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Mehndiratta M.,University of Delhi | Mohapatra D.,University of Delhi | Grover R.K.,Delhi State Cancer Institute | Puri D.,University of Delhi
Journal of Clinical and Diagnostic Research | Year: 2014

Background: Smoking has been considered to be the major cause of lung cancer. However, only a fraction of cigarette smokers develop this disease. This suggests the importance of genetic constitution in predicting the individual’s susceptibility towards lung cancer. This genetic susceptibility may result from inherited polymorphisms in genes controlling carcinogen metabolism and repair of damaged deoxyribonucleic acid (DNA). These repair systems are fundamental to the maintenance of genomic integrity. X-ray repair cross complimenting group I (XRCC1), a major DNA repair gene in the base excision repair (BER) pathway. It is involved in repair by interacting with components of DNA at the site of damage. Inconsistent results have been reported regarding the associations between the Arg399Gln polymorphism of XRCC1.This study demonstrates the importance of recognition of this relationship of lung carcinoma and genetic constitution of the person which will help guide clinicians on the optimal screening of this disease.Aim: To assess the role of XRCC1 gene polymorphism (Arg399Gln) directly on the variation in susceptibility to development of lung cancer in North Indian subjects.Materials and Methods: One hundred males with diagnosed cases of lung cancer were recruited from Delhi State Cancer Institute (DSCI). Hundred healthy volunteers were taken as controls. DNA isolation was done and Polymerase chain reaction–Restriction Fragment Length Polymorphism (PCR–RFLP) procedure undertaken to amplify the region containing Arg/Gln substitution at codon 399 (in exon 10).Results: XRCC1 gene polymorphism is associated with increased risk of lung cancer when the Arg/Arg genotype was used as the reference group. The Arg/Gln and Gln/Gln was associated with statistically increased risk for cancer.Conclusion: Arg399Gln polymorphism in XRCC1 gene polymorphism is associated with lung cancer in North Indian subjects and screening for this polymorphism will help in targeting predisposed individuals and its prevention. © 2014, Journal of Clinical and Diagnostic Research. All right reserved.


Ahmed N.H.,Delhi State Cancer Institute | Chowdhary A.,Sir JJ Group of Hospitals
Indian Journal of Sexually Transmitted Diseases | Year: 2015

Introduction: One of the major medical concerns in people living with HIV/AIDS (PLHA) is management of diarrhea that can lead to severe morbidity and mortality. Such clinical scenario warrants an analysis of intestinal parasites, which are important opportunistic pathogens in PLHA. Owing to the scarcity of recent pattern of intestinal opportunistic infections from this region, the study was designed to determine the opportunistic parasites causing diarrhea in PLHA; and to find out whether there is any significant difference in the enteric parasitic pathogens in patients with different immunological status and in those on highly active anti retro-viral therapy (HAART). Materials and Methods: Analysis of the spectrum of intestinal parasites was carried out with 192 subjects in two groups (142 HIV sero-positive patients having diarrhea and 50 HIV sero-negative patients having diarrhea). The routine light microscopic examination was carried out to determine the infection and CD4+ T-Lymphocyte count was estimated using flow cytometry. Results: Enteric parasites were detected in 35.9% of HIV sero-positive patients having diarrhea and 18% of HIV sero-negative patients having diarrhea. Most common opportunistic enteric parasite was Isospora belli (11.5%); others were Entamoeba histolytica (4.7%), Cryptosporidium sp. (3.6%), Strongyloides stercoralis (3.1%), Giardia intestinalis (3.1%) and Cyclospora cayatanenesis (1.6%). Opportunistic enteric parasites were detected in significantly low numbers in patients with CD4+ T-Lymphocyte counts >500 cells/ml; and in those taking HAART.


