Bankura Sammilani Medical College

INTRODUCTION: The existence of cancer stem cells (CSCs) has been associated with tumor initiation, therapy resistance, tumor relapse, angiogenesis, and metastasis. Curcumin, a plant ployphenol, has several anti-tumor effects and has been shown to target CSCs. Here, we aimed at evaluating (i) the mechanisms underlying the aggravated migration potential of breast CSCs (bCSCs) and (ii) the effects of curcumin in modulating the same. METHODS: The migratory behavior of MCF-7 bCSCs was assessed by using cell adhesion, spreading, transwell migration, and three-dimensional invasion assays. Stem cell characteristics were studied by using flow cytometry. The effects of curcumin on bCSCs were deciphered by cell viability assay, Western blotting, confocal microscopy, and small interfering RNA (siRNA)-mediated gene silencing. Evaluations of samples of patients with breast cancer were performed by using immunohistochemistry and flow cytometry. RESULTS: Here, we report that bCSCs are endowed with aggravated migration property due to the inherent suppression of the tumor suppressor, E-cadherin, which is restored by curcumin. A search for the underlying mechanism revealed that, in bCSCs, higher nuclear translocation of beta-catenin (i) decreases E-cadherin/beta-catenin complex formation and membrane retention of beta-catenin, (ii) upregulates the expression of its epithelial-mesenchymal transition (EMT)-promoting target genes (including Slug), and thereby (iii) downregulates E-cadherin transcription to subsequently promote EMT and migration of these bCSCs. In contrast, curcumin inhibits beta-catenin nuclear translocation, thus impeding trans-activation of Slug. As a consequence, E-cadherin expression is restored, thereby increasing E-cadherin/beta-catenin complex formation and cytosolic retention of more beta-catenin to finally suppress EMT and migration of bCSCs. CONCLUSIONS: Cumulatively, our findings disclose that curcumin inhibits bCSC migration by amplifying E-cadherin/beta-catenin negative feedback loop.

AIMS: To evaluate the behavioural and psychological symptoms of dementia (BPSD), to determine their correlation with types and stages of dementia and patient demographics, and to assess the impact on caregiver distress. METHODS: This cross-sectional study recruited consecutive dementia patients and caregivers who attended our cognitive clinic. Standard criteria were used to classify types of dementia. BPSD were assessed with the Neuropsychiatric Inventory, and its distress scale was used for caregiver distress. RESULTS: Of a total 107 patients, nearly all (99.1%) had at least one BPSD; 71% had ≥4 symptoms. Most frequent were apathy and agitation, followed by irritability, sleep and appetite disorders, and mood disorders; disinhibition and euphoria were least frequent. BPSD were less prominent with increasing age; males showed more agitation. Apathy and eating disorders were more prevalent in the rural community. BPSD were highest in frontotemporal dementia (FTD), followed by dementia with Lewy bodies (DLB), and least in vascular dementia. Hallucinations were more common in DLB, aberrant motor behaviour in FTD. All domains of BPSD, except for anxiety and euphoria, were more prominent with increasing severity of dementia. Increasing BPSD (except for euphoria) caused higher caregiver distress. CONCLUSION: BPSD are universally present, bear correlates with dementia type and severity, and cause significant caregiver distress.

Acquired chemoresistance has curtailed cancer survival since the dawn of chemotherapy. Accumulating evidence suggests a major role for cancer stem cells (CSC) in chemoresistance, although their involvement in acquired resistance is still unknown. The use of aspirin has been associated with reduced cancer risk and recurrence, suggesting that the anti-inflammatory drug may exert effects on CSCs. In this study, we investigated the contribution of CSCs to acquired chemoresistance of breast cancer and the avenues for reversing such effects with aspirin. We observed that the residual risk of recurrence was higher in breast cancer patients who had acquired chemoresistance. Treatment of preexisting CSCs with a genotoxic drug combination (5-fluorouracil, doxorubicin, and cyclophosphamide) generated an NFκB-IL6-dependent inflammatory environment that imparted stemness to nonstem cancer cells, induced multidrug resistance, and enhanced the migration potential of CSCs. Treatment with aspirin prior to chemotherapy suppressed the acquisition of chemoresistance by perturbing the nuclear translocation of NFκB in preexisting CSCs. Therefore, disruptions to the NFκB-IL6 feedback loop prevented CSC induction and sensitized preexisting CSCs to chemotherapy. Collectively, our findings suggest that combining aspirin and conventional chemotherapy may offer a new treatment strategy to improve recurrence-free survival of breast cancer patients. Cancer Res; 76(7); 2000-12. ©2016 AACR.

