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Wells J.,University of Chicago | Srinath A.,Sri Shankara Cancer Hospital and Research Center | Free C.,London School of Hygiene and Tropical Medicine | Forde G.,Michigan State University | Forde C.,University of South Florida
University of Toronto Medical Journal | Year: 2012

Objective: To examine the cost-effectiveness of a mobile phone SMS text-based smoking cessation intervention of young adult smokers in the United Kingdom. Design: A Markov model was constructed to examine data from British and international literature. The SMS text-based intervention is compared with a NHS behavioral modification smoking cessation program. Setting: Community setting in the United Kingdom. Participants: 200 people, average age of 37, in the London metropolitan area. Main Outcome Measures: Cost per life years gained. Results: The SMS text-based smoking intervention is more advantageous from the health care payer and societal viewpoints. Sensitivity analyses illustrate robust results. The incremental cost-effectiveness ratio (ICER) is £1.86 per life year gained, far below the NICE willingness to pay cost-effectiveness threshold of £20,000. Discussion: Cost-effectiveness modeling for smoking cessation intervention programs is a daunting challenge. However, even with the limitations of SMS text-based smoking cessation interventions, further research should be conducted with this burgeoning, innovative mode of facilitating behavioral modification through the use technology. Source


Bhagat R.,Kidwai Memorial Institute of Oncology | Kumar S.S.,Kidwai Memorial Institute of Oncology | Vaderhobli S.,Kidwai Memorial Institute of Oncology | Premalata C.S.,Kidwai Memorial Institute of Oncology | And 3 more authors.
Tumor Biology | Year: 2014

Silencing of tumor suppressor and tumor-related genes by promoter hypermethylation is one of the major events in ovarian carcinogenesis. In this study, we analyzed aberrant promoter methylation of p16 and RAR-β genes in 134 epithelial ovarian carcinomas (EOCs), 23 low malignant potential (LMP) tumors, 26 benign cystadenomas, and 15 normal ovarian tissues. Methylation was investigated by methylation-specific PCR (MSP), and the results were confirmed by bisulfite DNA sequencing. Relative gene expression of p16 and RAR-β was done using quantitative reverse transcriptase PCR (qRT-PCR) on 51 EOC cases, 9 LMP tumors, and 7 benign cystadenomas with 5 normal ovarian tissues. Aberrant methylation for p16 and RAR-β was present in 43 % (58/134) and 31 % (41/134) in carcinoma cases, 22 % (05/23) and 52 % (12/23) in LMP tumors, and 42 % (11/26) and 69 % (18/26) in benign cystadenomas. No methylation was observed in any of the normal ovarian tissues. The mRNA expression level of p16 and RAR-β was significantly downregulated in EOC and LMP tumors than the corresponding normal tissues whereas the expression level was normal in benign cystadenomas for p16 and slightly reduced for RAR-β. A significant correlation of p16 promoter methylation was observed with reduced gene expression in EOC. For RAR-β, no significant correlation was observed between promoter methylation and gene expression. Our results suggest that epigenetic alterations of p16 and RAR-β have an important role in ovarian carcinogenesis and that mechanism along with methylation plays a significant role in downregulation of RAR-β gene in ovarian cancer. © 2014, International Society of Oncology and BioMarkers (ISOBM). Source


Shilpa V.,Kidwai Memorial Institute of Oncology | Bhagat R.,Kidwai Memorial Institute of Oncology | Premalata C.S.,Kidwai Memorial Institute of Oncology | Pallavi V.R.,Kidwai Memorial Institute of Oncology | And 3 more authors.
Tumor Biology | Year: 2014

