Demographical and Epidemiological Contribution to Cancer Incidence in Delhi and Its Trends from 1991-2015

INTRODUCTION

Cancer incidences are rising worldwide, and India ranked third globally in cancer incidence as of 2020, according to estimates from GLOBOCAN. The three components that contributed to changes in cancer incidence include cancer-related risk factors, population size, and population structure. The present study aim is to derive the contribution of these factors to cancer incidence and to evaluate their trend from 1991 to 2015.

METHODS

The Data were extracted from the Delhi population-based cancer registry published reports. This longstanding registry covers nearly 100% of the Delhi population. The secular trends of cancer incidence from 1991-2015 were assessed for all sites combined as well as top-five cancer sites among males and females. Joinpoint regression and Riskdiff software were performed to assess the trend among the components of cancer incidence change.

RESULTS

Both males and females exhibited nearly equal age-standardised incidence rates over 25 years. Albeit, an overall trend in age-standardised rate was not significant for both sexes (0.68% for males and -0.16% for females) when considering all cancer sites combined. Lung, prostate, oral, and gallbladder cancer exhibits a significant rising trend in the age-standardised rates in males while in females only breast and endometrial cancer showed a rising trend. The cancer counts surged by 252% in males and 208.5% in females from 1991 to 2015. The population size component contributed a 180% increase in males and a 170% increase in females, respectively. The site-specific risk changes were more than 100% for the prostate, oral, and gallbladder cancers in males and endometrial cancer in females. The population structure (aging) contributed to rising cancer incidence varying from 35% to 60% in both genders.

CONCLUSION

A significant contribution to new cancer cases was observed due to a demographical shift in both population size and structure, in addition to plausible cancer-specific risk factors. This transformation could surge a potential burden on the Delhi healthcare system. Persistent endeavours are essential to expand and enhance the existing cancer care infrastructure to meet the rising demand driven by aging and population growth. Implementing a stringent population policy can help to mitigate the impact of population growth on cancer incidence.

Synthesis and characterization of marine seagrass (Cymodocea serrulata) mediated titanium dioxide nanoparticles for antibacterial, antibiofilm and antioxidant properties

Cymodocea serrulata mediated titanium dioxide nanoparticles (TiO2 NPs) were successfully synthesized. The XRD pattern and FTIR spectra demonstrated the crystalline structure of TiO2 NPs and the presence of phenols, flavonoids and alkaloids in the extract. Further SEM revealed that TiO2 NPs has uniform structure and spherical in shape with their size ranged from 58 to 117 nm. Antibacterial activity of TiO2 NPs against methicillin-resistant Staphylococcus aureus (MRSA) and Vibrio cholerae (V. cholerae), provided the zone of inhibition of 33.9 ± 1.7 and 36.3 ± 1.9 mm, respectively at 100 μg/mL concentration. MIC of TiO2 NPs against MRSA and V. cholerae showed 84% and 87% inhibition at 180 μg/mL and 160 μg/mL respectively. Subsequently, the sub-MIC of V. cholerae demonstrated minimal or no impact on bacterial growth at concentration of 42.5 μg/mL concentration. In addition, TiO2 NPs exhibited their ability to inhibit the biofilm forming V. cholerae which caused distinct morphological and intercellular damages analysed using CLSM and TEM. The antioxidant properties of TiO2 NPs were demonstrated through TAA and DPPH assays and exposed its scavenging activity with IC50 value of 36.42 and 68.85 μg/mL which denotes its valuable antioxidant properties with potential health benefits. Importantly, the brine shrimp based lethality experiment yielded a low cytotoxic effect with 13% mortality at 100 μg/mL. In conclusion, the multifaceted attributes of C. serrulata mediated TiO2 NPs encompassed the antibacterial, antioxidant and anti-biofilm inhibition effects with low cytotoxicity in nature were highlighted in this study and proved the bioderived TiO2 NPs could be used as a promising agent for biomedical applications.

Metal tolerance and biosorption of Pb ions by Bacillus cereus RMN 1 (MK521259) isolated from metal contaminated sites

Recent years, metal pollution is an alarming factor to know about protects the environmental ecosystem due to the toxic, persistent and abundant in nature. Metals are present everywhere in the biotic and abiotic samples including soil, water, and microbes. The rate of bioaccumulation and biotransformation are very high. The excess concentration of the metals causes heavy metal pollution or contamination. Due to these defects, the removal of metals using biological sources is heightened in the current research. In this current investigation, the biosorption potential ability of the metal tolerable Bacillus cereus on Pb and Cu rich environment was chosen and thoroughly monitored. The 16s rRNA of the Bacillus cereus was sequenced, and named as Bacillus cereus RMN 1 (MK521259). The various test concentration (10-60 mg/mL) of Pb and Cu was exhibited the maximum removal percentages of 85.2% and 60.2%. The result of bisorption factors exhibited, 300 mg/mL of the biosorbent potency, 60 min contact time and pH 7, and they found to be optimal to remove the maximum of Pb ion from the solution. In the regression coefficients, the Freundlich and Langmuir isotherm models were used to study the adsorption kinetics of metal ions. In addition, the isotherm model confirmed that the of B. cereus biomass medicated metal adsorption was more favourable reaction for metal degradation. With the above evidences, the results of the present investigation proved that B. cereus derived biomass was actively adsorbing the metals ions. Thus we are recommending for the implementation of effective waste water treatment.

The Trend and Prediction of Cervical Cancer Incidence in Delhi, India: An Age-Period-Cohort Analysis

OBJECTIVE

The objective of the study is to assess the trend of age-standardised incidence rate (ASIRs) of cervical cancer, standardised median age at diagnosis, and projection of cervical cancer incidence rate and the number of new cases up to 2030. The projections help in making strategies for resource allocation to circumvent the future burden.

METHODS

The data were extracted from the Delhi population-based cancer registry from 1990 to 2014. Joinpoint regression analysis was applied to ASIRs to assess the trend. The natural cubic splines age-period-cohort (APC) model was fitted to project the incidence rate and incidence cases. The trend of standardised median age at diagnosis and percentage of cervical cancer to total women cancer was also assessed using regression analysis. Projections of new cases are decomposed into three components aging, the structure of the population, and age-specific incidence rate.