BACKGROUND: Hereditary hemoglobin (Hb) disorders are the most commonly encountered single gene disorders in India. Proper timely identification of these disorders is of paramount importance to prevent thalassemia major and clinically severe hemoglobinopathy as well as for epidemiologic purposes. AIMS: Our aim was to determine the prevalence of thalassemia and hemoglobinopathy in patients of a tertiary care hospital of West Bengal, India. MATERIALS AND METHODS: This prospective study was conducted on 119,336 cases over a period of 10 years. After taking clinical history and familial history, complete hemogram report was obtained by an automated cell counter. High-performance liquid chromatography (HPLC) was performed on the samples with Bio-Rad Variant using beta thalassemia short program. Confirmatory tests were performed whenever required. RESULTS: A normal Hb pattern was observed in 104,804 (87.83%) cases and abnormalities were detected in 14,532 (12.17%) patients. β (beta) thalassemia trait was the commonest abnormality found in 5,488 (4.60%) patients. HbE trait was found in 3,604 (3.02%) patients, β thalassemia major/intermedia in 1,981 (1.66%) cases, and Eβ thalassemia in 1,384 (1.16 %) cases. Other variants detected included HbE disease, sickle-cell disease, sickle β thalassemia, HbD-Punjab trait, HbQ-India trait, α-thal trait, double heterozygous state of HbS and HbE, double heterozygous state of HbS and HbD, HbJ-Meerut, hereditary persistence of fetal hemoglobin (HPFH), HbH, delta β-thal trait, and Hb Lepore. CONCLUSION: In view of the high prevalence of hemoglobinopathy in this region, a routine premarital screening program is needed for the identification and prevention of high-risk marriages and thus, prevention of the psychosocial trauma of bearing a transfusion-dependent child for life.

Mimicking skin extracellular matrix hierarchy, the present work aims to develop a bilayer skin graft comprising a porous cotton-wool-like 3D layer with membranous structure of PCL-chitosan nanofibers. Emulsion electrospinning with differential stirring periods of PCL-chitosan emulsion results in development of a bilayer 3D structure with varied morphology. The electrospun membrane has fiber diameter ∼274 nm and pore size ∼1.16 μm while fluffy 3D layer has fiber diameter ∼1.62 μm and pore size ∼62 μm. The 3D layer was further coated with collagen I isolated from Cirrhinus cirrhosus fish scales to improve biofunctionality. Surface coating with collagen I resulted in bundling the fibers together, thereby increasing their average diameter to 2.80 μm and decreasing pore size to ∼45 μm. The architecture and composition of the scaffold promotes efficient cellular activity where interconnected porosity with ECM resembling collagen I coating assists cellular adhesion, infiltration, and proliferation from initial days of fibroblast seeding, while keratinocytes migrate on the surface only without infiltrating in the membranous nanofiber layer. Anatomy of the scaffold arising due to variation in pore size distribution at different layers thereby facilitates compartmentalization and prevents initial cellular transmigration. The scaffold also assists in extracellular matrix protein synthesis and keratinocyte stratification in vitro. Further, the scaffold effectively integrates and attaches with third-degree burn wound margins created in rat models and accelerates healing in comparison to standard Tegaderm dressing™. The bilayer scaffold is thus a promising, readily available, cost-effective, off-the-shelf matrix as a skin substitute.

The adoption of sustainable agricultural practices is increasingly imperative in addressing global food security and environmental concerns, with microbial based bio-inoculums emerging as a promising approach for nurturing soil health and fostering sustainable crop production.This review article explores the potential of microbial based bio-inoculumsor biofertilizers as a transformative approach toenhance plant disease resistance and growth. It explores the commercial prospects of biofertilizers, highlighting their role in addressing environmental concerns associated with conventional fertilizers while meeting the growing demand for eco-friendly agricultural practices. Additionally, this review discusses the future prospects of biofertilizers, emphasizing the ongoing advancements in biotechnology and formulation techniques that are expected to enhance their efficacy and applicability. Furthermore, this article provides insights into strategies for the successful acceptance of biofertilizers among farmers, including the importance of quality control, assurance, and education initiatives to raise awareness about their benefits and overcome barriers to adoption. By synthesizing the current research findings and industrial developments, this review offers valuable guidance for stakeholders seeking to exploit the potential of biofertilizers or beneficial microbes to promote soil health, ensure sustainable crop production, and addressing the challenges of modern agriculture.

