Association of cytokines levels with epidermal growth factor receptor mutation in lung cancer patients

Background: Lung cancer is one of the most frequent types of cancer and the leading cause of cancer-related deaths. Epidermal growth factor receptor (EGFR) is a receptor tyrosine kinase (TK) being highly expressed in lung cancers. Activation of EGFR through oncogenic mutations leads to upregulation of gene expression that may heighten the inflammatory response in certain situations. EGFR acts as a key regulator and a cellular hub for inflammatory cytokine signaling, thereby promoting tumor cell proliferation, invasion, migration, metastases, and survival. The aim of the present study is to determine the serum cytokines levels and EGFR mutation status in lung cancer patients to investigate the association between the EGFR mutation status and cytokines levels with lung cancer patients. Materials and Methods: Blood and tissue samples of lung cancer patients were collected. The EGFR mutations of lung cancer patients were determined by the immunohistochemistry (IHC) and serum cytokines levels of lung cancer patients were determined using ELISA. Results: Statistically significant association of EGFR mutations with adenocarcinoma subtypes and non-smokers were found (P < 0.05). Lung cancer patients with EGFR mutations had significantly higher tumor necrosis factor-alpha levels when compared to lung cancer patients without EGFR mutations (P < 0.01), and EGFR mutation status was not significantly associated with interleukin-6 levels (P = 0.24). Conclusion: EGFR mutation detection by the IHC method is a potentially useful tool to guide clinicians for personalized treatment of lung cancer patients of adenocarcinoma subtype, and cytokines are good biomarkers for the diagnosis, prognosis, and prediction of treatment responses in lung cancer patients as well as act as therapeutic targets. This study will provide biomarkers for lung cancer diagnosis and treatments

An adaptive clinical trial on patients with non variceal upper gastrointestinal bleed with the help of endoscopy

Background: Acute upper gastrointestinal hemorrhage (UGIH) is a common condition worldwide frequently leads to hospital admission also has a significant associated morbidity and mortality, especially in the elderly. A systematic diagnostic and definite therapeutic approach is essential to establish a diagnosis, relevant to specific investigations for appropriate treatment in tertiary medical care center.Methods: A comparative trial was done on n=109 cases with an objective to find out the different causes of UGI bleed in population, to assess the requirement of blood transfusion in patients with massive GI Bleed and to compare the treatment outcome of Proton pump inhibitors over Tranexamic acid and Octreotide in non-variceal UGI bleed. The cases were assigned to three different groups by lottery system. Proton pump inhibitors (Omeprazole), Somatostatin (Octreotide), Anti-fibrinolytic (Tranexamic acid), outcome was assessed after complete treatment and follow up.Results: Out of 150 cases, 109 were diagnosed with non-variceal GI bleed, 35 cases were treated with Omeprazole out of which 11.42% cases received blood transfusion, and 4 had history of re bleeding, Mean Duration of stay in hospital was 4.4±1.75, when compared to the other two group the duration of hospitalization was least as the P value was <0.0001.Conclusions: In this study it was demonstrated the use of PPI in case of Non-Variceal Bleeding significantly reduces the need of blood transfusion. Even it reduces the cases of re bleeding and duration of hospital stay.

Quantitative Assessment of Muscle Activity and Joint Load in Braced and Unbraced Osteoarthritis Knee by External Strain Gauge Sensor.

Objectives: Altered biomechanics leads to the development of degenerative joint disease. The joint pressure and dynamic loading varies during activities of daily living. The study was undertaken to assess the muscle activation pattern of the medial and lateral knee compartments (tibiofemoral joint) during gait in osteoarthritis subjects without and with knee brace undergoing either exercise therapy or balance therapy. The joint load was assessed by the strain gauge transducer and the weight shift pattern is taken as an indicator for the muscle activation pattern. Methods: In a prospective design study on 57 male subjects diagnosed osteoarthritis knee with KellagrenLawrennce scale walked barefooted with and without designed offloader knee brace on a level surface for three minutes. The subjects were allocated in two different study groups i.e. Conventional (exercise therapy) (Control Group, n=31) and Structured Neuromuscular Postural Training (SNPT) group (Balance therapy) (Study Group, n=26). The subjects were sub grouped as pre-elderly (40-60 Years) and elderly (>61 years) group in both. The quantitative assessment of muscle activity and joint loading with and without knee brace was done using designed strain gauge sensor instrument. The pressure changes of strain gauges of muscles around the knee joint viz. vastus medialis (VM), vastus lateralis (VL), semi membranosus / tendinosus (Medial Hamstring) (MH), Biceps Femoris (Lateral Hamstring) (LH), gastro-soleus (GS) and tibialis anterior (TA) muscles during normal gait were observed at baseline and 6 weeks follow up after undergoing exercise therapy or balance therapy treatment as per allocation of study groups. The digital values from MATLAB were recorded and analyzed. Results: At the end of 6 weeks conventional / SNPT (structured neuromuscular postural training) treatments, medial hamstring muscle activity showed significant difference (p<0.001) in pre-elderly subgroup, while significant difference was seen in vastus laterals (VL), medial hamstring (MH) (p<0.005) and lateral hamstring (LH) muscles (p<0.001) in elderly subgroup