Kumar V.,University of Delhi | Yadav C.S.,University of Delhi | Singh S.,National Institute of Communicable Diseases | Goel S.,University of Delhi | And 4 more authors.
Chemosphere | Year: 2010

Organochlorine pesticides (OCPs) and polymorphisms of xenobiotic metabolizing enzymes are reported to be associated with the possible risk of prostate cancer. OCPs are endocrine disruptors (EDs) which may act by disrupting the physiologic function of endogenous hormones and therefore possibly increase prostate cancer risk. CYP1A1 metabolizes several carcinogens and estrogens, etc. and hence polymorphism of this gene has been reported to be associated with prostate cancer risk. We studied 70 newly diagnosed prostate cancer patients and 61 age-matched healthy male controls. OCP levels in blood were determined by using gas chromatography-mass spectrometry (GC-MS) and CYP1A1 polymorphisms were analyzed by allele-specific PCR and RFLP-PCR methods. Significantly higher levels of β-HCH, γ-HCH and p,p'-DDE were found in cases as compared to controls (p-values=0.04, 0.008, and 0.01, respectively). Higher levels of γ-HCH were observed in advanced stages of prostate cancer cases (≤T2 vs ≥T3), (p-value=0.04). Dieldrin was found significantly higher in cases with initial stages (p-value=0.03). We did not observe any correlation between prostate cancer and CYP1A1 polymorphisms. Hence, higher level of OCPs, especially β-HCH, γ-HCH and p,p'-DDE might be associated with prostate cancer risk. © 2010 Elsevier Ltd.


Ahmed N.H.,Delhi State Cancer Institute | Hussain T.,Institute of Genomics and Integrative Biology
Journal of Global Infectious Diseases | Year: 2014

Objective: Dealing with severe blood stream infections (BSI) is one of the intractable conditions in hospitals. The empirical treatment given remains pertinent in determining patient outcome, which becomes evidence based when substantiated by knowledge of susceptibility patterns of prevalent pathogenic organisms in the set up. This study was undertaken to determine the occurrence, species prevalence, and antibiotic susceptibility pattern of laboratory confirmed BSI (LCBSI) in patients admitted to our multi-specialty sanatorium. Materials and Methods : Eight hundred and forty-six blood samples from 829 patients suspected of having BSI were cultured as per standard microbiological procedures. Antimicrobial susceptibility testing was done for bacterial isolates from positive blood cultures. Results: Sixty (7.2%) cases were established as LCBSI. A total of eight pathogenic bacterial genera were identified and their antimicrobial susceptibility pattern was noted. Staphylococcus spp. were most prevalent (33%), followed by Klebsiella pneumoniae (20%), Escherichia coli (13%), Acinetobacter spp. (13%), Enterococcus spp. (12%), Pseudomonas aeruginosa (3%), Proteus spp. (2%), and Citrobacter spp. (2%). Conclusions: The study shows the prevalence of common bacterial pathogens causing BSI and their susceptibility patterns. Such studies provide benefit of instantaneous choice of antibiotic therapy aiming at improved patient management and reduced drug resistance.


Rossi C.,University of Zürich | Sharma P.,Delhi State Cancer Institute | Pazahr S.,University of Zürich | Alkadhi H.,University of Zürich | And 2 more authors.
Investigative Radiology | Year: 2013

