A study of association between presence or absence of GSTT1 and GSTM1 and/or single nucleotide polymorphism in FABP2 and GSTP1 with incidence of diabetes type 2: A case-control study.

OBJECTIVE: To assess the association of single nucleotide polymorphisms in fatty acid binding protein-2 (rs1799883) and glutathione S-transferase pi (rs1695) genes with presence/absence of glutathione S-transferase mu and glutathione S-transferase theta genes in type 2 diabetes. METHODS: The cross-sectional case-control study was conducted at Institute of Molecular Biology and Biotechnology during March till September 2019 and comprised type 2 diabetes patients and non-diabetic controls from two districts in southern Punjab. Polymerase chain reaction, polymerase chain reaction-restriction fragment length polymorphism and tetra-primer amplification refractory mutation system-polymerase chain reaction were applied to investigate glutathione S-transferase theta, mu and pi genes as well as fatty acid binding protein-2, as appropriate. The association of single nucleotide polymorphisms in all genes with the disease were studied either individually or in various combinations. Data was analysed using Minitab 18. RESULTS: Of the 448 subjects, 248(55.4%) were patients and 200(44.6%) were controls. Overall there were 213(47.5%) males and 235(52.5) were females, and 141(31.5%) were aged 30-46 years. The presence of rs1799883 in fatty acid binding protein-2 (p=0.03) and the absence of glutathione S-transferase mu gene (p<0.001) had significant association with type 2 diabetes, while the presence of glutathione S-transferase theta and rs1695 in glutathione S-transferase pi genes were not associated with the disease. Individuals with glutathione S-transferase mu gene null and Ileu/Ileu or Ileu/Val genotype of rs1695 in glutathione S-transferase pi gene have potential to develop type 2 diabetes in their lifetime (p<0.05). CONCLUSIONS: The presence of rs1799883 in fatty acid binding protein-2 and the absence of glutathione S-transferase mu gene were found to play significantly in the development of type 2 diabetes.

A Rare Case of Cutaneous Metastasis of Unresectable Rectal Adenocarcinoma.

Colorectal cancer (CRC) is the third most common malignancy. Common metastatic sites for colorectal carcinoma are the lung and liver while cutaneous metastases are extremely rare. Skin metastasis may be an early manifestation of metastatic disease and represents a poor prognosis. Here we present a case of metachronous skin metastasis during chemoradiation treatment in a patient with locally advanced rectal cancer. A young boy aged 19 years presented to our hospital with radiological TNM staging of T3c N1 M0 with circumferential resection margin (CRM) involved. The treatment plan was defunctioning colostomy with neoadjuvant chemotherapy and radiotherapy with a later plan for surgery. Seven months later, there is a focal skin nodule in the nape of the neck. A core biopsy of this cutaneous nodule was done and proved metastatic. Surgery for the primary tumor and oligometastatic site was planned but due to extensive primary tumor, surgery was terminated and continues with chemotherapy and reassessment.

A Rare Case of Primary Intracerebral Malignant Melanoma.

Malignant melanomas occurring in the central nervous system are mostly metastatic. Primary intracranial malignant melanomas are a rare entity, accounting for 0.07% of all brain tumors. In the central nervous system, melanocytes originate from the neural crest cells that are found in the leptomeninges. Only a few cases of malignant melanoma primarily arising from the brain have been reported in the literature to date. We report a rare case of primary intracerebral malignant melanoma in a 39-year-old female. Through this case report, our aim is to highlight the role of imaging in the early diagnosis and management of malignant melanoma.

Association of Serum Zinc and Inflammatory Markers with the Severity of COVID-19 Infection in Adult Patients.

