Introduction: Preterm neonates have deranged thyroid hormones levels often characterized by low T3/FT3 and often low to normal T4/FT4 and TSH levels. Thus, it may be essential to find the pattern of thyroid hormones levels in preterm in comparison to term neonates, the status of HPT axis in preterms and occurrence of Transient Hypothyroxinemia of Prematurity (THOP) in this part of globe, since serum FT3 and FT4 levels are correlated with TSH levels after establishment of HPT axis. We have focussed on these hormones in our study. Methods: This prospective observational study was conducted at a tertiary care centre in Northern India including 100 neonates in the study group (33 preterm and 67 term neonates as per gestational age). FT3, FT4 and TSH were estimated by electrochemiluminescence immunoassay (ECLIA) using diagnostic kits from Roche Diagnostics. The history of maternal illness, gestational age and birth weight of each neonate was recorded. Results: All the three hormones i.e. FT3, FT4 and TSH were significantly lower in preterm in comparison to term neonates. In term neonates FT3 was significantly correlated to both FT4 (r=0.453; p=0.00) and TSH (r=0.299; p=0.014) while no such correlation was found in preterm neonates. Discussion: Both sick euthyroid (low T3 syndrome) and transient hypothyroxinemia of premature infants (THOP) are noticed in pereterm neonates. The causes of low T3 syndrome may include hypoxemia, acidosis, infections, hypoglycemia, hypocalcemia, malnutrition, transient secondary/tertiary hypothyroidism, transient primary hypothyroidism and permanent primary hypothyroidism while THOP may be caused by iodine deficiency, maternal thyrotropin receptor blocking antibodies, maternal intake of anti-thyroid drugs, maternal or neonatal iodine exposure, loss of function mutations and hepatic haemangioma(20), maternal hyperthyroidism, prematurity and drugs. Since it may lead to undesirable neurodevelopmental outcome, thyroid hormones supplementation in preterms should be cautiously studied in larger sample size. Also, these factors must be considered while screening for congenital hypothyroidism.
REVIEW ARTICLE | April 14, 2020
Leptospirosis: Rising Nuisance for Pets and Threat to Public Health
Leptospirosis is a contemporary zoonotic disease that spread through the direct and indirect contact with animals and its excreta. The rising nuisance of this communicable disease is increasing now days due to handling the pet animals by the family members and allow them upto beds. In most places, placing the pet on the lapses may increase the load of the infections directly from the pet to the humans. The bacterial and serological observations among the infectious individuals are rising steadily but very few eliciting clinical symptoms. Among of the exposures, the immunity scores the individuals and protect from the infection. Eventhough we have good and effective antimicrobials to kill the leptospires and control leptospiral complications, clinicians are not still aware about the pyrexia of unknown origin may be due to leptospirosis. Thus most of the positive cases may leads to chronic state of multiorgan dysfunction to multiorgan failure; in few situations, renal failure, pulmonary and cardiac issues leads to increased mortality. From this review it is requested to all the pet owners to keep your pets in separate place not in your living areas and hopefully asking the clinicians to consider leptospirosis also as one of the suspicions among PUOs.
CASE REPORT | April 21, 2020
Wilms tumor and Colorectal Adenocarcinoma an Unusual Concurrence
Dr. Pallavi Srivastava, Prof Nuzhat Husain, Dr. Saumya Shukla, Dr. Vani Gupta
Multiple synchronous primary malignancies have been reported in colon carcinoma and studied for lynch syndrome or constitutional mismatch repair deficiency syndrome, however we present first case of co-occurance of colorectal adenocarcinoma and wilms tumor with mismatch repair deficiency. A 17 year old girl presented with pain in abdomen. A computerized tomography of whole abdomen revealed a large left sided renal mass along with mass lesion seen in the rectum Histopathology from both the mass revealed presence of colorectal adenocarcinoma and wilms tumor in renal mass. Immunohistochemistry for microsatellite instability was performed which showed loss of expression for MSH2/MSH6 and absence of BRAF mutation with presence of KRAS mutation. Diagnosis of wilms tumor with colorectal adenocarcinoma was made and possibility of constitutional mismatch repair deficiency was considered. A multidisciplinary approach is required for diagnosing synchronous malignancies and apart from clinical, radiological and histopathological studies, microsatellite instability testing in patients with colorectal carcinoma should also be considered to rule out Lynch syndrome or Constitutional Mismatch Repair Deficiency Syndrome. This report describes for the first time the coexistence of a colon carcinoma with Wilms tumor.
