WNT pathway alteration is related to dysplastic cortical tissue and not to adjacent tissue of patients with FCD and refractory epilepsy

Background Focal cortical dysplasia (FCD) is a malformation of the cortical development that cause medical refractory seizures and the only treatment may be surgical resection of the affected area of the brain. People affected by FCD may present seizures of variable severity since childhood. The physiopathology of the disease is not yet understood, however it is known that several genes alterations may play their role. The WNT/β-catenin pathway is associated with cell transformation and migration and for this reason may be crucial for understanding FCD’s aetiology. The aim of this study was to explore genes related to the WNT/β-catenin pathway in patients with FCD type II. Methods Dysplastic tissue and tissue adjacent to the primary dysplastic lesion of patients with FCD type II were obtained from two patients who underwent surgical treatment. The analysis of the relative expression of genes was performed by a qRT-PCR array containing 84 genes related to the WNT pathway. Results In patient 1, the analysis showed a difference in the expression of seven genes, demonstrating an increase in AXIN2, FRAT2, FZD9, KREMENI and PP2R1A genes and a reduction in CSNK1G3 and PPP2CA genes in dysplastic tissue. In patient 2, the analysis showed increased expression of CSNK1A1, FZD4 and PPP2CA genes, as well as reduced of CTNNBIP1 gene in dysplastic tissue. Conclusion Dysregulation in the expression of genes that control the receptors of the WNT pathway keeps it in an inactivated state. Therefore, a eventual manipulation of this pathway focusing on its activation may influence molecular manifestations underlying the epileptogenic status in injured brain tissue, which could act as a therapeutic alternative to FCD type II. The WNT/ β-catenin signaling pathway is crucial for the control of embryonic development, which takes place through the regulation of cell differentiation, migration and proliferation, and apoptosis process.

The study of co-relation of pap smear with colposcopy and histopathology in sexually active woman with unhealthy cervix

Background: Unhealthy cervix is a group of cervical lesions, mostly chronic. Cervical cancer is the second most frequent cancer worldwide in women after breast carcinoma cervical cancer is a preventable and curable malignancy if identified and managed early. Primary objective was to study pap smear, colposcopy and histopathology in unhealthy cervix in sexually active woman with secondary objective to screen woman who have abnormal unhealthy, foul smelling cervical discharge.Methods: The present study was conducted in the department of obstetrics and gynecology L.L.R.M. medical College and associated SVBP hospital, Meerut from June 2019 to May 2020 with sample size of 70. Participant who fit the inclusion criteria were included in the study after taking a written and informed consent. The colposcopy finding was correlated with histopath findings of cervical biopsy that was undertaken.Results: Co relation of pap smear with colposcopy had sensitivity of 78% and specificity of 92% with positive predictive value of 52%and negative predictive value of 97%, p value less than 0.0001. The pattern of distribution of histopathological assessment with respect to the pap smear findings was significant statistically (p<0.0001). The proportion of patients with NILM on pap smear was significantly higher in the VILI negative category compared to the VILI Positive category (94.12% vs 77.78%, p=0.0525). In the present study, prevalence of CIN of any grade was detected in 8 (11.4%) cases. With CIN 1 in 5 (7.14%) and CIN2 in 2 (2.86%) and CIN3 in 1 (1.43%) case were seen.Conclusions: Several screening modalities are available of which pap smear is most widely used. colposcopy has been proven very useful to identify and guide the biopsy of dysplastic lesion.

Is Endoscopic Submucosal Dissection (ESD) Ready for Primetime in North America?

Endoscopic submucosal dissection (ESD) is a novel technique for endoscopic en bloc resection of neoplastic and dysplastic lesion in the gastrointestinal tract. Endoscopic Mucosal Resection (EMR) has been used historically however ESD carries the added advantage of providing accurate histopathologic evaluation for resection margins, low recurrence rate, curative resection. Also compared to surgery it carries a lower risk of morbidity and mortality. ESD is well established in Asia however its adoption is lagging in North America. We summarize the @GIJournal discussion held on March 10th, 2021 during which Draganov et al. “Endoscopic Submucosal Dissection (ESD) in North America: A Large Prospective Multicenter Study” was critically reviewed by our expert panel: Drs. Neil Sharma (NS), and Mohamed Othman (MO) and moderated by Dalbir Sandhu (DS).

