Investigating the effect of natural fermentation in modifying the physico-functional, structural and thermal characteristics of pearl and finger millet starch

BACKGROUND

In recent years, millets are often considered an emerging crop for sustainable agriculture. Therefore, millets can be exploited as an alternative source of starch which has many applications ranging from food, packaging, bioplastics, and others. However, starch is seldom used in its native form and is more often modified to enhance its functional properties. In literature, many traditional millet-based food recipes often incorporate a fermentation step before cooking. Therefore, using this traditional knowledge fermentation has been explored as a potential method for modifying millet starch.

RESULTS

Pearl millet (PM) and finger millet (FM) flour were allowed to naturally ferment for 24 h followed by starch extraction. Compared to native (N) starch, water/oil holding capacity and least gelation concentration of fermented (F) starch decreased with no significant change in swelling power. The solubility, paste clarity and in vitro digestibility of starch were significantly affected by fermentation. X-ray diffraction (XRD) data indicates that after fermentation, crystallinity increased while the A-type crystalline structure remained intact. Fourier-transform infrared (FTIR) spectra showed no deletion or addition of any new functional groups. Thermal characterization by differential scanning calorimetry (DSC) showed that the enthalpy of gelatinization of PM starch decreased while that of FM starch increased after fermentation.

CONCLUSION

The results indicate that 24 h natural fermentation had a significant impact on functional properties of starch without altering the structural architecture of starch granules. Therefore, fermentation can be further explored as a low-cost alternative for starch modification. © 2023 Society of Chemical Industry.

Dematiaceous Fungal Keratitis With Tentacles Mimicking Pythium Keratitis

This case report describes a diagnosis of Curvularia fungal keratitis in a man aged 60 years who presented with a paracentral corneal infiltrate in the right eye with tentacular projections.

Virtually selected phytochemicals from edible seeds as possible potential medicaments for hypercholesterolemia: an in silico approach

Hypercholesterolemia is one of the major health concerns in today's time. Bioactive compounds from various sources have been implicated in managing the conditions of Hypercholesterolemia. With advancements in research, several edible seeds have been explored in managing the disease. This study employs in silico approach to gain insights into the binding interactions of the bioactive compounds which are reportedly present in Edible seeds, against the protein HMG-CoA reductase, which plays a crucial role in cholesterol metabolism. The bioactive compounds were virtually screened and selected based on molecular docking studies which revealed the strong binding interactions of HMG-CoA reductase with Acacetin (-7.6 kcal/mol), Irilone (-7.5 kcal/mol), Orobanchol (-7.5 kcal/mol), Diadzein (-7.4 kcal/mol) and Malvidin (-7.4 kcal/mol). These compounds largely conformed to drug likeliness criteria and ADME properties with lesser mutagenic, hepatotoxic effects and higher absorption percentage in human intestine. Moreover, we performed molecular dynamics simulation studies for docked complexes to explore their stability under simulated conditions. Data gathered from this study will support the future in vitro and in vivo research in development of potential medicaments using the bioactive compounds from edible seeds for management of hypercholesterolemia.Communicated by Ramaswamy H. Sarma.

Development of rapid and non-destructive electric nose (E-nose) system for shelf life evaluation of different edible seeds

Shelf life estimation is crucial in ensuring the quality of food products. However, traditional methods are time-consuming and inefficient. Therefore, there is an urgent need for simple, efficient and rapid techniques for quality assessments. An electronic nose (E-nose) serves as a solution by rapidly and accurately detecting release of volatile organic compounds (VOCs) during food deterioration. This study aims to develop Arduino-Uno R3 microprocessor based E-nose, equipped with MQ4, MQ5, MQ9 and MQ135 sensors for evaluating shelf life of different edible seeds over the storage period of 150 days. Sensor values were recorded, revealing a significant increase (p-value ≤ 0.05) in MQ5 sensor readings for Nigella seeds from 349 to 480. Sensor values were positively correlated with physical, microbiological and Fourier-transform infrared (FTIR) spectroscopy parameters. Maximum peak shifts were observed from 3000 cm^-1 to 2800 cm^-1 and 1500 cm^-1 to 1000 cm^-1 wavenumbers. Hence, this study provides successful E-nose system to determine shelf life of seeds.

The effect of social determinants of health on severity of microbial keratitis presentation at a tertiary eye care hospital in Southern India

Purpose

Understanding the association between social determinants of health (SDoHs) and microbial keratitis (MK) can inform underlying risk for patients and identify risk factors associated with worse disease, such as presenting visual acuity (VA) and time to initial presentation.

Methods

This was a cross-sectional study was conducted with patients presenting with MK to the cornea clinic at a tertiary care hospital in Madurai, India. Patient demographics, SDoH survey responses, geographic pollution, and clinical features at presentation were collected. Descriptive statistics, univariate analysis, multi-variable linear regression models, and Poisson regression models were utilized.

Results

There were 51 patients evaluated. The mean age was 51.2 years (SD = 13.3); 33.3% were female and 55% did not visit a vision center (VC) prior to presenting to the clinic. The median presenting logarithm of the minimum angle of resolution (logMAR) VA was 1.1 [Snellen 20/240, inter-quartile range (IQR) = 20/80 to 20/4000]. The median time to presentation was 7 days (IQR = 4.5 to 10). The average particulate matter 2.5 (PM2.5) concentration, a measure of air pollution, for the districts from which the patients traveled was 24.3 μg/m3 (SD = 1.6). Age- and sex-adjusted linear regression and Poisson regression results showed that higher levels of PM2.5 were associated with 0.28 worse presenting logMAR VA (Snellen 2.8 lines, P = 0.002). Patients who did not visit a VC had a 100% longer time to presentation compared to those who did (incidence rate ratio = 2.0, 95% confidence interval = 1.3-3.0, P = 0.001).