RESULTS

The age-standardised incidence rate of cervical cancer decreased with an annual decline at a rate of 2.98% (95% CI -3.48 to -2.47) from 1990 to 2014. The standardised median age at diagnosis showed an upward trend with an average annual increase of 0.167 per year and the median age increased by 4.18 years during 25-years period, this change was due to the shifting of the peak from 40-44 in 1990 to 60-64 in 2014. The APC model revealed ASIRs would decline by 43.8% in 2030 compared to average ASIRs 2010-2014, albeit a net 12% increase in the incidence cases. An increase in incidence cases is primarily attributed to the aging of the population and population  growth by 38.87% and 33.84% respectively.  The trend analysis of  cervical cancer ASIRs in pre (< 50 years) and post menopause (≥ 50 years) showed a decreasing trend. However, the ratio of cervical to total women increased over time from 1:1 in 1990 to 2:3 in 2014.

CONCLUSION

The declining trend in ASIRs was observed in Delhi and will continue to decrease up to 2030.  The burden of the number of new cases of cervical cancer showed an upward trend primarily due to the aging of the population and shifting of population structure. To counter this big challenge a cost-effective vaccination for vulnerable populations, community-based screening programs, and awareness about cervical cancer prevention might help in eliminating this preventable cancer.

Isolation and molecular identification of biofilm producing P. aeruginosa and K. pneumoniae from urinary tract infections patient urine sample

BACKGROUND

Recent years, multi drug resistant pathogens and their pathogenicity were increased worldwide due to unauthorized consumption of antibiotics. In addition, correlation between multi drug resistant bacteria and biofilm formation is heightened due to the production of more virulence behavior. There is no better identification methods are available for detection of biofilm producing gram negative bacteria.

MATERIALS AND METHODS

In this research work, multi drug resistant strains of Pseudomonas aeruginosa (P. aeruginosa) and Klebsiella pneumoniae (K. pneumoniae) were identified based on the specific antibiotics and third generation cephalosporin discs by disc diffusion assay. Subsequently, biofilm forming ability of selected pathogens were identified tissue culture plate and tube test. Based on the multi-drug resistant ability and biofilm production, the molecular identification of P. aeruginosa and K. pneumoniae were confirmed by PCR using universal primers.

RESULTS AND CONCLUSIONS

No zone of inhibition present around the discs of muller hinton agar plates were confirm, selected P. aeruginosa and K. pneumoniae strains were multi drug resistant pathogens. Performed third generation cephalosporin antibiotics were also highly sensitive to selected pathogens of P. aeruginosa and K. pneumoniae. Further, biofilm forming ability of selected P. aeruginosa and K. pneumoniae was confirmed by tissue culture plate and tube methods. Finally, molecular identification of P. aeruginosa and K. pneumoniae was named as P. aeruginosa and K. pneumoniae. Our result was conclude, selected P. aeruginosa and K. pneumoniae as biofilm producing pathogens and also highly resistant to current antibiotics.

Isolation and molecular identification of extended spectrum beta-lactamase producing bacteria from urinary tract infection

BACKGROUND

Recent years, the treatment of multi-drug resistant bacteria and their effect are very difficult due to the virulence factors modification. Based on the world wide thread, we have tried to identify the ESBLs producing bacteria from urinary tract infection patients. In result, the highly antibiotic resistant effect of Pseudomonas aeruginosa and Klebsiella pneumoniae were identified.

METHODS

Initially, Hexa disc diffusion method was performed to detect the multi-drug resistant bacteria using respective antibiotics of HX066, HX033 and HX077, HX012 discs. Consecutively, the ESBL producing ability of confirmed multi drug resistant bacteria was performed to detect their ESBL producing ability using specific extended spectrum beta lactamase (ESBLs) detection discs of Hexa G-minus 24. Furthermore, the ESBL producing ability of the bacteria was confirmed by ESBLs detection Ezy MIC™ E-test stripe method.

RESULTS AND CONCLUSIONS

In result, 10, 5 and 4 mm and 10, 14 and 8 mm zone of inhibition against imipenem (IPM), Ticarcillin/Clavulanic acid (TCC), Cefoperazone (CPZ) and Ampicillin (AMP), Norfloxacin (NX), Nalidixic acid (NA) antibiotics for P. aeruginosa and 16, 22 and 10, 18 mm zone of inhibition against ceftazidime (CAZ), methicillin (MET), ampicillin amoxyclav (AMC), co-trimoxazole (COT) of the HX077 HX012 for K. pneumoniae were observed. Based on the Clinical & Laboratory Standards Institute (CLSI) guidelines, both the bacteria were more resistant to tested antibiotics and it could be developed more resistant against all the tested antibiotics. In addition, the phenotypic detection of ESBL production effect was also performed against both the selected uropathogens, and the results were shown ≥22 mm, ≥27 zone of inhibition against all the tested antibiotics. Further, the genetic identification of multi plux PCR result was shown TEM, SHV and CTX-m genes were present in both the selected uropathogens. Finally, our results were correlated each other and concluded that the selected uropathogens were multi drug resistant effect and also ESBLs producer.

Piperacillin/tazobactum and cefotaxime decrease the effect of beta lactamase production in multi-drug resistant K. pneumoniae

BACKGROUND

Worldwide, multi-drug resistant Klebsiella pneumoniae (K. pneumonia) and their virulence's were contributed more in the multi-drug resistant effect. According to the World Health organization report, it is an emerging thread in developing countries and also comes under first ever critical list. In this context, the current study was concentrated on detection of extended spectrum beta lactamase (ESBL) producing strain and their antimicrobial susceptibility study of K. pneumoniae.

MATERIALS AND METHODS

Firstly, the multi-drug resistant effect of the K. pneumoniae was identified from specific CLSI guidelines recommended antibiotics by disc diffusion method. Consecutively, the primary ESBL identification test was performed using ceftazidime and cefotaxime, followed by double disc combination and phenotypic confirmation tests using ceftazidime/clavulanic acid and cefotaxime/clavulanic acid. Finally, the minimum inhibition concentration of some important sensitive antibiotics were performed against selected K. pneumoniae was confirmed by micro broth dilution method.

