Understanding the promising role of antibody drug conjugates in breast and ovarian cancer.

A nascent category of anticancer therapeutic drugs called antibody-drug conjugates (ADCs) relate selectivity of aimed therapy using chemotherapeutic medicines with high cytotoxic power. Progressive linker technology led to the advancement of more efficacious and safer treatments. It offers neoteric as well as encouraging therapeutic strategies for treating cancer. ADCs selectively administer a medication by targeting antigens which are abundantly articulated on the membrane surface of tumor cells. Tumor-specific antigens are differently expressed in breast and ovarian cancers and can be utilized to direct ADCs. Compared to conventional chemotherapeutic drugs, this approach enables optimal tumor targeting while minimizing systemic damage. A cleavable linker improves the ADCs because it allows the toxic payload to be distributed to nearby cells that do not express the target protein, operating on assorted tumors with dissimilar cell aggregation. Presently fifteen ADCs are being studied in breast and ovarian carcinoma preclinically, and assortment of few have already undergone promising early-phase clinical trial testing. Furthermore, Phase I and II studies are investigating a wide variety of ADCs, and preliminary findings are encouraging. An expanding sum of ADCs will probably become feasible therapeutic choices as solo agents or in conjunction with chemotherapeutic agents. This review accentuates the most recent preclinical findings, pharmacodynamics, and upcoming applications of ADCs in breast and ovarian carcinoma.

Medicinal and therapeutic properties of garlic, garlic essential oil, and garlic-based snack food: An updated review.

Garlic (Allium sativum) is an edible tuber belonging to the family Liliaceae. It has been used since ancient times as a spice to enhance the sensory characteristics of food and as a household remedy for the treatment of a variety of ailments. Garlic has been studied for its medicinal and therapeutic effects in the treatment of various human diseases for a long time. Health benefits associated with the consumption of garlic are attributed to the various sulfur compounds present in it such as allicin, ajoene, vinyl-dithiin, and other volatile organosulfur compounds which are all metabolized from alliin. Several researches in the literature have shown evidence that garlic exhibits antioxidant, antiviral, anti-microbial, anti-fungal, antihypertensive, anti-anemic, anti-hyperlipidemic, anticarcinogenic, antiaggregant, and immunomodulatory properties. The present review identifies and discusses the various health benefits associated with the consumption of garlic, its essential oil, and bioactive constituents, along with exploring the various snack-food products developed by incorporating garlic.

Clinical implications of preoperative echocardiographic findings on cardiovascular outcomes following vascular surgery: An observational trial.

INTRODUCTION: Peripheral artery disease and cardiac disease are often comorbid conditions. Echocardiography is a diagnostic tool that can be performed preoperatively to risk stratify patients by a functional cardiac test. We hypothesized that ventricular dysfunction and valvular lesions were associated with an increased incidence of expanded major adverse cardiac events (Expanded MACE). METHODS AND MATERIALS: Retrospective cohort study from 2011 to 2020 including all patients from a major academic center who had vascular surgery and an echocardiographic study within two years of the index procedure. RESULTS: 813 patients were included in the study; a majority had a history of smoking (86%), an ASA score of 3 (65%), and were male (68%). Carotid endarterectomy was the most common surgery (24%) and the least common surgery was open abdominal aortic aneurysm repair (5%). We found no significant association between the echocardiographic findings of left ventricular dysfunction, right ventricular dysfunction, or valvular lesions and the postoperative development of Expanded MACE. CONCLUSIONS: The preoperative echocardiographic findings of left ventricular dysfunction, right ventricular dysfunction and moderate to severe valvular lesions were not predictive of an increased incidence of postoperative Expanded MACE. We identified a significant association between RV dysfunction and post-operative dialysis that should be interpreted carefully due to the small number of outcomes. The transition from open to endovascular surgery and advances in perioperative management may have led to improved cardiovascular outcomes. TRIAL REGISTRATION: Trial Registration: NCT04836702 (clinicaltrials.gov). https://www.google.com/search?client=firefox-b-d&q=NCT04836702.