Conclusion

Patient SDoH and environmental exposures can impact MK presentation. Understanding SDoH is important for public health and policy implications to mitigate eye health disparities in India.

Mechanistic insights into nanoparticle surface-bacterial membrane interactions in overcoming antibiotic resistance

Antimicrobial Resistance (AMR) raises a serious concern as it contributes to the global mortality by 5 million deaths per year. The overall impact pertaining to significant membrane changes, through broad spectrum drugs have rendered the bacteria resistant over the years. The economic expenditure due to increasing drug resistance poses a global burden on healthcare community and must be dealt with immediate effect. Nanoparticles (NP) have demonstrated inherent therapeutic potential or can serve as nanocarriers of antibiotics against multidrug resistant (MDR) pathogens. These carriers can mask the antibiotics and help evade the resistance mechanism of the bacteria. The targeted delivery can be fine-tuned through surface functionalization of Nanocarriers using aptamers, antibodies etc. This review covers various molecular mechanisms acquired by resistant bacteria towards membrane modification. Mechanistic insight on 'NP surface-bacterial membrane' interactions are crucial in deciding the role of NP as therapeutic. Finally, we highlight the potential accessible membrane targets for designing smart surface-functionalized nanocarriers which can act as bacteria-targeted robots over the existing clinically available antibiotics. As the bacterial strains around us continue to evolve into resistant versions, nanomedicine can offer promising and alternative tools in overcoming AMR.

Probiotics as multifaceted oral vaccines against colon cancer: A review

Probiotics are known as the live microorganisms that, upon adequate administration, elicit a health beneficial response inside the host. The probiotics are known as immunomodulators and exhibit anti-tumor properties. Advanced research has explored the potential use of probiotics as the oral vaccines without the latent risks of pathogenicity. Probiotic-based oral vaccines are known to induce mucosal immunity that prevents the host from several enteric infections. Probiotic bacteria have the ability to produce metabolites in the form of anti-inflammatory cytokines, which play an important role in the prevention of carcinogenesis and in the activation of the phagocytes that eliminate the preliminary stage cancer cells. This review discusses the advantages and disadvantages of using the oral probiotic vaccines as well as the mechanism of action of probiotics in colon cancer therapy. This review also employs the use of “PROBIO” database for selecting certain probiotics with immunomodulatory properties. Furthermore, the use of several probiotic bacteria as anti-colon cancer adjuvants has also been discussed in detail. Because the current studies and trials are more focused on using the attenuated pathogens instead of using the probiotic-based vaccines, future studies must involve the advanced research in exploiting the potential of several probiotic strains as adjuvants in cancer therapies.

Natural sources and encapsulating materials for probiotics delivery systems: Recent applications and challenges in functional food development

Probiotics are known as the live microorganisms which upon adequate administration elicit a health beneficial response inside the host by decreasing the luminal pH, eliminating the pathogenic bacteria in the gut as well as producing short chain fatty acids (SCFA). With advancements in research; probiotics have been explored as potential ingredients in foods. However, their use and applications in food industry have been limited due to restrictions of maintaining the viability of probiotic cells and targeting the successful delivery to gut. Encapsulation techniques have significant influence on increasing the viability rates of probiotic cells with the successful delivery of cells to the target site. Moreover, encapsulating techniques also prevent the live cells from harsh physiological conditions of gut. This review discusses several encapsulating techniques as well as materials derived from natural sources and nutraceutical compounds. In addition to this, this paper also comprehensively discusses the factors affecting the probiotics viability and evaluation of successful release and survival of probiotics under simulated gastric, intestinal conditions as well as bile, acid tolerant conditions. Lastly applications and challenges of using encapsulated bacteria in food industry for the development of novel functional foods have also been discussed in detail too. Future studies must include investigating the use of encapsulated bacterial formulations in in-vivo models for effective health beneficial properties as well as exploring the mechanisms behind the successful release of these formulations in gut, hence helping us to understand the encapsulation of probiotic cells in a meticulous manner.

Prevalence of incidental and total human immunodeficiency virus, hepatitis B and hepatitis C seropositivity among patients posted for cataract surgery at a tertiary care center in India

Purpose:

To study the prevalence of human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C (HCV) viral seropositive among the patients posted for cataract surgery at a tertiary care center in north India.

Methods:

It was a cross-sectional study done for 30 months duration. All the patients posted for cataract surgery underwent comprehensive ophthalmic evaluation followed by routine hematological workup, including viral markers for HIV, Hepatitis B surface antigen (HBsAg), and anti-HCV. Data were analyzed by the Statistical Package for Social Science (SPSS Version 20).