Mounting evidences suggest that aberrant methylation of CpGislands is amajor pathway leading to the inactivation of tumour suppressor genes and the development of cancer. The aim of the current study was to examine the prevalence of the promoter hypermethylation and protein expression of the BRCA1 gene in epithelial ovarian carcinoma (EOC) to understand the role of epigenetic silencing in ovarian carcinogenesis. We studied the promoter methylation of the BRCA1 gene by methylation-specific PCR in a cohort of 88 patients with EOC, 14 low malignant potential (LMP) tumours and 20 patients with benign tumours of the ovary. The expression of the BRCA1 protein by immunohistochemical analysis was carried out in a subset of 64 EOCs, 10 LMP tumours, 10 benign tumours and 5 normal ovarian tissues. The frequencies of methylation in EOCs and LMP tumours were 51.2 and 57%, respectively, significantly higher (p=0.000 and p=0.001) in comparison to benign tumours and normal ovarian tissue where no methylation was seen. Expression of BRCA1 was significantly lower in EOCs (p=0.003). Lack of protein expression correlated with tumour grade and type. The methylation status correlated well with downregulation of BRCA1 expression. Our results clearly demonstrate that hypermethylation of BRCA1 promoter is a frequent event in ovarian cancer. These data support the hypothesis that BRCA1 promoter methylation plays an important role in the functional inactivation of BRCA1. Follow-up clinical data will reveal the impact of BRCA1 methylation on survival. © International Society of Oncology and BioMarkers (ISOBM) 2014. Source


Murthy R.S.,Sri Shankara Cancer Hospital and Research Center
Current Opinion in Psychiatry | Year: 2016

PURPOSE OF REVIEW: Understand recent developments in psychosocial and behavioral aspects of populations affected by humanitarian emergencies. The review covers the prevalence, longitudinal course, risk factors, posttraumatic growth, biological basis and interventions to address the needs. RECENT FINDINGS: Populations living in humanitarian emergencies, over 50 million worldwide, have higher risk of developing a range of mental disorders. There is evidence of persistence of these disturbances over long periods of time. There is growing body of knowledge to indicate the biological pathways to the occurrence of mental disorders. A proportion of population report posttraumatic growth. There is new focus on identifying the characteristics of risk factors, resilience at the individual, family, community and societal levels. Range of interventions to address the mental health needs is in use from strengthening the coping of individuals, parenting, school-based interventions and use of cognitive behavior therapy. Biological basis is becoming clear. SUMMARY: The most important message of the review is the high mental health needs of individuals living in emergency situations and the urgent need to work toward adequate preparedness for natural disasters, integrate psychosocial interventions as part of relief, rehabilitation and reconstruction and work toward preventing situations of conflict, war, migration and refugee situations. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. Source


Janardhan B.,Kidwai Memorial Institute of Oncology | Vaderhobli S.,Kidwai Memorial Institute of Oncology | Bhagat R.,Kidwai Memorial Institute of Oncology | Srinivasamurthy P.C.,Kidwai Memorial Institute of Oncology | And 4 more authors.
PLoS ONE | Year: 2015

Epithelial ovarian cancer is one of the increasingly incident malignancies that is notorious because of its evasiveness for early diagnosis and high mortality rates. Epithelial ovarian cancers are highly dependent on pathologic vasculature and Vascular Endothelial Growth Factor is known to be one of the most efficient angiogenic factors. Polymorphisms of the VEGF gene, in this study, were assessed for association with the malignancy and other clinico-pathological factors. 300 case samples and 320 age and mensus status matched controls were inculcated into the study. rs699947, rs833061, rs1570360, rs2010963, rs1413711 and rs3025039 were the six single nucleotide polymorphisms that were scrutinized. Genotyping was carried out by polymerase chain reaction and restriction fragment length polymorphism. rs 3025039 showed immense promise as a marker for disease aggression and recurrence and a factor for poor prognosis. rs699947 showed least association with the disease and clinico-pathologic factors studied. rs833061, rs 1570360 showed significant association with some clinico-pathological factors such as bilateral affliction of ovaries and post operative CA-125 levels. rs2010963 associated with presence of ascites in higher volumes. The SNPs under consideration showed no formidable linkage in our study samples. A haplotype analysis (excluding rs699947 and rs1413711) revealed 5 frontrunners being present in >85% of the population with TGGC and CGCC associating significantly as protective and risk factors respectively. These haplotypes showed a dose dependent additive effect of their seeming functionality. This study is unique and a first of its kind carried out in the Indian population of South-east Asia. Copyright: © 2015 Janardhan et al. Source

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