Expression Profile of KRAS and p16 in Periampullary Cancer.

Activating point mutations in codons 12, 13, and 61 of the KRAS gene and loss of p16 expression, a tumor suppressor gene, are common genetic alterations in periampullary cancer (PAC). The present study explores expression profile of KRAS and p16 genes in PAC and its prognostic relevance. A total of 50 patients with PAC who underwent potentially curative pancreaticoduodenectomy were included in the study. Formalin-fixed, paraffin-embedded tissue samples were analyzed for point mutations in codons 12 and 13 of KRAS and codon 9 of p16 using polymerase chain reaction. KRAS mutation in codon 12/13 was found in 32 (64%) and loss of p16 expression in 36 (72%) cases. KRAS mutation was significantly associated with higher grade, higher pathological tumor (pT) stage, lymphovascular invasion (LVI), perineural invasion (PNI), and pathological lymph nodes (pN) involvement on univariate analysis. On multivariate analysis, significant association of KRAS remained with higher grade (p = 0.031), pT stage (p = 0.09), and LVI (p = 0.028). On univariate analysis, loss of p16 expression was significantly associated with higher grade, pN involvement, LVI, PNI, and pT stage whereas on multivariate analysis, statistical significant association of p16 was found with higher grade of tumor only (p = 0.04). Patients with KRAS mutation had significantly (p = 0.018) worse disease-free survival (DFS) whereas no significant association was found in overall survival (OS). Loss of p16 expression had no association with either DFS or OS. The presence of p16 and KRAS alterations in patients with PAC suggests aggressive tumor biology. KRAS mutations confer a significantly poor DFS in PAC.

Polysulfide Rejection Strategy in Lithium-Sulfur Batteries Using an Ion-Conducting Gel-Polymer Interlayer Membrane.

Lithium-sulfur batteries (LiSBs) are emerging as promising alternative to conventional secondary lithium-ion batteries (LiBs) due to their high energy density, low cost, and environmental friendliness. However, preventing polysulfide dissolution is a great challenge for their commercial viability. The present work is focused on preparing a lithium salt and ionic liquid (IL) solution (SIL) impregnated ion (lithium ion)-conducting gel-polymer membrane (IC-GPM) interlayer to prevent polysulfide migration toward the anode by using an electrostatic rejection and trapping strategy. Herein, we introduce an SIL-based freestanding optimized IC-GPM70 (70 wt % SIL) interlayer membrane with high lithium-ion conductivity (2.58 × 10-3 S cm-1) along with excellent thermal stability to suppress the migration of polysulfide toward the anode and prevent polysulfide dissolution in the electrolyte. Because of the coulombic interaction, the anionic groups, -CF2 of the ß-phase polymer host PVdF-HFP, TFSI- anion of IL EMIMTFSI, and anion BOB- of LIBOB salt, allow hopping of positively charged lithium ions (Li+) but reject negatively charged and relatively large-sized polysulfide anions (Sx-2, 4

Recent insights on tea metabolites, their biosynthesis and chemo-preventing effects: A review.

Tea manufactured from the cultivated shoots of Camellia sinensis (L.) O. Kuntze is the most commonly consumed nonalcoholic drink around the world. Tea is an agro-based, environmentally sustainable, labor-intensive, job-generating, and export-oriented industry in many countries. Tea includes phenolic compounds, flavonoids, alkaloids, vitamins, enzymes, crude fibers, protein, lipids, and carbohydrates, among other biochemical constituents. This review described the nature of tea metabolites, their biosynthesis and accumulation with response to various factors. The therapeutic application of various metabolites of tea against microbial diseases, cancer, neurological, and other metabolic disorders was also discussed in detail. The seasonal variation, cultivation practices and genetic variability influence tea metabolite synthesis. Tea biochemical constituents, especially polyphenols and its integral part catechin metabolites, are broadly focused on potential applicability for their action against various diseases. In addition to this, tea also contains bioactive flavonoids that possess health-beneficial effects. The catechin fractions, epigallocatechin 3-gallate and epicatechin 3-gallate, are the main components of tea that has strong antioxidant and medicinal properties. The synergistic function of natural tea metabolites with synthetic drugs provides effective protection against various diseases. Furthermore, the application of nanotechnologies enhanced bioavailability, enhancing the therapeutic potential of natural metabolites against numerous diseases and pathogens.