Results:

A total of 7,316 individuals underwent cataract surgery from Jan 2016 to August 2018, 4,073/7,316 (55.7%) were males. The prevalence for HIV was 58/7,316 (0.8%), HBsAg was 151/7,316 (2.1%), and HCV was 11/7,316 (0.1%); 28/58 (48.3%) HIV positives were unaware of their seropositivity till testing, as were 37/151 (24.5%) of HBsAg positives, and 4/11 (36.4%) HCV positives. There was a significant relationship between the mean age in the patients with HIV (P = 0.002) and anti-HCV (P = 0.045). A majority of the seropositive patients were found to be illiterate (45.6%), followed by educated up to high school level (29.1%), and graduate (25.0%).

Conclusion:

Viral seropositivity was significant among the patients posted for cataract surgery. The eye care providers could refer these patients for counseling and further management for the patient’s and their caretaker’s benefit.

Single center observational study of the efficacy of chemotherapy in breast cancer patients treated before and after the widespread use age of CD4/6 inhibitors: Is there evidence that chemotherapy response is impacted by prior use of CD4/6 inhibitors?

e13019

Background: Recently CD4/6 inhibitors have radically changed treatment pathways, leading to a deferment of chemotherapy for advanced disease. Patients still relapse following this treatment; we wish to share our experience of chemotherapy both before and after this change and explore whether there is a change in efficacy. In England CD4/6 inhibitors are prescribed according to the guidelines set out by NHS England (NICE), and are generally utilised in the first line setting unless there is visceral crisis. Methods: This is a retrospective double cohort observational single centre study comparing the efficacy of a chemotherapy regimen (vinorelbine and capecitabine vin cap) before and after the incorporation of CD4/6 inhibitors into breast cancer treatment (Jan 2017- Nov 20). The doublet chemotherapy is widely used at our centre providing a well tolerated and effective alternative to intravenous treatments such as taxanes or single agent capecitabine. Data was collected contemporaneously using e prescribing software and audited retrospectively Results: In the audit period n=19 treated with cap, n= 97 with vin cap, n= 24 treated with CD4/6, (of whom 5 relapsed). 5 patients received abemaciclib first line, as initial therapy, all G3, stage 11A or above, median number of cycles 4.2, I received ribociclib, G2, stage 111A, 7 cycles and 17 received palbociclib, 10 first line, 4 following 1 course chemo, 2 after 2 courses and 1 and after 3 courses, 30% G3 and 70% G2, mean number of cycles 11.06. Patients who received first line cap progressed after a median of 3.5 cycles, with a range of 0-22 months (RR= 47%), for cape vin a median of 8.6, a range of 0-60 months (RR=77%), post CD4/6 mean of 8, median of 9, a range of 0-17 (RR=80%). Conclusions: Those post CD4/6 requiring chemo relapsed far short of the median TTP of around 26months and may have specific characteristics predicting poor response to CD4/6. Despite small numbers salvage chemotherapy remains effective with similar responses. First line vin cap is more efficacious and better tolerated than Cap.[Table: see text]

A Novel GATA3 Variant Causing Familial Hypoparathyroidism, Renal Agenesis and Sensorineural Deafness Presenting With Atypical Symptoms of Chronic Hypocalcaemia

Introduction: Familial hypoparathyroidism is a rare cause of hypocalcaemia. We report a case of long-standing hypocalcaemia secondary to hypoparathyroidism caused by a novel GATA3 variant resulting in multiple organ involvement. Case: A 20 year old girl was referred to our bone metabolic clinic for hypocalcaemia. Her past medical history included Bechet’s disease, epilepsy and depression. She had bilateral sensorineural hearing loss and encephalitis as a child. She underwent right nephrectomy for an atrophic non-functioning kidney at the age of 16. Current medication included hydroxychloroquine, diazepam, oral calcium and cholecalciferol. It was noted that the hypocalcaemia dated back to 8 years, she denied any typical symptoms of hypocalcaemia but she did report visual and auditory hallucinations, fatigue and had low seizure threshold. She sustained recurrent fractures of her arm, elbow and wrist. Initial investigations: Corrected calcium 1.88 (2.20-2.60mmol/L), Phosphate 1.54 (0.80–1.50mmol/L), PTH 1.2 (1.6–6.9pmol/), 25-OH vitamin D 37 (50-120nmol/L). Myeloma screen, thyroid, renal and liver functions were all within the normal reference range. Other bone markers: Serum Procollagen Type 1 Amino Terminal Peptide was mildly raised at 82 (19-69ug/L), CTX 0.42 (0.1-0.5ug/L), 1,25 OH Vitamin D 29 (55-139pmol/L), 24,25-dihydroxyvitamin D was normal with normal 25:24,25 Dihyroxyvitamin D ratio at 18 normal. Bone density was in the normal range for her age. MRI of the brain was normal with no evidence of calcification. There was a family history of hypocalcemia in her estranged father. Subsequent genetic analysis showed a novel likely pathogenic GATA3 missense variant (c.961T>C p.(Cys321Arg). She was started on alfacalcidol and achieved near normocalcemia with adjusted calcium levels of 2.18nmol/L. Conclusion: Pathogenic variants in the GATA3 gene are responsible for Hypoparathyroidism-deafness-renal dysplasia (HDR) syndrome. In our patient, a novel missense variant in GATA3, p.(Cys321Arg), has been detected. This variant disrupts one of four conserved cysteine residues within a zinc-finger domain, which is involved in DNA binding and is presumed to have a deleterious effect on protein function. Patients may have longstanding asymptomatic hypocalcaemia with atypical features hence genetic testing is recommended in patient with multi-organ involvement. Alfacalcidol successfully restored calcium homeostasis in this case.

