Pilot Nanostring PanCancer pathway analysis of colon adenocarcinoma in a tertiary healthcare centre in Kerala, India.

The prevalence of microsatellite instability and deoxyribonucleic acid mismatch repair deficiency in colorectal adenocarcinoma (CRC) cases is higher in India compared to western populations. No major study on the molecular pathogenesis is currently available in the Indian population. We conducted a pilot study to explore the differences in molecular pathogenesis of microsatellite stable (MSS) and microsatellite unstable CRC from a tertiary care centre in Kerala, South India. Using Nanostring PanCancer panel assay in Stage II colorectal adenocarcinoma, tumour tissues (n = 11) were compared against normal colon tissues (n = 4). Differentially expressed (DE) genes were identified and super-imposed onto colon adenocarcinoma cohort of The Cancer Genome Atlas (TCGA) data (TCGA Colon Adenocarcinoma (TCGA COAD)), from the Genome Expression Profiling Interactive Analysis and Tumor Immune Estimation Resource (TIMER) to compare the gene associations. Significant DE genes were 59 out of 730 (false discovery rate adj. p-value < 0.05), 18 of which had a fold-change |FC(log2)| ≥ 2. On superimposition to TCGA COAD, 33 genes were significant in both TCGA and current study. ETV4 was expressed significantly higher in MSS with no immune cell infiltration. Other significant DE genes with high FC(log2), unique to the study were INHBA, COL1A1, COL11A1, COMP, SFRP4 and SPP1, which were clustered in STRING network analysis and correlated with tumour-infiltrating immune cells in TIMER, suggesting a specific interaction pathway. The preliminary study suggests a distinct pathogenesis of MSS CRC involving ETV4 in the Indian population and warrants further clinically extensive and high-dimensional expression studies.

Elevated oxidative stress among coronary artery disease patients on statin therapy: A cross sectional study.

BACKGROUND: Statins are a major group of drugs that reduces LDL-C levels, which are proven to have other beneficial effects such as preventing coronary events. The objective of this study was to evaluate oxidative stress and select novel coronary artery disease risk factors among coronary artery disease patients on statins. METHODS: In this observational, cross-sectional study, we compared total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, apolipoprotein B, lipoprotein (a), homocysteine, reduced glutathione, glutathione peroxidase, superoxide dismutase, ascorbic acid, malondialdehyde and oxidized LDL among male coronary artery disease patients on statin therapy (group 2, n = 151) with sex-matched, diabetic patients (group 3, n = 80) as well as healthy controls (group 1, n = 84). RESULTS: Total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol were significantly lower among subjects of group 2 compared to other two groups. The novel risk factors studied did not differ significantly between groups, except for a higher homocysteine level among group 2 subjects compared to the other two groups. Elevated oxidative stress, indicated by lower reduced glutathione, glutathione peroxidase, and ascorbic acid as well as higher malondialdehyde and oxidized LDL was observed among group 2 subjects. Triglycerides, HDL-cholesterol, ascorbic acid and malondialdehyde were found to be independent predictors for coronary artery disease among this study population. CONCLUSIONS: Though coronary artery disease subjects had healthy lipid profile, oxidative stress, a recognized risk factor for coronary events, was still elevated among this patient group. Novel risk factors were not found to be major predictors for coronary artery disease among the study subjects.

Impact of beta-carotene supplementation through red palm.

A 10-month long feeding trial was conducted to assess the impact of beta-carotene supplementation through red palm oil (RPO) with the focus on vitamin A status, morbidity status and acceptability of an RPO-incorporated noon-meal as a dietary supplement among two cohorts of 409 (experimental) and 346 (control) preschool children in two southern districts of rural Tamil Nadu, selected by stratified random sampling. Information was gathered on ocular symptoms of vitamin A deficiency and anthropometry, and blood samples were drawn at baseline and final rounds for estimation of serum beta-carotene, retinol and tocopherol. Data about Socioeconomic Status (SES) were collected once during the study period, while information on attendance, consumption and morbidity was recorded by preschool teachers. The results showed the following. 1. Significant improvement in the vitamin A status of children in terms of disappearance of Bitot's spots (50.0 per cent) in the experimental group vs. 28.0 per cent in the control group. 2. After feeding of RPO, incidence rate of new Bitot's spots cases was low at 2.13 in the experimental children vs. 4.78 in control children. 3. Marked improvement in the serum beta-carotene levels after 10 months of feeding. 4. RPO is acceptable to children as an edible grade oil as there is no perceptible difference in the consumption pattern between experimental and control children.

High morbidity and low mortality--the experience of urban preschool children in Kerala.

This study was undertaken to estimate the morbidity pattern in children under 3 years in urban Kerala. Two cohorts of 111 and 74 children were selected from contrasting areas in Trivandrum city, capital of Kerala, by systematic sampling. Morbidity information on each child was gathered for one year through weekly visits and recording of symptoms by trained investigators. The results showed: 1. very high incidence rates of all illness groups studied, with peak incidence being observed in the first 6 months and the lowest in the third year; 2. up to six times greater risk for many disease groups in the more environmentally deprived area; 3. no significant differences in risk between sexes; 4. no seasonal variation. We conclude that despite low infant and child mortality levels, morbidity load in Kerala, for 0-3-year-old children is very high and this is directly related to the quality of the environment.

Vitamin B-complex deficiency and visual acuity.

1. A study was carried out on 973 school children to find out any relationship between vitamin B-complex deficiency signs and defective vision, and the effect of supplementation of B-complex vitamins on visual acuity. 2. The results of the study showed a significant association between presence of clinical signs of vitamin B-complex deficiency and defective vision. 3. Supplementation with vitamin B-complex was found to have a beneficial effect in improving the visual-acuity status of defective children and in preventing visual defects from developing. 4. It is concluded, therefore, that from the present study it appears that the relationship between vitamin B-complex deficiency and visual defects could be one of 'cause and effect'.

Evaluation of domicilliary management of protein-calorie malnutrition.

An approach to tackle protein-calorie malnutrition through domiciliary management is described. Children suffering from moderate and severe protein-calorie malnutrition were managed using a food supplement containing low cost locally available foodstuffs and nutrition education. An evaluation showed that the anthropometric improvement was closely associated with better concepts in nutrition and improved dietary practices following nutrition education. Parents of children suffering from kwashiorkor had better knowledge and practice compared with those of marasmus.