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Molecular subtyping of breast cancer is based mostly on HR/HER2 and gene expression-based immune, DNA repair deficiency, and luminal signatures. We extend this description via functional protein pathway activation mapping using pre-treatment, quantitative expression data from 139 proteins/phosphoproteins from 736 patients across 8 treatment arms of the I-SPY 2 Trial (ClinicalTrials.gov: NCT01042379). We identify predictive fit-for-purpose, mechanism-of-action-based signatures and individual predictive protein biomarker candidates by evaluating associations with pathologic complete response. Elevated levels of cyclin D1, estrogen receptor alpha, and androgen receptor S650 associate with non-response and are biomarkers for global resistance. We uncover protein/phosphoprotein-based signatures that can be utilized both for molecularly rationalized therapeutic selection and for response prediction. We introduce a dichotomous HER2 activation response predictive signature for stratifying triple-negative breast cancer patients to either HER2 or immune checkpoint therapy response as a model for how protein activation signatures provide a different lens to view the molecular landscape of breast cancer and synergize with transcriptomic-defined signatures.

Introduction: Branch retinal vein occlusion (BRVO) almost always occurs at an arteriovenous crossing, where the artery and vein share a common adventitial sheath. Aim: The study was designed to evaluate the anatomic position of the crossing vessels at the site of occlusion in a case of BRVO. Materials and Methods: A cross sectional descriptive study was conducted among 20 BRVO patients attending Ophthalmology outpatient department of a tertiary care hospital during the period of September 2013 to August 2014. A semi structured questionnaire was used to evaluate the sociodemographic characters and co-morbidity among the patients. The fundus of the patients were examined with 90D lens under slit lamp and the fundus photographs were taken. Results: Twenty patients were considered in the study. Eleven were male and nine were female patients. Mean age of the male group was 50.09±4.94 years. Mean age of the female group was 49.33±3.77 years. In all, there were 21 eyes with branch retinal vein occlusion. Out of which 11 were left eyes, eight were right eyes and one patient was having occlusion in both the eyes. In BRVO cases, among 17(80.9%) eyes, the artery was anterior to the vein and in the remaining 4(19.1%) eyes the vein was anterior to the artery. No statistically significant difference was observed regarding the position of artery and vein in BRVO and control eyes (p=0.9). The superiotemporal occlusions were more in number 13 (61.9%) as compared to inferiotemporal occlusions in 8 (38.1%) eyes. Amajority 17(85%) of patients were hypertensive. Conclusion: In the present study the incidence of artery anterior to the vein was higher compare to vein anterior to the artery, the knowledge of which is useful to understand the patho-physiology and management of BRVO

Introduction: Mother to child transmission (MTCT) of HIV continues to be a significant public health concern. MTCT has a deleterious effect on child survival, hence its knowledge is of utmost importance for prevention of transmission of HIV from mother to child. Materials and Methods: A cross sectional descriptive study was conducted during October –December 2013 among women attending antiretroviral therapy (ART) clinic. A semistr u c t u r e d q u e sti o n n a ir e c o n sist e d o f sociodemographic characteristics, clinical characteristics and knowledge about MTCT was administered to 80 women. Results: The mean age of the respondents was 24.89 ± 3.62 years and 30% were illiterate. The majority (62.5%) of them were belonged to an upper lower class. Atotal 47.5% of the respondents were aware of their HIV status since 1-5 years. The majority (82.5%) perceived that HIV can be transmitted from mother to child. Many of the respondents felt that MTCT of HIV may occur during breastfeeding 49 (74.24%), pregnancy 48 (72.72%) and labour 42 (63.63%). The majority 62 (93.93%) of the respondents were aware that MTCT of HIV can be prevented. Avoidance of breastfeeding was the most frequently mentioned strategy by 40 (64.51%) respondents, followed by maternal ARV prophylaxis by 35 (56.45%) and caesarean section by 25 (40.32%) of the respondents. Conclusion: The study demonstrates a relatively good level of knowledge on MTCT of HIV, but some knowledge gaps on certain specific aspects still remained which needs to be addressed for effective prevention of mother to child transmission of HIV