A Rare Case of Chronic Myeloid Leukemia with t(3;9;22) 3-way Translocation

Introduction/Objective

Chronic Myeloid Leukemia (CML) is a myeloproliferative neoplasm originating from malignant clonal proliferation of a pluripotent hematopoietic stem cell. CML is characterized by a reciprocal translocation between chromosomes 9 and 22, t(9;22)(q34;q11), that gives rise to an abnormal chromosome 22 called the Philadelphia (Ph) chromosome. The translocation results in the formation of a chimeric BCR-ABL1 fusion gene, which is the molecular hallmark of the disease. However, 5-10% of CML patients present with additional chromosomal abnormalities which is often considered a sign of clonal evolution, genetic instability, and is generally thought to portend a poor prognosis.

Methods

We present a case of CML with a rare 3- way translocation, t(3;9;22)(q21;q34;q11.2), who achieved a major molecular response on imatinib for 18 months. A review of the literature and Mitelman database search is presented focusing on the prognostic implications of this 3 way translocation in the era of tyrosine kinase inhibitors starting in 2001 till now.

Results

Twenty seven cases were reported, but the patient therapeutic response to imatinib and clinical outcome were only reported in 11 cases. Nine cases achieved a cytogenetic remission while the remaining two cases had an adverse outcome.

Conclusion

Taken in conjunction with the favorable outcome in our patient, we suggest that t(3;9;22) is not an adverse prognostic factor in the era of tyrosine kinase inhibitors.

P2238Prognostic value and incremental benefit of ischaemic myocardial burden subtended by non-invasive CT-derived fractional flow reserve (FFRCT) significant stenoses

Background

Fractional flow reserve derived from CT-coronary angiography (FFRCT) accurately identifies ischaemic vessels which may be associated with clinical outcomes. Its predictive value in grey zone FFRCT values between 0.7–0.8 is not defined. The technique permits estimation of burden of ischaemic myocardium subtended by FFRCT significant vessels.

Purpose

To evaluate the prognostic value and incremental benefit of FFRCT defined ischaemic myocardial burden when compared to FFRCT alone.

Methods

This is a subanalysis of NXT (Analysis of Coronary Blood-Flow Using CTA:Next-Steps), a prospective study of stable coronary artery disease (CAD) patients referred for invasive angiography (ICA) undergoing invasive FFR, CTA and FFRCT in whom treating physicians had been blinded to FFRCT results. Primary endpoint, defined as a composite of non-fatal myocardial infarction and any revascularisation, was determined in 206 patients (age 64±9.5 years, 64% male) and 618 vessels. Burden of ischaemic myocardium was defined as percentage of myocardium subtended beyond the point at which a vessel's FFRCT becomes ≤0.8 as estimated by APPROACH score (FFRCT-APPROACH). In significant FFRCT vessels, the predictive value and incremental benefit of FFRCT-APPROACH was compared with significant FFRCT (≤0.8) for primary endpoint as measured by area under the receiver operator characteristic curve (AUC). Significant ischaemic myocardial burden was defined as >10%. The incidence and relationship between the primary endpoint with each 10% increase in FFRCT-APPROACH and 0.05-unit decrease in FFRCT values ≤0.8 was determined.

Results

Significant FFRCT was identified in 52.9% of patients (109/206) and 29.3% of vessels (181/618). At 4.7 years median follow-up the incidence of the primary endpoint in vessels with significant FFRCT-APPROACH was 58.9% (96/163) which was comparable with vessels with significant FFRCT (55.2%,100/181; P=0.50). The predictive value of FFRCT-APPROACH for the primary endpoint was comparable with FFRCT (AUC 0.72 [95% CI 0.65–0.79] vs 0.71 [0.63–0.78], P=0.79). When combined, there was significant predictive improvement compared with FFRCT alone (AUC 0.77 [0.70–0.84]; P=0.01). The largest incremental benefit upon FFRCT was observed in vessels with FFRCT values in the grey zone between 0.70–0.80 (AUC 0.76 [0.65–0.86] vs 0.62 [0.48–0.74]; P<0.01). Each 10% increase in FFRCT-APPROACH (Adjusted-HR 1.36; 95% CI 1.16–1.60; P<0.001) and each 0.05-unit FFRCT decrease (Adjusted-HR 1.42; 1.19–1.70; P<0.001) were independently associated with significant increase in the incidence of the primary-endpoint.

Conclusion

In patients with stable CAD referred for ICA, the burden of ischaemic myocardium subtended by FFRCT significant vessels predicted non-fatal myocardial infarction and future revascularisation. This provided significant incremental benefit when used in combination with FFRCT particularly at FFRCT values in the grey zone between 0.7 to 0.8.

Abstract P5-13-07: Tolerance of HER-2 directed therapy for early stage breast cancer in a predominantly Hispanic population with high prevalence of cardiovascular risk factors

Introduction:

Trastuzumab based therapy is recommended for patients with early stage HER-2 overexpressing breast cancer, because it improves survival. Significant racial disparities exist in the receipt of trastuzumab with minorities being 25% less likely than whites in being treated with it. (Reeder-Hayes K et al, JCO 2016; 34:2003-2009).

Trastuzumab can affect cardiac function. Cardiac complications associated with trastuzumab are influenced by age and pre-existing risk factors including obesity, hypertension and diabetes mellitus. These co-morbidities occur more frequently in medically underserved minority populations and might influence the practitioner's decision regarding withholding the drug.

