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To address the ambiguity of different modes of human papillomavirus (HPV) transmission in breast, the immunohistochemical expression of two oncoproteins E6/E7 of HPV16 was analyzed in primary breast cancer (BC) and adjacent normal skin of 4 samples. The patients were of 35–55 years old having no previous history of cancer. The E6/E7 expressions were evident in both skin and BC. In skin, high/moderate cytoplasmic expressions of E6/E7 proteins were seen in all samples, whereas in BC, high/moderate cytoplasmic expressions of the proteins were observed in 2–3 samples. Thus, it seems that HPV infection in the breast may occur through the skin.

The tumor suppressor protein p53 is known to control cell cycle arrest and apoptosis. Lupeol is a phytochemical that has been found to induce apoptosis in different cancer types through the extrinsic pathway. As yet, however, its role in the induction of cell cycle arrest and apoptosis through the intrinsic pathway in head and neck cancer has not been investigated. Here, we aimed at understanding the mechanism underlying the antitumor effect of Lupeol in head and neck cancer. The antitumor effect of Lupeol on oral and laryngeal carcinomas was assessed using two in vitro 2D cell line models (HEp-2, UPCI:SCC-131) and, subsequently, an ex vivo 3D tumor explant culture platform that maintains key features of the native tumor microenvironment. The mechanism underlying Lupeol-mediated antitumor responses was delineated using MTT, colony formation, flow cytometry, immunofluorescence, Western blotting and immunohistochemistry assays. We found that Lupeol induced an enhanced expression of p53 in both cell line models tested and, subsequently, cell cycle arrest at the G1 phase. In addition we found that, following Lupeol treatment, p53 induced Bax expression and activated the intrinsic apoptotic pathway (as measured by Caspase-3 cleavage). Interestingly, Lupeol was also found to trigger G1 cell cycle arrest through up-regulation of the expression of CDKN2A, but not p21, resulting in inhibition of CyclinD1. In an ex vivo platform Lupeol was found to impart a potent antitumor response as defined by inhibition of Ki67 expression, decreased cell viability and concomitant activation (cleavage) of Caspase-3. Finally, we found that Lupeol can re-sensitize primary head and neck squamous cell carcinoma (HNSCC) tumor samples that had clinically progressed under a Cisplatin treatment regimen. Together, our data indicate that Lupeol may orchestrate a bifurcated regulation of neoplastic growth and apoptosis in head and neck cancers and may serve as a promising agent for the management of tumors that have progressed on a platinum-based treatment regimen.

Dermatofibrosarcoma protuberans is a cutaneous soft tissue neoplasm with potential for local recurrence but distant metastasis is rare. Trunk and extremities are most commonly involved. This case presented as left-sided breast lump in a male patient. The patient underwent left-sided modified radical mastectomy. Tissues were subjected to histopathological and immunohistochemical test subsequently. The tumor cells showed storiform arrangement with nuclear pleomorphism and increased mitotic figures at places. They were reactive to CD34 and non-reactive to S-100, smooth muscle actin, desmin, cytokeratin and epithelial membrane antigen. The diagnosis of dermatofibrosarcoma protuberans with areas of fibrosarcomatous change was given. Though trunk is a common site for this tumor but its presentation as male breast lump has made the case unique.

Epidermal growth factor receptor (EGFR) and its downstream elements are overexpressed in most cases of the head and neck squamous cell carcinoma. This study investigated the expression pattern of key proteins linked to the EGFR pathway in laryngeal carcinoma patients with a history of cannabis smoking. We selected 83 male glottic cancer patients, aged between 45 to 75 years with three distinct populations-nonsmoker, cigarette smoker, and cannabis smoker. Immunohistochemical staining was performed for EGFR, protein kinase B (PKB or Akt), nuclear factor kappa B p50 (NF-КB), and cyclooxygenase-2 (COX-2) followed by boolean scoring for statistical analysis. Experimental data showed upregulation of the selected EGFR cascade in tumor cells, stromal expression of EGFR, and nuclear localization of COX-2 in metaplastic gland cells of laryngeal cancer tissue sample. Statistical analyses indicated that overexpression of the EGFR cascade is significantly correlated to cannabis smoking. Cannabis smokers had higher expression (p 0.01) of these onco-proteins with respect to both nonsmokers as well as cigarette smokers. Risk factor analysis showed high risk of these proteins expression in age60 years (odds ratio (OR) 1.5) as the lower age group had relatively higher number of cannabis smokers. This study provides evidence for a direct association between cannabis smoking and increased risk of laryngeal cancer. Higher expression of the EGFR cascade in cannabis smokers revealed that cannabis smoking may be a major cause for the early onset of aggressive laryngeal cancer.

Objectives Human papillomavirus (HPV) causes tumors primarily Cervical cancer. Recently, inconsistent reports came up in Breast cancer (BC) too. In India, despite treatment 70,218 BC patients die each year. So, we explored the association of HPV, if any, with BC prognosis in Indian pre-therapeutic (PT) and Neo-adjuvant chemotherapy (NACT) patients with subsequent analysis of HPV profile. Methods HPV prevalence was checked and analysis of physical status, copy number, genome variation, promoter methylation and expression (mRNA and protein) of the prevalent subtype was done. Results High prevalence of HPV was observed in both PT (64.0%) and NACT (71.0%) cases with significant association with younger (20-45 yrs) PT patients. Interestingly, HPV infection was significantly increased from adjacent normal breast (9.5%, 2/21), fibro adenomas (30%, 3/10) to tumors (64.8%, 203/313) samples. In both PT and NACT cases, HPV16 was the most prevalent subtype (69.0%) followed by HPV18 and HPV33. Survival analysis illustrated hrHPV infected PT patients had worst prognosis. So, detailed analysis of HPV16 profile was done which showed Europian-G350 as the most frequent HPV16 variant along with high rate of integration. Moreover, low copy number and hyper-methylation of P97 early promoter were concordant with low HPV16 E6 and E7 mRNA and protein expression. Notably, four novel variations (KT020838, KT020840, KT020841 and KT020839) in the LCR region and two (KT020836 and KT020837) in the E6 region were identified for the first time along with two novel E6^E7*I (KU199314) and E6^E7*II (KU199315) fusion transcript variants. Conclusion Thus, significant association of hrHPV with prognosis of Indian BC patients led to additional investigation of HPV16 profile. Outcomes indicated a plausible role of HPV in Indian BC patients.

