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Abstract Pinolenic acid (PNLA), an omega-6 polyunsaturated fatty acid from pine nuts, has anti-inflammatory and anti-atherogenic effects. We aimed to investigate the direct anti-inflammatory effect and anti-atherogenic effects of PNLA on activated purified CD14 monocytes from peripheral blood of patients with rheumatoid arthritis (RA) in vitro. Flow cytometry was used to assess the proportions of CD14 monocytes expressing TNF-α, IL-6, IL-1β, and IL-8 in purified monocytes from patients with RA after lipopolysaccharide (LPS) stimulation with/without PNLA pre-treatment. The whole genomic transcriptome (WGT) profile of PNLA-treated, and LPS-activated monocytes from patients with active RA was investigated by RNA-sequencing. PNLA reduced percentage of monocytes expressing cytokines: TNF-α by 23% (p = 0.048), IL-6 by 25% (p = 0.011), IL-1β by 23% (p = 0.050), IL-8 by 20% (p = 0.066). Pathway analysis identified upstream activation of peroxisome proliferator-activated receptors (PPARs), sirtuin3, and let7 miRNA, and KLF15, which are anti-inflammatory and antioxidative. In contrast, DAP3, LIF and STAT3, which are involved in TNF-α, and IL-6 signal transduction, were inhibited. Canonical Pathway analysis showed that PNLA inhibited oxidative phosphorylation (p = 9.14E−09) and mitochondrial dysfunction (p = 4.18E−08), while the sirtuin (SIRTs) signalling pathway was activated (p = 8.89E−06) which interfere with the pathophysiological process of atherosclerosis. Many miRNAs were modulated by PNLA suggesting potential post-transcriptional regulation of metabolic and immune response that has not been described previously. Multiple miRNAs target pyruvate dehydrogenase kinase-4 (PDK4), single-immunoglobulin interleukin-1 receptor molecule (SIGIRR), mitochondrially encoded ATP synthase membrane subunit 6 (MT-ATP6) and acetyl-CoA acyltranferase2 (ACAA2); genes implicated in regulation of lipid and cell metabolism, inflammation, and mitochondrial dysfunction. PNLA has potential anti-atherogenic and immune-metabolic effects on monocytes that are pathogenic in RA and atherosclerosis. Dietary PNLA supplementation regulates key miRNAs that are involved in metabolic, mitochondrial, and inflammatory pathways.

Introduction- Dengue is a dreaded mosquito-borne viral disease with a wide spectrum of presentations ranging from subclinical disease to severe dengue. It is endemic in tropical regions. The objective of this study was to assess the clinical and laboratory profile of dengue patients in a tertiary care hospital in Northern India. Material and methods- The present cross-sectional study was conducted among the confirmed cases of dengue fever for a period of three months at a tertiary care hospital in Northern India. A total of 530 confirmed cases of dengue were studied. The clinical, biochemical, and haematological profiles of the patients were analysed after their classification as per WHO guidelines into one of the three groups. Results- Of the 530 cases, 71.3% were males and 28.68% were females. Most of the subjects were in the age group of 21-30 years (37.17%) while only 0.94% belonged to the age group greater than 60 years. A total of 74.2% were classified into dengue fever group, 19.1% dengue hemorrhagic fever and only 6.7% in the dengue shock group. The most common symptoms were fever (98.49%) and bodyache (89.06%) while ascites (40%) was the most common clinical finding followed by pleural effusion 24.75%. Mortality rate among the patients was 2.1% and a significant association was observed between mortality rate and pleural effusion. Mortality was highest in dengue shock group 16.8%.Leucopenia (44.1%) was the commonest laboratory finding in patients with dengue fever while elevation in liver enzymes (SGOT) was encountered in 69.4% and 75.2% patients with dengue shock syndrome and dengue hemorrhagic fever respectively. Conclusion- Fever was the commonest presenting symptom of a dengue infection. Leucopenia, thrombocytopenia, anemia, and increased liver enzymes were the frequent associated laboratory findings. It is imperative to understand these clinical and laboratory characteristics for the timely diagnosis, assessment of dengue infection severity, prediction of any associated risk factors with severity and general management of the illness. [ABSTRACT FROM AUTHOR]

Pancreatic ductal adenocarcinoma (PDAC) is one of the most common tumor subtypes and remains associated with very poor survival. T cell infiltration into tumor tissue is associated with improved clinical outcome but little is known regarding the potential role of NK cells in disease control. Here we analyze the phenotype and function of NK cells in the blood and tumor tissue from patients with PDAC. Peripheral NK cells are present in normal numbers but display a CD16hiCD57hi phenotype with marked downregulation of NKG2D. Importantly, these cells demonstrate reduced cytotoxic activity and low levels of IFN-γ expression but instead produce high levels of intracellular IL-10, an immunoregulatory cytokine found at increased levels in the blood of PDAC patients. In contrast, NK cells are largely excluded from tumor tissue where they display strong downregulation of both CD16 and CD57, a phenotype that was recapitulated in primary NK cells following co-culture with PDAC organoids. Moreover, expression of activatory proteins, including DNAM-1 and NKP30, was markedly suppressed and the DNAM-1 ligand PVR was strongly expressed on tumor cells. As such, in situ and peripheral NK cells display differential features in patients with PDAC and indicate local and systemic mechanisms by which the tumor can evade immune control. These findings offer a number of potential options for NK-based immunotherapy in the management of patients with PDAC.