We previously identified a high prevalence of metabolic syndrome and obesity in our predominantly Hispanic, medically underserved patient population (SABCC 2015 abstract P1-09-07)). For this study, we analyzed the echocardiographic data and cardiac complications associated with trastuzumab use in this patient population.

Methods:

All patients diagnosed with early stage (stage 1, 2 or 3) HER 2 positive breast cancer between Jan 1st, 2010 and Jan 1st, 2015 at our institution were identified. Age, race, body mass index, pre-existing cardiovascular risk factors, and antihypertensive medication use was collected. Tumor size, nodal status, ER, PR and HER 2 status was recorded. All echocardiograms obtained were reviewed for ejection fraction changes. Repeated measures one sided ANOVA was used to analyze changes in EF. Hospitalization for cardiac complications was recorded. Early interruption of planned therapy and its reasons were recorded. Study was approved by the institutional IRB.

Results:

Sixty patient were treated with trastuzumab based chemo immunotherapy over the study period. 93% were Hispanic, median age was 61 years (Range 31-83), 40% had hypertension, 35% had dyslipidemia, 35% had glucose intolerance or type II diabetes mellitus and 70% were overweight or obese. 33% were dependent on charity care. 26% had stage 1, 37% had stage 2 and 37% had stage 3 cancer. Docetaxel, carboplatin, trastuzumab (TCH) was the most commonly used regimen (63%) followed by doxorubicin, cyclophosphamide, paclitaxel and transtuzumab (28%).

Ten patients (16.6%) required early discontinuation of cytotoxic chemotherapy. Only 1 patient was unable to complete planned 1 year of trastuzumab due to declining ejection fraction. There were no hospitalizations related to cardiac events during therapy.

Trastuzumab based treatment elicited statistically significant changes in LVEF over time, F (2,98) =13.974, p&lt;.0005, with LVEF decreasing from 65.4±.844 prior to therapy to 64.7±.724 during 3-6months of therapy and 62.2±.81 at the end of therapy. Two patients had a decline in LVEF ≥ 10%. Of these, 1 resolved at follow up ECHO in 6 weeks.

Conclusion

In a predominantly Hispanic, HER 2+ breast cancer cohort, with a high prevalence of cardiovascular risk factors and limited health care access, we found that the vast majority were able to complete 1 year of trastuzumab without significant cardiac complications. As trastuzumab improves survival, practitioners should adhere to national guidelines regarding its use as much as possible.

Citation Format: Gaur S, McAlice M, Alshaban A, Mahfoud A, Corral J, Philipovskiy A. Tolerance of HER-2 directed therapy for early stage breast cancer in a predominantly Hispanic population with high prevalence of cardiovascular risk factors [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-13-07.

Changes in prostate cancer detection rate of MRI-TRUS fusion vs systematic biopsy over time: evidence of a learning curve

BACKGROUND

To determine the effect of urologist and radiologist learning curves and changes in MRI-TRUS fusion platform during 9 years of NCI's experience with multiparametric magnetic resonance imaging (mpMRI)/TRUS fusion biopsy.

METHODS

A prospectively maintained database of patients undergoing mpMRI followed by fusion biopsy (Fbx) and systematic biopsy (Sbx) from 2007 to 2016 was reviewed. The patients were stratified based on the timing of first biopsy. Cohort 1 (7/2007-12/2010) accounted for learning curve. Cohort 2 (1/2011-5/2013) and cohort 3 (5/2013-4/2016) included patients biopsied prior to and after debut of a new software platform, respectively. Clinically significant (CS) disease was defined as Gleason 7 (3+4) or higher. McNemar's test compared cancer detection rates (CDRs) of Sbx and Fbx between time periods.

RESULTS

1528 patients were included in the study with 230, 537 and 761 patients included in three respective cohorts. Median age (interquartile range) was 61.0 (±9.0), 62.0 (±7.3), and 64.0 (±11.0) years in three cohorts, respectively (P<0.001). Fbx and Sbx had comparable CS CDR in cohort 1 (24.8 vs 22.2%, P=0.377). Fbx detected significantly more CS disease compared to Sbx in the following two periods (cohort 2: 31.5 vs 25.0%, P=0.001; cohort 3: 36.4 vs 30.3%, P<0.001) and detected significantly less low risk disease in the same period (cohort 2: 14.5 vs 19.6%, P<0.001; cohort 3: 12.6 vs 16.7%, P<0.001). Even after multivariate adjustment with age, PSA, race, clinical stage and MRI suspicion score, Fbx CS cancer detection increased in successive cohorts (cohort 2: OR 2.23, P=0.043; cohort 3: OR 2.92, P=0.007).

CONCLUSIONS

In the past 9 years, there has been significant improvement in the accuracy of Fbx. Our results show that after an early learning period, Fbx detected higher rates of CS cancer and lower rates of clinically insignificant cancer than Sbx. Software advances allowed for even greater detection of CS disease.