COVID-19 infection can spread in the host body without any adequate immune response. Zinc is an essential trace element with strong immunoregulatory and antiviral properties and its deficiency might lead to inflammation and oxidative stress. The aim of the current study was to determine the association of serum zinc and inflammatory markers with the severity of COVID-19 infection. This was a prospective observational study in which 123 COVID-19-positive adult patients and 48 controls were recruited. The initial comparative analysis was conducted between COVID-19 patients and controls. COVID-19-positive patients were further divided into three different groups (mild, moderate, and severe) based on the severity of COVID-19 infection. COVID-19 patients showed significantly lower serum zinc levels (8.8 ± 2.3 µmol/L) compared to healthy controls (11.9 ± 1.8 µmol/L). There was a negative correlation between serum zinc levels and the severity of COVID-19 infection (r = −0.584, p < 0.0001) and this effect was independent of age (r = −0.361, p < 0.0001). Furthermore, inflammatory markers showed a positive correlation with the severity of COVID-19 infection and a negative correlation with the levels of serum zinc. The study demonstrated an association between COVID-19 infection with low serum zinc levels and elevated inflammatory markers. Further studies to assess the significance of this observation are needed, which may justify zinc supplementation to mitigate the severity of COVID-19 infection.

Diaphragmatic Hernia Presenting as Acute Gastric Outlet Obstruction: A Rare Complication of Left Lower Lobectomy.

Diaphragmatic hernia is defined as the prolapse of abdominal contents into the thoracic cavity through a defect in the diaphragm that is either congenital or acquired. Acquired hernias are common in adults and frequently occur as the result of trauma, either iatrogenic or non-iatrogenic. Iatrogenic diaphragmatic hernia is a rare complication of patient-related treatment maneuvers/procedures. The rate of late presentations of an iatrogenic diaphragmatic hernia is disparate, ranging from 5 to 62%. Iatrogenic diaphragmatic hernia after pulmonary resection is extremely rare with only two case reports published worldwide so far. In this report, we discuss the case of a young male presenting several years after undergoing left lower lobectomy with signs and symptoms of acute gastric outlet obstruction.

A Rare Case of Single Gallbladder and Multiple Pancreatic Metastases of Renal Cell Carcinoma.

Renal cell carcinoma (RCC) is the most common tumor to metastasize to uncommon sites. Synchronous metastases in the gall bladder and pancreas are rare entities. In this report, we present the case of a 43-year-old male with a complaint of hematuria presenting with a left renal mass. Contrast-enhanced CT revealed an arterially enhancing mass in the left kidney, a synchronous tiny polyp in the gall bladder, and multiple focal lesions in the pancreas. The patient underwent surgery and the tumor was histopathologically labeled as a clear cell RCC with metastases to the pancreas and gall bladder. Post-surgery, the patient has been followed up.

A study of CD10 positivity of stromal cells in core needle biopsy specimen of breast cancer patients and its relation with histological grade and lymphovascular invasion.

BACKGROUND: In core needle biopsy (CNB) often the histological grade of invasive breast carcinoma is under-estimated due to heterogeneity of epithelial component. Stroma is relatively homogenous throughout the tumor and strong CD10 stromal positivity is proposed to be associated with high tumor grade. AIMS AND OBJECTIVES: The aim of this work was to study the expression of CD10 in stromal cells of invasive carcinoma of breast, no specific type (NST) in CNB specimens, and analyze its association with final histological grade and lymphovascular invasion (LVI). MATERIALS AND METHODS: A total of 50 cases of invasive carcinoma of breast, NST were studied for 18 months. CNB specimens were graded according to modified Scarff-Bloom-Richardson (SBR) system and CD10 positivity was assessed in stromal cells. Mastectomy specimens were also similarly graded. Relation of stromal CD10 positivity with histological grading and LVI was studied. STATISTICS: Associations between the variables were studied by Chi-square test. A value of P < 0.05 was considered to be statistically significant. RESULTS: On CNB 46% patients had a grade 2 tumor, followed by 30% grade 3 and 24% grade 1 tumor. Strong CD10 positivity was seen in 40% cases, 32% showed weak positivity and 28% were negative for CD10 in stromal cells in CNB specimen. On evaluation of mastectomy specimen 48% of the patients had a grade 2 tumor, followed by 40% grade 3 tumor and 12% grade 1 tumor. Strong CD10 positivity was found to be significantly associated with final grade 3 tumor (P < 0.001) and LVI (P = 0.005). CONCLUSIONS: There was underestimation of histological grade on CNB, while strong stromal CD10 positivity in CNB was significantly associated with final grade 3 tumor and LVI.

