Search

Introductionand Aim: Etiopathogenesis of Pulmonary tuberculosis(PTB), is well established. Yet, the mechanisms by which a treatment regimen brings about remodelling of the pulmonary tissue during recovery phase is not well understood. The involvement of matrix metalloproteinase in this regard is debated, due to its dual role, either in disseminating the disease due to lung cavitation or reducing the inflammation due to recruitment of macrophages to the lung granulomas. PTB is a disease also driven by undernourishment.This study focuses on the association of nutritional status of PTB patients in restoring healthy lung tissue, monitored by blood levels of albumin, iron and MMP9, during the course of intensive treatment. Materials and Methods: Serum levels of MMP9, iron, Total protein and albumin were estimated in 30 PTB patients who visited the Directly Observed Treatment Short course (DOTS) Centre at Government Wenlock Hospital, Mangalore, Karnataka,India. Twenty controls were enrolled for comparative statistics. Samples were collected at baseline and after two months of DOTS treatment in case of patients.Pre-treatment and post treatment values were compared by paired t test.Student’s ‘t’ test was used for comparing parameters in controls and patients. Correlation between parameters was done by Pearson’s correlation test. Results: A significant increase was observed in serum iron (P=0.002) and total protein(P=0.01) levels post treatment but there was no significance in the levels of MMP9. Further, serum MMP9 correlatednegatively with body weight, BMI and serum total protein levels, post treatment, which was statistically significant. No other correlations were significant. Conclusion: We conclude that MMP9 neither seems to be a diagnostic marker nor a therapeutic target in the treatment of tuberculosis. Although serum iron appears to be a predictor of improved nutritional status post treatment, it probably may have a role in tissue remodelling independent of MMP-9.

Introduction and Aim: Breast cancer is the most common malignancy in females worldwide. Almost 1.4 million new cases have been diagnosed with breast cancer every year. This aims to study the clinicopathological profile and molecular subtypes of invasive breast carcinoma in resected mastectomy specimens over a period of 5 years. Materials and Methods:A retrospective study of 90 mastectomy and wide local resection specimens received during the period of January 2012 to June 2017 were analyzed. The clinical data of patients including age, gender, and stage of the diseasewere obtained from the medical records section. Immunohistochemical staining for Estrogen Receptor [ER], Progesterone Receptor[PR] and Human Epidermal Growth Factor Receptor 2HER2neu were done.The cases were classified according to the molecular classification based on the ER, PR and HER2 receptor status. Results: The peak incidence of breast carcinoma was in the age group 50 to 60 years. Invasive ductal carcinoma,Not otherwise specified[NOS] accounted for the most common histologic type. There was higher incidence of pT2 tumors in our study. The most common molecular subtype was luminal A, followed by triple negative tumors. These molecular subtypes associated well with Tumor grade and HGDCIS with a statistically significant p value of 0.001 and 0.015 respectively. An increased proportion of Grade 3 tumors were Triple Negative tumors. Conclusion:In breast carcinomas the routine histopathological features provide inexpensive method for understanding tumour biology and prognosis. It`s essential in areas with poor resources. ER, PR and HER2 assessment helps in identifying hormonal status and enables for hormone therapy and anti HER2 therapy.

Introduction: Matrix Metalloproteinase-2 (MMP-2) is over expressed in a variety of malignant tumours and their expression and activity are often associated with tumour aggressiveness and a poor prognosis. It serves as a prognostic marker in breast carcinoma regardless of patient age, disease stage, malignancy grade, or hormone receptor status and modulation of MMP-2 expression and activation provides a new mechanism for breast cancer treatment. Aim: To evaluate the expression of MMP-2 in breast carcinoma tumour cells and peritumoural stroma and also to analyse the findings with the existing other prognostic markers of mammary carcinoma. Materials and Methods: The present study was a retrospective study conducted on paraffin blocks of 90 cases of invasive breast carcinoma specimens received in the Department of Pathology, Sri Raamachandra Institute of Higher Education and Research a tertiary care centre in Chennai, Tamil Nadu, India, from January 2012 to June 2017. Immunohistochemical staining for MMP-2, Oestrogen Receptor (ER), Progesterone Receptor (PR) and Human Epidermal Growth Factor Receptor 2 (HER2) was done. Statistical analysis was done on the data collected by using the software GNU-PSPP version 0.10.1. Pearson Chi-square test was used to determine significant clinicopathological differences between MMP-2 expression in positive and negative tumours. Differences were considered statistically significant when p-value was

Aim The aim of this present study was to investigate the antifungal mechanism of sertraline against Candida auris (C. auris) and its effect on biofilm formation. Methods and results Sertraline, a repurposing drug with a history of human use for the treatment of depression was screened against three different isolates of C. auris, and was found to possess efficient antifungal activity. The antifungal activity of sertraline was further confirmed by killing kinetics assay and post-antifungal effect (PAFE). Sertraline inhibited C. auris yeast to hyphae conversion and further the inhibition of biofilm formation showed 71% inhibition upon treatment. Cell damage caused due to C. auris after treatment with sertraline was observed using SEM and cell membrane damage was ascertained using flow cytometry by Propidium Iodide (PI) uptake assay. The results of sorbitol protection assay and ergosterol effect assay suggested that sertraline did not affect the cell wall and did not act by binding to membrane ergosterol. The mechanism of action of sertraline against C. auris was understood through in silico docking studies that revealed the binding nature of sertraline to the sterol 14 alpha demethylase which is involved in ergosterol biosynthesis. Ergosterol that was quantified from treated cells showed a 5·5-fold decrease in ergosterol production. Conclusion Sertraline displayed promising antifungal activity against C. auris involved in candidiasis infection and the mechanism of action was predicted. Significance and impact of this study The results of this study can encourage for the development of new antifungal agents and can be promising antifungal agent against C. auris infection.