Clinical trials looking at which treatment is better must have certain checks in place. Appropriate "control" selection while comparing the investigating agent to the "control group is essential to rule out selection bias. Randomization is another step to minimize variability or "confounders." By randomization, research participants have an equal chance of being selected into any treatment group of the study, generating comparable intervention groups, thereby distributing the confounders. A trial can be "open labeled" or "blinded." By the process of blinding, we make the participant and/or assessing physician unaware of the treatment he/she is going to receive. Thus, the element of bias which can creep in owing to personal preference or subjective component to the assessment of outcome can be eliminated. Concealment of allocation is done as the participant enters the trial. Concealment secures randomization and prevents "selection bias".

Context: Birth Preparedness and Complication Readiness (BPCR) is crucial in averting maternal morbidity and mortality. Objectives: To find out awareness and practices regarding BPCR among pregnant and recently delivered women in Uttar Dinajpur, West Bengal. Materials and Methods: This is a cross-sectional, community-based, mixed methods study. Two-stage, 40 cluster sampling technique was used to select three pregnant and six recently delivered women separately. Information on socio-demographic variables as well as awareness and practices regarding BPCR were collected through semi-structured interview. In-depth interviews with one respondent per cluster were also conducted. For statistical analysis Z test was used. Results: Around 50% of the respondents planned for first antenatal check-up (ANC) within 12 weeks, four or more ANCs and institutional delivery. Proportion of women aware of at least one key danger sign each of pregnancy, labor, postpartum, and newborn ranged from 12.1% to 37.2%, whereas 58.3% knew at least one key component of essential newborn care. Around two-thirds and one-third of women, respectively, especially those from backward and below poverty line (BPL) families knew about cash incentive and referral transport schemes. Proportions of women with first ANC within 12 weeks, four or more ANCs, institutional delivery, saving money, identifying transport, and blood donor were 50.4%, 33.6%, 46.2%, 40.8%, 27.3%, and 9.6%, respectively. Hindu religion, backward castes, BPL status, and education ≥ 5 years influenced the practices except for two regarding ANC. Overall BPCR index of the study population was 34.5. Conclusion: Preparedness in health system, ensuring competence, and motivation of workers are needed for promoting BPCR among the study population.

BACKGROUND: Diarrheal diseases are an important cause of mortality and morbidity globally in children under 5 years of age. OBJECTIVE: To find the prevalence and risk factors of diarrhea among children under 5 years. MATERIALS AND METHODS: A population-based analytical cross-sectional study was conducted in the urban slums of Bankura, West Bengal on the prevalence of diarrhea and feeding practices, nutrition, and immunization among 152 children under 5 years (69 males and 83 females). RESULTS: Overall prevalence of diarrhea was 22.36%; 21.73% males and 22.89% females were affected with diarrhea. There were 57.69% diarrhea cases in children of 7-12 months age group, followed by 25.71% in those of 13-24 months age group; with increasing age, the prevalence of diarrhea gradually decreased. Diarrhea was noted to be 20.33% in exclusively breastfed children and 31.57% in children who were breastfed for less than 6 months. In bottle-fed children, the frequency of diarrhea was 26.08%. The prevalence of diarrhea was 21.83% in completely immunized children and 30% in partially immunized children. Risk of diarrhea was 19.80% in normal participants and 27.45% in undernourished children. CONCLUSION: The present study identified a high prevalence of diarrhea in children under the age of 5 years. Findings of the study also revealed the demographic features, feeding practices, immunization practices, and nutritional status as risk factors of diarrhea, which can be tackled by effective education of the community.