Objective: Though sinu-nasal neoplasms comprise of a small percentage of head neck tumours, they areincreasing in incidence due to rapid industrialization and an increase in life expectancy. Further in many cases they present at an advanced stage and data from studies on them from eastern region of the country is limited, encouraging this study. The aim of this study to evaluate the clinical and demographic profile as well as the histological variation of sinunasal neoplasms and it relation with occupation and addiction. Methods: Design: Prospective study Setting: Tertiary government teaching hospital Participants: All patients presenting with neoplastic lesion in nasal cavity between December, 2009 to May, 2011 Results: Eighty two(82) patients-- 57 (69.51%) male and 25 (30.49%) female aged upto 80 years, were included, displaying male predominance and clustering in the fifth decade of life. Benign lesions (44 cases , 53.66%) were more common than the malignant lesions (33 cases , 40.24% ) and 5 cases (6.10%) were seen indeterminant for malignancy/low-grade malignant potential. Most common anatomical location was nasal cavity(57.32%) and farmers were mostly affected by sinonasal neoplasm (30%). Commonest clinical presentation was epistaxis (31.71%). Conclusion: Sinonasal neoplasms have wide range of possibilities. Commonly, patients present with nasal obstruction and epistaxis. Early diagnosis with the help of newer diagnostic modalities with prompt treatment is necessary for these patients. Histopathological diagnosis is necessary for any neoplastic lesion in nasal cavity. This will guide us for further management of these lesions Keywords: Paranasal sinus ; Neoplastic lesion ; Nasal obstruction ; Epistaxis ; Sinonasal neoplasm

Acute megakaryoblastic leukemia(AML-M7) is a rare type of pediatric AML. It represents approximately 1% of all leukemias during childhood & has an incidence of 0.5% per million per year. In young children with Down syndrome, AML-M7 is the most common type of AML. There is no association reported till date in between Down syndrome & Haemoglobin E-Beta thalassaemia. In our case we got rare association of AML-M7 in a case of Down syndrome with Haemoglobin E-Beta thalassemia. This association may be incidental. But we are reporting this case for future review. Keywords - Acute Megakaryoblastic Leukemia, AML-M7, Down syndrome, Haemoglobin E-Beta thalassaemia, rare association.

A 13-year-old girl presented with chief complaints of severe headache and vomiting followed by hemiparesis. Radiological examination suggested a space occupying lesion in the right parietal lobe. Craniotomy and debulking of the tumor mass were done. Histopathological and subsequent immunohistochemical examination showed a tumor composed of fascicle of atypical spindle cells which revealed reactivity to vimentin with interspersed areas of well-differentiated cartilage tissue. Hence, the diagnosis of teratoma with sarcomatous transformation was given. Detailed discussion including review of literature has been made regarding different aspect of the tumor.

The placement process for summer placements at IIM Ahmedabad renders a series of decisions to be judiciously taken by every student owing to the limited time availability and a highly competitive environment. In this paper, we have primarily analysed the period between the day students of first year management programme have their CVs frozen (cannot be altered later) and the day the last student of the batch gets an internship offer. The dilemmas faced by a student are dependent on their personal profile but also largely on the sequence of events unfolding during the period. Using the publicly available data of last two years’ summer placements, a survey administered to second year students, long form conversational interviews (LFCI) with concerned office bearers over the last one month, and the previously established econometric models for utility derived in various human activities as given in literature have been quantitatively and qualitatively analysed and combined together to generate a set of inequalities attempting to resolve the dilemmas that students face. The various decisions are considered as subgames in a decision tree, and have been solved using the inequalities developed. Significant insights about the proposed rational behaviour has been drawn and interpreted back in non-mathematical terms in the end. In an attempt to maximise the various utility functions, some of the variables have been taken as categorical predictors providing a discrete description of the placement process. Overall, the paper attempts to give a systematic method of analysing and recommend the decisions a rational student should optimally take during the three months period of excessive work load, and high stakes.

Netflix has been on the rise since its beginning in 1997, when one sees it from a distant perspective. However, a close analysis of its unique strategies shows that the company faced several small and big challenges in its growth journey, some of which, had the potential to throw the company away permanently from the market itself. Nevertheless, it responded tactically to all such issues, many of them being dealt in preventive and pro-active manner; while other cases being dealt with quick reactions, essentially faster than any other competitors. This report is a study of many such issues that the company faced, since its beginning till recently, when it almost conquered the whole world, after establishing its feet in China as well, in collaboration with the service provider Baidu. The report also entails some unique strategies that the company followed while continuously and marginally changing its business model, which would seldom be possible in a brick-mortar economy. As such, the company made use of its deeper understanding of how markets react in an internet economy. Effort has been made to throw some light on the way the company has dealt the issues of digital discrimination allegations against it, and also its stance on net neutrality. Finally, some of the challenges and opportunities that the company has encountered recently, including the lawsuits has been touched upon, presenting the company’s as well as outsider media’s view on those, and has been concluded with potential problems and future aspects