BACKGROUND Gallbladder cancer(GBC)is one of the leading and aggressive cancers in this region of India.It is very difficult to diagnose in the early stage,as it lacks typical early signs and symptoms;thus,the diagnosi...BACKGROUND Gallbladder cancer(GBC)is one of the leading and aggressive cancers in this region of India.It is very difficult to diagnose in the early stage,as it lacks typical early signs and symptoms;thus,the diagnosis is often in the advanced stage,which ultimately leads to a poor 5-year survival outcome.Tumor markers including carbohydrate antigen 19-9(CA 19-9),carcinoembryonic antigen(CEA),CA 125,CA 242,and alpha fetoprotein are used as indicators in the diagnosis and prognosis of GBC.AIM To compare tumor marker levels between GBC and benign GB diseases(GBDs)and to assess the combined use of tumor markers to increase the diagnostic accuracy for GBC.METHODS Patients of either sex aged≥18 years,with suspected GBC(GB polyp,irregular thick GB wall,GB mass,porcelain GB)on the basis of radiological imaging were included in this study.GB wall thickness using ultrasonography and tumor markers CEA,CA 125,CA 19-9,and CA 242 in all patients were recorded.All cases after surgical intervention were divided into two groups,GBC and benign GBD,according to histopathological examination findings.The cases were followed up and clinical findings,radiological findings,and levels of tumor markers were assessed.RESULTS A total of 200 patients were included in this study,of whom 80 patients had GBC and 120 patients had benign GBD.The median(interquartile range)age was 52.0(41.0-60.0)years and the majority of patients(132,66.0%)were women.Tumor markers including CA 19-9,CA 125,CEA,and CA 242 were significantly elevated in patients with GBC(P<0.001).There was a significant reduction in tumor markers at 3 and 6 mo from baseline(P<0.001).The mean survival of patients with normal and elevated levels of tumor markers CA 125,CA 19-9,and CEA was comparable;however lymph node metastasis and CA 242 expression level were independent prognostic factors.CONCLUSION Serum levels of tumor markers including CA 19-9,CA 125,CEA,and CA 242 were significantly associated with GBC.However,no significant association was observed between the presence of elevated levels of any tumor marker with respect to survival.Tumor marker assessment during follow-up may represent a treatment response.展开更多
The Garhwal Himalaya is among the major repositories of immensely valuable wild edible plants and provides food security to the local population.Among the valuable plant species that grow in this region,Paeonia emodi(...The Garhwal Himalaya is among the major repositories of immensely valuable wild edible plants and provides food security to the local population.Among the valuable plant species that grow in this region,Paeonia emodi(family Paeoniaceae)is an important wild edible species that found in temperate regions with an altitude range between 1800 and 2800 m.The species is facing a severe threat to its sustainability due to overharvesting,habitat disturbances,and a lack of effort regarding conservation.For the first time,this study investigated anthropogenic pressure,population decline perceptions in the natural habitat,and vulnerability assessment of P.emodi under selected study sites(n=23 villages).A semi structured questionnaire was used to interview approximately 45%of the local inhabitants,including herbal practitioners(Vaidhyas or Dais)of each village.On the basis of demographic characteristics,the perceptions and responses of 464 local people were documented regarding potential causes of deterioration and feasible options for sustainable utilization.Using the weight survey method,we estimated the actual amount of collection based on personal interaction and direct observation.In order to determine the threats status,a rapid vulnerability assessment(RVA)was performed and were used based on the current exploitation and usage.The present study revealed that leaf(100%)was the most frequently harvested part,followed by stem(95.65%),seed(26.09%),root(21.74%)and flower(13.04%).The village Triyuginarayan and Pothivasa recorded the highest collection scores while the purpose of the collection was mostly edible(100%),medicinal(100%),and least commercial(8.70%).According to the literature review and the present survey,the RVA(total=21)is categorized as category II(intermediate side of the RVA index),indicating a degree of vulnerability.The study revealed that P.emodi faces extinction in the Garhwal Himalayas.Growing this species through agro-production techniques may alleviate the pressure on the existing population as a result of the availability of raw materials for commercial and household uses.These findings will provide an effective framework for conservation and management decisions and plans.展开更多