RESULTS AND CONCLUSIONS

The current result was most favorable to selected K. pneumoniae with more multi drug resistant characteristic nature. All the performed antibiotics were almost more sensitive to selected K. pneumoniae. The effective antibiotics of piperacillin was also exhibited more resistant effect against tested bacteria and it cleaved the bacterial enzyme clearly. The present result of primary ESBL identification test result was exhibited with ≤22 mm and ≤27 mm against ceftazidime and cefotaxime were observed respectively. Followed result of double disc combination and phenotypic confirmation experiments results were clearly stated that the selected K. pneumoniae was ESBL producer. The ceftazidime, cefotaxime and ceftazidime/clavulanic acid and cefotaxime/clavulanic acid were exhibited with merged zones and ≥5 mm zones around the combination disc when compared with disc alone were observed. All the ESBL detection test results were clearly indicated that the selected K. pneumoniae strain was ESBL producer.

Partially purified actinomycetes compounds enhance the intracellular damages in multi-drug resistant P. aeruginosa and K. pneumoniae

Based on the excellent nutrient level, the current study was focused on isolation and anti-bacterial activity of the actinomycetes from marine mangrove soil samples. As result, 10 different strains of actinomycetes strains were identified on actinomycetes isolation agar plates. The identified strains were shown with white, clear, uncontaminated well matured spore producing ability. Based on the initial observation, the isolated colonies were actinomycetes. The partially extracted crude compound shown excellent anti-bacterial activity against P. aeruginosa and K. pneumoniae with 15 mm and 13 mm zone of inhibitions were observed at 500 μL concentrations. The minimum inhibition concentration result was also confirmed the 500 μL concentration against both the tested concentration with high inhibition rate. Then, the intracellular damages, decreased cell growth of the crude actinomycetes extract treated bacterial strains were clearly observed by confocal laser scanning electron microscope. The extracellular damages of bacterial cell wall and shape of the both the pathogens were clearly shown by scanning electron microscope. Therefore, all the results were clearly supported to the partially extracted crude compound and it has excellent anti-bacterial activity against tested multi drug resistant bacteria.

Enlightening the characteristics of bioflocculant of endophytic actinomycetes from marine algae and its biosorption of heavy metal removal

The removal of toxic heavy metal ions from contaminated environments is a great challenge and requires an alternative rapid, efficient, economical bioremediation approach. Henceforth, bioflocculant producing endophytic actinobacterial sp. was isolated from heavy metal contaminated marine environments for heavy metal biosorption process. After molecular characterization, the isolated actinomycete starin was Nocardiopsis sp. GRG 3 (KT235642). It was indicated that the maximum flocculating activity of 80.90% with glucose, and yield is 4.52 g L¹. The optimum flocculating activity was reached at pH 7 in the presence of CaCl₂ ions. Further, the bioflocculent produced Nocardiopsis sp. GRG 3 (KT235642) was characterized by fourier transform infrared analysis spectra (FTIR) and displayed the presence of carboxyl, hydroxyl, amino groups and characteristic of more polysaccharide and protein. The heavy metal sorption by bioflocculant Nocardiopsis sp. GRG 3 (KT235642) was effectively removed 55.90% Cd, 85.90% Cr, 74.7% Pb, and 51.90% Hg. Therefore, this study was proved that the bioflocculant derived from endophytic actinobacteria, Nocardiopsis sp. GRG 3 (KT235642) as a effective alternative method for decreasing the heavy metals towards sustainable environmental management.

Phytochemical screening and anti-oxidant activity of Sargassum wightii enhances the anti-bacterial activity against Pseudomonas aeruginosa

In this study, the phytochemical, phenolic, flavonoid and bioactive compounds were successfully screened from crude extract of Sargassum wightii by LC-MS analysis after NIST interpretation. Bacterial growth inhibition study result was shown with 24 mm zone inhibition at 200 µg/mL concentration against P. aeruginosa. The increased phenolic content was much closed to gallic acid and the range was observed at 250 μg/mL concentration. In addition, flavonoid contents of the algae extract was indicated more significant with rutin at 200 μg/mL. In result, both the phenolic and flavonoid contents of the extract were more correlated with gallic acid and rutin. Further, the total anti-oxidant and DPPH radical scavenging activities were shown increased activity at 200 μg/mL concentrations. Furthermore, the excellent anti-bacterial alteration result was observed at 200 μg/mL concentration by minimum inhibition concentration. Therefore, the result was revealed that the marine algae Sargassum wightii has excellent phytochemical and anti-oxidant activities, and it has improved anti-bacterial activity against P. aeruginosa.

Identification of carbapenems resistant genes on biofilm forming K. pneumoniae from urinary tract infection

The multi-drug resistant effect of the Gram negative bacteria K. pneumoniae was identified by disc diffusion method using specific UTI panel discs of Kleb 1 HX077 and Kleb 2 HX090 HEXA. Among the multi-drug resistant bacteria, the carbapenem resistant (CR) effect of the K. pneumoniae was screened by specific carbapenem detection antibiotics of HEXA HX066 and HX0103 HEXA by disc diffusion method. In addition, the effective antibiotics were further performed against K. pneumoniae by minimum inhibition concentration method. Further, the carbapenemase genes of VIM 1 and IMP 1 were detected from the isolated strains by multiplex PCR method. Furthermore, the biofilm forming ability of selected carbapenem resistant K. pneumoniae was initially identified by tissue culture plate method and confirmed by exopolysaccharide arrest ability of congo red agar assay. Finally, our result was proved that the identified K. pneumoniae is carbapenemase producing strain, and its virulence was extended with strong biofilm formation.

