ObjectivesHuman papillomavirus (HPV) causes tumors primarily Cervical cancer. Recently, inconsistent reports came up in Breast cancer (BC) too. In India, despite treatment 70,218 BC patients die each year. So, we explored the association of HPV, if any, with BC prognosis in Indian pre-therapeutic (PT) and Neo-adjuvant chemotherapy (NACT) patients with subsequent analysis of HPV profile.MethodsHPV prevalence was checked and analysis of physical status, copy number, genome variation, promoter methylation and expression (mRNA and protein) of the prevalent subtype was done.ResultsHigh prevalence of HPV was observed in both PT (64.0%) and NACT (71.0%) cases with significant association with younger (20–45 yrs) PT patients. Interestingly, HPV infection was significantly increased from adjacent normal breast (9.5%, 2/21), fibro adenomas (30%, 3/10) to tumors (64.8%, 203/313) samples. In both PT and NACT cases, HPV16 was the most prevalent subtype (69.0%) followed by HPV18 and HPV33. Survival analysis illustrated hrHPV infected PT patients had worst prognosis. So, detailed analysis of HPV16 profile was done which showed Europian-G350 as the most frequent HPV16 variant along with high rate of integration. Moreover, low copy number and hyper-methylation of P97 early promoter were concordant with low HPV16 E6 and E7 mRNA and protein expression. Notably, four novel variations (KT020838, KT020840, KT020841 and KT020839) in the LCR region and two (KT020836 and KT020837) in the E6 region were identified for the first time along with two novel E6^E7*I (KU199314) and E6^E7*II (KU199315) fusion transcript variants.ConclusionThus, significant association of hrHPV with prognosis of Indian BC patients led to additional investigation of HPV16 profile. Outcomes indicated a plausible role of HPV in Indian BC patients.
Netflix has been on the rise since its beginning in 1997, when one sees it from a distant perspective. However, a close analysis of its unique strategies shows that the company faced several small and big challenges in its growth journey, some of which, had the potential to throw the company away permanently from the market itself. Nevertheless, it responded tactically to all such issues, many of them being dealt in preventive and pro-active manner; while other cases being dealt with quick reactions, essentially faster than any other competitors. This report is a study of many such issues that the company faced, since its beginning till recently, when it almost conquered the whole world, after establishing its feet in China as well, in collaboration with the service provider Baidu. The report also entails some unique strategies that the company followed while continuously and marginally changing its business model, which would seldom be possible in a brick-mortar economy. As such, the company made use of its deeper understanding of how markets react in an internet economy. Effort has been made to throw some light on the way the company has dealt the issues of digital discrimination allegations against it, and also its stance on net neutrality. Finally, some of the challenges and opportunities that the company has encountered recently, including the lawsuits has been touched upon, presenting the company’s as well as outsider media’s view on those, and has been concluded with potential problems and future aspects
A middle aged male patient, trumpet blower by occupation presented with progressive dyspnea with chest heaviness for 2 weeks and low grade fever for 1 week. It started with sudden severe retrosternal chest discomfort and episodic vomiting during practicing trumpet blowing. Patient was toxic with high fever, tachycardia and tachypnoea. Clinicoradiologically patient was diagnosed as left sided hydropneumothorax. Intercostal chest tube was inserted at left 5th. intercostal space at midaxillary line following which pus and air came out. Pleural fluid was acidic with high amylase level and polymicrobial growth. Repeat chest x-ray showed partial resolution of left sided hydropneumothorax. From 4th. day food particles were noticed in the drainage bag. For screening 0.1% sterile methylene blue was given orally which came in ICD tube and bag within 24 hours. Subsequently barium swallow esophagus, CT thorax with oral and intravenous contrast and upper gastrointestinal endoscopy confirmed left sided esophagopleural fistula.Bangladesh J Medicine Jan 2017; 28(1) : 41-45
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