Review ofa Case of Coexisting KRAS and BRAF Mutations in a Patient with Metastatic Colon Adenocarcinoma | Chapter 17 | Innovations in Medicine and Medical Research Vol.2

KRAS and BRAF mutations are found in 30-50% and 10% of metastatic colorectal cancer (mCRC) patients respectively. Here we report a unique case of mCRC with coexistent KRAS and BRAF mutations. Patients harboring concomitant KRAS and BRAF mutations do not usually respond to standard chemotherapeutic regimens, usually have aggressive course of illness with poor prognosis and we are in dire need of developing new treatment strategies.

Author(s)Details

Anusha Vittal
Liver Diseases Branch, NIDDK, NIH, Bethesda, MD, The University of Kansas Medical Center, Kansas City, Kansas, USA.  

Anup Kasi,
Division of Medical Oncology, The University of Kansas Medical Center, Kansas City, Kansas, USA.

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TLP Sequenced and Studied for Its Functions with Targets Diagnostic and Therapeutic: Recent Perspective | Chapter 16 | Innovations in Medicine and Medical Research Vol.2

From the first analysis of immuneprecipitation followed by Western Blotting (WB) Corin and TLP seem to precipitate at the same height (approximately 50 KDa) and are recognized by the same antibodies. In parallel the tests of immunoprecipitation by the use of cell extracts derived from lung cancer cells A549 and NCI-H23 are improved with the aim to be able of obtaining a precipitate containing only the TLP. In fact the partial aminoacid sequence of TLP showes a high homology with the sequence of human Corin (only one aminoacid is different) and is present in lung cancer under different isoforms. It is known that human Corin is expressed mostly outside the cells and the protein extract derived from the extracellular medium and from the cells transfected with the plasmid, which overexpresses Corin, showes many more bands analyzed on SDS-PAGE that are equivalent to the bands (about 50-100 KDa) observed in the WB analyzed with anti-TLP. 

Author(s) Details

Giulio Tarro
Beaumont Bonelli Foundation for Cancer Research, Naples, Italy and Committee on Biotechnologies and VirusSphere, World Academy of Biomedical Technologies, UNESCO, Paris, France.

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Current Research on Abdominal Cocoon Syndrome: Two Cases of an Anatomical Abnormality | Chapter 15 | Innovations in Medicine and Medical Research Vol. 2

Introduction: Idiopathic sclerosing encapsulating peritonitis or abdominal cocoon syndrome (ACS) is a rare anatomical deformity characterized by the partial or complete encasement of the small intestine with fibrotic peritoneum. 193 incidents have been described worldwide. The aim of this study was to present two ACS cases successfully treated at the Surgical Clinic of the Agios Dimitrios General Hospital in Thessaloniki, Greece. Presentation of Cases: Two men (55 and 54 years old) presented to the emergency department complaining of abdominal pain, distension, constipation, nausea, and vomiting. Neither of these patients had surgical histories. The computed tomography of the first patient showed considerable distension of the small bowel, suggestive of an internal hernia. The second case showed distention of the jejunum with no obvious cause. Both patients underwent emergency surgery. Intraoperatively, we found that a fibrous membrane had completely covered the small intestine of the first patient, and the jejunum and part of the large intestine of the second patient. Adhesiolysis and a partial excision of the membrane were performed in both cases. Discussion: ACS is a rare cause of small bowel ileus. Although pharmaceutical treatments with immunosuppressants and steroids have been described, surgical treatment is the gold standard.  Conclusion: Preoperative clinical suspicion of this disease can help determine the diagnosis and protect surgeons from intraoperative “surprises.”  

Author(s) Details


Apostolos Sovatzidis
Healthcare Center of Evosmos, Thessaloniki, Greece.

Eirini Nikolaidou
Department of Plastic, Reconstructive and Hand Surgery and Burns ICU, General Hospital of Thessaloniki “G. Papanikolaou”, Thessaloniki, Greece.

Anastasios Katsourakis
Department of Surgery, Agios Dimitrios General Hospital, Thessaloniki, 54634, Greece. 

George Noussios
School of Physical Education and Sports Sciences, Aristotle University of Thessaloniki, 54623, Greece.