Epigenetic Silencing of p16INK4a gene in Sporadic Breast Cancer.

Epigenetic alterations of tumor suppressor genes (TSG) involved in the onset and progression of Breast Cancer (BC) may serve as biomarkers for early detection and prediction of disease prognosis. We have herein tried to determine the methylation status of TSG, p16INK4a, in our 50 BC patients and their association with clinicopathological parameters. The methylation status of the p16INK4a gene in fresh tissue samples from 50 patients with BC was assessed by methylation-specific polymerase chain reaction (MS-PCR). The mean age of BC patients was 49.30 ± 9.75 years. Of 50 BC samples tested, 21 (42%) had methylated p16INK4a gene. p16INK4a gene hypermethylation was significantly associated with age ≤ 50 years, premenopausal status and advanced BC stage. Multivariate analysis revealed a strong association between advanced BC stage (Stage III and Stage IV) and p16INK4a hypermethylation (P = 0.008, RR = 5.996, 95% CI = 1.581-22.739). p16INK4a methylation was significantly associated with Triple Negative BC (TNBC) (P = 0.045, OR = 4.181, 95% CI = 1.030-16.981). These findings indicate that p16INK4a hypermethylation frequently occurs in BC. Hypermethylation of p16INK4a in young, premenopausal, TNBC and with advance stage in BC patients suggests its association with aggressive BC.

Electrochemical Performance of High-Valence Mo6+ and Low-Valence Mn2+ Doped- Na3 V2 (PO4 )3 @C Cathode for Sodium-Ion Batteries.

The sodium superionic conductor (NASICON)-Na3 V2 (PO4 )3 (NVP) is an attractive cathode for sodium-ion batteries, which is still confronted with limited rate performance due to its low electronic conductivity. In this paper, a chemical strategy is adopted to partially replace V3+ of the NVP framework by low-valence Mn2+ and high-valence Mo6+ substitution. The crystal structure, sodium-ion diffusion coefficient and electrochemical performance of Mn-Mo-doped [Na3.94 V0.98 Mo0.02 Mn(PO4 )3 @C] cathode were investigated. X-ray diffraction confirmed the NASICON-type structure and XPS analysis confirmed the oxidation state of Mn and Mo in doped NVP cathode. The Na ion diffusion processes were inferred from Cyclic Voltammetry (CV), Galvanostatic intermittent titration technique (GITT) and Electrochemical Impedance Spectroscopy (EIS) measurement, which clearly show rapid Na-ion diffusion in NASICON-type cathode materials. The Mn-Mo-substituted NVP shows smoother charge-discharge profiles, improved rate performance (64.80 mAh/g at 1 C rate), better energy density (308.61 mWh/g) and superior Na-ion kinetics than that of unsubstituted NVP@C cathode. Their enhanced performance is attributed to large interstitial volume mainly created by high valence Mo6+ and enhanced capacity is attributed to the low valence Mn2+ doping. These results demonstrate that Mn-Mo-doped NVP cathode is strongly promising cathode material for sodium-ion batteries.

Enhanced thermo-tolerance in transgenic potato (Solanum tuberosum L.) overexpressing hydrogen peroxide-producing germin-like protein (GLP).

