Deletion of 3'CBFbeta in an inv(16)(p13.lq22) ascertained by fluorescence in situ hybridization and reverse-transcriptase polymerase chain reaction.
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Biomedical subjects
Publications and source records attributed to P Sharma.
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OBJECTIVES: Preliminary trials reflected the low prevalence of diabetes in Raica community consuming camel milk habitually. Our objective was to describe the prevalence and clinical factors associated with impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and diabetes (DM) among adults (>or=20 years) in large population group. DESIGN: Population based, cross sectional study METHODS: 2099 participants from different villages of north-west Rajasthan were selected using stratified sampling of a representative Raica and non-Raica Community, consuming or not consuming camel milk. Demographic, clinical, anthropometric parameters were obtained and oral glucose tolerance tests were performed in all individuals to diagnose IFG, IGT and DM. Associations were investigated using multivariate logistic regression using SPSS Version 10.0. RESULTS: In the present study, the prevalence of diabetes in Raica community consuming camel milk (RCCM, n=501) was 0%; Raica community not consuming camel milk (RCNCM, n=554) was 0.7%; non-Raica community consuming milk (NRCCM, n=515) was 0.4% and non-Raica community not consuming camel milk (NRCNCM, n=529) was 5.5%. Stepwise logistic regression analysis showed that consumption of camel milk was statistically highly significant as protective factor for diabetes. Multiple logistic regression analysis revealed that camel milk consumption and community factor were associated with decreased prevalence of diabetes. CONCLUSION: Camel milk consumption and lifestyle have definite influence on prevalence of diabetes. Hence, adopting such life pattern may play protective role in preventing diabetes to some extent.
Pyrazinamide (PZA) is an important first-line antituberculosis drug because of its sterilizing activity against semidormant tubercle bacilli. In spite of its very high in vivo activity, its in vitro activity is not apparent unless an acidic environment is available, which makes PZA susceptibility testing difficult by conventional methods. The present study was, therefore, planned to assess the performance of the colorimetric BacT/ALERT 3D system and compare the results with those from conventional tests, i.e., the Löwenstein-Jensen (LJ) proportion method (pH 4.85) and Wayne's pyrazinamidase (PZase) assay, using 107 clinical isolates. The concordance among all of these tests was 89.71% after the first round of testing and reached 92.52% after resolution of the discordant results by retesting. Prolonged incubation of the PZase tube for up to 10 days was found to increase the specificity of the PZase test. The concordances between LJ proportion and BacT/ALERT 3D, LJ proportion and the PZase assay, and BacT/ALERT 3D and the PZase assay were found to be 99.06%, 93.46%, and 92.52%, respectively. Using the LJ results as the gold standard, the sensitivities of BacT/ALERT 3D and the PZase assay were 100 and 82.85%, respectively, while the specificity was 98.61% for both of the tests. The difference between the sensitivities of BacT/ALERT 3D and the PZase assay was significant (P = 0.025). The mean turnaround times for the detection of resistant and susceptible results by BacT/ALERT 3D were 8.04 and 11.32 days, respectively. While the major limitations associated with the PZase assay and the LJ proportion method are lower sensitivity in previously treated patients and a longer time requirement, respectively, the BacT/ALERT 3D system was found to be rapid, highly sensitive, and specific.
We report seasonal variation in CH(4) and N(2)O emission rate from solid storage of bovine manure in Delhi as well as emission factors and emission inventory from manure management systems in India. Emission flux observed in the year 2002-2003 was 4.29+/-1, 4.84+/-2.44 and 12.92+/-4.25 mg CH(4)kg(-1)dung day(-1), as well as 31.29+/-4.93, 72.11+/-16.22 and 6.39+/-1.76 microgN(2)O kg(-1)dung day(-1) in winter, summer and rainy seasons, respectively. CH(4) emission factors varied from 0.8 to 3.3 kg hd(-1)year(-1) for bovines and were lower than IPCC-1996 default values. N(2)O emission factors varied from 3 to 11.7 mg hd(-1)year(-1) from solid storage of manure. Inventory estimates were found to about 698+/-27 Gg CH(4) from all manure management systems and 2.3+/-0.46 tons of N(2)O from solid storage of manure for the year 2000.
We report the results of experiments that establish the possibility of bringing about multiple ionization and Coulomb explosion of molecular clusters with nanosecond laser pulses at intensities as small as 10(9) W cm(-2). We demonstrate several new facets of the laser-cluster interaction in the low-intensity, long-pulse domain: (i) The choice of laser wavelength for a given cluster species is very crucial. (ii) Excited electronic states play a very important role in the ionization dynamics. (iii) When field ionization is insignificant and ponderomotive energies are very small, it is energy pooling rather than inverse bremsstrahlung that determines how clusters absorb energy from the optical field.