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Paul Ehlrich’s Mastzellon- The Legend Lives | Chapter 14 | Innovations in Medicine and Medical Research Vol. 2

Background: Mast cells (MC) secrete a variety of molecules that are implicated in either promoting tumour growth or may act in an opposite manner in other tumour types.  Aim: To evaluate the association of mast cells in the different grades of Oral Squamous Cell Carcinoma (OSCC).  Material and Methods: 45 diagnosed cases each of well, moderate and poorly differentiated OSCC were identified from the institutional archival material. Slides were made of 5 µm thickness and stained with Hematoxylin and eosin and 1% Toluidine blue stain. Each section was evaluated for mast cells in peritumoural, intratumoural locations and at the invasive front of the tumour. The results obtained were subjected to statistical evaluation by an SPSS version 19 using Chi square test, Anova and Post hoc Tuckey tests.  Results: An inverse relation was observed between MC count with grade of the tumour with maximum MC located in the peritumoural area followed by the invasive front and the least in the intra tumoural areas.  Conclusion: The results of the present study suggest that a decrease in MC count is associated with an advanced histologic grade of OSCC and hence a poorer prognosis, thus favouring the protective role of mast cells in OSCC.

Author(s) Details
Dr. Uzma Iqbal Belgaumi
Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed University, Karad, Maharashtra, India.

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An Approach of Acute Encephalitis Syndrome in Muzaffarpur, Bihar; A Different Perspective | Chapter 13 | Innovations in Medicine and Medical Research Vol.2

Acute encephalitis syndrome (AES) is a disease characterized by fever and mental confusion, disorientation, delirium, or coma. It could be due to various causes such as viruses, bacteria, fungus, parasites, spirochetes, chemical, and toxins. This chapter is an outcome of an Epidemiological investigation of AES occurred in Muzaffarpur, Bihar in 2011 which was done by a team consisting of experts from various disciplines. The team visited Muzaffarpur, from 14th to 20th July 2011 and reviewed the situation of deaths among children due to AES, as directed by the Authorities. A total of 147 cases of fever with altered sensorium were admitted between 11th June to 18th July 2011 in a private hospital and a Medical College Hospital of Muzaffarpur. Out of these, 54 patients died indicating case fatality rate of 36.73%. Clinico-epidemiological and environmental evidence supports the diagnosis of Acute Encephalitis Syndrome which has significant mortality, affecting predominantly rural population with poor sanitation and presence of wild rats. No significant association of litchi consumption and poor nutritional status of children with AES disease were found. Evidences suggest that there were increased chances of contacts between cases and wild rats during the period of occurrence of outbreak. Key observation was the sudden drop in incidence of cases with rainfall as during and just after the rain children abandons the outdoor games in farmlands/ litchi gardens due to accumulation of water in these areas and exposure from the rodents prevented Etiological agent could not be identified by laboratory tests. Time, place and person distribution of cases is suggestive of infectious disease of short incubation period (<1 day) having wider spectrum of sub clinical and clinical phases & lifelong immunity after first infection.

Author(s) Details
Dr. Anil Kumar
Directorate General of Health Services, Ministry of Health & Family Welfare, India.

Deepika Karotia
National Leprosy Eradication Program, India

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Hybrid Appliance for the Correction of Parafunctional Habits | Chapter 12 | Innovations in Medicine and Medical Research Vol. 2

Tongue thrusting and thumb sucking are the most commonly seen oral habits which act as the major etiological factors in the development of dental malocclusion. This case report describes a fixed habit correcting appliance, Hybrid Habit Correcting Appliance (HHCA), designed to eliminate these habits. This hybrid appliance is effective in less compliant patients and if desired can be used along with the fixed orthodontic appliance. Its components can act as mechanical restrainers and muscle retraining devices. It is also effective in cases with mild posterior crossbites.

Author(s) Details

Reji Abraham
Department of Orthodontics and Dentofacial Orthopedics, Sri Hasanamba Dental College and Hospital, Hassan, Karnataka, India

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Immunotherapy Using Mycobacterium w Vaccine in Locally Advanced Head and Neck Cancer: Illustrative Research | Chapter 11 | Innovations in Medicine and Medical Research Vol. 2

The oncological treatment has been advanced promisingly over the past decades. The patients may be treated with surgery, chemotherapy (CT), radiotherapy (RT) or combination of these treatment modalities. Immunotherapy for prevention and treatment of malignant disease is also in initial stage and has raised a hope that improving immune mechanism can be of use. Most suitable treatment modality for the patient is selected after the final diagnosis. The use of Mycobacterium w (Mw) vaccine in Head and neck cancer (HNC) is an effort to reduce treatment induced toxicity with resultant improvement in the response rate. Immunotherapy in the form of Mw vaccine may be useful as concurrent therapy with radical intent concomitant chemo radiation treatment to improve response rate with less side effects in patients suffering from locally advanced head and neck squamous cell carcinoma

Author (s) Details

Dr. Rakesh Dhankhar
Department of Radiotherapy, Regional Cancer Centre, Pt. Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.