文摘BACKGROUND Gallbladder cancer(GBC)is one of the leading and aggressive cancers in this region of India.It is very difficult to diagnose in the early stage,as it lacks typical early signs and symptoms;thus,the diagnosis is often in the advanced stage,which ultimately leads to a poor 5-year survival outcome.Tumor markers including carbohydrate antigen 19-9(CA 19-9),carcinoembryonic antigen(CEA),CA 125,CA 242,and alpha fetoprotein are used as indicators in the diagnosis and prognosis of GBC.AIM To compare tumor marker levels between GBC and benign GB diseases(GBDs)and to assess the combined use of tumor markers to increase the diagnostic accuracy for GBC.METHODS Patients of either sex aged≥18 years,with suspected GBC(GB polyp,irregular thick GB wall,GB mass,porcelain GB)on the basis of radiological imaging were included in this study.GB wall thickness using ultrasonography and tumor markers CEA,CA 125,CA 19-9,and CA 242 in all patients were recorded.All cases after surgical intervention were divided into two groups,GBC and benign GBD,according to histopathological examination findings.The cases were followed up and clinical findings,radiological findings,and levels of tumor markers were assessed.RESULTS A total of 200 patients were included in this study,of whom 80 patients had GBC and 120 patients had benign GBD.The median(interquartile range)age was 52.0(41.0-60.0)years and the majority of patients(132,66.0%)were women.Tumor markers including CA 19-9,CA 125,CEA,and CA 242 were significantly elevated in patients with GBC(P<0.001).There was a significant reduction in tumor markers at 3 and 6 mo from baseline(P<0.001).The mean survival of patients with normal and elevated levels of tumor markers CA 125,CA 19-9,and CEA was comparable;however lymph node metastasis and CA 242 expression level were independent prognostic factors.CONCLUSION Serum levels of tumor markers including CA 19-9,CA 125,CEA,and CA 242 were significantly associated with GBC.However,no significant association was observed between the presence of elevated levels of any tumor marker with respect to survival.Tumor marker assessment during follow-up may represent a treatment response.
文摘The Garhwal Himalaya is among the major repositories of immensely valuable wild edible plants and provides food security to the local population.Among the valuable plant species that grow in this region,Paeonia emodi(family Paeoniaceae)is an important wild edible species that found in temperate regions with an altitude range between 1800 and 2800 m.The species is facing a severe threat to its sustainability due to overharvesting,habitat disturbances,and a lack of effort regarding conservation.For the first time,this study investigated anthropogenic pressure,population decline perceptions in the natural habitat,and vulnerability assessment of P.emodi under selected study sites(n=23 villages).A semi structured questionnaire was used to interview approximately 45%of the local inhabitants,including herbal practitioners(Vaidhyas or Dais)of each village.On the basis of demographic characteristics,the perceptions and responses of 464 local people were documented regarding potential causes of deterioration and feasible options for sustainable utilization.Using the weight survey method,we estimated the actual amount of collection based on personal interaction and direct observation.In order to determine the threats status,a rapid vulnerability assessment(RVA)was performed and were used based on the current exploitation and usage.The present study revealed that leaf(100%)was the most frequently harvested part,followed by stem(95.65%),seed(26.09%),root(21.74%)and flower(13.04%).The village Triyuginarayan and Pothivasa recorded the highest collection scores while the purpose of the collection was mostly edible(100%),medicinal(100%),and least commercial(8.70%).According to the literature review and the present survey,the RVA(total=21)is categorized as category II(intermediate side of the RVA index),indicating a degree of vulnerability.The study revealed that P.emodi faces extinction in the Garhwal Himalayas.Growing this species through agro-production techniques may alleviate the pressure on the existing population as a result of the availability of raw materials for commercial and household uses.These findings will provide an effective framework for conservation and management decisions and plans.
