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Background: The most prevalent naturally occurring amino polysaccharide is chitosan. Chitosan’s biocompatibility biodegradability and non-toxicity have led to its wide spread use in the pharmaceutical industry according to research. The biopolymer chitosan is typically extracted from the crustacean shells such as, Crab, Prawn, Lobster, fish scales etc. Methods: The research was accomplished during 2021-2022 to examine the extraction and characterization of chitosan (polymer) from four different organism of fresh water i.e fish scales, bivalve, prawn and crab shells. Extracted chitosan has been produced by using various parameters i.e. demineralization deproteinization and deacetylation as chemical methods. Result: Results showed that chitosan was found maximum in the crab (Bareytelphusa guerini) 87.29% followed by Prawn (Macrobrachium rosenbergii) and scales of fish (Channa striatus) which have an average yield (38.55% and 32.56%) respectively and (18.14%)which is lowest yield among all obtained from fresh water mussel (bivalve). The chitosan extracted from the samples were characterized by Fourier transform infrared spectroscopy (FTIR) and existence of chitosan was confirmed and best yield of chitosan was obtained from Bareytelphusa guerini.

Solanum nigrum belonging to the family Solanaceae, has been considered as a remedy for treating various ailments like epilepsy, gastric ulcers etc. and is believed to have hepatoprotective activities. In this study, the total phenolic and flavonoid content of the extracts of Ethyl acetate and Methanol from the Solanum nigrum leaves and their antioxidant activity was carried out by using spectrophotometric methods. Methanol extract with high absorbance exhibited highest antioxidant activity containing highest quantity of phenolics and flavonoids followed by Ethyl Acetate. The presence of phenolic and flavonoid compounds indicated that these compounds can contribute to the antioxidant activity. These active constituents alone or in combination with others may be responsible for the observed antioxidant activity. The findings indicated promising antioxidant activity of crude extracts of leaves needs further exploration for their effective use in both modern and traditional system of medicines. The Solanum nigrum leaf can be regarded as promising candidate for natural plant sources of antioxidants with higher values. A comparative study of the total phenolic and flavonoid contents extracted by the solvents, and their in-vitro antioxidant activity that could be an effective remedy in hepatoprotection was carried out in the study.

Background: Hypertension (HTN) is a modifiable and major risk factor for coronary artery disease, heart failure, cerebrovascular disease and chronic renal failure. Present study conducted to study the prevalence of hypertension among bank employees of Rajkot city and to study the associated risk factors of hypertension among them. Methods: Rajkot city has around 160 different bank branches, including 35 private and 125 nationalized bank branches. Total 70 bank branches selected including all 35 private and similar number of nationalized bank branches (35) by using systemic random sampling. The present study was conducted from January to December 2017. Information regarding demographic profile and risk factors of hypertension was collected on pretested proforma. Results: Out of total 800 employees, prevalence of hypertension was found 30.4% including 7.6% self reported and 22.8% detected in the study. Highest prevalence of hypertension was reported in 50-59 years age group followed by 20-29 years (26.3%). Hypertension found more among male (90.9%) and work experience less than 10 years (42.8%). Significant association found on assessing risk factors like history of addiction, not doing any physical exercise, obesity, high BMI and hypertension. Conclusion: Hypertension was reported more in elder age group and Males among bank employees. Age and sex were found significantly associated with hypertension. Addiction (tobacco and alcohol), not doing any physical exercise, central obesity and high BMI status found significant risk factors for hypertension.

The prime goal of drug delivery through drug carrier system to the specific target site at the suitable concentration for therapeutic action. Recently thin films are acquiring attention as drug carrier and various scientists are working on the formulation and development of thin films as a novel drug delivery system. Because of its capacity to safely load medications and release them in a regulated manner, thin films have attracted increasing interest in the field of drug delivery, which improves drug efficacy. They are more patient compliance and alternative to oral drug delivery employing self-application, prolonged action and easily terminate if drug toxicity is produced. Oral, buccal, sublingual, ocular, and transdermal routes have all been employed to deliver this delivery mechanism for both systemic and local effects. The development of thin films comprises of various methods with keeping in mind the anatomical and physiological constraints, physicochemical properties and types of drug substance and use of various polymers (matrix, hydrophilic and hydrophobic) as well as the characterisation methods with recent trends.