Objectives: The aim of this study was to quantify the influence of image resolution on the apparent transverse relaxivity (R2*) of the magnetic resonance (MR) signal in human renal tissue in vivo and in phantom measurements. Materials and Methods: This prospective study included 17 healthy volunteers (age, 32 ± 8 years, 6 women). Parametrical R 2* maps were computed via monoexponential fitting of multiecho 2-dimensional fast-field echo data measured at 1.5 T (repetition time [TR], 150 milliseconds; flip angle [FA], 40 ; minimum echo time [TE], 4.6 milliseconds; ΔTE, 5 milliseconds; 16 echoes) and at 3 T (TR, 140 milliseconds; FA, 70 ; minimum TE, 2 milliseconds; ΔTE, 5 milliseconds; 16 echoes) with varying nominal volumes of the encoded voxels (from 5.76 to 36.0 mm). For each voxel size, mean R2* values were computed in regions of interest drawn in the left and right renal parenchyma. For data acquired using minimum voxel size, the mean R2* values were computed over the cortex and medulla separately. The squared 2-norm of the residuals was computed to evaluate the goodness of the pixel-wise exponential fits. Six multiecho MR images of a water phantom were acquired using a 2-dimensional fast-field echo sequence (FA, 50 ; TR, 108 milliseconds; TE, 4 milliseconds; ΔTE, 20 milliseconds) at 3 T after shim adjustment and in the presence of a uniform background gradient of 40 μT/m. The nominal voxel size was varied in a range between 2 and 12.5 mm. Results: Mean R2* values of 13.04 ± 0.71 s (right renal cortex) and 16.47 ± 1.92 s (right renal medulla) were computed at 1.5 T. At 3 T, the R2* of the right medulla was 28.27 ± 1.52 s and the cortical R2* was 19.22 ± 2.32 s. Comparable relaxivity values were found over the left kidney at both field strengths. Increasing R2* values were observed for increasing voxel volume in both the water phantom and renal tissue data. At a constant slice thickness of 4 mm, the decrease in the in-plane resolution from 1.2 × 1.2 mm to 3.0 × 3.0 mm led to a maximum increase of the renal R2* of 15% at 1.5 T and of 12% at 3 T. Increasing the slice thickness from 3 to 8 mm at a constant in-plane resolution of 1.5 × 1.5 mm resulted in a maximum increase of the renal R 2* of 30% at 1.5 T and of 26% at 3 T. On the other hand, increasing the voxel size improved the goodness of the fit implied by the smaller residuals. Conclusions: The phantom experiments and in vivo acquisitions of healthy renal tissue documented a significant dependence of the apparent R2* relaxation rate on the spatial resolution of the MR imaging data. In clinical practice, the voxel volume for the quantification of renal R2* should be optimized in a compromise between minimizing the effects of macroscopic field inhomogeneity and maintaining a sufficiently high signal-to-noise ratio and goodness of fit. When comparing quantitative R 2* among different publications, the influence of the spatial resolution should be taken into account. © 2013 by Lippincott Williams & Wilkins.


Kaur N.,University of Delhi | Miglani R.,University of Delhi | Grover R.K.,Delhi State Cancer Institute
Indian Journal of Cancer | Year: 2014

Background: Breast cancer causes significant disruption to the quality of life (QOL) of its patients, which is compounded further by lack of information and adequate facilities for rehabilitation. Materials and Methods: This descriptive cross-sectional study was conducted in women who had completed their Primary treatment of breast cancer. The QOL was assessed by Functional assessment of cancer therapy-breast (FACT-B) version 4, and information and rehabilitation needs were enquired about in a semi-structured interview. Results: A total of 154 patients were enrolled and divided into three groups according to the time elapsed after initial treatment; Group I: 1-2 years, Group II: 2-5 years, Group III: >5 years The FACT-B mean scores were; Group I (n = 64): 79.06 ± 14.60; Group II (n = 48): 85.75 ± 20.15; and Group III (n = 42): 89.83 ± 12.80. Patients in Group I scored lowest on physical well-being subscale, Group II on breast specific subscale and Group III on Social well-being subscale. Pain, lack of energy, inability to meet the needs of the family, fear that the condition will get worse and loss of body image were significant factors contributing to poor QOL. Analysis of interviewshowed many unmet information needs. Main rehabilitation needs were effective treatment of physical symptoms and counselling about body image issues and sexual dysfunctions. Easy availability of clinical and social support services were major felt needs in the long-term follow-up. Conclusions: Targeted Interventions are needed to address issues relating to QOL and rehabilitation needs of breast cancer patients.


Biswal I.,Delhi State Cancer Institute | Arora B.S.,Vardhman Mahavir Medical College and Safdarjang Hospital | Kasana D.,Vardhman Mahavir Medical College and Safdarjang Hospital | Neetushree,Hindu Rao Medical College and Hospital
Journal of Clinical and Diagnostic Research | Year: 2014

