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Cancer is a disease characterized by the uncontrolled multiplication of cells in human body with the inability to be controlled or stopped, consequently forming tumors of malignant cells with the potential to be metastatic. Around one third of deaths due to cancer are due to five leading behavioral and dietary risks: high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use and alcohol use. According to the World Health Organization, cancer is the second leading cause of death globally and about one in 6 deaths is due to cancer. The economic impact of cancer is significant and is increasing. The total annual economic cost of cancer in 2010 was estimated at approximately US 1.16 trillion. The economic burden on low- and middle-income countries is profound since approximately 70% of deaths due to cancer occur in these countries. To combat the growing challenge, development in cures and preventative therapies has emerged through rapid research in this area. Current treatments include chemotherapy, radiotherapy and chemically derived drugs which have severe side effects. Therefore, there is an increasing impetus on development and use of natural alternative therapies against cancer. Plants sources have been exploited in medicine for their natural antiseptic properties. Thus, research has developed into investigating the potential properties and uses of terrestrial plant extracts for the preparation of potential nanomaterial-based drugs for diseases including cancer. This article aims to take an overview of naturally derived compounds that have anticancer therapeutic properties and their current status in this field.

Adaptive threshold estimation procedures sample close to a subject’s perceptual threshold by dynamically adapting the stimulation based on the subject’s performance. Yet, perceptual thresholds not only depend on the observers’ sensory capabilities but also on any bias in terms of their expectations and response preferences, thus distorting the precision of the threshold estimates. Using the framework of signal detection theory (SDT), independent estimates of both, an observer’s sensitivity and internal processing bias can be delineated from threshold estimates. While this approach is commonly available for estimation procedures engaging the method of constant stimuli (MCS), correction procedures for adaptive methods (AM) are only scarcely applied. In this article, we introduce a new AM that takes individual biases into account, and that allows for a bias-corrected assessment of subjects’ sensitivity. This novel AM is validated with simulations and compared to a typical MCS-procedure, for which the implementation of bias correction has been previously demonstrated.Comparing AM and MCS demonstrates the viability of the presented AM. Besides its feasibility, the results of the simulation reveal both, advantages, and limitations of the proposed AM. The procedure has considerable practical implications, in particular for the design of shaping procedures in sensory training experiments, in which task difficulty has to be constantly adapted to an observer’s performance, to improve training efficiency.

The case talks about Hind Tea Pvt. Ltd (HTPL)-a small and medium enterprise (SME) in India that is 100% owned by Wadhwa family. HTPL procures processed tea from auctions and sells it to distributors under its own brand names. The case describes the journey of two brothers and how the next generation of the family takes over and aspires to make the company a national level player. These aspirations pose new demands on the owners and the business; the case talks about decision making in the family under such a scenario. The case poses interesting questions related to governance, professionalization, succession, and decision making in the family.

Introduction: Hypertension and atherosclerosis though separate entities, are interrelated as hypertension plays an important role in the pathogenesis of atherosclerosis. This study was undertaken to study the association of carotid intimal medial thickness with left ventricular hypertrophy (LVH) in hypertensive patients. Materials and Methods: Hundred hypertensives (JNC-7, Stage 1 and 2) between 30 and 55 years were enrolled in this prospective observational study conducted at a tertiary care teaching institute of Punjab, India. Electrocardiogram, Carotid Doppler, and Echocardiography were carried out in addition to routine biochemical investigations. Results: Increased carotid intimal medial thickness (CIMT) had statistically significant association with age, duration of hypertension, high systolic and diastolic blood pressure (BP), left ventricular hypertrophy and left ventricular mass index but was not associated with body mass index, low-density lipoproteins, and total cholesterol. Conclusions: LVH and arterial wall changes occur concurrently, and therefore, management of hypertension should not be limited just to control of BP but should also include therapy for carotid plaques and increased CIMT.

Background There is need to assess left ventricular diastolic dysfunction (LVDD) in metabolic syndrome to effectively implicate and strengthen population-based prevention strategies. Objectives To assess the prevalence of LVDD in metabolic syndrome. Methods This study was conducted in the Department of Medicine, Guru Gobind Singh Medical College and Hospital, Faridkot on 100 cases (with metabolic syndrome diagnosed on International Diabetic Federation criteria) and 100 age- and sex-matched controls (without metabolic syndrome) between 30 and 60 years of age by echocardiography to assess LVDD. Results Overall prevalence of diastolic dysfunction was 73% in the cases and 14% in controls with an increasing trend with increasing age in both groups showing age an important determinant of diastolic dysfunction; gender-wise difference was not significant in any group. However, increasing trend with increasing body mass index, elevated blood pressure, elevated fasting blood sugar, elevated serum triglyceride, and deceased serum high density lipoprotein was noted showing their risk correlation in the outcome of diastolic dysfunction; participants without metabolic syndrome had lesser diastolic dysfunction (14%). Conclusions The diastolic dysfunction in metabolic syndrome was found to be higher that supports the assumption that metabolic syndrome could be correlated to risk of development of LVDD. Holistic prevention of metabolic syndrome has an important role to prevent development of diastolic dysfunction.