Anti-biofilm activity of LC-MS based Solanum nigrum essential oils against multi drug resistant biofilm forming P. mirabilis

Urinary tract infections are second most important diseases worldwide due to the increased amount of antibiotic resistant microbes. Among the Gram negative bacteria, P. mirabilis is the dominant biofilm producer in urinary tract infections next to E. coli. Biofilm is a process that produced self-matrix of more virulence pathogens on colloidal surfaces. Based on the above fact, this study was concentrated to inhibit the P. mirabilis biofilm formation by various in-vitro experiments. In the current study, the anti-biofilm effect of essential oils was recovered from the medicinal plant of Solanum nigrum, and confirmed the available essential oils by liquid chromatography-mass spectroscopy analysis. The excellent anti-microbial activity and minimum biofilm inhibition concentration of the essential oils against P. mirabilis was indicated at 200 µg/mL. The absence of viability and altered exopolysaccharide structure of treated cells were showed by biofilm metabolic assay and phenol-sulphuric acid method. The fluorescence differentiation of P. mirabilis treated cells was showed with more damages by confocal laser scanning electron microscope. Further, more morphological changes of essential oils treated cells were differentiated from normal cells by scanning electron microscope. Altogether, the results were reported that the S. nigrum essential oils have anti-biofilm ability.

Biosynthesized silver nanoparticles using Caulerpa taxifolia against A549 lung cancer cell line through cytotoxicity effect/morphological damage

The Caulerpa taxifolia is excellent marine green algae, which produced enormous bioactive compounds with more biological activities. Also, it is an excellent source for synthesis of Ag NPs with increased bioactivity against various infections. In our study, the marine algae marine algae Caulerpa taxifolia mediated Ag NPs was synthesized effectively. The synthesized Ag NPs was characterized well using UV-spectrometer and X-ray powder diffraction (XRD) and confirmed as synthesized particle was Ag NPs. The available structure of the Ag NPs was morphologically identified by scanning electron microscope (SEM), and exact minimum size, polydispersive spherical shape of the entire Ag NPs structure was confirmed by Transmission electron microscope (TEM). Further, the anti-cancer efficiency of biosynthesized Ag NPs against A549 lung cancer cells was found at 40 µg/mL concentration by cytotoxicity experiment. In addition, the phase contrast images of the result were supported the Ag NPs, which damaged the A549 morphologically clearly. Finally, florescence microscopic images were effectively proved the anti-cancerous effect against A549 lung cancer cells due to the condensed morphology of increased death cells. All the confirmed in-vitro results were clearly stated that the Caulerpa taxifolia mediated Ag NPs has superior anti-cancer agent against A549 lung cancer cells.

Anti-cancer activity of biosynthesized silver nanoparticles using Avicennia marina against A549 lung cancer cells through ROS/mitochondrial damages

The biosynthesized Ag NPs was synthesized by using marine mangrove plant extract Avicennia marina. The synthesized Ag NPs was confirmed by various physiochemical characterization including UV-spectrometer and XRD analysis. In addition, the shape and of the synthesized Ag NPs was morphologically identified by SEM initially and TEM finally. After confirmation, the anti-cancer property of synthesized Ag NPs was confirmed at 50 µg/mL concentration against A549 lung cancer cells by MTT assay. Further, the ability to stimulate the ROS generation and mitochondrial membrane at the IC50 concentration of Ag NPs was confirmed by fluorescence microscopy using DCFH-DA and rhodamine 123 dyes respectively. Finally, the result was concluded that the synthesized Ag NPs has improved anti-cancer activity against A549 cells at lowest concentration.

Anti-bacterial activity of chitosan loaded plant essential oil against multi drug resistant K. pneumoniae

The development of antibiotic resistant in K. pneumoniae is an emerging thread worldwide due to the poor antimicrobial drugs. To overcome this issue, researchers are focused on plant material and their essential oils to fight against multi drug resistant bacteria. In this context, the current study was concentrated in medicinal plant of guva leaves and their essential oils to combat multi drug resistant bacterial infections. The essential oils were successfully screened and confirmed by HRLC-MS analysis. The anti-bacterial ability of the compounds were loaded into the chitosan nanoparticles and proved by FT-IR analysis. In addition, the chitosan loaded essential oils morphology was compared with chitosan alone in SEM analysis and suggested that the material was loaded successfully. Further, the anti-bacterial ability of the chitosan loaded essential oils were primarily confirmed by agar well diffusion method. At the 100 µg/mL of lowest concentration of chitosan loaded essential oils, the multi-drug resistant K. pneumoniae was inhibited with 96% and confirmed by minimum inhibition concentration experiment. Hence, all the experiments were proved that the essential oils were successfully loaded into the chitosan nanoparticles, and it has more anti-bacterial activity against multi-drug resistant K. pneumoniae.

Molecular identification and structural characterization of marine endophytic actinomycetes Nocardiopsis sp. GRG 2 (KT 235641) and its antibacterial efficacy against isolated ESBL producing bacteria

The present study was designed to identify the potential bioactive compound from endophytic actinomycetes (EA) Nocardiopsis sp. GRG 2 (KT 235641) against selected extended spectrum beta lactamase (ESBL) producing Pseudomonas aeruginosa (P. aeruginosa) and Klebsiella pneumoniae (K. pneumoniae). Initially, the multi drug resistance (MDR) effect of selected uropathogens was confirmed by respective UTI panel of Hexa antibiotics disc methods. The zone of inhibition ≤22 mm for ceftazidime, ≤ 27 mm for cefotaxime and ≤8 mm zone of MIC stripe against both the uropathogens of phenotypic methods confirmed, the selected strains were ESBL producer. Among the various EA extracts, GRG 2 extract showed excellent antibacterial activity against both ESBL producing P. aeruginosa and K. pneumonia by agar well diffution method. The molecular identification of selected GRG 2 strain was named as Nocardiopsis sp. GRG 2 (KT235641). The antibacterial metabolites present in the TLC elution was exhibited at 274 nm by UV visible spectrometer. The partial purification of preparative HPLC fraction 3 showed 14, 16 mm against P. aeruginosa and K. pneumoniae, respectively. Based on the antibacterial effect, the FT-IR, GC-MS and LC-MS analysis of fraction 3 was confirmed as 1, 4-diaza-2, 5-dioxo-3-isobutyl bicyclo[4.3.0]nonane (DDIBN). Further, the dose dependent inhibition of DDIBN against both ESBL producing pathogens was observed at 75 μg/mL by minimum inhibition concentration (MIC) and minimum bactericidal concentration (MBC). The increased cell death and disrupted cell membrane integrity were observed at MIC of DDIBN by confocal laser scanning electron microscope (CLSM) and scanning electron microscope (SEM). The results were proved that the DDIBN has potential antibacterial metabolites against ESBL producing pathogens and it can be applied for various other biomedical fields.