Botulinum Toxin: Dentistry Insight.

Botulinum toxin is the first biologic toxin to be used in the treatment of human diseases. It is a minimally invasive, revolutionary and a novel approach to treat several orofacial disorders. It is produced by autolysis of gram positive anaerobic bacterium called Clostridium botulinum. Botulinum toxin is lethal and is well known for its lingering threat of bioterrorism which is associated with it. On the other hand it has a therapeutic potential when injected in minute quantities in hyperactive muscles. Over the past two decades the cosmetic and non - cosmetic uses of botulinum toxin in the orofacial region has gained wide popularity. The purpose of this article is to overview the tortuous course of botulinum toxin from its discovery as a lethal toxin to its cosmetic and non- cosmetic enhancement roles in the perioral region and to determine its usefulness and effectiveness in wide range of orofacial disorders.

Drug carrier transfersomes: A novel tool for transdermal drug delivery system.

Transport of the drug through skin is best route of drug delivery because of the skin is largest organ human organ with total weight 3 kg and a surface of 1.5 -2.0 m2. Drug carries used in transdermal drug delivery such as liposomes, noisomes, or microemulsions has problem that they remains mostly confined to the skin surface and therefore do not transport drugs efficiently through the skin. By using the concept of rational membrane design we have recently devised special composite bodies, so-called Transfersomes. Transfersomes penetrate through the pores of stratum corneum which are smaller than its size and get into the underlying viable skin in intact form. This is because of its deformable nature. The system can be characterized by in vitro for vesicle shape and size, entrapment efficiency, degree of deformability, number of vesicles per cubic mm. They can act as a carrier for low as well as high molecular weight drugs e.g. analgesic, anesthetic, corticosteroids, sex hormone, anticancer, insulin, gap junction protein, and albumin.

Ethosomes: A recent vesicle of transdermal drug delivery system.

Transdermal drug delivery system was first introduced more than 30 years ago. The technology generated tremendous excitement and interest amongst major pharmaceutical companies in the 1980s and 90s. By the mid to late 1990s, the trend of transdermal drug delivery system merged into larger organizations. Ethosomes are the ethanolic phospholipid vesicles which are used mainly for transdermal delivery of drugs. Ethosomes have higher penetration rate through the skin as compared to liposomes hence these can be used widely in place of liposomes. Ethosomes have become an area of research interest, because of its enhanced skin permeation, improved drug delivery, increased drug entrapment efficiency etc. The purpose of writing this review on ethosomes drug delivery was to compile the focus on the various aspects of ethosomes including their mechanism of penetration, preparation, advantages, composition, characterization, application and marketed product of ethosomes. Characterizations of ethosomes include Particle size, Zeta potential, Differential Scanning Calorimertry, Entrapment efficiency, Surface tension activity measurement, Vesicle stability and Penetration Studies etc.

Novel oral sustained release technology: A concise review.

The advantage of administering a single dose of a drug that is released over an extended period of time instead of numerous doses is now a day’s area of interest for formulation scientists in Pharmaceutical industry. There are several advantages of sustained release drug delivery over conventional dosage forms like improved patient compliance due to less frequent drug administration, maximum utilization of the drug, increased safety margin of potent drug, reduction of fluctuation in steady-state drug levels, reduction in healthcare costs through improved therapy and shorter treatment period. Wide varieties of polymers like Hydroxy Propyl Methyl Cellulose (HPMC), Carboxy Methyl Cellulose (CMC), Ethyl Cellulose (EC), Cellulose Acetate Phthalate, HPMC K100M, Xanthan gum, Carrageenan gum, Karaya gum, HPMC K15, Carbopol 971P and Carbopol 974P etc. are available for retarding the release rate of drugs hence sustains the action of drugs. This review article describes the basic information regarding sustained-release formulation, its advantages, disadvantages, selection of drug for sustain release, mechanism of release, different types, and factor involved in oral sustained-release dosage form design.