Context: Pseudomonas aeruginosa is an important pathogen which causes nosocomial infections in immunocompromised patients, especially in hospitalized burn patients. In recent times, it has emerged as a widespread Multi Drug Resistant (MDR) pathogen which requires antibiotic susceptibility testing on a regular as well as a periodic basis. Aim of the study: The present study was undertaken to determine the antibiogram of P. aeruginosa which was isolated from inpatients and environmental sources, and to type the strains, based on their antibiogram patterns.Settings and Design: A prospective study was undertaken with 525 samples (blood and wound swabs) which were taken from 60 patients who were admitted to Vardhman Mahavir Medical College and Safdarjang hospital with burn injuries and with 101 samples which were obtained from environmental sources viz. surgical instruments, dressings, suction devices, sinks, antiseptic solutions, etc. Materials and Methods: The strains were cultured and identified by standard microbiological techniques and Kirby- Bauer disc diffusion antibiotic susceptibility testing was done for each. Statistical analysis: Chi -squire tests were done and p- values of less than 0.05 were considered to be significant. Results: Fifty six strains and two strains, respectively, of P. aeruginosa were isolated from inpatients and environmental samples (one strain from sink and one strain from door wall, among the two) respectively. In total, 58 (81%) P. aeruginosa strains were found to be resistant to aminoglycosides, 41-70% were resistant to beta-lactams - piperacillin, ceftazidime, and aztreonam, 34.5% were resistant to piperacillin-tazobactam, 12.06% were resistant to ciprofloxacin and 13-19% were resistant to carbapenems. All strains were sensitive to colistin. P. aeruginosa was resistant to three of the four 'in-use' drugs i.e. piperacillin+tazobactam, imipenem, ceftazidime, and gentamicin, which was taken as MDR, which depicted MDR percentage as 36.2 (21/58). Conclusion: Strategies of optimal prescribing, including control of antibiotic usage, coupled with periodic studies on MDR P. aeruginosa infections in burn patients, appear to be leading priorities which help in improving therapeutic gains in such patients.


Ahmed N.H.,Delhi State Cancer Institute | Samantaray J.C.,All India Institute of Medical Sciences
Journal of Clinical and Diagnostic Research | Year: 2014

Quantitative buffy coat (QBC) analysis, which is based on principle of centrifugal stratification of blood components, is a well-known and a very sensitive technique which can be used for the detection of malarial parasites in peripheral blood. In our experience, this technique is also highly specific for doing speciation of malarial parasite in Indian set up. In addition, this technique was also found to be a sensitive and specific tool for diagnosing filariasis. Lastly, the cellular pattern of buffy coat in QBC, together with other non-specific findings, has many times aided in making correct diagnoses in difficult cases of visceral Leishmaniasis.


Baruah F.K.,Delhi State Cancer Institute | Grover R.K.,Delhi State Cancer Institute
Journal of Clinical and Diagnostic Research | Year: 2014

Shewanella species are Gram-negative, non-fermentative, oxidase positive, motile bacilli with the major phenotypic characteristic of production of large amounts of hydrogen sulfide. Shewanella putrefaciens, primarily considered to be an environmental bacterium, is infrequently recovered from clinical specimens. Herein, we report a case of ascitic fluid infection with carbapenem resistant Shewanella putrefaciens in a patient with underlying liver disorder requiring repeated ascitic fluid tapping. Proper antibiotic therapy helped in complete recovery of the patient. © 2014, Journal of Clinical and Diagnostic Research. All rights reserved.


Baruah F.K.,Delhi State Cancer Institute | Jain M.,Delhi State Cancer Institute | Lodha M.,Delhi State Cancer Institute | Grover R.K.,Delhi State Cancer Institute
Indian Journal of Pathology and Microbiology | Year: 2014

Oligella ureolytica is an emerging bacteria rarely implicated as a human pathogen. It is infrequently recovered from clinical specimens probably because of inadequate processing of non-fermenting oxidase positive Gram negative bacilli. We present here a case of a 30 year old male suffering from right lung adenocarcinoma (moderately differentiated) with multiple abdominal lymph node metastasis with Syringohydromyelia whose blood culture yielded Oligella ureolytica in pure culture. Oligella ureolytica isolation in pure culture and the patient's response to targeted treatment supported that Oligella ureolytica was the true causative agent of the blood stream infection. Early suspicion, diagnosis and treatment with potent antibiotics are needed to prevent further complications resulting from infection with this emerging pathogen.

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