Background Few studies have investigated risk factor heterogeneity by molecular subtypes in indigenous African populations where prevalence of traditional breast cancer (BC) risk factors, genetic background, and environmental exposures show marked differences compared to European ancestry populations. Methods We conducted a case-only analysis of 838 pathologically confirmed BC cases recruited from 5 groups of public, faith-based, and private institutions across Kenya between March 2012 to May 2015. Centralized pathology review and immunohistochemistry (IHC) for key markers (ER, PR, HER2, EGFR, CK5-6, and Ki67) was performed to define subtypes. Risk factor data was collected at time of diagnosis through a questionnaire. Multivariable polytomous logistic regression models were used to determine associations between BC risk factors and tumor molecular subtypes, adjusted for clinical characteristics and risk factors. Results The median age at menarche and first pregnancy were 14 and 21 years, median number of children was 3, and breastfeeding duration was 62 months per child. Distribution of molecular subtypes for luminal A, luminal B, HER2-enriched, and triple negative (TN) breast cancers was 34.8%, 35.8%, 10.7%, and 18.6%, respectively. After adjusting for covariates, compared to patients with ER-positive tumors, ER-negative patients were more likely to have higher parity (OR = 2.03, 95% CI = (1.11, 3.72), p = 0.021, comparing ≥ 5 to ≤ 2 children). Compared to patients with luminal A tumors, luminal B patients were more likely to have lower parity (OR = 0.45, 95% CI = 0.23, 0.87, p = 0.018, comparing ≥ 5 to ≤ 2 children); HER2-enriched patients were less likely to be obese (OR = 0.36, 95% CI = 0.16, 0.81, p = 0.013) or older age at menopause (OR = 0.38, 95% CI = 0.15, 0.997, p = 0.049). Body mass index (BMI), either overall or by menopausal status, did not vary significantly by ER status. Overall, cumulative or average breastfeeding duration did not vary significantly across subtypes. Conclusions In Kenya, we found associations between parity-related risk factors and ER status consistent with observations in European ancestry populations, but differing associations with BMI and breastfeeding. Inclusion of diverse populations in cancer etiology studies is needed to develop population and subtype-specific risk prediction/prevention strategies.

Physiochemical Parameters of the Halali reservoir located Vidisha in Bhopal were studied in the whole year of 2016-2017. Ecological parameters like temperature, dissolved oxygen (DO), pH, conductivity and nitrogen. All physiochemical parameters give a picture of the quality parameter in pond water of the Halali. By observing the results, it can be concluded that the parameters which were taken for study the water quality are below the pollution level for ground water, which satisfy the requirement for the use of various purposes like domestic, agricultural, industrial, aquaculture etc.

Purpose The goal of this study was to describe the pathologic findings and early follow-up experience of patients who underwent a sentinel lymph node biopsy (SLNB) at Aga Khan University Hospital (AKUH) between 2008 and 2017. Patients and Methods We performed a retrospective analysis of women with breast cancer who underwent an SLNB at AKUH between 2008 and 2017. The SLNB was performed on patients with stage I and stage II breast cancer, and identification of the sentinel lymph node was made by radioactive tracer, blue dye, or both, per availability and surgeon preference. Demographic, surgical, and pathologic data, including immunohistochemistry of the surgical sample for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2, were abstracted from the patient records. Follow-up data were available for a subset of patients. Results Between 2008 and 2017, six surgeons performed SLNBs on 138 women, 129 of whom had complete records and were included in the study. Thirty-one of 129 (24%) had a positive SLNB, including 10 of 73 (14%) with stage I and 21 of 56 (38%) with stage II disease. Seventy-eight patients (60%) received systemic adjuvant chemotherapy and 79 (62%) received radiation therapy, and of the 102 patients who were estrogen receptor positive, 86 (85%) received endocrine therapy. Seventy-nine patients were observed for > 2 years, and, of these, four (5.1%) had a regional recurrence. Conclusion The SLNB positivity rates were similar to those of high-income country (HIC) cohorts. However, preliminary data suggest that recurrence rates are elevated at AKUH as compared with those of HIC cohorts, perhaps because of a lower use of radiotherapy and chemotherapy at AKUH compared with HIC cohorts or because of differences in the characteristics of the primary tumor in patients at AKUH as compared with those in HICs.

There are no published data from specific regions of sub-Saharan Africa describing the clinical and pathological characteristics and molecular subtypes of invasive breast cancer by ethnic group. The purpose of this study was to investigate these characteristics among the three major ethno-cultural groupings in Kenya. The study included women with pathologically confirmed breast cancer diagnosed between March 2012 and May 2015 at 11 hospitals throughout Kenya. Sociodemographic, clinical, and reproductive data were collected by questionnaire, and pathology review and immunohistochemistry were performed centrally. The 846 cases included 661 Bantus (78.1%), 143 Nilotes (16.9%), 19 Cushites (2.3%), and 23 patients of mixed ethnicity (2.7%). In analyses comparing the two major ethnic groups, Bantus were more educated, more overweight, had an older age at first birth, and had a younger age at menopause than Nilotes (p