ORIGINAL RESEARCH ARTICLE | April 29, 2020
Morphometric Analysis of the Orbit in Dry Skulls of North Indian Population: A Direct Measurement Study
Introduction: Human orbit is a complex anatomical region, comprising visual apparatus along with its neurovascular structures. Morphometric analysis of orbit is of significant value for anthropologists, anatomists, forensic experts and surgeons. The objective of this study was to provide gender-related data on various orbital parameters in the North Indian population, and to compare the results with previous authors. Materials and Methods: The orbital dimensions of 86 dry adult skulls (45 males and 41 females) were used for direct measurement with vernier caliper. The calculation was carried out on both the right and the left sides. All the data obtained were tabulated and statistically analyzed. Results: The mean orbital height for males and females was 32.53 ±2.00 mm and 32.43 ±1.57 mm while the mean orbital width was 39.98 ±1.81 mm and 39.37 ±1.65 mm, respectively. The mean volume of the bony orbit was 26.09 ±2.15 ml in males, and 24.04 ±2.30 ml in females. Orbital index was calculated by using the formula Ht /Br x 100. The mean orbital index was 81.51 ±6.11 mm and 82.54 ±5.38 mm in males and females respectively, which classified both genders in the microseme category of orbit. There was no statistically significant difference observed between the right and left side of the orbital parameters. Conclusion: Comparison of findings with earlier research reveals that the anatomical character of the orbital cavity differs greatly, not only because of the diversity of the parameters used, but also because of ethnic variations, different methods of measurement and sample size. Data collected in the present investigation could serve as a baseline orbital morphometric data for the North Indian population, which is very useful during plastic surgery, maxillofacial and neurosurgery, as well as in forensic science.
ORIGINAL RESEARCH ARTICLE | April 29, 2020
Analysis of Expression of Myofibroblast in Oral Squamous Cell Carcinoma Cases: A Case-Control Study
Background: In the past couple of decades, considerable importance has been given on the role of myofibroblasts (MFs) in tumour progression and prognosis. Myofibroblasts create a physical barrier between carcinoma cells and immune system of the: body against cancer. Hence; the present study was undertaken for assessing the expression of myofibroblast in oral squamous cell carcinoma cases and comparing it with healthy controls. Materials & Methods: A total of 20 biopsy specimens of oral squamous cell carcinoma and 20 healthy controls were enrolled in the present study. Complete demographic details and clinical data of all the specimens were obtained from data records. Two sections were obtained from each specimen: one for staining immune-histo-chemically using α- SMA antibody (alpha-smooth muscle actin antibody) and other for staining with haematoxylin and eosin. Criteria described by Etemad-Moghadam S et al were used for evaluating the expression of myofibroblast. Based on these criteria, staining index was graded as zero, moderate and high. Blood capillaries were taken as positive controls. Comparison was done in between the OSCC group and the control group. All the results were recorded in Microsoft excel sheet and were analysed by SPSS software. Results: In the OSCC group, 90 percent of the cases had high staining index of myofibroblast, while the remaining 10 percent of the cases had moderate staining index. In the control group, all the specimens showed negative staining index. While comparing statistically, it was observed that mean staining was significantly higher among OSCC group in comparison to the control group. Conclusion: Myofibroblast play a definitive role in the invasive behaviour of OSCC. Hence, it is suggested that myofibroblasts might be used as a stromal marker for observing the severity and progression of OSCC.
ORIGINAL RESEARCH ARTICLE | April 30, 2020
In Vitro and In Silico Anti-Breast Cancer Analysis of Bioactive Metabolites of Bacillus subtilis Isolated From Soil
Ram Kumar A, Rajagopal. K, Meenambiga SS, Kumaresan S
Objective: Breast cancer is the most common cancer faced by women around the worldwide. The Estrogen receptor alpha (ERα) has been playing a major role in the stimulation of breast cancer. The present study aims to identify the anticancer activity of crude extract of Bacillus subtilis against breast cancer cell line by in vitro and in silico methods. Methods: The soil samples were collected from different regions in the reserve forests of Western Ghats of Nilgiris district in Tamil Nadu, India. Isolation of bacterial strain from the collected soil samples was performed by serial dilution method. Identification of bacterial strain was done by 16S rRNA sequencing analysis. The anti-cancer potential of crude extract of bacterial strain was tested against breast cancer cell line (MCF-7) by MTT assay. Further, the bioactive compounds found in the crude extract of bacterial strain was identified by GC-MS and the identified compounds was subjected to in silico docking studies against the targeted breast cancer protein Estrogen receptor alpha (ERα). Result: The bacterial strain isolated from the soil sample by serial dilution method was identified as Bacillus subtilis by 16S rRNA analysis. In vitro anti-breast cancer analysis of crude extract of Bacillus subtilis showed potential activity against MCF-7 breast cancer cell line with the IC50 value of 100μg/ml. The GC-MS analysis of the ethyl acetate extract of Bacillus subtilis showed twenty-six bioactive compounds. The compound Metaraminol showed maximum docking score -7.27 Kcal/mol against the target protein. Conclusion: The crude extract of soil bacterium showed potent anti-cancer activity against breast cancer cell lines. Further, the bioactive compounds showed good binding interactions with the virulence factor of breast cancer. Thus, the compounds of soil bacterium Bacillus subtilis could effectively used as leads for developing drugs against breast cancer.
Scholars Middle East Publishers
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