BACKGROUND: The risk factors predictive of intracranial aneurysm rupture remain incompletely defined. OBJECTIVE: To examine the association between various nonmodifiable risk factors and aneurysm rupture in a large cohort of patients evaluated at a single institution. METHODS: A retrospective analysis of patients admitted to a cerebrovascular facility between January 2006 and 2010 with a primary diagnosis of cerebral aneurysm. Aneurysms were divided into 2 groups: unruptured or ruptured. The dome diameter, aspect ratio (AR), location, sidedness, neck morphology, and multiplicity were entered into a central database. A full model was constructed, and a systematic removal of the least significant variables was performed in a sequential fashion until only those variables reaching significance remained. RESULTS: We identified 2347 patients harboring 5134 individual aneurysms, of which 34.90% were ruptured and 65.09% were unruptured. On admission, 25.89% of aneurysms with a dome diameter <10 mm and 58.33% of aneurysms with a dome >10 mm were ruptured (P < .001). Of aneurysms with an AR >1.6, 52.44% presented following a rupture (P < .001). The highest incidence of rupture (69.21%) was observed in aneurysms with an AR >1.6, dome diameter <10 mm, and a deviated neck. Deviated neck-type aneurysms had a significantly greater incidence of rupture than classical neck-type aneurysms (P < .001). CONCLUSION: An AR >1.6, dome diameter >10 mm, a deviated neck, and right-sidedness are independently associated with aneurysm rupture.

Electrospun nanofibrous scaffold has long been studied as skin substitutes for their structural resemblance to the dermal extracellular matrix. However, packed fibrous architecture with small pore size restricts cellular infiltration into nanofibrous mat. In this article, we report highly porous, nano-/microfibrous 3D structure using polycaprolactone-chitosan emulsion and its application in skin regeneration. Under the influence of electric field, the emulsion containing encapsulated charged chitosan droplets enhances charge of the spinning solution and residual charge in the core of the deposited fiber, thereby creating core–shell, cotton-like fluffy structure with average pore size 62 μm, fiber diameter ∼1.62 μm, contact angle of 72° and 80% water uptake capacity of the scaffold. Further, differential stirring period of the specific emulsion developed compact nanofibrous membrane with nanometer ranged pore size emphasizing the role played by emulsion droplet size and the charge carried thereafter. Presence of nanofibers with high-interconnected porosity promoted efficient cellular infiltration and proliferation from initial days of cell seeding. The scaffold supported extracellular matrix protein expression and stratified epithelialization in vitro. Effective integration and attachment of scaffold with margins of a full-thickness excision wound created in a rat model with accelerated healing within 3 weeks proved the efficiency of the scaffold as skin substitute. Additionally, gradual and prolong release of acidic chitosan from the core section benefitted wound healing by lowering the pH of wound environment. Simple technique with inexpensive raw materials endorsed the scaffold as a promising off-the-shelf matrix for skin tissue regeneration.

BACKGROUND AND AIMS: Different additives have been used to prolong brachial plexus block. We evaluated the effect of adding dexmedetomidine to ropivacaine for supraclavicular brachial plexus blockade. The primary endpoints were the onset and duration of sensory and motor block and duration of analgesia. MATERIALS AND METHODS: A total of 84 patients (20-50 years) posted for elective forearm and hand surgery under supraclavicular brachial plexus block were divided into two equal groups (Group R and RD) in a randomized, double-blind fashion. In group RD (n = 42) 30 ml 0.5% ropivacaine +1 ml (100 μg) of dexmedetomidine and group R (n = 42) 30 ml 0.5% ropivacaine +1 ml normal saline were administered in supraclavicular block. Sensory and motor block onset times and block durations, time to first analgesic use, total analgesic need, postoperative visual analog scale (VAS), hemodynamics and side-effects were recorded for each patient. RESULTS: Though with similar demographic profile in both groups, sensory and motor block in group RD (P < 0.05) was earlier than group R. Sensory and motor block duration and time to first analgesic use were significantly longer and the total need for rescue analgesics was lower in group RD (P < 0.05) than group R. Post-operative VAS value at 12 h were significantly lower in group RD (P < 0.05). Intra-operative hemodynamics were significantly lower in group RD (P < 0.05) without any appreciable side-effects. CONCLUSION: It can be concluded that adding dexmedetomidine to supraclavicular brachial plexus block increases the sensory and motor block duration and time to first analgesic use, and decreases total analgesic use with no side-effects.