INTRODUCTION The majority of women with breast cancer in Kenya present with node-positive (stage II) or locally advanced Q7 disease (stage IIIB). Diagnosis is made on fine needle aspirate cytology and treatment is with surgery if resectable. Diagnostic core biopsy is available only at subspecialty hospitals. Processing and reporting of biopsy tissue are not standardised. Hormone receptor and HER2 analyses are rarely done preoperatively. METHODS As part of a larger study investigating the prevalence of triple negative breast cancer in Kenya, a multidisciplinary workshop of collaborators from 10 healthcare facilities was held. Process gaps were identified, preanalytic variables impacting on ER/PR/HER2 discussed and training in core biopsy provided. Local remedial strategies were deliberated. CONCLUSION We describe our experience and outcome from the workshop, which can be modelled for other resource poor settings.

Objective The vegetable fern Diplazium esculentum Retz. was traditionally as well as scientifically examined to possess anti anaphylactic and mast cell stabilizing potential. It was thus needed to investigate its phytochemical constituents, antioxidant potential along with HPTLC Profiling. Methods The aqueous and the ethanolic extracts of the fern were studied for the antioxidant activity by ABTS radical scavenging assay and H2O2 radical scavenging potential. Polyphenols namely phenols and flavonoids are believed to play key roles in providing protection against oxidative stress for which they were quantified using spectrophotometric methods and compared with their respective standards. Later HPTLC chromatogram was developed with particular solvent system for separation of flavonoids and saponins present in the fronds of the fern. Results The results obtained suggested that the ethanolic extract have more phenolics, flavonoid and saponins than the aqueous extract. In the HPTLC chromatogram, a number of peaks at different Rf values were obtained which suggested presence of varied types of polyphenols and steroidal saponins. Conclusion Owing to the present findings it can be concluded that the fern D. esculentum have considerable amount of polyphenols and saponins which might collectively be responsible for its pharmacological principles.

Objectives To assess diagnostic accuracy of breast cytology through histological correlation and identify reasons for diagnostic pitfalls. Methods A total of 2700 cases were reported in cytology during the study period of 14 months, of which 1100 (40%) were from breast lesions. Only 96 (9%) cases had histological follow up in the form of core biopsy, lumpectomy and/or mastectomy. The cases in which cytology diagnosis did not match with histology diagnosis were reviewed by two pathologists and reasons for the diagnostic pitfalls in cytology were recorded. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of cytology were calculated. Results Seventy cases (73%) had no cytohistologic discrepancy, three cases were reported as unsatisfactory while 23(24%) showed discrepancy with histology. Interpretation errors occurred in 16 cases in 3 categories (benign C2, atypical C3 and suspicious C4). There were 2 false negatives (C2) and 14 false positives (C3 and C4). Majority (58%, 8 out of 14) of the errors in the false positive groups were due to the poor quality of smears received from our satellite centres. Misclassification of subtypes within benign and malignant categories occurred in 2 cases each due to overlapping features. Sampling errors occurred in three cases due to inherent nature of the lesion. Sensitivity of our FNA was 91%, Specificity was 79%, Positive predictive value (PPV) 59% and negative predictive value (NPV) was 96%. Conclusions There was no major discrepancy to influence the management or prognosis significantly. Minor discrepancies resulted due to sampling and interpretation errors. Poor quality smear emerged as a major cause of interpretation errors. This calls for corrective measures to be applied for both sample providers and pathologists.

Introduction Breast cancer is a heterogeneous disease with varying clinical outcomes in histologically similar tumors. Micro arrays gene profiling has identified several breast cancer subtypes which include luminal A, Luminal B, Basal, and Her2 subtype. These subtypes show variable prognosis and response to therapy. Objectives To determine the proportion of the various subtypes at Aga Khan University hospital and describe their clinical and pathological characteristics. Study Design & setting Cross sectional study of all breast cancer specimens received in the pathology department of the Aga Khan university Hospital Nairobi between November 2007 and November 2008. Methods 101 cases of breast cancer were analysed using immunohistochemical surrogates to identify the subtypes. The subtype definition was; Luminal A ( Estrogen receptor(Er) or Progesterone receptor(Pr) positive Her2 negative), Luminal B ( Er, Pr, and Her2 positive), Her 2 sub type (Her2 positive, Er and Pr negative), and basal (Er, Pr,and Her2 negative Cytokeratin 5/6 (Ck5/6) and or Her1 positive). Cases not falling into any category were unclassified. Other clinical pathological characteristics including age, race, menopause status, tumor size, grade and stage were determined in each sub type. Results Luminal A was the most common, 42%, followed by basal, Her2, and luminal B at 23%, 21%, and 4% respectively. 10% of the cases were unclassified. There was no significant difference between the sub types with regard to age, menopause, tumor size and stage. There was a significant difference with regards to grade with the Her2 and basal subtypes having a higher grade. Conclusion The molecular sub types of breast cancer exist in our population. The prevalence of the basal subtype is higher than that seen in studies amongst Caucasians while the prevalence of Luminal A is lower.