Note: Effect of Barley Flour, Wet Gluten and Ascorbic Acid on Bread Crumb Texture

Barley flour (0, 10 and 20% w/w), wet gluten (0, 7.5 and 15% w/w) and ascorbic acid (0, 10 and 20 ppm) were incorporated into wheat flour to prepare bread. The addition of barley flour alone tended to reduce bread volume whereas wet gluten and ascorbic acid improved loaf volume. Effect of staling on bread crumb texture was studied over a period of 72 h using an Instron universal testing machine. It was found that barley flour, ascorbic acid and wet gluten have antistaling effects and a synergistic effect was also observed since in combination the three ingredients had a greater antistaling effect. A regression model ( R2 > 0.8) is presented to predict the bread volume, cohesiveness and firmness of bread crumb.

Abstract P1-09-07: Effects of breast cancer treatment on markers of metabolic syndrome in a predominantly hispanic patient population

Background: Adjuvant chemotherapy improves survival in early breast cancer, however has been reported to contribute to weight gain and insulin resistance. Hispanics are reported to have higher levels of insulin resistance and features of metabolic syndrome as compared to caucasians and as such may be at higher risk of metabolic decompensation during treatment of their cancer. We sought to evaluate the effects of adjuvant/ neo-adjuvant breast cancer treatment on markers of metabolic syndrome in a predominantly hispanic population. Study was funded by the institutions department of medicine seed grant funds.

Methods: We enrolled 35 consecutive patients who were about to commence adjuvant or neo-adjuvant chemotherapy for breast cancer. Patients with diabetes mellitus or hyperlipidemia were excluded. Fasting glucose, HBA1C, insulin levels, HDL cholesterol, triglyceride levels, waist circumference and blood pressure were measured before starting chemotherapy and then every 3 months for 1 year. Results were analyzed using repeated measures ANOVA for normally distributed data. For data that was not normally distributed, Friedmans non parametric test was utilized.

A survey of dietary habits, exercise frequency and life style factors was administered before initiating treatment and at completion of the study.

Results:

Baseline characteristics: Of the 35 patients enrolled 31 were hispanics (89%). Median age was 47 years (33-68). 31 (82.8%) were over weight or obese. 13 (37%) had insulin resistance as assessed by HOMA (homeostatic model assessment)-IR, and 12 (34%) met the international diabetic federation (IDF) criteria for metabolic syndrome. 17% had stage 1, 52% had stage 2 and 31% had stage 3 disease. Most common chemotherapy regimen used was dose dense doxorubicin, cyclophosphamide and weekly paclitaxel.

No significant change was noted in the fasting glucose, HBA1C levels, insulin levels, HOMA-IR, weight or waist circumference at any point during the 1 year follow up. Triglyceride levels increased from a mean of 162.2mg/dl prior to therapy to 202.8mg/dl by 3 months, p=0.014. HDL-cholesterol fell from a mean of 50.6 mg/dl to 44mg/dl by 3 months, p=0.04.

Both triglyceride levels and HDL levels returned to baseline by 9 months and there was no change noted by 12 months. Overall 12 patients (34%) met the IDF criteria for metabolic syndrome before initiating adjuvant therapy as compared to 14 (40%) at 1 year.

Subgroup analysis of patients with preexisting metabolic syndrome, obesity or insulin resistance (HOMA-IR &gt;3.8) showed similar results.

Analysis of the survey data showed 22 of the 35 patients (62%) had improved their dietary and exercise habits over the course of the study.

Conclusions: Contrary to other studies, we did not find a significant difference in most of the parameters of metabolic syndrome in a predominantly hispanic patient population. A transient increase in triglyceride levels and a decline in HDL cholesterol level was noted at 3 months, however resolved by the 9th month of treatment. Our data suggests that life style modification may mitigate most of the metabolic adverse effects of therapy and women, at the time of diagnosis, may be particularly motivated to make such changes.

Citation Format: Gaur S, Ochoa C, Sanchez L, Nahleh Z. Effects of breast cancer treatment on markers of metabolic syndrome in a predominantly hispanic patient population. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-09-07.

An in-silico insight into the characteristics of β-propeller phytase

Phytase is an enzyme that is found extensively in the plant kingdom and in some species of bacteria and fungi. This paper identifies and analyses the available full length sequences of β-propeller phytases (BPP). BPP was chosen due to its potential applicability in the field of aquaculture. The sequences were obtained from the Uniprot database and subject to various online bioinformatics tools to elucidate the physio-chemical characteristics, secondary structures and active site compositions of BPP. Protparam and SOPMA were used to analyse the physiochemical and secondary structure characteristics, while the Expasy online modelling tool and CASTp were used to model the 3-D structure and identify the active sites of the BPP sequences. The amino acid compositions of the four sequences were compared and composed in a graphical format to identify similarities and highlight the potentially important amino acids that form the active site of BPP. This study aims to analyse BPP and contribute to the clarification of the molecular mechanism involved in the enzyme activity of BPP and contribute in part to the possibility of constructing a synthetic version of BPP.

Acute leukemia of ambiguous lineage with trisomy 4 as the sole cytogenetic abnormality: A case report and literature review

We describe a patient with acute leukemia of ambiguous lineage who had trisomy 4 as the sole cytogenetic abnormality. Clinical, pathological, immunophenotypic and molecular features are presented and compared with the previous 4 published cases. Over expression of c-kit, which is localized to chromosome 4, was documented on the leukemic blasts. Prognosis seems to be poor. Treatment with acute lymphoblastic leukemia like regimens seems to be superior compared to acute myeloid leukemia like regimens and allogeneic stem cell transplant is recommended after achieving remission.

