rice, maize grains and mustard seeds) and associated health risks was carried out for residents of Ropar wetland and its environs. All the soil samples had high cadmium and cobalt contents, whereas, all crop samples had high contents of cobalt and lead. Bioconcentration factor (BCF) analysis indicated that rice grains act as hyper-accumulators of chromium (BCF = 17.98) and copper (BCF = 10.91), whereas, maize grains act as hyper-accumulators of copper (BCF = 30.43). One-way ANOVA suggested that heavy metal content in food crops varied significantly at p ≤ 0.05 for different sites, indicating anthropogenic contribution of heavy metals in agricultural fields. Dietary intake of cobalt via all food crops posed higher non-cancer health risk to residents in comparison to other heavy metals. Chromium posed highest cancer risk through consumption of wheat grains, being staple diet in study area.

Assessment of arsenic content in soil, rice grains and groundwater and associated health risks in human population from Ropar wetland, India, and its vicinity.

In the present study, potential health risks posed to human population from Ropar wetland and its vicinity, by consumption of inorganic arsenic (i-As) via arsenic contaminated rice grains and groundwater, were assessed. Total arsenic (t-As) in soil and rice grains were found in the range of 0.06-0.11 mg/kg and 0.03-0.33 mg/kg, respectively, on dry weight basis. Total arsenic in groundwater was in the range of 2.31-15.91 µg/L. i-As was calculated from t-As using relevant conversion factors. Rice plants were found to be arsenic accumulators as bioconcentration factor (BCF) was observed to be >1 in 75% of rice grain samples. Further, correlation analysis revealed that arsenic accumulation in rice grains decreased with increase in the electrical conductivity of soil. One-way ANOVA, cluster analysis and principal component analysis indicated that both geogenic and anthropogenic sources affected t-As in soil and groundwater. Hazard index and total cancer risk estimated for individuals from the study area were above the USEPA limits of 1.00 and 1.00 × 10-6, respectively. Kruskal-Wallis H test indicated that groundwater intake posed significantly higher health risk than rice grain consumption (χ 2(1) = 17.280, p = 0.00003).