Germins and germin-like proteins (GLPs) were reported to participate in plant response to biotic and abiotic stresses involving hydrogen peroxide (H2O2) production, but their role in mitigating heat stress is poorly understood. Here, we investigated the ability of a Solanum tuberosum L. GLP (StGLP) gene isolated from the yeast cDNA library generated from heat-stressed potato plants and characterized its role in generating innate and/or acquired thermo-tolerance to potato via genetic transformation. The transgenic plants exhibited enhanced tolerance to gradual heat stress (GHS) compared with sudden heat shock (SHS) in terms of maximal cell viability, minimal ion leakage and reduced chlorophyll breakdown. Further, three StGLP transgenic lines (G9, G12 and G15) exhibited enhanced production of H2O2, which was either reduced or blocked by inhibitors of H2O2 under normal and heat stress conditions. This tolerance was mediated by up-regulation of antioxidant enzymes (catalase, ascorbate peroxidase and glutathione reductase) and other heat stress-responsive genes (StHSP70, StHSP20 and StHSP90) in transgenic potato plants. These results demonstrate that H2O2 produced by over-expression of StGLP in transgenic potato plants triggered the reactive oxygen species (ROS) scavenging signaling pathways controlling antioxidant and heat stress-responsive genes in these plants imparting tolerance to heat stress.

Mesoporous Octahedron-Shaped Tricobalt Tetroxide Nanoparticles for Photocatalytic Degradation of Toxic Dyes.

The present article reports a facile approach to fabrication of mesoporous octahedron-shaped tricobalt tetroxide nanoparticles (Co3O4 NPs) with a very narrow size distribution for eco-friendly remediation of toxic dyes. Co3O4 NPs were fabricated by a sol-gel process using cobalt chloride hexahydrate (CoCl2·6H2O) and monosodium succinate (C4H5O4Na) as a chelating/structure-directing agent and sodium dodecyl sulfate as a surfactant. Moreover, the phase structure, elemental composition, and thermal and morphological facets of Co3O4 NPs were investigated using XRD, FT-IR, EDS, Raman, XPS, TGA, SEM, and TEM techniques. The face-centered cubic spinel crystalline structure of the Co3O4 NPs was confirmed by XRD and SEM, and TEM analysis revealed their octahedron morphology with a smooth surface. Moreover, the narrow pore size distribution and the mesoporous nature of the Co3O4 NPs were confirmed by Brunauer-Emmett-Teller measurements. The photocatalytic activity of Co3O4 NPs for degradation of methyl red (MR), Eriochrome Black-T (EBT), bromophenol blue (BPB), and malachite green (MG) was examined under visible light irradiation, and the kinetics of the dye degradation was pseudo-zero-order with the rate constant in the order of MR > EBT > MG > BPB. Furthermore, the mechanism of photo-disintegration mechanism of the dye was examined by a scavenging test using liquid chromatography-mass chromatography, and its excellent photodegradation activities were attributed to the photogenerated holes (h+), superoxide (O2 -) anions, and hydroxyl (·OH) radicals. Finally, the synergistic effect of the nano-interconnected channels with octahedron geometry, mesoporous nature, and charge transfer properties along with photogenerated charge separations leads to an enhanced Co3O4 photocatalytic activity.

Mesoporous PbO nanoparticle-catalyzed synthesis of arylbenzodioxy xanthenedione scaffolds under solvent-free conditions in a ball mill.

A protocol for the efficient synthesis of arylbenzodioxy xanthenedione scaffolds was developed via a one-pot multi-component reaction of aromatic aldehydes, 2-hydroxy-1,4-naphthoquinone, and 3,4-methylenedioxy phenol using mesoporous PbO nanoparticles (NPs) as a catalyst under ball milling conditions. The synthesis protocol offers outstanding advantages, including short reaction time (60 min), excellent yields of the products (92-97%), solvent-free conditions, use of mild and reusable PbO NPs as a catalyst, simple purification of the products by recrystallization, and finally, the use of a green process of dry ball milling.

Effective Antimicrobial Activity of Green ZnO Nano Particles of Catharanthus roseus.