Caesium-resistant (Cs+-R) mutant clones of the cyanobacterium Nostoc muscorum were characterized for diazotrophic growth in a medium devoid of Cs+ or Rb+ or both. Cs+-R phenotype suffered severe genetic damage of a pleiotropic nature affecting diazotrophic growth, chlorophyll a content, nitrogenase activity and photosynthetic O2 evolution. Mutation leading to development of Cs+-R phenotype could be overcome by availability of Cs+/Rb+. Parent and mutant strains were similar with respect to their Cs+/Rb+ uptake. Available data suggests operation of an efficient coupling of the two incompatible reactions viz. oxygenic photosynthesis and oxygen sensitive N2 fixation in this cyanobacterium. (© 2006 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)

139 Background: An analysis of 322 cases referred to Aga Khan University, Nairobi, revealed 56% estrogen receptor (ER) positive tumors and 35% prevalence of triple-negative breast cancer (TNBC). Findings were retrospective and limited by inability to control pre-analytical variables that could potentially impact results. Methods: As part of an ongoing prospective study assessing prevalence of TNBC in the three major ethnic groups in Kenya, we gathered a multidisciplinary team from 10 collaborating health facilities around Kenya for an educational workshop. The objectives were to assess baseline capabilities and pre-analytic variables at each center, identify gaps and provide hands-on training in order to ensure accuracy and validity of ER/PR/HER2 prevalence data gathered as part of the study. Results: See table. Breast cancer biopsies ranged from one to 20 per month per center. Diagnosis was predominantly by FNA and ER/PR/HER2 was not routinely performed. Buffered formalin fixative and standardized CAP reporting format was employed only at one center. A survey 3 months following the workshop demonstrated increase in diagnostic core biopsiesby 90%, and uniform use of buffered formalin fixative, and adoption of synoptic reporting. 66 prospective cases of breast cancer from the 10 institutions with patients from different ethnic backgrounds have been subsequently collected and IHC data will be presented. Conclusions: Much has been made of the difference in prevalence of TNBC in Africa as compared to North America, yet little attention has been paid to differences in diagnostic methodologies and basic tissue handling techniques that can potentially alter results. Despite limitations of resources, educational workshops make it possible to improve the practice of breast cancer diagnosis, and thereby enable accurate comparative analysis between breast cancers in the developing and the developed world. [Table: see text]

35 Background: Previous sub classification of breast cancer in Kenya has been fraught by small sample size, non uniform staining methodology and lack of independent review. Triple Negative Breast Cancer (TNBC) is a “special interest” cancer since it represents a significant proportion of breast cancer patients and is associated with a poorer prognosis. We aimed to determine the estrogen receptor (ER), progesterone receptor (PR) and Her2/neu receptor characteristics of breast cancers and the prevalence of TNBC diagnosed at Aga Khan University Hospital, Nairobi (AKUHN) between 2007 to date. Methods: Slides and blocks of archived invasive breast cancers diagnosed at AKUHN were identified, retrieved and reviewed by two independent pathologists. Histological type, grade and pathological stage were documented. Representative sections from available blocks were stained for ER, PR, Her2 with appropriate internal controls. Scores for ER/PR were interpreted based on the ALLRED system, Her2 /neu scoring followed CAP guidelines. The initial 111 cases were validated and confirmed at Sunnybrook Health Sciences Centre, Toronto. Results: 456 cases of invasive breast cancers were diagnosed at AKUHN during the study period. 91% of cases were invasive ductal carcinomas (NOS).The rest were special types. 37% of the tumors were grade 3 and 63% were grade 2. Blocks for 318 of 456 cases were available for receptor analysis. 54% were ER and/or PR positive, with 52% of these in women < 50 yrs. 86% of the ER and/or PR positive tumors were grade 2. Only 12% were Her2/neu positive. Of the 318 cases studied, 111 (32%) were identified as TNBC. Median age was 53 yrs. 88% were grade 3. Conclusions: Invasive ductal carcinoma (NOS) was the most common breast cancer in our study. Nearly half of our cases were ER and/or PR positive and a third were TNBC. Both occurred predominantly in women less than 50 yrs. This represents the largest validated pathologic sub classification of breast cancer from a tertiary academic hospital in Kenya. Expansion of this study to encompass all breast cancers diagnosed in Kenya is underway.