Benzimidazole Derivative Ameliorates Opioid-Mediated Tolerance during Anticancer- Induced Neuropathic Pain in Mice.

BACKGROUND: Cancer is known to be the second significant cause of death worldwide. Chemotherapeutic agents such as platinum-based compounds are frequently used single-handedly or accompanied by additional chemotherapies to treat cancer patients. Chemotherapy-induced peripheral painful neuropathy is seen in around 40% of patients who are treated with platinum-based compounds, including cisplatin. This not only decreases the quality of life of patients but also patients' compliance with cisplatin. OBJECTIVES: Nalbuphine, an opioid, is frequently used to treat acute and chronic pain, coupled with cisplatin in cancer patients. However, long term use of nalbuphine induces tolerance to its analgesic effects. We employed the same strategy to induce tolerance in mice. METHODS: Here, we investigated analgesic effects of 2-[(pyrrolidin-1-yl) methyl]-1H-benzimidazole (BNZ), a benzimidazole derivative, on nalbuphine-induced tolerance during cisplatin-induced neuropathic pain using hot plate test, tail-flick tests and von Frey filament in mouse models. Furthermore, we investigated the effects of BNZ on the expression of Tumor Necrosis Factor-alpha (TNF-α) in the spinal cord. RESULTS: The results showed that BNZ reduced tolerance to analgesic effects of nalbuphine and TNF-α expression in mice. CONCLUSION: BNZ could be a potential drug candidate for the management of nalbuphine-induced tolerance in cisplatin-induced neuropathic pain.

A report of two cases of dedifferentiated endometrioid carcinoma: A newly described underrecognized tumor of poor prognosis.

Dedifferentiated endometrioid carcinoma or dedifferentiated endometrioid adenocarcinoma (DEAC) is defined by the presence of undifferentiated carcinoma with endometrioid carcinoma. Undifferentiated component can be misinterpreted as solid component of high-grade endometrioid carcinoma or sarcomatous component of malignant mixed mullerian tumor. We present two cases of DEAC. Two postmenopausal women underwent hysterectomy for vaginal bleeding. Microscopically, sections from the endometrial tumors showed a biphasic growth consisting of an undifferentiated component and a glandular component with sharp transition between the two components. The undifferentiated component showed focal positivity for cytokeratin and vimentin, while glandular component was diffusely positive for cytokeratin and negative for vimentin expression.

Synthesis, characterization, and biocompatibility of lanthanum titanate nanoparticles in albino mice in a sex-specific manner.

The aim of this study is to report the synthesis, characterization, and biocompatibility of lanthanum titanate nanoparticles (LT NPs) in albino mice. Microemulsion method was used to generate LT NPs. Seven-week-old albino mice of both sexes orally received 50 mg/ml saline/kg body weight of nanoparticles for 15 days (group 1) and 29 days (group 2). Control groups were maintained in parallel. Selected behavioral (rotarod, light and dark box, open-field and Morris water maze) tests were conducted, blood biochemical analysis was done, and antioxidants were determined in vital organs of all treatments. Male mice treated with LT NPs for 15 days spent significantly more time in light and less time in dark during light dark box test. While they had made significantly more platform entries and platform maximum visits during acquisition phase of Morris water maze test, they remained unaffected in probe trail performance when compared with control. These male mice had significantly reduced white blood cells, lymphocyte, and monocyte count and significantly increased triglyceride levels in serum than the control group. They had higher level of superoxide dismutase (SOD) in heart and reduced level of malonaldehyde (MDA) in kidney while 15-day LT NP-treated females had significantly higher level of SOD in liver and kidney. Male mice treated with NPs for 29 days had increased anticlockwise rotations during open field, reduced level of triglycerides in serum, and significantly higher level of SOD in kidney and MDA in lungs. In contrast, female mice treated with NPs for 29 days had higher SOD level in liver, kidney, and heart than their control group. Oral supplementation of LT NPs for variable duration improved the exploratory behavior in male but disturbed blood chemistry and antioxidants from vital organs under both experimental conditions.