BACKGROUND: The purpose of this study was to examine the feasibility of single-stage resection and anastomosis for acute left-sided colonic obstruction due to acute sigmoid volvulus without intraoperative lavage. Mechanical bowel preparation has been shown to be unnecessary for elective colorectal surgery. Colonic decompression without intraoperative lavage may simplify operations in acute left-sided colorectal obstruction. METHODS: Emergency resection of acute sigmoid volvulus was performed. This was followed by primary anastomosis without on-table lavage after closed bowel decompression. RESULTS: A total of 197 patients underwent bowel decompression, resection and primary colonic anastomosis. Two patients developed anastomosis leak, requiring re-laparotomy, Hartmann's procedure and delayed closure. Two deaths occurred postoperatively; these were unrelated to the nature of the surgery. The mean hospital stay was 9.8 days. CONCLUSION: Primary colonic anastomosis can be safely done for obstructed left colon due to acute sigmoid volvulus without intraoperative colonic lavage.

BACKGROUND: While the cause of Parkinson's disease (PD) remains unknown, evidence suggests certain environmental factors, such as well water drinking, herbicides, pesticides exposure and neurotoxins, may trigger the chain of oxidative reactions culminating in the death of dopaminergic neurons in substantia nigra to cause Parkinsonism. To investigate the possible impact of environmental risk factors for idiopathic PD, a case-control study was performed in the Eastern India. METHODS: During the period from January 1st, 2006 and December 10th, 2009, 175 PD patients (140 men, 35 women) and 350 non-Parkinson age-sex matched controls were included in the study. Subjects were given a structured neurological examination and completed an administered questionnaire which elicited detailed information on demographic data, pesticides, herbicides family history, occupation, dietary and smoking habits. RESULTS: The multivariate analysis revealed that family history of PD, pesticide exposure, exposure to toxins other than pesticides and herbicides, rural living and previous history of depression were associated with increased risk of PD, whereas, smoking appeared to be a protective factor. Well water drinking for at least five years, though a significant risk factor on univariate analysis (OR = 4.5, 95% CI = 2.1-9.9), could not be proved significant in multivariate analysis. Head trauma, vegetarian dietary habit, occupation involving physical exertion and exposure to domestic pets were not as significant risk factors. CONCLUSION: Results of our study support the hypothesis of multifactorial etiology of PD with environmental factors acting on a genetically susceptible host.

BACKGROUND: Myopia is one of the most common causes of visual impairment worldwide.It is proved in earlier studies that the eye shape is different in myopic and nonmyopic children even at a very young age, with the former manifesting asymmetric axial globe elongation and the latter global expansion but limited information is available regarding hypermetropia. AIM: To find out the variations of axial ocular dimensions in relation to age, sex, height and to demonstrate any possible correlation of body mass index (BMI) in myopic hypermetropic and emmetropic patients. SETTINGS: It is a cross-sectional observational study. MATERIALS AND METHODS: All the patients attending eye OPD in the Regional Institute of Ophthalmology (R.I.O.), Medical College, Kolkata, West Bengal, India from June2010 to May 2011.Axial dimensions were measured by B-mode USG. Refractive status was measured.Age, gender, height and BMI were also observed. After collecting all the data,all the variables were summarised by descriptive statistics followed by correlation testing by Pearson's Correlation Coefficient r. RESULTS: Height was positively correlated with axial length, anterior chamber depth, vitreous chamber depth ;age was positively correlated with axial length, vitreous chamber depth and negatively correlated with anterior chamber depth. Subjects with higher BMI tended to had refractions that were more hypermetropic. CONCLUSION: The findings of the present study can highlight not only the normal range of the different ocular parameters namely axial length, anterior chamber depth, vitreous chamber depth and lens thickness but their variation with age, gender, height and weight.

Chronic tophaceous gout classically occurs after 10 years or more of recurrent polyarticular gout. However, tophi can also occur as first sign of the disorder. Here we report a 20-year-old male presenting with multiple subcutaneous nodules on bilateral feet and toes, left palm, right elbow, helix of left ear since last one and half year prior to any other manifestation of gout. He was having mild intermittent arthritis since last six months. Fine Needle Aspiration Cytology of one tophus showed monosodium urate crystals, which are pathognomonic for gout. His serum uric acid was normal and ultrasound revealed bilateral nephrocalcinosis. So far as we know, this is the first case report from India, demonstrating tophi as the initial clinical presentation of gout.