Traumatic Aortic and Celiac Pseudoaneurysm with Aortocaval Fistula Managed with Endovascular Aortic Cuff Deployment and Open Hepatic Revascularization.

We present the case of a young patient who sustained a gunshot wound to the abdomen initially treated with laparotomy and repair of small bowel, splenic vein and diaphragmatic injuries. Subsequent computed tomography (CT) performed for hemodynamic instability demonstrated a pseudoaneurysm involving the aorta and proximal celiac artery, with an associated aortocaval fistula. An attempt at transperitoneal repair of these injuries was aborted due to extensive inflammatory changes in the region encountered during exposure. Subsequently, a hybrid repair was performed. This consisted of exclusion of the aortic and celiac artery pseudoaneurysm using an endovascular aortic cuff (22 × 39 mm, Cook Medical) via infrarenal aortic access, surgical ligation of the celiac artery branches, and revascularization via bypass from the infrarenal aortic access site arteriotomy to the common hepatic artery.

Hydrogeochemical Assessment of Groundwater for Drinking and Agricultural Use: A Case Study of Rural Areas of Alwar, Rajasthan.

Groundwater contributes substantially to the development of arid and semi-arid regions around the globe. The present study integrates groundwater quality and its suitability for drinking and irrigation around Alwar city of Rajasthan state, where agriculture is the major land use. The application for drinking was assessed by comparing the observed value with prescribed standards of WHO. Groundwater was found suitable for drinking at most of the locations. The suitability of groundwater for irrigation was determined by calculating ion-based ratios and comparing them against the suggested ratios and indices for agricultural quality. Suitability for irrigation was assessed against electrical conductivity (EC), percentage sodium (%Na), residual Na2CO3 (RSC), per cent soluble sodium (SSP), sodium adsorption ratio (SAR), Mg hazard and permeability index (PI) etc., and the quality was compromised for EC, %Na and Mg Hz. Since the soil was sandy, the groundwater was found suitable for irrigation over long-term use, with the only problem of magnesium hazard. Based on the different ratios of anions and cations, silicate weathering was observed to be regulating groundwater chemistry, and the groundwater belonged to mixed CaMgCl and CaHCO3- type based on Piper's classification and relative abundance of ions. Further, meteoric genesis classification showed that the groundwater in the study region had direct base exchange and shallow meteoric water percolation. Presence of kaolinite and quartz minerals in soil confirmed that silicate weathering is the major process controlling groundwater chemistry.

Physico-chemical properties of Khoa prepared from lactose hydrolyzed buffalo milk.

Lactose is a reducing sugar which is abundantly found in mammalian milk. Lactose intolerance affects more than 70% of the world population, being apparent by the absence of ß-galactosidase enzyme, thus leading to the inability to consume dairy products. In the present work, Khoa was prepared from lactose hydrolysed milk and its physico-chemical, textural and microbiological quality were examined during storage at 5-7 °C for 28 days. The sensory quality of low lactose Khoa was comparable with that of the control Khoa up to the 14th day of storage. Significant differences (p < 0.05) between the acidity, hydroxyl methyl furfural (HMF) content, lightness, redness, springiness, chewiness and hardness values of the low lactose Khoa and the control Khoa were observed. The standard plate count (SPC), coliform and yeast and mould counts of the low lactose Khoa were within Food safety and standards authority of India (FSSAI) standards throughout the 28 days of storage. Therefore, the low lactose Khoa developed in this study had different physicochemical properties from the control sample with better shelf life.

Knowledge, Attitude, and Practice toward Impression Technique and Materials for Recording Impression in Implant Placement among Dental Practitioners in Patna City, Bihar.