•

Acute leukemia of ambiguous lineage with trisomy 4 as the sole abnormality is a rare disease.

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Clinical and pathological details of a case are presented and compared with prior 4 published cases.

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Over expression of c-kit, localized to chromosome 4, may play a pathogenic role in this disease.

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Prognosis seems to be poor.

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Treatment with ALL like regimens seems to be superior compared to AML like regimens.

A rare presentation of orbital complication of invasive fungal sinusitis in an immunocompetent young boy-a rare case

We present a case of allergic fungal sinusitis (AFS) in a 24 -year old man with history of left sided nasal obstruction and discharge since few years. Since few months he developed epiphora in the left eye associated with discomfort on eye movements. Patient was examined and CT with contrast was done. CT contrast showed an enhancing lesion in Left maxillary and ethmoid sinuses and erosion of the inferior bony wall of the orbit and medial wall of maxillary sinus. Though most patients of fungal sinusitis are immunocompromised but this patient was young male immunocompetent and made an unusual presentation with visual epiphora and painful eye movements. CT showed bony erosion of the Left inferior Bony wall of the Orbit and medial wall of Maxillary Sinus. After through examination and specific investigations, the patient was posted for surgery. We planed for Cald well –Luc’s Surgery and Endoscopic excision of the mass .Histological examination was reported as non malignant and microscopy showed Fungal Hyphae. After the surgery patient was discharged satisfactorily within couple of days and followed up regularly. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 48-51 DOI: http://dx.doi.org/10.3126/jcmsn.v8i1.6826

Pharmacotherapy for multidrug resistant tuberculosis

The current global concern in the treatment of tuberculosis (TB) is the emergence of resistance to the two most potent drugs namely, isoniazid and rifampicin. Emergence of multidrug resistance tuberculosis (MDR-TB) is now a health problem faced by most of the developing countries as well as developed countries across the globe. MDR-TB is a man-made disease that is caused by improper treatment, inadequate drug supplies, and poor patient supervision. HIV infection and AIDS have been implicated as important cause for this. The review of a published literature suggests that the most powerful predictor of treatment of MDR-TB is a history of treatment of TB. Although the treatment is efficacious, there are also a number of adverse effects caused by drugs used in the treatment of MDR-TB.

Multi-Criteria Decision Analysis for Identifying a Suitable Location for Groundwater Pumping Wells

The paper presents the methodology for the combined use of GIS-based multi-criteria analysis and simulation-optimisation modelling for management of the groundwater resources of the Dore river basin in France. The study identifies the suitable location and maximum discharge for the new groundwater pumping wells. The multi-criteria analysis (MCA), with the help of GIS-based geospatial analysis, was performed to identify those areas suitable for pumping wells by considering different criteria, such as hydraulic conductivity, land use, river aquifer exchange, depth to water, and geomorphology. Different criteria were selected with the help of regional experts and stakeholders. For the study area, the groundwater flow model was developed. Further, new pumping wells in the suitable zones, those identified by MCA, were considered and a simulation-optimisation technique was used to identify the maximum discharge from those wells. Finally, the results obtained from both the methods were to finalise the potential zone. The developed methodology proves to be a more realistic approach to identifying new locations for pumping wells.

Underweight in low socioeconomic status preschool children with severe early childhood caries

BACKGROUND

The prevalence of severe early childhood caries (sECC) is high in developing nations like India. It has local as well as systemic manifestations.

AIMS

This study evaluated the influence of sECC and its management on growth parameters and quality of life (QoL) of preschool children from low socioeconomic status families.

MATERIALS AND METHODS

100 preschool children (50 with sECC and 50 with no dental caries; mean age 5.42 ± 0.74 years) from low socioeconomic status were studied. QoL; Decayed, extracted and filled teeth (def) index; Height (Ht); Weight (Wt); Head circumference (HC); Mid arm circumference (MAC); and, Body Mass Index (BMI) were recorded at baseline and compared after six months of dental rehabilitation. The test group included children with sECC having def > 6 and at least one pulpally involved tooth.The control group children did not have DC (def =0). Both the groups were age, gender and socioeconomic status matched.

STATISTICAL ANALYSIS

Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) v.11.0 computer software. Chi-square test, Analysis of Variance (ANOVA), Fisher's exact and paired t tests were performed for comparing the groups at baseline and six month recall visit.

RESULTS

Baseline measurements showed that 46% of children with sECC had Wt below 3rd percentile (underweight; mean 15.49 ± 1.87Kg) which was less than the controls (mean Wt 16.34 ± 1.46 kg). They also complained of pain (40%), avoidance of hard food (24%), noticed Wt loss (18%) and sleep disturbances (12%). After 6 months of dental rehabilitation, there was a significant improvement in their Wt (P= 0.002) and QoL.

CONCLUSIONS

sECC negatively influenced the Wt and QoL of children. Awareness, education of parents and facilitation of oral health services may help in improving their Wt and QoL.

Oral findings in a child with lipoid proteinosis: a case report and review

Lipoid proteinosis, a very rare autosomal recessive genodermatosis, results in hyaline material deposition in the skin and mucous membrane of various organs leading to multisystem involvement. A case report of a 12-year-old female child is presented here who showed classic features of the disease with generalized thickening, hardening, and scarring of the skin and vocal cord infiltration causing voice changes. The patient also had numerous oral mucosal and dental findings. The knowledge of the clinical features of the disease may help the oral health professional in rendering the appropriate treatment in order to improve the quality of life deteriorated by the disease.