Byline: Manzoor. Bhat, Bashir. Laway, Farhat. Mustafa Pathological calcification of basal ganglia has been encountered in children since long back and is associated with various disease entities both acute and [...]

Background: Meningiomas comprise 15%–20% of all primary intracranial tumors. They are generally benign tumors, and most patients are cured after surgery and remain free of recurrence. However, some tumors behave in an aggressive manner, and patients develop local recurrence or metastasis. Overall prognosis is good. Patients and Methods: This is an 11-year retrospective study conducted in the Departments of Pathology and Neurosurgery at Sheri-I-Kashmir Institute of Medical Sciences, Kashmir, India. Besides the demographic profile, the parameters analyzed were location of tumor on imaging, histopathological subtype, and grade of tumor according to the 2007 WHO classification and recurrence at follow-up. Results: A total of 254 patients were included in our study, of which 205 (80.7%) were brain meningiomas and 49 (19.3%) were spinal, with an overall female: male ratio of 2:1. Female: male ratio was more in spinal meningiomas, 15.3:1. Most of our patients were in the 4–6th decade of life with a mean age of 48 years (range: 5–73 years). Meningothelial meningioma was the most common histological type. Of ten patients who showed recurrence, seven cases showed only recurrence, but no progression to higher grade and three cases showed recurrence with progression by one WHO-grade. We also noticed that recurrence was higher in Simpson Grades II and III. Conclusion: Meningiomas are common in females and most of the meningiomas do well after surgery. The recurrence rate was 3.93% in our study and Simpson grade of tumor excision and histopathological grade contribute significantly to the recurrence of the tumor. [ABSTRACT FROM AUTHOR]

Distal renal tubular acidosis is a syndrome of abnormal urine acidification and is characterized by hyperchloremic metabolic acidosis, hypokalemia, hypercalciurea, nephrocalcinosis and nephrolithiasis. Despite the presence of persistent hypokalemia, acute muscular paralysis is rarely encountered in males. Here, we will report an eighteen year old male patient who presented with flaccid quadriparesis and was subsequently found to have rhabdomyolysis, severe short stature, skeletal deformities and primary distal renal tubular acidosis. [ABSTRACT FROM AUTHOR]

Metastatic breast carcinoma is rarely seen in clinical practice. It has been reported that lymphoma-leukemia, melanoma and sarcomas can metastasize to the breast. Bilateral metastases to the breast are rare and commonly have been seen to originate from ovarian carcinoma. Adenocarcinoma of rectum metastasizing to breast is an extremely rare clinico-pathological situation. We report a 28-year-old female who presented with bilateral breast metastasis 9 months after abdominoperineal resection and total meso-rectal excision for a locally advanced mucinous adenocarcinoma of the rectum. A few case reports of a mucinous adenocarcinoma of rectum presenting with bilateral breast metastasis have been seen in the world literature and we hereby report this case who till now is the youngest patient reported [ABSTRACT FROM AUTHOR]

Synovial sarcomas are rare tumors accounting for approximately 5-10% of soft tissue sarcomas. They occur predominantly in the extremities, followed by head and neck. Primary pulmonary sarcomas are very rare and comprise only 0.5% of all primary lung malignancies. The diagnosis is established only after sarcomas like primary lung malignancies, and metastatic sarcomas have been excluded. For synovial sarcomas that arise at unusual locations, a deinitive diagnosis is challenging and requires the use of ancillary diagnostic procedures such as immunohistochemistry (IHC) and molecular genetic techniques for conirmation of diagnosis. We report a case of 29-year-old male who had right lower lobe lung mass. He underwent right lower lobectomy. Intraoperative squash smears revealed spindle cell sarcoma. Subsequent histopathology and IHC conirmed the diagnosis as synovial sarcoma. We report this case on account of its rarity and to emphasize the utility of intraoperative squash smears in the diagnosis of such cases, which has been under-utilized in clinical practice. [ABSTRACT FROM AUTHOR]

Intraventricular tuberculomas are very rare. The usual presentation is of raised intracranial pressure symptoms.A case of a lateral intraventricular tuberculoma mimicking a meningioma that on imaging revealed a uniformly enhancing lesion with white matter edema.This case is reported for its rarity in this location.It is important to consider tuberculoma as a differential diagnosis of intraventricular lesions in areas endemic for tuberculosis. [ABSTRACT FROM AUTHOR]

Distal renal tubular acidosis is a syndrome of abnormal urine acidification and is characterized by hyperchloremic metabolic acidosis, hypokalemia, hypercalciurea, nephrocalcinosis and nephrolithiasis. Despite the presence of persistent hypokalemia, acute muscular paralysis is rarely encountered in males. Here, we will report an eighteen year old male patient who presented with flaccid quadriparesis and was subsequently found to have rhabdomyolysis, severe short stature, skeletal deformities and primary distal renal tubular acidosis.