OBJECTIVES: The present study is conducted to explore the knowledge, attitude, and practice towards impression technique and materials for recording impression in implant placement among general dental practitioners. MATERIALS AND METHODS: The present study is a cross-sectional questionnaire study. The study was conducted among general dental practitioners in Patna city in November-December 2017. Patna city was divided into five directions, which are north, south, east, west, and central. From each direction, 20 clinics were selected randomly, and dental practitioners from there clinics were interviewed. A closed-ended questionnaire consists of 19 items was prepared, the questionnaire was divided into four parts. RESULTS: Majority of study participants (58 [34%]) were above the age of 40 years. 96 (56%) of study participants were male. Most of the study participants (89 [50%]) were having MDS degree. Knowledge, attitude, and behavior scores among study participants. About 43% of study participants have good knowledge scores regarding impression technique and material in implant placement while 50% of study participants had fair attitude score. About 58% of study participants had fair practice score. There was statistically significant correlation (P ≤ 0.05*) between knowledge and attitude of study participants. CONCLUSION: It was concluded that there was good knowledge, fair attitude, and practice among the dental professionals regarding the impression technique and materials for recording impression in implant placement. There was statistically significant correlation between knowledge and attitude of study participants. There was statistically significant correlation between some demographic variables and knowledge, attitude, and practice of study participants.

Outcomes for concomitant common iliac artery aneurysms after endovascular abdominal aortic aneurysm repair.

OBJECTIVE: This study evaluated the morbidity of endovascular abdominal aortic aneurysm repair (EVAR) in patients with concomitant common iliac artery aneurysm (CCIAA). METHODS: This was a retrospective review of all patients who underwent elective EVAR from June 2006 through June 2012 at a single institution. Demographics, comorbidities, preoperative presentation, intraoperative details, and postoperative complications were tabulated. Patients with CCIAA were categorized into three groups according to the distal extent of their iliac limb: iliac limb extension into the external iliac artery with internal iliac artery coil embolization (EE); flared iliac limb ≥20 mm in diameter to the iliac bifurcation (FL); and iliac limb ≤20 mm ending proximal to the CCIAA (no-FL). RESULTS: During this period, 627 consecutive patients underwent elective EVAR and preoperative computed tomographic angiograms were available for 523 patients to evaluate the presence of CCIAA. Of these, 211 patients (40.2%) had a CCIAA in at least one common iliac artery, with a total of 307 aneurysmal arteries. Of these 307 aneurysmal arteries, 62 (20.2%) were treated with EE, 132 (43.0%) were treated with FL, and 113 (36.8%) had a sufficient landing zone in the proximal common iliac artery to use an iliac limb ≤20 mm in diameter (no-FL). The overall reintervention rate was 12.4% of patients, with a higher reintervention rate between patients with CCIAA compared with those without (15.2% vs 10.9%; P = .039). There were no significant differences in reintervention rates between the EE, FL, and no-FL techniques (4.5% vs 4.8% vs 6.2%; P = .802) over a mean 59.8 months follow-up. The FL and EE techniques had a lower risk of distal endoleak than the no-FL technique, but the difference was not statistically significant (3.2% vs 2.3% vs 5.3% compared with 4.23% in the entire cohort). CONCLUSIONS: Patients with CCIAA had a higher reintervention rate after EVAR for abdominal aortic aneurysm compared with non-CCIAA patients. Of the techniques studied (EE, FL, and no-FL), there was no significant difference in reintervention rates between the three. All three techniques remain viable options for the endovascular repair of CCIAA.

Nodal vascularity as an indicator of cervicofacial metastasis in oral cancer: A Doppler sonographic study.

BACKGROUND: The objective of this study was to assess nodal vascularity by Doppler sonography and to find out the correlation between clinical and various Doppler sonographic features for the detection of the metastatic nodes in oral cancer patients. PATIENTS AND METHODS: A total number of 55 patients of histopathologically proven oral cancer presenting with enlarged superficial cervicofacial lymph nodes were included in the study. Patients were subjected to clinical examination according to a specially designed proforma and the TNM staging was done. If more than one enlarged nodes were present, then the node with the largest diameter was chosen for further Doppler ultrasonographic examination followed by fine needle aspiration cytology test of the same node. RESULTS: Correlations of patterns of color Doppler flow signals with cytological diagnosis showed that central type of vascular pattern was statistically significant parameter for benign lymph nodes and peripheral type of vascularity was highly significant parameter for malignant lymphadenopathy. It was found that the cut-off value of resistive index 0.6 was statistically significant in the assessment of metastatic node (P < 0.01) with a sensitivity of 45.5% and specificity of 93.9%. On comparison of the clinical features (TNM staging) with Doppler sonographic features, it was found that the characteristic features suggestive of malignant lymph nodes on Doppler sonography such as peripheral blood flow and high resistive index were more consistently and frequently associated with the higher sub-stages of T3 and T4 and N2b and N2c of TNM staging system. CONCLUSION: Nodal vascularity may be used to differentiate benign from malignant lymphadenopathy. Proper judicious use of non-invasive color Doppler ultrasonographic examination provides an opportunity to eliminate the need for biopsy in reactive nodes and provide treatment in a more precise manner.