BACKGROUND: Postoperative nausea and vomiting (PONV) is a serious concern in patients undergoing laparoscopic cholecystectomy (LC), with an incidence of 46 to 72%. The purpose of this study was to compare the antiemetic efficacy of intravenous (iv) ondansetron 8 mg, ramosetron 0.3 mg, and palonosetron 0.075 mg for prophylaxis of PONV in high-risk patients undergoing LC. MATERIALS AND METHODS: In this prospective, randomized, double-blinded study, 87 female patients, 18 to 70 years of age (ASA I and II) and undergoing elective LC under general anesthesia were randomly allocated into three equal groups, the ondansetron group (8 mg iv; n=29), the ramosetron group (0.3 mg iv; n=29), and the palonosetron group (0.075 mg iv; n=29), and the treatments were given just after completion of surgery before extubation. The incidence of complete response (patients who had no PONV and needed no other rescue antiemetic medication), nausea, vomiting, retching, and need for rescue antiemetics over 24 hours after surgery were evaluated. RESULTS: The number of complete responders were 19 (65.5%) for ramosetron, 11 (37.9%) for palonosetron, and 10 (34.5%) for ondansetron, representing a significant difference overall (P=0.034) as well as between ramosetron and ondansetron (P=0.035). Comparison between ramosetron and palonosetron also showed a clear trend favoring the former (P=0.065). CONCLUSION: Ramosetron 0.3 mg iv was more effective than palonosetron 0.075 mg and ondansetron 8 mg in the early postoperative period, but there was no significant difference in the overall incidence of nausea suffered.

A community-based cross-sectional study was conducted to find out the prevalence of composite index of anthropometric failure (CIAF) among 117 slum dwelling under-five children in Bankura town, West Bengal and its relation with some common socio-economic factors. Among study population, the prevalence of underweight was 41.6%, whereas CIAF was 80.3%. CIAF gave a near complete estimation of undernutrition unlike underweight. Children who were unimmunized, with more number of siblings, living in a nuclear family, or with illiterate mothers were more likely to be undernourished.

This study describes the electron transfer (ET) phenomenon through a series of (Pro-Hyp-Gly) repeat units containing collagen mimics. The peptides contain redox-active ferrocene (Fc) and thiol-functionalized cystein (Cys) at the N- and C-terminals, respectively. Peptide films were prepared on gold surfaces and characterized by X-ray photoelectron spectroscopy (XPS), ellipsometry, and Fourier transform-reflection absorption infrared spectroscopy (FT-RAIRS). Electrochemical investigations of the films showed a linear but weakly distance-dependent ET. The importance of H-bonding was realized, and the possibility of a conformationally gated ET mechanism has been discussed.

Background: Fine needle aspiration cytology (FNAC) of the thyroid gland has been widely and successfully utilized for diagnosis. Aim: Our aim was to demonstrate the effectiveness of this cheap and simple procedure for the diagnosis of different thyroid lesions, particularly, differentiation of malignant and nonmalignant lesions. In addition, we sought to highlight probable causes of error and possible remedies in the cases showing lack of correlation between cytological and histological diagnoses. Materials and Methods: A total of 288 cases of thyroid swellings were aspirated in our two-year study period. Cases were divided into four groups, namely, aspiration inadequate where diagnosis was not offered; a nonneoplastic group which included different goiters and thyroiditis; an indeterminate group which included cases showing features of follicular or Hurthle cell neoplasms, and a malignant group that included nonfollicular malignant tumors of the thyroid. Cases showing cytohistologic disparity were reevaluated. Results: Almost 14% of the cases could not be reported because of inadequate aspiration, however, an overall cytohistological correlation was achieved in 82.66% of all cases. Sensitivity and specificity for the diagnosis of malignancy were 92.7 and 98.2%, respectively. There were four false negative malignant cases with one false positive case and 13 cases failed to show any cytohistological correlation. Conclusions: FNAC is the single most important test for preoperative assessment of thyroid pathology if attention is paid to the clinical features and collection of samples from proper sites.