Context: No single factor can predict the occurrence of post total thyroidectomy (TT) hypocalcemia. Aims: This study was conducted to look at various factors usually implicated in post TT clinically significant hypocalcemia (CSH) and to develop a scoring system using a combination of these factors to predict CSH. Settings and Design: Prospective study, tertiary care center. Materials and Methods: 145 patients, who underwent total thyroidectomy for benign goiters and early carcinoma thyroid ( < T2/N0/M0), were included. Age of the patient, presence, or absence of hyperthyroidism, pre-operative levels of serum calcium and 25 OH vitamin D, post-operative iPTH at 8 hours and calcium at 12 hours, intra-operative parathyroid preservation status, and nodule size were studied. CSH prediction score (0 to 8) was designed based on these 8 factors. Statistical Analysis: SPSS 13 software was used. For comparison between groups′ independent samples T-test and Chi-square test was used. Statistical significance was set at P 3 had 91% sensitivity, 84% specificity with a PPV of 71% and NPV of 95%, whereas score of ≥ 4 had 100% specificity and PPV in predicting CSH. Conclusions: CSH after TT is multi-factorial, and a combination of factors (Hypocalcemia prediction score > 3) can be used to predict it so as to discharge patients within 24 hours after surgery.

Morbidity after thyroidectomy is related to injuries to the parathyroids, recurrent laryngeal (RLN) and external branch of superior laryngeal nerves (EBSLN). Mostly these are due to variations in the surgical anatomy. In this study we analyse the surgical anatomy of the laryngeal nerves in Indian patients undergoing thyroidectomy. Materials and Methods. Retrospective study (February 2008 to February 2010). Patients undergoing surgery for benign goitres, T1, T2 thyroid cancers without lymph node involvement were included. Data on EBSLN types, RLN course and its relation to the TZ & LOB were recorded. Results. 404 thyroid surgeries (180 total & 224 hemithyroidectomy) were performed. Data related to 584 EBSLN and RLN were included (324 right sided & 260 left sided). EBSLN patterns were Type 1 in 71.4%, Type IIA in 12.3%, and Type IIB in 7.36%. The nerve was not seen in 4.3% cases. RLN had one branch in 69.34%, two branches in 29.11% and three branches in 1.36%. 25% of the RLN was superficial to the inferior thyroid artery, 65% deep to it and 8.2% between the branches. TZ was Grade 1 in 65.2%, Grade II in 25.1% and Grade III in 9.5%. 31.16% of the RLN passes through the LOB. Conclusions. A thorough knowledge of the laryngeal nerves and anatomical variations is necessary for safe thyroid surgery.

Malnutrition and hidden hunger are among the most pressing development concerns in the world today. The United Nations (UN) estimates that over 795 million people in the world are undernourished. The number is higher if we consider the World Health Organization (WHO) estimate that two billion people suffer from ‘hidden hunger’ or lack of vitamins, minerals and essential nutrients.

Emerging data indicate that gut-derived endotoxin (metabolic endotoxemia) may contribute to low-grade systemic inflammation in insulin-resistant states. Specific gut bacteria seem to serve as lipopolysaccharide (LPS) sources and several reports claim a role for increased intestinal permeability in the genesis of metabolic disorders. Therefore, we investigated the serum levels of LPS and zonulin (ZO-1, a marker of gut permeability) along with systemic levels of tumor necrosis factor-α (TNF-α) and Interleukin-6 (IL-6) in patients with type 2 diabetes mellitus (T2DM) compared to control subjects. Study subjects were recruited from the Chennai Urban Rural Epidemiology Study [CURES], Chennai, India. Study group (n = 45 each) comprised of a) subjects with normal glucose tolerance (NGT) and (b) patients with T2DM. LPS, ZO-1, TNF-α, and IL-6 levels were measured by ELISA. Serum levels of LPS [p

Harlequin syndrome (HS) is known to be associated with conditions like brain stem infarcts and superior mediastinal neurinoma. However, it has not been reported in association with autoimmune hyperthyroidism. We report a case of exacerbation of unilateral sweating in a patient with HS following the onset of toxic goitre. Previous reports have suggested that a tortuous inferior thyroid artery can produce neurovascular compression of the sympathetic chain which was not observed in our patient. Autoimmune aetiology for HS needs to be explored. Increased sweating in hyperthyroid patients needs to be assessed properly so as to prognosticate appropriately.

Primary hyperparathyroidism (PHPT) has become an asymptomatic disease in the Western world with the introduction of routine calcium screening. However, the same phenomenon is not observed in India. We have now systematically reviewed the status of PHPT in India. While there is a paucity of literature on PHPT from India when compared to Western countries, some information can be gleaned upon. Most patients present with symptomatic disease whereas very few are screen-detected cases (bone disease 77%, renal disease 36%, and 5.6% asymptomatic). Mean calcium, parathyroid hormone (PTH), and alkaline phosphate levels are high while Vitamin D levels are low. The average parathyroid gland weight is large and the majority being parathyroid adenomas (89.1%). Hungry bone syndrome (HBS) is common in the postoperative period. The disease-related mortality rate is 7.4%, recurrence 4.16%, and persistent disease 2.17%. We suggest that dedicated efforts are needed to pick up asymptomatic disease in India by methods like incorporating calcium estimation in the routine health check-up programs.