Oral Myiasis Caused by Chrysomya bezziana in Anterior Maxilla.

Oral myiasis is a rare pathology and is associated with poor oral hygiene, alcoholism, senility, suppurating lesions, and severe halitosis. It arises from invasion of body tissues or cavities of living animals by maggots or larvae of certain dipterian flies. It is mostly reported in developing countries and in the tropics. We hereby report a rare case of oral myiasis in a 70-year-old female with extensive necrotic oral lesion burrowing into the hard palate through which numerous live maggots (larvae) and seen emerging out and discuss the definition, etiology, predisposing factors, classification, and management of the same. Furthermore, the life cycle of the causative organism in the present case, that is, Chrysomya bezziana, has also been discussed.

Ligation of macrophage Fcγ receptors recapitulates the gene expression pattern of vulnerable human carotid plaques.

Stroke is a leading cause of death in the United States. As ∼60% of strokes result from carotid plaque rupture, elucidating the mechanisms that underlie vulnerability is critical for therapeutic intervention. We tested the hypothesis that stable and vulnerable human plaques differentially express genes associated with matrix degradation. Examination established that femoral, and the distal region of carotid, plaques were histologically stable while the proximal carotid plaque regions were vulnerable. Quantitative RT-PCR was used to compare expression of 22 genes among these tissues. Distal carotid and femoral gene expression was not significantly different, permitting the distal carotid segments to be used as a paired control for their corresponding proximal regions. Analysis of the paired plaques revealed differences in 16 genes that impact plaque stability: matrix metalloproteinases (MMP, higher in vulnerable), MMP modulators (inhibitors: lower, activators: higher in vulnerable), activating Fc receptors (FcγR, higher in vulnerable) and FcγR signaling molecules (higher in vulnerable). Surprisingly, the relative expression of smooth muscle cell and macrophage markers in the three plaque types was not significantly different, suggesting that macrophage distribution and/or activation state correlates with (in)stability. Immunohistochemistry revealed that macrophages and smooth muscle cells localize to distinct and non-overlapping regions in all plaques. MMP protein localized to macrophage-rich regions. In vitro, treatment of macrophages with immune complexes, but not oxidized low density lipoprotein, C-reactive protein, or TNF-α, induced a gene expression profile similar to that of the vulnerable plaques. That ligation of FcγR recapitulates the pattern of gene expression in vulnerable plaques suggests that the FcγR → macrophage activation pathway may play a greater role in human plaque vulnerability than previously appreciated.

Dengue Fever presenting with macular hemorrhages.

PURPOSE: To report ocular manifestations in cases of previously undiagnosed dengue fever. METHODS: A retrospective study was done to evaluate the cause of sudden painless loss of vision in three cases with history of fever. Detailed systemic evaluation and ophthalmologic examination consisting of fundus photographs, fundus fluorescein angiography, and optical coherence tomography were done, where needed. RESULTS: All three patients tested positive for dengue serology, which had been undiagnosed earlier. Retinal hemorrhages were found in all three patients, while one patient also showed evidence of retinitis-like lesions. He was treated with oral steroids and showed improvement in visual acuity over a period of 6 weeks. Two of the three patients had subhyaloid hemorrhages, which were seen to resolve spontaneously. CONCLUSION: A significant subset of patients with mild form of dengue fever may go undiagnosed.