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Introduction:Biomarkers predictive of response to mechanistic target of rapamycin (mTOR) inhibitor, everolimus, in endocrine receptor (ER)-positive metastatic breast cancer (MBC) are a work in progress. We evaluated the feasibility of directly measuring mTOR activity and phosphatase and tensin homolog (PTEN) expression and correlating their expression with response and survival.Materials and Methods:MBC patients who received everolimus with endocrine therapy (ET) after progression on an aromatase inhibitor and had adequate tissue preservation for estimation of mTOR activity and PTEN expression were selected for analysis from a prospectively maintained database. Progression-free survival (PFS) and overall survival (OS) were estimated by Kaplan–Meier method, and correlation between mTOR activity and PTEN expression with survival was done by log-rank test.Results:Thirteen ER-positive MBC patients were available for analysis. PTEN expression was lost in 11/13 (84.6%) patients and retained in 2/13 patients (15.4%). mTOR activity was absent in four patients (30.7%), weak in six patients (46.1%), and moderate in 3 patients (23.2%). Median PFS for the entire population was 2.5 months while median OS was not reached. Patients with an absent mTOR activity showed a longer PFS (5 vs. 1.5 vs. 2 months) than those with weak and moderate activity, respectively (P = 0.043). There was no correlation between loss of PTEN expression and PFS.Conclusions:Measurement of direct mTOR activity in patients with MBC receiving everolimus/ET combination appears feasible. Absent mTOR activity may predict for longer PFS with everolimus-ET combination and requires further study.

Rice Husk Ash (RHA) and Cow Dung Ash (CDA) are agriculturally based pozzolanic materials, these materials are available in huge quantities. This final year project report highlights and presents the results of the study on the use of Cow Dung Ash and Rice Husk Ash as partial replacement of cement in concrete. The experiments were conducted to study the impacts of adding Cow Dung Ash and Rice Husk Ash in several percentages by weight (0%, 5%, 10%, 15%, and 20%) of cement and cure for periods of 28 days before testing for compression strength. The consistency, workability, sieve analysis of aggregates were also tested in this research study. The Compressive test results are 37.75 N/mm2, 31.25 N/mm2, 31.25N/mm2 and 25.25 N/mm2 for 0%, 5%, 10% and 15% replacement of cement with Cow Dung Ash and Rice Husk Ash respectively at 28days. The Workability results gives 45mm, 49mm, 56mm, 68mm and 75mm respectively for 0%,5%, 10%, 15%, and 20% replacement of cement with Cow Dung Ash and Rice Husk Ash. The consistency test results are 0.29, 0.32, 0.36, 0.41 and 0.43 for 0%, 5%, 10%, 15% and 20% replacement of cement with Cow Dung Ash and Rice Husk Ash respectively. The bulk density results are 2452.53 kg/m3, 2370.8 kg/m3, 2380.0 kg/m3 and 2348.5 kg/m3 for 0%, 5%, 10% and 15% replacement of cement with Cow Dung Ash and Rice Husk Ash respectively. The main highlights, it should be highlighted that the more quantity of water is required to standard consistency as the percentages of Cow Dung Ash and Rice Husk Ash are added. Dung Ash and Rice Husk Ash concrete is recommended for use when a ten percentage (10%) of Cow Dung Ash and rice husk ash are not exceeded. Keywords: Cow dung ash, Rice husk ash, workability, standard consistency, Slump test, bulk density, compressive strength

Background: Pseudomonas aeruginosa is a clinically troublesome gram-negative pathogen that causes both opportunistic infections and nosocomial outbreaks. Metallo beta lactamase have recently emerged as a worrisome resistance mechanism. Carbapenems had been the drug of choice for the infections caused by most penicillin- or cephalosporin-resistant gram-negative bacteria due to its broad-spectrum activity and stability to hydrolysis by most beta-lactamases. This does not hold good anymore due to rapid uprise of MBL producing strains. The current research covered 163 hospitalized cases of neonatal septicaemia from which Pseudomonas aeruginosa is isolated in the Paediatric Department of KIMS, Bhubaneswar. The study aimed at detecting the prevalence of metallo-beta lactamases in clinical isolates of imipenem resistant Pseudomonas aeruginosa from neonatal septicemia cases and to establish the antibiogram of Imipenem-resistant P. aeruginosa these cases. Methods: Clinical samples obtained from suspected cases of neonatal septicemia were first cultured by conventional methods and then identification was done by VITEK-2 instrument. Metallo beta lactamase (MBL) production was done by combined disc synergy test (CDST) using imipenem and EDTA (CDST-IPM) and double disc synergy test (DDST) using IPM and EDTA (DDST-IPM). Results: Among 1510 processed clinical specimens from cases of neonatal septicaemia; 637 (42.18%) showed positive growth of various clinically significant pathogens. Out of them in 163 (25.58%) cases Pseudomonas spp. was isolated. Of these, a total of 95 (58.28%) Pseudomonas spp. was found resistant to imipenem. All imipenem-resistant Pseudomonas isolates were positive for MBL by CDST imipenem-EDTA (CDST-IPM) method, whereas 89 (93.68%) were positive by DDST-IPM method, respectively. Pseudomonas aeruginosa was mostly isolated from endotracheal tube aspirate (57.89%) followed by pus (56.41%). Out of the 95 cases of MBL-producing Pseudomonas; 46 (48.42%) isolates showed the maximum susceptibility to piperacillin-tazobactam combination. All MBL-producing Pseudomonas isolates were resistant to ceftriaxone.Conclusions: MBL-producing Pseudomonas is found to be highly prevalent in our hospital, which is one of the major causes of multidrug resistance and need regular surveillance and strict adherence to a robust antibiotic policy.

Certain undifferentiated round cell sarcomas characterised by specific underlying genetic fusions have been reported. This case describes cytomorphological and corresponding histopathological, including immunohistochemical features of a rare case of CIC‐DUX4 positive sarcoma, including a literature review of similar reported cases.

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