In the present study, zinc oxide nanoparticles (ZnO NPs) were synthesized using leaf extract of Catharanthus roseus (C. roseus) under different physical parameters. Biosynthesis of ZnO NPs was confirmed by UV-Visible spectrophotometer and further, characterized by X-Ray Diffraction (XRD), Fourier Transform Infrared spectroscopy (FTIR), Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM), Energy-Dispersive X-ray spectroscopy (EDX), Atomic Force Microscopy (AFM), Photoluminescence study and Dynamic Light Scattering (DLS). We have also confirmed that several physical parameters such as pH, temperature, concentration of metal ions and reaction time were able to regulate shape and size of synthesized ZnO NPs. XRD and TEM analysis provided the information about the average size and hexagonal morphology of ZnO NPs. FTIR spectra analysis suggested that phenolic compounds played crucial role in the biosynthesis of ZnO NPs. The significant antibacterial activity of ZnO NPs was observed against Staphylococcus aureus MTCC 9760 (S. aureus), Streptococcus pyogenes MTCC 1926 (S. pyogenes), Bacillus cereus MTCC 430 (B. cereus), Pseudomonas aeruginosa MTCC 424 (P. aeruginosa), Proteus mirabilis MTCC 3310 (P. mirabilis) and Escherichia coli MTCC 40 (E. coli). The synthesized ZnO NPs have shown antibacterial efficacy against both Gram-positive and Gram-negative pathogens. Synergistic effects of ZnO NPs and streptomycin showed increased efficacy as indicated by the increased zone of clearance in comparison to their individual effects (either ZnO NPs or streptomycin). Overall, the results elucidated a rapid, cost-effective, environmentally friendly and convenient method for ZnO NPs synthesis, which could be used as a potential antimicrobial agent against drug resistant microbes.

Occurrence of multidrug resistant Escherichia coli in groundwater of Brij region (Uttar Pradesh) and its public health implications.

AIM: The study evaluates the microbial as well as physicochemical pollution of groundwater of Brij region of Uttar Pradesh, a major tourist destination in the country along with estimating the drug resistance evident in the isolated Escherichia coli. MATERIALS AND METHODS: A total of 60 samples of groundwater were collected from six different sites and assessed for physicochemical (pH, color, taste, turbidity, total dissolved solids [TDS], total hardness [TH], chlorides, fluorides, nitrates, and iron) and microbiological parameters (standard plate count [SPC], most probable number test [MPN], E. coli). RESULTS: A majority of the samples were found to be out of the range for most of the parameters except iron. Particularly, high values of TDS (up to 9000 ppm), TH (1500 mg/L), chlorides (3250 mg/L), fluorides (2.5 mg/L), and nitrates (100.2 mg/L) were observed at most of the sites in the region highlighting the fact that groundwater of the area is not potable. Samples were turbid and salty to taste. High SPC values, up to 3500 colony-forming unit/ml and coliforms beyond BIS range were found in 40% samples suggesting gross microbial contamination. Only 2 sites (G3 and G5) had low MPN values. Overall 16 (26.67%) E. coli were isolated with 3 (18.75%) producing red colonies on conge red agar, hence supposed to be pathogenic. No E. coli O157:H7 was isolated. High antimicrobial resistance was observed against amoxicillin and erythromycin, whereas E. coli isolates were sensitive toward cefotaxime-clavulanic acid and imipenem. 12 isolates (75%) were multidrug resistant (MDR) with MDR index >20%, and 2 isolates (12.5%) were found to be extended spectrum beta-lactamases positive. CONCLUSION: Groundwater is considered to be a safe option for potable water but it is obvious from the findings of this study that considerable physicochemical and microbial contamination is there in groundwater samples of Brij region. The occurrence of MDR E. coli in these waters is a matter of great public health concern.

Enhanced Tolerance of Transgenic Potato Plants Over-Expressing Non-specific Lipid Transfer Protein-1 (StnsLTP1) against Multiple Abiotic Stresses.

