Renal cell carcinoma in allograft kidney – a case report with unusual findings at autopsy

A 30-year old male who had a non-related cadaveric renal transplant at the age of 12 years, presented with generalised CNS symptoms and meningeal enhancement on CT scan of the brain, 18 years after the transplantation. Autopsy revealed renal cell carcinoma in the transplanted kidney and metastatic tumour in a variety of organs including the brain. Prior ultrasound scans done at various post-transplant periods had all been normal.     

Bacterial proteins as potential drugs in the treatment of leukemia

Azurin and Laz are bacterial proteins that have been shown to exert anticancer effects against a variety of solid tumors. Their effects on liquid cancers have never been studied. We now show that they are also effective against liquid-borne cancers such as leukemia. Azurin and Laz can each enter in two leukemia cell lines but Laz exerts a greater cytotoxic effect on both K562 and HL60 cells, while having little effect on peripheral blood mononuclear cells, where they have very limited entry. In addition to Azurin and Laz, we have recently identified another protein, Pa-CARD, from Pseudomonas aeruginosa that carries a caspase recruiment domain (CARD)-like domain. This CARD domain polypeptide, called Pa-CARD, demonstrates cytotoxic activity against leukemia cells. In the leukemia cell lines, HL60 and K562, the anticancer activity of Laz and Pa-CARD is mediated through cell cycle arrest at the G2/M phase involving the Wee1 protein stabilization and the depletion of phosphorylated AKT-Ser-473, the active form of a serine/threonine kinase that is often dysregulated in many cancer types.     

Nurses failure to appreciate the risks of infection due to needle stick accidents: a hospital based survey.

One of the most important occupational risks to healthcare workers is exposure is to blood-borne viruses. This study examined nurses' perceptions of risk of contracting infection following single or multiple exposure to blood or body fluids. Two hundred and ninety nurses were surveyed using a questionnaire. One hundred and thirty-three responded; 85 worked in higher risk areas (ITU, Haematology, Haemodialysis and Neonatal Surgical Units) (Group A) and 48 worked in lower risk areas (medical wards, an orthopaedic and an ENT ward) (Group B). Forty-nine percent of subjects from group A and 60% of subjects from Group B believed that a needle stick injury with a needle contaminated with infected blood was an unlikely source of infection. Fifteen percent from group A and 20% from group B thought that infection with a blood-borne virus following a needle stick injury contaminated with Human Immunodeficiency Virus (HIV) infected blood was very unlikely. Twelve percent from group A and 10% from Group B did not know whether resheathing needles between use can provide protection against HIV. Sixty-seven percent from group A and 71% from group B disagreed with the statement that nurses are at higher risk of exposure to HIV/HBV than the other healthcare workers. Thirteen percent from group A and 5% from group B agreed with the statement, whereas 8% from group A and 5% from group B thought that nurses are at less risk. Only 22% from group A and 23% from group B would take more precautions if they knew that the patient had HIV/HBV infection, whilst 11% and 8% respectively admitted that they would take special precautions only when the patient has clinical symptoms of HIV/HBV infection. The findings suggest that these nurses would benefit from further education regarding infection from blood-borne viruses.     

Physical Growth and Nutritional Status of the Shabar Tribal Adolescents of Orissa, India: a Cross-sectional Study

The aim of the study is to assess the growth and nutritional status of adolescents of the Shabar tribe of Orissa, India. There are no studies on the growth pattern of the Shabar tribe, one of the largest tribal communities of Orissa. Studies of other tribes have shown poor health status of their members. This cross-sectional study was carried out on 328 adolescents (149 boys and 179 girls), aged 10 to 18 years from Khurda and Cuttack districts of Orissa. Anthropometric measurements were taken to assess growth and nutritional status. Means, standard deviation and percentile curves were used to examine the pattern of growth, while t-test and 50th percentile values were used to compare the nutritional status with other studies. Values of <5th percentile of body mass index (BMI) for age were considered as indicators of under-nutrition. Most of the body measurements showed high rates of increase between 14 to 15 years among boys and 12 to 13 years among girls, which correspond to the adolescent growth spurt. The Shabar adolescents were significantly (p<0.01) shorter and lighter than the NCHS (National Center for Health Statistics) 50th percentile curves. There was high prevalence of chronic under-nutrition (<5th percentile of BMI for age). It is noted that the nutritional status of the Shabar children is generally better than that of other tribes. These findings may be attributed to various nutritional programmes for children. However, poor socio-economic status of this tribe remains an important factor for the high prevalence of chronic under-nutrition and poor growth pattern. In-depth studies are necessary for identifying other factors that lead to growth retardation and under-nutrition among the adolescents of the Shabar population.     

Growth and nutritional status of Bengali adolescent girls

Objective  Assessment of the growth and nutritional status among healthy Bengali adolescent schoolgirls at peri-urban area. Methods  In this cross sectional study, sample consists of 527 school going adolescent girls, aged 10 to 18 years. The sample of the present study was collected from a peri-urban area (Duttapukur) of north 24 parganas district of West Bengal, India. Standard anthropometric measurements including linear, curvilinear and skinfold thickness were collected from each subject. Percentile curves and nutritional indices were used to determine the growth and nutritional status respectively. Results  The nature of distance curves and percentile curves of the body measurements showed a high rate of increase in 10–11 years of age group corresponding to an earlier adolescent growth spurt than average Indian girls. The adolescent girls in the current study were found to be significantly (p<0.0001) taller than Indian girls and heavier than both Indian and urban Bengali girls but slightly shorter than urban Bengali girls. They are significantly (p<0.0001) shorter and lighter than American girls, which also corresponded to 50^th percentile curves. Age specific nutritional assessment shows different grades of malnutrition among them. Gomez’s classification indicates about 60 % to 70 % adolescent girls show either moderate to mild malnutrition during their growth period. Both the indices of Waterlow’s classification show least percentage of least malnutrition among the girls. Conclusion  The growth pattern and nutritional status observed among adolescent girls in peri-urban situation show heterogeneity with respect to some anthropometric traits and in conformity with the growth pattern and nutritional status of urban girls.     

Can Homeopathy Bring Additional Benefits to Thalassemic Patients on Hydroxyurea Therapy? Encouraging Results of a Preliminary Study

Several homeopathic remedies, namely, Pulsatilla Nigricans (30th potency), Ceanothus Americanus (both mother tincture and 6th potency) and Ferrum Metallicum (30th potency) selected as per similia principles were administered to 38 thalassemic patients receiving Hydroxyurea (HU) therapy for a varying period of time. Levels of serum ferritin (SF), fetal hemoglobin (HbF), hemoglobin (Hb), platelet count (PC), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular hemoglobin (MCH), white blood cell (WBC) count, bilirubin content, alanine amino transferase (ALT), aspartate amino transferase (AST) and serum total protein content of patients were determined before and 3 months after administration of the homeopathic remedies in combination with HU to evaluate additional benefits, if any, derived by the homeopathic remedies, by comparing the data with those of 38 subjects receiving only HU therapy. Preliminary results indicated that there was a significant decrease in the SF and increase in HbF levels in the combined, treated subjects. Although the changes in other parameters were not so significant, there was a significant decrease in size of spleen in most patients with spleenomegaly and improvement in general health conditions along with an increased gap between transfusions in most patients receiving the combined homeopathic treatment. The homeopathic remedies being inexpensive and without any known side-effects seem to have great potentials in bringing additional benefits to thalassemic patients; particularly in the developing world where blood transfusions suffer from inadequate screening and fall short of the stringent safety standards followed in the developed countries. Further independent studies are encouraged.