Encoding protein 3D structures into 1D string using short structural prototypes or structural alphabets opens a new front for structure comparison and analysis. Using the well-documented 16 motifs of Protein Blocks (PBs) as structural alphabet, we have developed a methodology to compare protein structures that are encoded as sequences of PBs by aligning them using dynamic programming which uses a substitution matrix for PBs. This methodology is implemented in the applications available in Protein Block Expert (PBE) server. PBE addresses common issues in the field of protein structure analysis such as comparison of proteins structures and identification of protein structures in structural databanks that resemble a given structure. PBE-T provides facility to transform any PDB file into sequences of PBs. PBE-ALIGNc performs comparison of two protein structures based on the alignment of their corresponding PB sequences. PBE-ALIGNm is a facility for mining SCOP database for similar structures based on the alignment of PBs. Besides, PBE provides an interface to a database (PBE-SAdb) of preprocessed PB sequences from SCOP culled at 95% and of all-against-all pairwise PB alignments at family and superfamily levels. PBE server is freely available at http://bioinformatics.univ-reunion.fr/PBE/.
PURPOSE: The study was conducted to assess the marital status and fertility in adults with epilepsy. METHODS: The study group consisted of 240 subjects with epilepsy aged 15 and above, Unmarried males (m) 55, unmarried females (f) 73 and married males 48, married females 64. Data was collected according to standard protocol regarding age, sex, age at marriage and onset of seizure, effect of epilepsy on marriage, type of seizure and control, fertility pattern and abortions. The study group was followed up for 30 months. The data was compared with latest available state and national data using Student's 't'-test, chi square, Fisher Z-test. RESULTS: The mean age of married subjects was 26.19 + 6.2 years and of the unmarried was 24.94 +/- 7.1 years. People with epilepsy had significantly (p < 0.05) higher mean age at marriage, significantly (p < 0.05) lower rate of marriage (m 46.6% f 46.72%), significantly (p < 0.05) higher divorce rate and withheld marriage. Females compared to males had higher divorce rate (f 5.84%) and withheld marriage (m 5.45% f 10.96%). The marriage rate of subjects with onset of epilepsy in the first decade (m 38.71% f 34.09%) and second decade (m 33.33% f 35.42%) was significantly lower (p < 0.05) than that of subjects with age at onset of epilepsy greater than 20 years (m 66.67% f 71.11%). Subjects with epilepsy not in remission had significantly (p < 0.05) higher mean age at marriage, lower marriage rate and lower fertility per person-year of marriage than those in remission. Majority (95.54%) did not disclose epilepsy before marriage. Total fertility rate (TFR) in males (4.56) and females (5.45) with epilepsy was comparable to general population. Abortions per pregnancy were 4.76%. CONCLUSION: Subjects with epilepsy had lower marriage prevalence rate, delayed marriage (especially females), withheld marriage and higher divorce rate compared to general population. Marriage rate was lower in people with age at onset of epilepsy less than 20 years and in whom seizures were not in remission. Majority of people with epilepsy did not disclose epilepsy before marriage. Though fertility was not affected in people with epilepsy as compared to general population, males had lower fertility than females.
The liver organ allocation policy of the United Network for Organ Sharing (UNOS) is based on the model for end-stage liver disease (MELD). The policy provides additional priority for candidates with hepatocellular carcinoma (HCC) who are awaiting deceased donor liver transplantation (DDLT). However, this priority was reduced on February 27, 2003 to a MELD of 20 for stage T1 and of 24 for stage T2 HCC. The aim of this study was to determine the impact of reduced priority on HCC candidate survival while on the waiting list. The UNOS database was reviewed for all HCC candidates listed after February 27, 2002, The HCC candidates were grouped into two time periods: MELD 1 (listed between February 27, 2002, and February 26, 2003) and MELD 2 (listed between February 27, 2003 and February 26, 2004). For the two time periods, the national DDLT incidence rates for HCC patients were 1.44 versus 1.53 DDLT per person-year (p = NS) and the waiting times were similar for the two periods (138.0 +/- 196.8 vs. 129.0 +/- 133.8 days; p = NS). Furthermore, the 3-, 6- and 12-month candidate, patient survival and dropout rates were also similar nationally. Regional differences in rates of DDLT for HCC were observed during both MELD periods. Consequently, the reduced MELD score for stage T1 and T2 HCC candidates awaiting DDLT has not had an impact nationally either on their survival on the waiting list or on their ability to obtain a liver transplant within a reasonable time frame. However, regional variations point to the need for reform in how organs are allocated for HCC at the regional level.