Abiotic stresses such as heat, drought, and salinity are major environmental constraints that limit potato (Solanum tuberosum L.) production worldwide. Previously, we found a potential thermo-tolerance gene, named StnsLTP1 from potato using yeast functional screening. Here, we report the functional characterization of StnsLTP1 and its role in multiple abiotic stresses in potato plants. Computational analysis of StnsLTP1 with other plant LTPs showed eight conserved cysteine residues, and four α-helices stabilized by four disulfide bridges. Expression analysis of StnsLTP1 gene showed differential expression under heat, water-deficit and salt stresses. Transgenic potato lines over-expressing StnsLTP1 gene displayed enhanced cell membrane integrity under stress conditions, as indicated by reduced membrane lipid per-oxidation, and hydrogen peroxide content relative to untransformed (UT) control plants. In addition, transgenic lines over-expressing StLTP1 also exhibited increased antioxidant enzyme activity with enhanced accumulation of ascorbates, and up-regulation of stress-related genes including StAPX, StCAT, StSOD, StHsfA3, StHSP70, and StsHSP20 compared with the UT plants. These results suggests that StnsLTP1 transgenic plants acquired improved tolerance to multiple abiotic stresses through enhanced activation of antioxidative defense mechanisms via cyclic scavenging of reactive oxygen species and regulated expression of stress-related genes.

Phage therapy of staphylococcal chronic osteomyelitis in experimental animal model.

BACKGROUND & OBJECTIVES: Methicillin resistant Staphylococcus aureus (MRSA) are the commonest cause of osteomyelitis. The aim of this study was to evaluate the role of an alternative therapy i.e. application of S. aureus specific bacteriophages in cases of osteomyelitis caused by MRSA in animal model. METHODS: Twenty two rabbits were included in this study. The first two rabbits were used to test the safety of phage cocktail while the remaining 20 rabbits were divided into three groups; group A (n=4) to assess the establishment of osteomyelitis; group B (n=4) osteomyelitis developed but therapy started only after six weeks; and group C (n=12) osteomyelitis developed and therapy started after three weeks. Groups B and C rabbits were treated with four doses of cocktail of seven virulent bacteriophages at the interval of 48 h. Comparison between three groups was made on the basis of observation of clinical, radiological, microbiological, and histopathological examinations. RESULTS: Experimental group rabbits recovered from the illness in the subsequent two weeks of the therapy. Appetite and activity of the rabbits improved, local oedema, erythema and induration subsided. There were minimal changes associated with osteomyelitis in X-ray and histopathology also showed no signs of infection with new bone formation. Control B group rabbits also recovered well from the infection. INTERPRETATION & CONCLUSIONS: The present study shows a potential of phage therapy to treat difficult infections caused by multidrug resistant bacteria.

Association of Helicobacter pylori infection with inflammatory cytokine expression in patients with gallbladder cancer.

AIM: Gallbladder cancer (GBC) may be associated with Helicobacter pylori. The present study was designed to analyze the association of cytokine expression with H. pylori in patients with GBC. METHODS: GBC tissue sample and 5 mL blood were collected from each of 54 GBC patients. H. pylori was identified in tissue samples using biochemical tests, histology, culture, nested polymerase chain reaction (PCR), and partial genome sequencing. Tissue samples were categorized as H. pylori-positive (case) and H. pylori-negative groups (control) on the basis of nested PCR of tissue sample. Cytokines interleukin 1-ß (IL-1ß), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and interleukin-5 (IL-5) were assayed in blood samples using ELISA. RESULTS: Presence of H. pylori was confirmed in 18 (33 %) of 54 GBC tissue samples. Levels of IL-1ß (p = 0.001) and TNF-α (p = 0.01) were significantly elevated in H. pylori-positive GBC compared to the control group. IFN-γ and IL-5 levels did not significantly differ between the two groups. CONCLUSIONS: H. pylori DNA was detected in the gallbladder of a third of GBC patients and was associated with higher circulating levels of some cytokines.

Layered double hydroxide induced advancement in joint prosthesis using bone cement: the effect of metal substitution.