Feasibility and Results of Cancer Registry and Noncommunicable Disease Cohort Data Linkages in India

Background: Cancer registries worldwide are vital to determine cancer burden, plan cancer control measures, and facilitate research. Population-based cancer registries are a priority for LMICs by the UICC; the National Cancer Registry Program (NCRP) of India oversees 28 such registries. A primary function of registries is to combine data for the same individual from multiple sources. For other disease cohorts where cancer is an outcome of interest, registries can potentially connect information by linking datasets together. Barriers to successful registration and linkages include systems in which cancer is not a notifiable disease, no universal unique individual identifier exists, and lack of trained personnel. This study utilizes technology and infrastructure to develop better linkages, surveillance, and outcomes. Aim: To assess the feasibility of linking large cohorts designed for cardio-metabolic disease research with cancer registries in New Delhi and Chennai; determine additional steps required for linkage accuracy and completeness; and develop detailed protocols for future applications. Methods: A pilot protocol for linkage between a large diabetes cohort and cancer registries in Delhi and Chennai was developed using MatchPro, a probabilistic record linkage program developed for cancer registries. Probabilistic software links datasets together in the presence of uncertainty (eg misspelled or abbreviated names) to identify record pairs with high probability of representing the same individual. For this study, algorithms were developed to address unique aspects of names and demographics in India. The software and algorithms focused on: detecting duplicates in cancer registries; and linking registries with external files from diabetes cohorts. In Delhi, 3 1-year datasets covering 3 years (2010, 2011, 2012) were linked with the diabetes cohort; in Chennai, the linkage included 3 5-year datasets covering 15 years (2000-04, '05-'09, '10-'14). The unique ID (Aadhaar) is not collected or linked systematically between different systems at this point in time. Results: Linkage attempts yielded potential matches ranked according to probabilistic scores; highest scores were reviewed to determine true matches. In Chennai, this process yielded: (2010-2014) 21% self-reported (SR) cases matching perfectly, 36% requiring follow-up, 13 nonreported (NR) cases found; 2005-2009: 33% SR cases matched perfectly, 1 NR case found; 2000-2004: 1 NR case. Also, 2 training workshops on data linkages and software were held. Conclusion: Linkages between cancer registries and other data sources are feasible in LMICs using probabilistic record linkage software augmented by manual matching. Future efforts to use existing epidemiologic resources (cohorts) and cancer research infrastructure (registries and clinical centers) can enhance research including understanding shared risk factors and pathophysiologic mechanisms e.g., between cancer and other NCD.

Antibacterial and anticancer potential of marine endophytic actinomycetes Streptomyces coeruleorubidus GRG 4 (KY457708) compound against colistin resistant uropathogens and A549 lung cancer cells

The aim of the current study is to identify bioactive compound from marine endophytic actinomycetes (MEA) isolated from Gulf of Mannar region, Southeast coast of India. Among the isolated actinomycetes, strain GRG 4 exhibited excellent ability to inhibit isolated colistin resistant (CR) Pseudomonas aeruginosa (P. aeruginosa) and Klebsiella pneumoniae (K. pneumoniae), which is a emerging threat to the world. The strain was identified as Streptomyces coeruleorubidus GRG 4 (KY457708), based on morphological, biochemical, phenotypic and genotypic characters. The bioactive metabolites present in the methanolic extract were partially purified by TLC and preparative HPLC. The active HPLC fraction 2 showed 15, 20 mm zone of inhibition against both CR P. aeruginosa and K. pneumoniae respectively. Analytical HPLC and FT-IR results of fraction 2 showed with carbonyl group. Both GC-MS and LC-MS results confirmed that the fraction 2 contained chemical constituents of Bis (2-Ethylhexyl) Phthalate (BEP). The compromised structure with loosely integrated and ruptured cell wall of BEP treated CR bacteria were observed by confocal laser scanning microscope (CLSM) and scanning electron microscope (SEM) at 75 μg/mL of minimum inhibitory concentration (MIC) dose. Further, cytotoxic effect of BEP against A549 human lung cancer cells revealed complete inhibition by cell proliferation and apoptosis was observed at 100 μg/mL in 24 h treatment. In addition, irreversible ROS dependent oxidative damage was clearly observed at the IC₅₀ concentration of BEP. The toxicity of BEP was also studied against Vibrio fischeri (V. fischeri) and found to be highly toxic after 15 and 30 min of treatment. Based on the results it could be concluded that the identified compound BEP is a potent inhibitor for CR bacteria and A549 lung cancer cells.

Trends in incidence of Ewing sarcoma of bone in India - Evidence from the National Cancer Registry Programme (1982-2011)

Background

Ewing sarcoma is a malignant tumour found mainly in childhood and adolescence. The present study aims at analyzing the data on Ewing sarcoma cases of bone from the National Cancer Registry Programme, India to provide incidence, patterns, and trends in the Indian population.

Materials and Methods

The data of five Population Based Cancer Registries (PBCR) of Bangalore, Mumbai, Chennai, Bhopal and Delhi over 30 years period (1982- 2011) were used to calculate the Age Specific and Age Standardized Incidence Rates (ASpR and ASIR), and trends in incidence was analyzed by linear and Joinpoint Regression.

Results

Ewing sarcoma comprised around 15 % of all bone malignancies. Sixty-eight percent were 0-19 years, with 1.6 times risk of tumour in bones of limbs as compared to other bones. The highest incidence rate (per million) was in the 10-14 years age group (male -4.4, female -2.9) with significantly increasing trend in ASpR observed in both sexes. Pooled ASIR per million for all ages was higher in male (1.6) than female (1.0) with an increasing rate ratio of ASIR with increase in age. Trend of pooled ASIR for all ages was significantly increased in both sexes. Twelve percent cases were reported in ≥30 years of age.

Conclusion

This paper has described population based measurements on burden and trends in incidence of skeletal Ewing in India. These may steer further research questions on the clinical and molecular epidemiology to explain factors associated with the increasing incidence of Ewing sarcoma bone observed in India.