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Development on Tumor Associated Antigen with Specific Target toward Lung Cancer: Recent Developments | Chapter 19 | Innovations in Medicine and Medical Research Vol. 2

Tumor liberated protein (TLP) has been previously described as a TAA (complex) present in the sera from lung cancer patients with early stage disease. Since early detection improves overall survival in lung cancer, identification of screening biomarkers for patients at risk for the development of this disease represents an important target. Starting from the peptide epitope RTNKEASI previously isolated from TLP complexes, we generated a rabbit anti-RTNKEASI serum. This antiserum detected and immunoprecipitated a 55 kDa protein band in the lysate of the lung cancer cell line A549. This protein band was identified as aldehyde dehydrogenase is form 1A1 through mass spectrometry, revealing the molecular nature of at least one component of the previously described TLP complex. 

Author(s) Details

Giulio Tarro
Beaumont Bonelli Foundation for Cancer Research, Naples, Italy and Committee on Biotechnologies and VirusSphere, World Academy of Biomedical Technologies, UNESCO, Paris, France.

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Evaluation of Novel Cost-effective Technique for Speedy Resolution of Infantile Umbilical Hernia: Ammannaya’s Technique | Chapter 18 | Innovations in Medicine and Medical Research Vol. 2

Umbilical hernia in the infant is common and resolves in majority of the cases by 6 years of age. Observation till this age and surgery in the event of persistence are the widely followed management strategies. Trusses, taping and adhesive strapping have been tried to achieve speedy resolution with variable success and a significant incidence of skin complications. We present a novel, simple, easily reproducible, and highly cost-effective technique to achieve complete resolution of infantile umbilical hernia in a span of 8 weeks, with no skin complications. 


Author(s) Details

Dr. Ganesh Kumar K. Ammannaya
Department of Cardiovascular & Thoracic Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India.

Ninada Sripad
Department of Microbiology, Goa Medical College, Goa, India.

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Fluoroquinolone Resistance in Relation to Phylogenetic Background and Iron Uptake Associated Virulence Profile among Urinary Escherichia coli Isolates from HIV and Non-HIV Patients | Chapter 9 | Innovations in Medicine and Medical Research Vol.2

Introduction: Urinary tract infection is a major cause of morbidity among HIV patients and is more often underestimated in developing countries. Urinary Escherichia coli isolated from HIV and non-HIV patients in South India were analyzed to determine the virulence profile and phylogenetic distribution and their correlation with fluoroquinolone (FQ) resistance. Methods: This study aimed to assess the difference in the incidence of iron uptake associated virulence genes among urinary E. coli isolated from HIV (n= 76) and non-HIV antenatal patients (n=42). We compared the incidence of virulence associated genes (VAGs) among the E. coli isolates in relation to FQ resistance, phylogeny and host immunocompromise.  Results: fyuA was higher among the isolates from HIV than from non-HIV patients (P=0.00024).              E. coli isolates from HIV, non-HIV patients primarily belonged to the phylogroups D and B2 respectively. Q and FQ resistance were higher among isolates from HIV patients compared to nonHIV patients (P=0.000414, P<0.0001 respectively). PhylogroupB2 strains were predominant among the FQ susceptible than FQ-resistant strains (P=0.000652). fyuA and iutA was higher among the Qresistant isolates than their susceptible counterparts (P<0.0001; P=0.000132). FQ resistant isolates harboured fyuA, iutA than the susceptible isolates (P=0.0063; P=0.000478). Hly+ phenotype was significantly associated with FQ-susceptible isolates (P=0.003253).  Discussion: Our results establish the relative predominance of non-hemolytic, fyuA+, Q, FQ resistant E. coli isolates primarily of phylogroup-D among the HIV patients and there by suggests that non-B2 strains with lower virulence but with increased antibiotic resistance establish infection in HIV patients.

Author(s) Details

Dr. Kesavaram Padmavathy
Department of Microbiology, Research Laboratory for Oral and Systemic Health, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, India and Department of Microbiology, Dr. ALM PGIBMS, University of Madras, Chennai, India.

Dr. Krishnan Padma
Department of Microbiology, Dr. ALM PGIBMS, University of Madras, Chennai, India.

Dr. Sikhamani Rajasekaran
Government Hospital of Thoracic Medicine, Chennai, India.

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