Poly(methyl methacrylate) based bone cement and its nanocomposites with layered double hydroxide (LDH) have been developed with greater mechanical strength and biocompatibility as a grouting material for total joint arthroplasty. Bivalent magnesium has been replaced with trivalent aluminium with various mole ratios, keeping the layered pattern of the LDH intact, to cater for the effect of varying substitution on the property enhancement of the nanocomposites. The intercalation of polymer inside the LDH layers makes them disordered and mechanically stiffer and tougher by more than 100%. The thermal stability of bone cement has increased by more than 30 °C in the presence of 1 wt% of nanoLDH, homogenously distributed in the bone cement matrix by creating an inorganic thermal barrier out of the LDH dispersion. The improvement in the properties of the nanocomposites has been explained in terms of the strong interaction between nanoLDH and polymer. The superior bioactivity and biocompatibility of the nanocomposites, as compared to pure bone cement, has been established through hemolysis assay, cell adhesion, MTT assay and cell proliferation using fluorescence imaging. The developed nanocomposites have been used as a grouting material and significant improvements have been achieved in fatigue behaviour with gradual increment of Al substitution in the Mg : Al mole ratio in nanoLDH, demonstrating the real use of the material in the biomedical area. In vivo experiments on rabbits clearly revealed the superior efficacy of bone cement nanocomposites, over pure bone cement and a blank.

Genetic interaction and mapping studies on the leaflet development (lld) mutant in Pisum sativum.

In Pisum sativum, the completely penetrant leaflet development (lld) mutation is known to sporadically abort pinnae suborgans in the unipinnate compound leaf. Here, the frequency and morphology of abortion was studied in each of the leaf suborgans in 36 genotypes and in presence of auxin and gibberellin, and their antagonists. Various lld genotypes were constructed by multifariously recombining lld with a coch homeotic stipule mutation and with af, ins, mare, mfp, tl and uni-tac leaf morphology mutations. It was observed that the suborgans at all levels of pinna subdivisions underwent lld-led abortion events at different stages of development. As in leafblades, lld aborted the pinnae in leaf-like compound coch stipules. The lld mutation interacted with mfp synergistically and with other leaf mutations additively. The rod-shaped and trumpet-shaped aborted pea leaf suborgans mimicked the phenotype of aborted leaves in HD-ZIP-III-deficient Arabidopsis thaliana mutants. Suborganwise aborted morphologies in lld gnotypes were in agreement with basipetal differentiation of leaflets and acropetal differentiation in tendrils. Altogether, the observations suggested that LLD was the master regulator of pinna development. On the basis of molecular markers found linked to lld, its locus was positioned on the linkage group III of the P. sativum genetic map.

Dendritic cell therapy in advanced gastric cancer: a promising new hope?

Advanced gastric cancer carries a very poor prognosis when the tumor becomes unresectable. Even with the best currently available chemotherapy regimens the survival rate remains dismal. A recent breakthrough in the treatment paradigm has been the approval of trastuzumab, a monoclonal antibody, in HER2-positive metastatic gastric cancer. A large number of trials are underway using dendritic cells (DCs) in a number of human malignancies and do show a ray of hope in management of these patients. This review attempts to summarize tumor immunology and the current data regarding use of DCs in gastric cancer therapy.

Genetic aberrations in gallbladder cancer.

Gallbladder carcinoma (GBC) is the most common type of biliary tract carcinoma and the third commonest digestive tract malignancy in our region. Studies available in literature do not clearly define the molecular genetic mechanisms involved in the pathogenesis of GBC. Most of these studies are limited to protein expression analysis by immunohistochemistry and western blotting, and only a few have been done on mRNA (messenger RNA) and mutation analysis. This review aims to critically analyze all the available evidence on genetic aberrations in gallbladder carcinoma.

Helicobacter pylori and pathogenesis of gallbladder cancer.

BACKGROUND AND AIM: Gallbladder cancer (GBC) is a rare but leading cause of cancer-related deaths worldwide. The incidence of GBC is increasing at an alarming rate in the Varanasi region, and its etiology remains obscure. METHODS: A total of 108 patients, 54 with GBC and 54 with gallstone diseases (GSD), were examined for Helicobacter pylori (H. pylori) in gallbladder specimens by rapid urease test, biochemical test, histology, culture, serology, polymerase chain reaction (PCR), and partial DNA sequencing. PCR was done using heat shock protein-60 (Hsp60) gene-nested primers. RESULT: Forty (74%) patients with GBC had gallstones. Upon culture, H. pylori colonies were identified in 24 (44%) GBC and 18 (33%) GSD specimens. H. pylori was detected in 20 (37%) GBC and 15 (28%) GSD samples upon histology. Serology was positive in 17 (32%) GBC and 15 (28%) GSD patients. The DNA isolated from GBC and GSD specimens was amplified by PCR with Hsp60-nested primers in 18 (33%) patients with GBC and 15 (28%) with GSD (P > 0.05). These sequences had 98% similarity with the presubmitted Hsp60 sequences of H. pylori in the National Centre for Biotechnology Information's GenBank. CONCLUSION: The results revealed that H. pylori was present in a large population, including both GBC and GSD patients, which indicates its endemic presence in the Varanasi region. Thus, it appears H. pylori might not have a significant role in the etiopathogenesis of GBC in our region.