Prevalence of HIV in Patients with Malignancy and of Malignancy in HIV Patients in a Tertiary Care Center from North India

BACKGROUND AND OBJECTIVES

People living with HIV/AIDS are at an increased risk of developing cancer. The goals of this study were to obtain data on the prevalence of HIV in the cancer population and vice versa at a major tertiary cancer and HIV center in North India.

METHODS

This cross-sectional study was conducted over a 3-year period from July 2013 to June 2016, wherein successive HIV positive patients from an anti-retroviral therapy (ART) center were screened for malignancy. Simultaneously, successive cancer patients at the cancer center were screened for HIV. Baseline demographic details, risk factors, and laboratory investigations were obtained for all the patients.

RESULTS

Among the 999 HIV-positive patients at the ART center, the prevalence of malignancy was 2% (n=20; 95% confidence interval (CI) 1.13, 2.87). Among the 998 patients with a malignancy, the prevalence of HIV infection was 0.9% (n=9; 95% CI 0.31, 1.49). Weight loss, loss of appetite, and fever were the most common symptoms in patients with HIV and cancer. Among 29 patients with HIV and cancer, AIDS-defining cancer was found in 19 patients; non-Hodgkin's lymphoma was the most common malignancy reported (n=13).

INTERPRETATION AND CONCLUSION

There is a low prevalence of HIV in cancer patients as well as a low prevalence of cancer in HIV patients. AIDS-defining cancers remain much more common than non-AIDS-defining cancers. With the increased coverage of ART, it is expected that non-AIDSdefining cancers will increase, as is evident from data from more developed countries.

Molecular characterization and antibacterial effect of endophytic actinomycetes Nocardiopsis sp. GRG1 (KT235640) from brown algae against MDR strains of uropathogens

Our study is to evaluate the potential bioactive compound of Nocardiopsis sp. GRG1 (KT235640) and its antibacterial activity against multi drug resistant strains (MDRS) on urinary tract infections (UTIs). Two brown algae samples were collected and were subjected to isolation of endophytic actinomycetes. 100 strains of actinomycetes were isolated from algal samples based on observation of morphology and physiological characters. 40 strains were active in antagonistic activity against various clinical pathogens. Among the strains, 10 showed better antimicrobial activity against MDRS on UTIs. The secondary metabolite of Nocardiopsis sp. GRG1 (KT235640) has showed tremendous antibacterial activity against UTI pathogens compared to other strains. Influence of various growth parameters were used for synthesis of secondary metabolites, such as optimum pH 7, incubation time 5-7 days, temperature (30 °C), salinity (5%), fructose and mannitol as the suitable carbon and nitrogen sources. At 100 μg/ml concentration MIC of Nocardiopsis sp. GRG1 (KT235640) showed highest percentage of inhibition against Proteus mirabilis (85%), and E.coli, Staphylococcus auerues, Psuedomonas aeroginasa, Enterobactor sp and Coagulinase negative staphylococci 78-85% respectively.

Paediatric retinoblastoma in India: evidence from the National Cancer Registry Programme

BACKGROUND

Globally, retinoblastoma is the most common primary intraocular malignancy occurring in children. This paper documents the recent incidence rates of retinoblastoma by age and sex groups from the Population Based Cancer Registries (PBCRs) of Bangalore, Mumbai, Chennai, Delhi and Kolkata using the data from the National Cancer Registry Programme.

MATERIALS AND METHODS

Relative proportions, sex ratio, method of diagnosis, and incidence rates (crude and age standardized) for each PBCR and pooled rates of the five PBCRs were calculated for the years 2005/06 to 2009/10. Standard errors and 95% confidence limits of ASIRs by sex group in each PBCR were calculated using the Poisson distribution. Standardised rate ratios of ASIR by sex group and rate ratios at risk were also calculated.

RESULTS

The maximum retinoblastoma cases were in the 0-4 age group, accounting for 78% (females) and 81% (males) of pooled cases from five PBCRs. The pooled crude incidence rate in the 0-14 age group was 3.5 and the pooled ASIR was 4.4 per million. The pooled ASIR in the 0-4, 5-9 and 10-14 age group were 9.6, 2.0 and 0.1 respectively. The M/F ratio in Chennai (1.9) and Bangalore PBCRs (2.0) was much higher than the other PBCRs. Among the PBCRs, the highest incidence rate in 0-4 age group was found in males in Chennai (21.7 per million), and females in Kolkata (18.9 per million). There was a distinct variation in incidence rates in the PBCRs in different geographic regions of India.

Evaluation of Delhi Population Based Cancer Registry and Trends of Tobacco Related Cancers

BACKGROUND

Tobacco use is the single most important preventable risk factor for cancer. Surveillance of tobacco-related cancers (TRC) is critical for monitoring trends and evaluating tobacco control programmes. We analysed the trends of TRC and evaluated the population-based cancer registry (PBCR) in Delhi for simplicity, comparability, validity, timeliness and representativeness.

MATERIALS AND METHODS

We interviewed key informants, observed registry processes and analysed the PBCR dataset for the period 1988-2009 using the 2009 TRC definition of the International Agency for Research on Cancer. We calculated the percentages of morphologically verified cancers, death certificate-only (DCO) cases, missing values of key variables and the time between cancer diagnosis and registration or publication for the year 2009.

RESULTS

The number of new cancer cases increased from 5,854 to 15,244 (160%) during 1988-2009. TRC constituted 58% of all cancers among men and 47% among women in 2009. The age-adjusted incidence rates of TRC per 100,000 population increased from 64.2 to 97.3 among men, and from 66.2 to 69.2 among women during 1988-2009. Data on all cancer cases presenting at all major government and private health facilities are actively collected by the PBCR staff using standard paper-based forms. Data abstraction and coding is conducted manually following ICD-10 classifications. Eighty per cent of cases were morphologically verified and 1% were identified by death certificate only. Less than 1% of key variables had missing values. The median time to registration and publishing was 13 and 32 months, respectively.

CONCLUSIONS

The burden of TRC in Delhi is high and increasing. The Delhi PBCR is well organized and generates high-quality, representative data. However, data could be published earlier if paper-based data are replaced by electronic data abstraction.