A new series of 5-[2-(2-methylprop1-enyl)-1H benzimidazol-1yl]-4,6-diphenyl-pyrimidin-2-(5H)-thione derivatives [3a-q] has been synthesized and subjected to evaluate their antibacterial properties. All the synthesized compounds of the series displayed, remarkable activity in comparison to standard drug (ampicillin). A number of descriptors were tested to adjudge a quantitative correlation between activity and structural features. However, significant correlations have emerged between activity and physicochemical parameters viz. polarizability parameter (MR). Moreover, results are interpreted on the basis of multiple regression and cross-validation methodology.
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BACKGROUND AND STUDY AIMS: There have been no multicenter studies investigating the use of magnification chromoendoscopy (MCE) for the detection of intestinal metaplasia and dysplasia/cancer in Barrett's esophagus. Our aims were to assess the ability of MCE to predict the histological diagnosis (non-biopsy detection), to compare the yield of MCE-targeted versus random biopsies for dysplasia, and to compare procedure times. PATIENTS AND METHODS: In this prospective multicenter study, patients with known or suspected Barrett's esophagus underwent MCE with indigo carmine dye staining. Three mucosal patterns (ridge/villous, circular, and irregular/distorted) were standardized, based on past experience. Mucosal patterns were noted and target biopsies were obtained only if irregular/distorted patterns were identified. Otherwise, random four-quadrant biopsies were obtained. RESULTS: A total of 56 patients (mean age 64 years, mean length of Barrett's esophagus 2.7cm) were prospectively evaluated: 38 patients (67.8 %) had ridge/villous patterns, four patients (7.1 %) had circular patterns, four patients (7.1 %) had irregular/distorted patterns, and ten patients (17.8 %) had a combination of patterns. Histologically, intestinal metaplasia was not shown in eight patients (14.2 %), nondysplastic Barrett's esophagus was diagnosed in 30 patients (53.5 %), low-grade dysplasia was detected in 12 patients (21.4 %), and high-grade dysplasia was detected in six patients (10.7 %). An irregular/distorted pattern either throughout the entire segment of Barrett's esophagus or in combination with a ridge/villous or circular pattern had a sensitivity or 83 %, a specificity of 88 %, a positive predictive value of 45 %, and a negative predictive value of 98 % for high-grade dysplasia. The yield of high-grade dysplasia was similar for the two techniques but the time taken to perform MCE was less than the time taken to perform random biopsies. CONCLUSION: An irregular/distorted pattern is specific for high-grade dysplasia and so it may not be necessary to perform biopsies in patients with ridge/villous or circular mucosal patterns.
Leiomyosarcoma of the inferior vena cava is a rare primary tumour. We present a case report of a 67-year-old man with a long history of abdominal pain and gastroesophageal reflux, who was found to have a large retroperitoneal mass confirmed to be a leiomyosarcoma. The clinical and imaging features are outlined, and in addition the treatment and prognosis.
BACKGROUND: Many modalities have been used to ablate Barrett's oesophagus (BO). However, long term results and comparative effectiveness are unknown. AIMS: Our aim was to compare the long term efficacy of achieving complete reversal (endoscopic and histological) between multipolar electrocoagulation (MPEC) and argon plasma coagulation (APC) in BO patients and assess factors influencing successful ablation. METHODS: Patients with BO, 2-6 cm long, underwent 24 hour pH testing on proton pump inhibitor (PPI) therapy. Patients were then randomised by BO length to undergo ablation with MPEC or APC every 4-8 weeks until endoscopic reversal or maximal of six treatment sessions. RESULTS: Thirty five BO patients have been followed for at least two years following endoscopic ablation, 16 treated with MPEC and 19 with APC. There was complete reversal of BO in 24 patients (69%); 75% with MPEC and 63% with APC (p = 0.49). There was no difference in the number of sessions required in the two groups. There was no difference in age, pH results, BO length, PPI dose, or hiatal hernia size between patients with and without complete reversal. One patient developed an oesophageal stricture but there were no major complications such as bleeding or perforation. CONCLUSIONS: In BO patients treated with MPEC or APC in combination with acid suppression, at long term follow up, complete reversal of BO can be maintained in approximately 70% of patients, irrespective of the technique. There are no predictors associated with achieving complete reversal of BO. Continued surveillance is still indicated in the post ablative setting. As yet, these techniques are not ready for clinical application (other than for high grade dysplasia or early oesophageal adenocarcinoma) and cannot be offered outside the research arena.