Introduction: Acute poisoning is an important cause of morbidity and mortality in India. It is estimated that more than 50,000 people die every year from toxin exposure. In India, intentional cases alone reach some 126,000 cases annually and organophosphorus compounds constitute major poisonings. Materials and Methods: A cross sectional, descriptive study was conducted among 30 cases of acute poisoning admitted in Prathima Institute of Medical Sciences, Karimnagar, Andhra Pradesh during September 2011-12. Socio-demographic variables assessed were age, sex and area wise distribution of the respondents. Type of poison, the amount ingested, clinical presentation and outcome were studied. Results: In this study, maximum cases 13 (43.4%) were between 17 to 20 years, males 17 (57%) were more commonly involved in acute poisoning and 20 (67%) cases came from rural areas. The majority 13 (43.3%) of cases were organophosphates poisonings and 28 (93%) of cases were of suicidal intentions. Most of the suicidal poisonings were due to economical problems 14 (50%), followed by broken relationships 6 (21%) and studies related reasons were observed in 5 (18%) of cases. Out of total 30 cases of poisonings in this study, 26 cases (86.66%) were recovered completely, whereas 4 cases (13.3%) expired. Conclusion: Prevention of poisoning requires further exploration of underlying factors in their cultural context and effective strategies including management of these problems. Changing the knowledge, attitudes and behaviors of the community and improvement in the medical treatment plan is required to curtail the incidence and mortality

Introduction: The Fontan operation is usually the final palliative procedure in patients with univentricular heart. The objectives of this study were firstly to describe the clinical and hemodynamic characteristics of a group of patients with univentricular physiology who had previously been palliated with a right modified Blalock Taussig's Shunt, Bidirectional Glenn Shunt and secondly to identify the risk factors that can influence post-operative outcomes after Fontan operation. Materials and Methods: Aretrospective analysis of 20 patients who underwent Fontan operation between January 2005 to January 2014 was conducted. Clinical characteristics, catheterization data, type and duration of surgery were reviewed and analysed as predictors of post-operative outcome. Results: We operated 20 cases out of which 14 were males and 6 were females. The majority of the patients (10) were in the age group of 11-20 years. The diagnosis included double outlet right ventricle (DORV) 5 patients, ventricular septal defect with pulmonary stenosis 5 patients, transposition of great arteries (TGA) 3 patients, tricuspid atresia (TA) 6 patients and double inlet left ventricle with pulmonary stenosis (DILV, PS) 1 patient. Out of these, 4 patients were palliated with right modified Blalock-Taussig (BT) shunt, and 6 patients with Glenn Shunt. The rest were for the direct Fontan procedure. Two patients died during the postoperative period. Conclusion: The performance of hemodynamic study before Fontan operation made it possible to select high risk patients for surgery. Fontan operation showed dramatic improvements in symptoms and saturations.

Introduction: Placenta is a foeto-maternal organ which connects the developing foetus to the uterine wall of the mother. It allows the transfer of nutrients, elimination of wastes, and exchange of gases via mother's blood supply. The birth weight and placental insufficiency are significant risk factors for the development of the metabolic syndrome in later life. Aims and Objectives:The purpose of this study is to analyze the weight of the placenta and site of attachment of umbilical cord to the placenta by dissection method and to correlate them with any abnormalities of the mother as well as foetus. Materials and Methods: A total of 50 specimens were collected from Prathima Institute of Medical INTRODUCTION Placenta is a foeto-maternal organ which connects the developing foetus to the uterine wall of mother and is expelled from the womb by natural maternal forces after the delivery of the foetus. It is the only organ that belongs to two people at the same time. It allows the nutrition, elimination of wastes, and exchange of gases via mother's blood supply. All the anabolites required for foetal metabolism comes from the mother's blood and foetal catabolites are transported back into the mother's circulation through placenta. This extraordinary organ is dedicated to the survival of the baby, even to the extent of putting the mother at risk in some cases like postpartum hemorrhage. The birth weight and placental insufficiency are significant risk factors for Perspectives in Medical Research | September - December 2014 | Vol 2 | Issue 3 Sciences during the period of February 2013 to May 2014 and subjected to thorough examination. Details were recorded and analyzed. Results: Study showed a mean weight of 450.40g. Central attachment of umbilical cord in 27(54%), battledore 15 (30%), velamentous 7(14%) and double umbilical cord 1 (2 %) was observed. Conclusion: Variations in the placenta are also associated with abnormalities in the foetus as well as the mother. Therefore, it is essential that the delivering physician performs a thorough, accurate examination of the placenta which in case of abnormality will be helpful for immediate and later management of mother and infant