In Silico Analysis of Conformational Changes Induced by Normal and Mutation of Macrophage Infectivity Potentiator Catalytic Residues and its Interactions with Rapamycin

The Legionella pneumophila (Lp), human pathogen, causes severe and often fatal Legionnaires' disease, produces a major virulence factor, termed 'macrophage infectivity potentiator protein' (Mip), that is necessary for optimal multiplication of the bacteria within human alveolar macrophages. Mip exhibits peptidyl prolyl cis-trans isomerase (PPIase) activity, which can be inhibited by rapamycin and FK506. It was previously shown that substitutions at the catalytic residues, aspartate-142 position replaced to leucine-142 and tyrosine-185 position replaced to alanine-185 strongly reduces the PPIase activity of Mip proteins. Therefore, we aim to develop an in silico mutagenesis model for both important catalytic residues, validated the stability of the mutated model. Further, we have docked the known inhibitor rapamycin with Lp Mip (native) and mutants (D142L and Y185A) to analyze the conformational and binding mode. Electrostatic contributions and van der Waals interactions are the major driving forces for rapamycin binding and largely responsible for the binding differences between the Lp Mip (native and mutated) proteins.

In silico analysis of conformational changes induced by normal and mutation of macrophage infectivity potentiator catalytic residues and its interactions with Rapamycin

The Legionella pneumophila (Lp), human pathogen causes severe and often fatal Legionnaires' disease, produces a major virulence factor, termed 'macrophage infectivity potentiator protein' (Mip), that is necessary for optimal multiplication of the bacteria within human alveolar macrophages. Mip exhibits peptidyl prolyl cistrans isomerase (PPIase) activity, which can be inhibited by Rapamycin and FK506. Mutation of Mip protein on catalytic residues at Aspartate-142 position replaced to Leucine-142 and Tyrosine-185 position replaced to Alanine-185 that strongly reduces the PPIase activity. Therefore, we aim to develop an in-silico mutagenesis model for both important catalytic residues, validated the stability of the mutated model. Further, we have docked to the known inhibitor rapamycin with Lp Mip (native) and mutants (D142L and Y185A) to analyze the conformational and binding model. For electrostatic contributions and VanderWaals interactions are the major driving force for rapamycin binding and largely responsible for the binding differences between the Lp Mip (native and mutated) proteins.

Descriptive epidemiology of primary brain and CNS tumors in Delhi, 2003-2007

The Delhi Population Based Cancer Registry data during the period 2003-2007 were used to describe the epidemiology of primary malignant brain and central nervous system tumors in Delhi. A total of 1989 brain and CNS tumors cases in 1291 males and 698 females were registered during the period 1st January 2003 to 31st December 2007. The age adjusted (world population) incidence rates were 3.9 per 100,000 for males and 2.4 per 100,000 for females. Gliomas were the most frequently reported histology both in males (26.6%) and females (23.2%). A male predominance in incidence was observed for all histological classifications. The rates in Delhi are low compared to the incidences reported from developed countries.

Cancer incidences in rural Delhi--2004-05

There are no data available on cancer incidence pattern in rural Delhi. This is the first report on cancer incidence among Delhi Rural population during 2004-05 which gives the first hand information on cancer incidence. The data for this report has been collected by Delhi Population based cancer registry. The sources for cancer registration are more than 162 Government Hospitals/centers and 250 private hospitals and nursing homes. A total of 594 cancer cases with 317 males and 277 females were registered during the period 1st January 2004 to 31st December 2005. The age adjusted (world population) incidence rates for all sites were 55.2 per 100,000 for males and 47.7 per 100,000 for females. The leading sites of cancer among Delhi Rural males was oral cavity (ASR: 8.0 per 100000) followed by lung (ASR: 6.5), larynx (ASR: 4.0) and bladder (ASR: 4.1). In females cervix uteri (ASR: 10.3 per 100,000) was the most common site of cancer followed by breast (ASR: 7.8), gallbladder (ASR: 3.5) and ovary (ASR: 3.3). The overall incidence rates of cancer in Delhi Rural were comparatively very less than Delhi Urban. A statistically significant difference was also found between Delhi Rural and Delhi Urban in incidence rates (ASR) for first four common sites. The rates in Delhi Rural are also comparatively lower than other rural registries situated in India.

Antibacterial copper-nickel bilayers and multilayer coatings by pulsed laser deposition on titanium

Biofouling, especially microfouling, is a major concern with the use of titanium (Ti) in the marine environment as a condenser material in cooling water systems. Earlier, copper-nickel (Cu/Ni) alloys were extensively used in marine environments due to their high corrosion and biofouling resistance. However, the choice of condenser material for the new fast breeder reactor in Kalpakkam is Ti to avoid steam side corrosion problems, which may pose a threat to steam generator parts having sodium as the secondary coolant. This study evaluates the surface modification of Ti using nano films of copper (Cu) and nickel (Ni) to utilize the antibacterial property of copper ions in reducing microfouling. The surface modification of Ti was carried out by the deposition of a Cu/Ni bilayer and (Cu/Ni)(10) multilayer films using a pulsed laser deposition technique. Various surface characterization studies revealed that the deposited Cu/Ni films were thin and nanocrystalline in nature. The antibacterial properties were evaluated using total viable count and epifluorescence microscopic techniques. The results showed an apparent decrease in bacterial attachment on multilayered and bilayered Cu/Ni thin films on Ti surfaces. Comparative studies between the two types of films showed a bigger reduction in numbers of microorganisms on the multilayers.

Surface modification of titanium using nanothin films of copper for biofouling control

Biofouling is one of the major impediment in the use of titanium, which is otherwise excellent material with respect to corrosion resistance and mechanical properties, for seawater-cooled condensers of power plants. The routine chlorination treatment and sponge ball cleaning may not be successful to keep the titanium condenser tube clean over a period extending to years. This brings into focus the relevance of surface modification of titanium to improve the antimicrobial properties, which can effectively supplement the present treatment programmes. In this study antimicrobial thin film of copper (Cu) is developed on titanium surfaces, as copper is known to be very toxic to microorganisms and effectively kills most of the microbes by blocking the respiratory enzyme system. The preparation of nanocrystalline thin films of copper on titanium surfaces was done by pulsed DC magnetron-sputtering technique. Then this thin film was characterized using Glancing Incidence X-ray Diffraction (GIXRD) and Atomic Force Microscopy (AFM). Antimicrobial properties of these specimens were evaluated by exposure studies in seawater. Results showed two order decrease in the bacterial density on copper coated surface and epifluorescence micrographs depicted very few fluorescing cells and no biofilm formation clearly demonstrating the superior antibacterial capability of this nanocrystalline copper thin film.