BACKGROUND: There is increasing interest in the management of stroke in ethnic minorities but few studies have considered this issue. This study investigated if differences in acute stroke management exist between a white European and Bangladeshi populations living in London, England. METHODS: All stroke surviving patients discharged over a five year period in a major London teaching hospital based in an ethnically diverse area of inner city London were recruited. Cerebrovascular risk factors, their management, and investigation for acute stroke syndromes were recorded and comparison between white and Bangladeshi cohorts was made. Categorical data were analysed using Fisher's exact test. RESULTS: Measurement of cholesterol concentrations are undertaken less often in those from a Bangladeshi background (25%) compared with white Europeans (76%) (p<0.0001). Statin therapy tends to be given less often to Bangladeshis. However, neuroimaging (p<0.05) and echocardiography (p<0.0001) is performed more often in Bangladeshis compared with white Europeans. CONCLUSION: There are variations in the management of acute stroke because of ethnicity and these variations could have substantial consequences on secondary rates of cerebrovascular and cardiovascular disease. Whether the reasons for this disparity are attributable to inequity or iniquity of care need to be further investigated perhaps along with the development of ethnicity specific protocols. Overall the management of stroke and its risk factors in either racial group remains lamentable.
The effectiveness and success of antitubercular therapy is mainly measured by identifying the organism in sputum. In certain patients, especially in geriatric patients, available tuberculosis tests are not satisfactory and do not provide enough information on the effectiveness of antitubercular therapy, as the symptoms might be confused with the existing symptoms of ongoing diseases. Therefore, 60 diagnosed and randomly selected patients with tuberculosis were included into this study. The patients with other associated diseases likely to influence serum copper and zinc were not included in the study. The estimations of serum copper and zinc were done in healthy volunteers and in tubercular patients before the start of treatment and after 4 wk of antitubercular treatment. The average plasma concentration of serum copper and zinc in healthy volunteers were 102 +/- 20 microg/dL and 96 +/- 18 microg/dL respectively. In tuberculosis patients, serum copper and zinc levels were 123.65 +/- 9.98 microg/dL and 64.14 +/- 3.97 microg/dL, respectively, before the start of treatment, which came down to 116.23 +/- 4.27 mug/dL and 74.31 +/- 3.60 microg/dL, respectively, after 4 wk of antitubercular treatment.
Diarrhea is, in reality, as much a nutritional disease as one of fluid and electrolyte loss. Children who die from diarrhea, despite good management of dehydration, are usually malnourished and often severely so. In this study, we determined the serum levels of zinc and copper before and after standard oral rehydration solution (ORS) therapy in children with acute diarrhea and correlated it with diarrheal duration and severity. One hundred ten children suffering from acute diarrhea were included. Serum zinc and copper levels of these children were estimated at the time of enrollment and after treatment with standard ORS therapy. This study shows that children suffering from acute diarrhea show a statistically significant decrease of 13.1% and 12.8% in serum zinc and copper concentrations, respectively, compared to normal. These levels further decrease by 22.6% and 22.4%, respectively, after treatment with standard ORS therapy. Our study shows that children with the lower plasma zinc and copper levels suffered with more severe and longer duration of diarrhea. Zinc and copper supplementation could be added to standard ORS therapy for the reduction in morbidity and mortality associated with acute diarrhea in children.
Choriocarcinoma is a gestational trophoblastic tumour with a high metastatic potential but presentation with gastrointestinal haemorrhage due to jejunal mucosal metastasis is very rare. A 25-year-old Nepali woman presented with severe anaemia and massive gastrointestinal haemorrhage after normal pregnancy following evacuation of a hydatiform mole. During laparotomy, the patient was found to have extensive jejunal mucosal metastases.
Bladder cancer is a major cause of new cancer diagnosis throughout the world. The standard therapy for muscle-invasive bladder cancer is radical cystectomy, while superficial bladder cancer can often be managed with serial resections or intravesical therapy. The 5-year overall survival for patients undergoing radical cystectomy is only about 50%, with the majority of deaths due to metastatic bladder cancer. For these patients and for those who have metastases at diagnosis, chemotherapy with the combination of methotrexate, vinblastine, doxorubicin, and cisplatin is still the standard treatment. Gemcitabine, taxanes, ifosfamide, and pemetrexed have also demonstrated activity in bladder cancer, allowing the development of less toxic chemotherapy regimens that are the subject of ongoing clinical research. Recent insights into the biology of bladder cancer, the introduction of new chemotherapy regimens, and randomized trials of perioperative chemo-therapy have significantly improved the outlook for patients with metastatic bladder cancer. Molecular markers appear to correlate with prognosis after cystectomy, but require further clinical validation and have not replaced pathologic staging for the purpose of making adjuvant treatment decisions. Recent advances in the fields of tumor genetics, angiogenesis, and tumor immunology have been applied in the ongoing development of novel treatment strategies for this challenging disease.