Background: The emergency department of every tertiary care teaching hospital is the backbone of community health care service. Aims: This study was undertaken to identify the pattern of emergencies in the hospital, and to identify the risk factors associated with these emergencies. Materials and Methods: This was a retrospective record analysis of the emergency department from Jan 2010 to Dec 2010. The data were analyzed for various types of medical emergencies presented at the hospital at Guru Gobind Singh Medical College and Hospital, Faridkot. Results: A total of 2310 patients presented in the emergency department of which nearly half were males; a great majority were in the age group of 15-40 years. The diseases related to the cardiovascular system, 367 (15.89%), topped the list of which hypertension was noted in 267 (11.56%) cases. This was followed by morbidities related to the neurological system, diabetes, hepatobiliary, respiratory, renal 168 (7.27%), poisoning, pyrexia of unknown origin, and multi-organ involvement. With regard to the specific diseases, the majority were contributed by coronary artery disease 217 (9.39%), stroke 178 (7.71%), alcoholic liver disease 160 (6.93%), and chronic obstructive lung diseases 90 (3.90%). In our series, we noted that a great majority of cases were in the 41-60 age groups except poisoning (majority less than 40 years). The age groups were significantly related with selected morbidities. Conclusions: There are transparent evidence that we need an organized emergency care system in India as relatively the younger age group (15-40 years) comprised nearly half cases.

A male patient presented with horizontal diplopia and conjugate gaze palsy. Magnetic resonance imaging (MRI) revealed acute infarct in right facial colliculus which is an anatomical elevation on the dorsal aspect of Pons. This elevation is due the 6th cranial nerve nucleus and the motor fibres of facial nerve which loop dorsal to this nucleus. Anatomical correlation of the clinical symptoms is also depicted in this report.

Electrolyte imbalance always poses challenging situations to the attending intensivists, particularly if it is associated with endocrinopathies and other comorbidities. One such rare clinical scenario is hypokalemic periodic paralysis (HPP) due to hyperthyroidism. The epidemiology of such a condition is slightly higher among males of Asian origin as compared to its universal occurrence. The diagnostic challenges in this clinical situation can lead to higher morbidity if timeliness is compromised from the presentation to active management. Moreover, atypical presentation of this pathologic condition further compounds the problem if it is associated with overt hyperthyroidism. Here, we report a unique case that presented to the emergency medicine department of our institute with weakness of all the four limbs and in which we faced all the diagnostic and management challenges as the clinical condition of hypokalemia was somehow dominated by overt hyperthyroidism.

Background: Diabetes mellitus (DM), being a long-term condition, requires consistent blood glucose monitoring and adjustment of doses of the antidiabetic drugs and insulin. Telehealth is an emerging field that can have a positive impact on the management of this disease. Aim: The aim was to study the impact of the frequency of consultation and follow-up on telephone of diagnosed follow-up patients of DM on glycemic and metabolic profiles, the patients' compliance, and their quality of life (QoL), and to compare the effectiveness of different modes of follow-up. Materials and Methods: One hundred twenty patients were enrolled from the outpatient department (OPD) including both type 1 and type 2 DM patients who had already been diagnosed and were on treatment. They were randomly assigned to one of three groups, each consisting of 40 subjects, according to the mode of follow-up: A (rare, i.e., less frequent outpatient visits), B (moderate, i.e., more frequent outpatient visits), and C (frequent, i.e., more frequent outpatient visits with weekly telephonic consultation). Metabolic profiles and the QoL were monitored. The patients' compliance with and adherence to the treatment, and dietary and exercise advice were assessed. Results: The patients' compliance with and adherence to the treatment was higher in group C, followed by groups B and A. There was a net decrease in adverse events, with an increase in the frequency of follow-up. Changes in glycated hemoglobin (HbA1c) suggested a positive impact of weekly telephonic consultation. The lipid profile was also positively affected, with maximum improvement being in high-density lipoproteins (HDLs) and triglycerides. There was an improvement in the QoL domains pertaining to physical health and endurance in patients with higher frequency of follow-ups. There was no effect on emotional or mental health. There was an overall deterioration of the financial domain, being most marked in group B. The treatment satisfaction questionnaire showed better results in the telephone intervention group. Conclusion: Telephonic consultation can be a useful measure to improve the follow-up and management of patients with DM.