Salmonella typhi and gallbladder cancer: report from an endemic region.

BACKGROUND: Evidence exists of a link between chronic infection by Salmonella typhi (S. typhi) and the development of gallbladder cancer (GBC), but several studies from endemic regions contradict its role in the etiopathogenesis of GBC. This study used various tools to assess the prevalence of S. typhi in patients with GBC and gallstone disease (GSD) in this region with a high incidence of GBC. METHODS: S. typhi was detected in tissue and bile by PCR and culture and in serum by the Widal test and indirect hemagglutination assay (IHA). PCR with two pairs of S. typhi specific primers (flagellin gene H1d and SOP E gene) could detect 0.6 ng of S. typhi DNA. Fifty-four patients with GBC (cases) were matched with 54 patients with GSD (controls). RESULTS: Of the 54 cases, 24 (44.44%) were positive on the Widal test and 12 (22.22%) on IHA, compared to 13 (24.07%) and 5 (9.26%) respectively in the controls. Eighteen (33.33%) cases showed a positive result on PCR (tissue) and 2 on PCR (bile) vs. none in the controls. Bile culture revealed no Salmonella colonies in either cases or controls. Only 3 cases were positive for Salmonella on tissue culture compared to none in the controls. The sensitivity of PCR (tissue) relative to the Widal test, IHA, culture (bile and tissue) and PCR (bile) was 100% vs. 66.67%, 11.11%, and 11.11%, and the specificity was 83.33% vs. 100%, 100%, and 100%, respectively. CONCLUSIONS: S. typhi is significantly associated with GBC compared to GSD (33% vs. 0%). PCR appears to be the most specific diagnostic tool, the gold standard for S. typhi in tissue samples.

Helicobacter bilis in human gallbladder cancer: results of a case-control study and a meta-analysis.

INTRODUCTION: Gallbladder cancer is an uncommon neoplasm of uncertain etiology and poor survival. Recently, interest has been generated in bacterial infections and cancers. Helicobacter is one such bacterium found to be associated with gastric MALToma, gastric adenocarcinoma and hepatobiliary neoplasms. PATIENTS AND METHODS: Fifty four gallbladder cancer and 55 controls with cholelithiasis were studied. Helicobacter bilis was identified using 16S rRNA PCR. Relative risk and odds ratio with 95% CI were estimated. A detailed search of literature was carried out and selected relevant articles were extracted. A meta analysis was carried out using a random effect model. RESULTS: Helicobacter bilis was identified in 32/54 patients and 32/55 controls, The relative risk of gallbladder cancer in H. bilis positive cases was 1.05 (95% CI 0.49 to 2.24). Of the 10 identified case control studies on Helicobacter in the hepatobiliary tract 3 each were on gallbladder cancer and H. bilis. In meta analysis a pooled odds ratio of 4.13 (95% CI 2.68-6.36) favoring Helicobacter was observed. Pooled analysis of published studies on gallbladder cancer showed an odds ratio of 1.24 (95% CI 0.63-2.44). CONCLUSIONS: The present study failed to demonstrate any increase in risk of gallbladder cancer in presence of Helicobacter bilis. It may be hypothesized that increased risk observed in earlier studies may be indirectly due to increase in the risk of gallstones, although lack of any study specifically looking at this aspect and absence of normal controls in the present study makes this assumption superfluous.