Cancer incidences in urban Delhi - 2001-05

The Delhi Population based cancer registry collects data on new cancer cases diagnosed among Delhi urban resident population. The sources for cancer registration are more than 162 government hospitals/centers and 250 private hospitals and nursing homes. During the period 1st January 2001 to 31st December 2005 a total of 54,554 cases were registered of which 28,262 were males and 26,292 were females. The age adjusted (world population) incidence rates were 116.9 per 100,000 for males and 116.7 per 100,000 for females. The leading sites of cancer among Delhi males was lung (ASR: 13.8 per 100,000) followed by oral cavity (ASR: 11.4), prostate (ASR: 9.0) and larynx (ASR: 7.9). In females, breast (ASR: 30.2 per 100,000) was the most common site of cancer, followed by cervix uteri (ASR: 17.5), ovary (ASR: 8.5) and gallbladder (ASR: 7.4). The incidence of prostate cancer in males and ovary cancer in females in Delhi were the highest among the Indian registries, while larynx among males was the second highest and the gallbladder cancer in females was the highest among Indian metropolitan cities.

Breast dose heterogeneity in CT-based radiotherapy treatment planning

The aim of this study was to evaluate the breast dose heterogeneity in CT-based radiotherapy treatment planning and to correlate with breast parameters. Also, the number of slices required for treatment planning in breast cancer by tangential field technique has been assessed by comparing the treatment plans according to International Commission on Radiation Units and Measurement (ICRU) 50 guidelines (1993) for single-slice, three-slice, and multi-slice (3D) planning . Sixty women who underwent isocentric tangential field breast radiotherapy were included in this study. The plans were optimized and analyzed with dose volume histograms. Sixty-three percent of the single-slice plans and 26.7% of the three-slice plans showed poor dose homogeneity as compared to the 3D plans. Dose inhomogeneity correlated better with breast volume (r² = 0.43) than the chest wall separation (r² = 0.37) and breast area product (r² = 0.36). Similarly, breast volume correlated better with breast area product (r² = 0.80) than with chest wall separation (r² = 0.56). Breast volume can be approximated to breast area product from the relation, breast volume = [(breast area product × 8.85) − 120.05]. The results of this study showed that most of the cases require 3D planning for breast cancer. It also showed that patients with large breast are prone to have more dose inhomogeneity with standard tangential field radiotherapy. In centers where 3D planning is not possible due to lack of facilities or workload, three slices–based planning can be performed to approximate the dosimetric advantage of 3D planning.

Trends of Cancer Prevalence in Some Districts of West Bengal

An attempt has been made to understand the cancer prevalence in eight districts of West Bengal. Special emphasis was on the types of cancer most prevalent among the male and female populations. In this study we have represented the frequency by age and sex of different tumors among 9034 cancer cases registered over five years. Our findings indicate that liver cancer is predominant among males and cancer of the cervix uteri is most prevalent among females. The valuesby age indicate that cancer incidence increased during this study period, especially in Kolkatta.

The Madurai Intraocular Lens Study. II: Clinical outcomes

PURPOSE

To evaluate the safety and efficacy of extracapsular cataract extraction with posterior chamber intraocular lens (ECCE/PC-IOL) compared with intracapsular cataract extraction with aphakic glasses (ICCE-AG).

METHODS

In a nonmasked randomized controlled clinical trial, 3,400 bilaterally vision-impaired patients aged 40 to 75 years with operable cataract were randomly assigned to receive either ICCE-AG or ECCE/PC-IOL at the Aravind Eye Hospital in India. The surgery was performed by one of four study surgeons. Patients were hospitalized for 5 postoperative days, with follow-up visits at 2, 6, and 12 months after discharge. Postsurgery evaluations were conducted by two independent study ophthalmologists.

RESULTS

At any single postoperative follow-up time point, there were no statistically significant differences of clinical relevance between treatment groups for any complication of a serious nature except cystoid macular edema, which was more common with ICCE (4.2% vs 1.6%). In general, whether of a trivial, intermediate, or serious nature, complication rates were low at each evaluation time point. Cumulatively, the incidence of serious complications of all types throughout the 1-year study period was 14.5% for patients in the ICCE-AG group and 7.7% in the ECCE group (P < .001). Best-corrected visual acuity of 20/40 or better at 12 months was attained by 90.7% of ICCE-AG patients and 96.3% of ECCE/PC-IOL patients (P < .001).

CONCLUSION

Although both operative procedures are safe and effective for cataract patients with bilateral impairment, ECCE/PC-IOL is superior to ICCE-AG in terms of both visual acuity restoration and safety.

Lens induced glaucomas--visual results and risk factors for final visual acuity

Lens induced glaucomas are a common occurrence in India. An attempt was made to understand the clinical modes of presentation and post operative visual results in 93 patients with lens induced glaucoma, 49 phacomorphic and 44 phacolytic, attending our institute during 1994. All these patients were subjected to a planned extracapsular cataract extraction. Forty four percent had a posterior chamber intraocular lens implantation following surgery. Fifty seven percent eyes with phacomorphic glaucoma and 61% with phacolytic glaucoma recovered visual acuity of 6/12 or better. There was no significant difference in the final visual acuity between those patients who had an intraocular lens implanted and those who did not (P = 0.18). Univariate analysis was performed for selected risk factors such as age, sex and duration of glaucomatous process as predictors of final visual acuity and odds ratios with 95% confidence intervals were calculated. Patients with age more than 60 years (OR = 2.7, 95% CI = 1.04-6.93) and in whom the glaucoma was present for more than 5 days (OR = 3.1, 95% CI = 1.21-8.13) had a significantly higher risk of poor visual outcome post-operatively.