Purification of Protease from Pseudomonas thermaerum GW1 Isolated from Poultry Waste Site

An extracellular protease was purified from Pseudomonas thermaerum GW1 a new strain identified by morphological, biochemical and 16S rDNA sequencing. It was isolated from soil of Poultry waste site at Ghazipur near Ghaziabad, Delhi. The strain produces extra cellular protease in the culture media that was maintained at 37°C, 140 rpm. The media was harvested for protease after 48 hrs of incubation at 37°C in basal media supplemented with 1% casein. We report 6.08 fold purification of enzyme following ammonium sulphate precipitation and DEAE-cellulose chromatography. The molecular weight of the enzyme was estimated to be approximately 43,000 daltons as shown by casein zymography studies. The optimum pH for the proteolytic activity was pH 8.0 and enzyme remained stable between pH 5 -11 at 60°C. Interestingly Mn²⁺ (5mM) activated enzyme activity by 5 fold, while Cu²⁺, Mg²⁺and Ca²⁺ moderately activated enzyme activity, where as Zn²⁺, Fe²⁺ and Hg²⁺ inhibited enzyme activity. The protease produced was stable in presence of 50 % (v/v) ethylacetate and acetone. Isopropanol, methanol and benzene increased protease activity by 2.7, 1.3 and 1.1 fold respectively but was inhibited in presence of glycerol and DMSO. This organic solvent-stable protease could be used as a biocatalyst for enzymatic peptide synthesis

The impact of environmental risk factors on HIV-associated cognitive decline in children

Both the human immunodeficiency virus (HIV) and environmental stress have been independently associated with decreased cognitive functioning in children. Given that they are also known to have a strong relationship with each other, the present study sought to test the hypothesis that children in conditions of high environmental risk would be at greater risk for the cognitive complications related to immunosuppression. A retrospective review was conducted to examine the records of 141 children treated at a large pediatric AIDS clinic from 1993 to 2000. CD4+ lymphocyte levels were recorded from laboratory results and IQ scores were recorded from routine psychological evaluations. Key indicators of environmental risk were collected and combined into one measure of overall environmental risk. Pearson product moment correlations were conducted to examine the relationship between environmental risk, age-adjusted CD4 and IQ. Results indicated a significant correlation between CD4 and IQ, with higher levels of immunocompetence predicting higher IQ scores. When subjects were dichotomized based on their environmental risk score, there was no relationship between CD4 count and IQ in the low environmental risk group. In contrast, CD4 was positively associated with IQ in the high environmental risk group. It is proposed that this may be due to gp120 levels in immunocompromised children being particularly toxic to the hippocampus and cortex under conditions of high stress but not so under conditions of low stress.

A clonogenic study of arsenic trioxide (ATO) and temozolomide (TMZ) together and in combination with radiation therapy (RT) in a human glioma cell line

11506

Background: ATO is effective in the treatment of acute promyelocytic leukemia, but its role in the management of solid tumors has yet to be defined. Post-operative therapy consisting of TMZ with and without RT is considered the standard of care for patients with newly-diagnosed glioblastoma multiforme (GBM). ATO has been shown to potentiate the effects of RT in preclinical models. Therefore, we investigated the cytotoxicity of ATO and TMZ both together and in combination with RT in the U251T human glioma cell line. Methods: U251T cells in log phase growth were treated with ATO (0.05–5 μM) and/or TMZ (0.05–5 μM) for 24 hours or sequentially according to the following schedules: ATO for 18 hours followed by TMZ for 6 hours or the reverse sequence. For RT experiments, cells were treated with 0–10 Gy of ionizing RT using a Cesium-137 source. Following drug and/or RT treatment, cells were replated onto 1.5 cm tissue culture dishes in triplicate and incubated at 37oC for 8 to 10 days to form colonies. Colonies of more than 40 cells each were counted and the IC50 values and combination indices (CI) were derived using Calcusyn software (Biosoft, Cambridge, UK). Each combination was repeated at least 3 times. Results: The mean single agent IC50 for ATO, TMZ, and RT were 1.10 ± 0.28 μM, 1.88 ± 0.91 μM, and 2.62 ± 0.23 Gy, respectively. Simultaneous treatment with ATO and TMZ was slightly synergistic, while sequential treatment was either additive (TMZ→ATO) or synergistic (ATO→TMZ). Combinations of RT with ATO, TMZ or both were all synergistic, with the triple agent combination showing the greatest synergy. Conclusions: RT followed by ATO and TMZ given sequentially demonstrated striking synergy in U251T human glioma cells. A clinical trial of this combination therapy in patients with newly-diagnosed GBM is currently under development.

[Table: see text]

No significant financial relationships to disclose.

T-cell large granular lymphocytic leukemia and hereditary hemochromatosis: a fortuitous association?

We describe a patient with hereditary hemochromatosis (homozygous for C282Y mutation) and neutropenia who was found to have underlying T-cell large granular lymphocytic (T-LGL) leukemia. The diagnosis was confirmed by demonstrating T-cell receptor (TCR) gene rearrangement by polymerase chain reaction (PCR). Multiple quantitative and qualitative defects have been described for the T cells of patients with hemochromatosis. Although the association between the two may be fortuitous, this case report raises the possibility that the T cells in these patients may be susceptible to leukemic transformation as well.