COVID-19 Pandemic: Which IBD Patients Need to Be Scoped—Who Gets Scoped Now, Who Can Wait, and how to Resume to Normal

Endoscopy is an essential component in the management of inflammatory bowel disease [IBD]. There is a risk of SARS-CoV-2 transmission during endoscopic procedures. The International Organization for the study of IBD [IOIBD] has developed 11 position statements, based on an online survey, that focus on how to prioritise endoscopies in IBD patients during the COVID-19 pandemic, alternative modes for disease monitoring, and ways to triage the high number of postponed endoscopies after the pandemic. We propose to pre-screen patients for suspected or confirmed COVID-19 and test for SARS-CoV-2 before endoscopy if available. High priority endoscopies during pandemic include acute gastrointestinal bleed, acute severe ulcerative colitis, new IBD diagnosis, cholangitis in primary sclerosing cholangitis, and partial bowel obstruction. Alternative modes of monitoring using clinical symptoms, serum inflammatory markers, and faecal calprotectin should be considered during the pandemic. Prioritising access to endoscopy in the post-pandemic period should be guided by control of COVID-19 in the local community and availability of manpower and personal protective equipment. Endoscopy should be considered within 3 months after the pandemic for patients with a past history of dysplasia and endoscopic resection for dysplastic lesion. Endoscopy should be considered 3–6 months after the pandemic for assessment of postoperative recurrence or new biologic initiation. Endoscopy can be postponed until after 6 months of pandemic for routine IBD surveillance and assessment of mucosal healing.

Zinc α-2 Glycoprotein (ZAG) a Novel Biomarker for the Detection of Oral Squamous Cell Carcinoma

Oral cancer, the most challenging and life threatening disease in the field of dentistry, may start as a reactive lesion due to constant stimulus from tobacco consumption, transform into a pre-malignant lesion (dysplastic lesion) and ultimately develop into a cancerous lesion (Invasive carcinoma). There is a fundamental revolution taking place in the analyzing methods; extraction of biological protein from the saliva rather than from tissues or blood. Several of the biomarkers have been studied with pro-carcinogenic effects like Interleukins (ILs), tumor necrosis factor (TNF) and leptin, but only a few have been stated in the literature, which show anti-cancer characteristics like adiponectin and zinc alpha-2 glycoprotein. This review explored the diagnostic and prognostic values of a biomarkers zinc alpha-2 glycoprotein (ZAG) in adults suspected of oral squamous cell carcinoma (OSCC). The PubMed, EMBASE and Google Scholar were searched for scientific studies reported on the potential mechanism of zinc alpha-2 glycoprotein. All the research articles were selected in which ZAG is applied solely or in conjunction with other biomarkers in oral cancer and other cancers. These literatures were carefully assessed to find out and compile the diagnostic and prognostic values and to inquire therapeutic action of ZAG in the process of carcinogenesis.

Evaluation of swede score and reid score to improve the predictive value of colposcopy and its correlation with histology

Background: Cervical carcinoma is the second most common malignancy amongst women in India. It is regarded as a public health problem and a priority in cancer control programmes by the WHO. Colposcopy has proven to be very useful in identifying and guiding the biopsy of dysplastic lesion. To minimize inter-observer variation, colposcopic scoring system has been introduced.Methods: A prospective cross- sectional study including 250 women in whom the prevalence of different grades CIN was done. Co-relation of Pap (cytology) with colposcopy scoring system viz. Reid’s and Swede scores, has been made in this study. The two screening methods were compared and their statistical association with histological findings were analyzed.Results: Per speculum examination performed in 250 sexually active women with suspicious looking cervix, belonging to 25-60 years of age, with most common presenting complaints of pain abdomen (38.8%) followed by leucorrhoea, irregular cycles and Post coital bleed. Unhealthy cervix (49.2%) and persistent discharge (28%) were the most common indications for colposcopy. An assessment of both SWEDE score and Reid score as a function of histological findings was done, while Swede score of >5 showed slightly more sensitivity (100%) for diagnosing CIN1+ lesions, Reids score of >5 was more specific (100%) with a higher positive predictive value (100%) for diagnosing CIN 1, 2, 3 and invasive cervical carcinoma. There was a marked positive association between Reid score and SWEDE score.Conclusions: The colposcopic scoring systems and histopathology showed significant compliance. Predictive accuracy of colposcopy increased with increasing severity of disease.

Colon cancer: risk factors and screening

Colon and rectal cancers are usually combined under the same term "colorectal cancer". It should be noted that the lesion of the colon is much more common. Colorectal cancer ranks fourth in the overall structure of oncological pathology in terms of prevalence, and in some countries even comes third after lung and stomach cancer. Risk factors that contribute to the development of colorectal cancer include bowel polyps, ulcerative colitis and Crohn's disease, and a genetic predisposition. Most often, neoplastic transformation occurs at the site of an adenoma or dysplastic lesion of the intestinal mucosa. Due to the high risk of neoplastic process in a sufficiently large number of elderly people, it is recommended that every person over the age of 50 should undergo compulsory screening to detect latent cancer. The simplest, but at the same time insufficiently informative method is a blood culture test - analysis for the presence of blood in the feces. Method of total colonoscopy and double-contrast radiography is distinguished by a higher information content, but at the same time a higher cost. It is recommended to have these examinations every three to five years after the age of 50 years without clinical manifestations, and after the age of 40 for those at risk for colorectal cancer.