Solid Dispersion: Methods and Polymers to increase the solubility of poorly soluble drugs.

The solubility behaviour of drugs remains one of the most exigent aspects in formulation development. These days, the number of new chemical entities has dramatically increased having hiccups of poor solubility and poor permeability. Solid dispersion as a dosage form has been established a superior option for the drugs having poor aqueous solubility. Solid dispersions in water-soluble carriers have engrossed considerable interest as a means of improving the dissolution rate and bioavailability of hydrophobic drugs. Although solid dispersions have tremendous potential for improving drug solubility and only a few marketed products using this approach. There are various methods available to improve the solubility of the new drug in which solid dispersion emerged promising. A Solid dispersion generally composed of two components- the drug and the polymer matrix. Numerous methods are existing to prepare the solid dispersions such as melting method, solvent evaporation method, fusion method, kneading method, melting method, spray drying method, co-grinding method, lyophilization technique, hot melt extrusion, melt agglomeration, supercritical fluid (SCF) technology etc. A variety of hydrophilic carriers have been investigated for enhancement of dissolution characteristics and bioavailability of poorly aqueous-soluble drugs. In this review an endeavour is made to discuss about the comprehensive methods of preparation and numerous carriers are used for solid dispersions.

Circulation of Dengue virus-1 (DENV-1) serotype in Delhi, during 2010–11 after Dengue virus-3 (DENV-3) predominance: A single centre hospital-based study.

Background: Delhi, a city in north India, has so far witnessed several reported outbreaks of dengue. Dengue in Delhi from being epidemic is slowly changing towards being endemic and hyper-endemic. Circulating type of the virus is also changing over the years. In the absence of an effective vaccine, dengue prevention to a major extent relies on virological surveillance, and development of effective, locally adapted control programmes. In the present study, we tried to identify the between-year non-epidemic serotype of dengue virus circulating in Delhi, during 2010–11. Methods: Acute-phase samples were collected from the patients attending the Institute of Liver & Biliary Sciences, New Delhi, India. Dengue diagnosis was done using WHO case definitions. All the samples were subjected to Dengue NS1 Ag ELISA and modified nested RT-PCR. Results: A total of 75 acute-phase samples were received, of which 19 (25.3%) were positive for dengue NS1 antigen. Dengue RT-PCR was positive in 14.6% (11/75) samples. All the RT-PCR isolates were of DENV-1 serotype. No case of concomitant infection with more than one serotype was observed. Median age of involvement was 23 yr (range10–86). Maximum number of cases were seen in the age group of 21–30 yr. Male to female ratio was 1.2 : 1. Maximum number of suspected dengue cases (n=79) was seen during September and October. Conclusions: DENV-1 was circulating in Delhi in the year 2010–11 in non-epidemic period following reported predominance of DENV-3 and co-circulation of all dengue serotypes in the epidemic years 2003, 2006 and 2007.

Studies on antioxidative enzymes induced by cadmium in pea plants (Pisum sativum).

Pea plants (Pisum sativum cv. Swati) exposed to different concentration of cadmium (50, 100, 200 9M Cd) under controlled glass house conditions were quantified for different physiological parameters and antioxidative enzymes. In pea plants, Cd produced a significant inhibition of growth and induced chlorosis, marginal yellowing and necrosis in young leaves, the effect being most pronounced at 200 9M Cd supply. An alteration in the activated oxygen metabolism of pea plants were also detected as evidenced by an increase in concentration of H2O2 and TBARS along with decrease in the chlorophyll and carotenoid concentration in leaves. Cadmium toxicity induced an increase in non- protein thiol, ascorbate, proline and cysteine concentration. A significant increment in the activity of SOD, APX and GR, and a decrease in CAT was observed as a result of Cd treatment. The enhanced activity of SOD and inhibition of CAT and POD produces a high build up of H2O2 which appears to be the main cause of oxidative stress due to Cd toxicity in pea plants.

Multiple Impact Supernumary Teeth - A Rare Case Report.

While impaction of tooth is widespread, multiple impacted teeth by itself is a rare condition and is found in association with syndromes such as cleidocranial dysplasia or Gardner’s syndrome. This paper describes a young male who didn’t possess any systemic conditions or syndromes with forty six multiple impacted teeth involving both jaws. Based on the clinical presentation, radiographic examination and histopathological studies, this paper discusses the differential diagnosis and management of such cases.