ObG Watch June 2013

1. ObG Watch June 2013 Narayanan

2. Anjelina Jolie

3. Breast Cancer Genes Women with mutations in BRCA1 and BRCA2 genes have up to an 80 percent chance of getting breast cancer at some point in life. Other genes may be linked to breast cancer risk as well.

4. "My doctors estimated that I had an 87% risk of breast cancer (12% in average woman) and a 50% risk of ovarian cancer," wrote Jolie, whose mother was diagnosed with ovarian cancer at 46 years of age and died a decade later.

5. “Epitome of individualized medicine” - Topol E, Editor in chief, Medscape

6. Recommendations • 2 first-degree relatives (mother, daughter, or sister) diagnosed with breast cancer, one of whom was younger than 50 years • 3 or more first- or second-degree relatives (aunt or grandmother) diagnosed regardless of age • combination of first- and second-degree relatives diagnosed with breast and ovarian cancer regardless of age • first-degree relative with bilateral breast cancer • breast cancer in a male relative • combination of 2 or more first- or second-degree relatives with ovarian cancer • The BRCA gene only accounts for 5% to 10% of breast cancer -US preventive Task Force

7. BRCA2 gene

8. 53 year old Man from London was the first to undergo prophylactic Prostatectomy BRCA2 mutation has an 8.6-fold increased risk of developing prostate cancer It is more aggressive and more likely to be fatal -J Clin Oncol 2013;31:17-18-1757 Sword of Damocles

9. Man may disappear! “The poorly designed Y chromosome that makes men is degrading rapidly and will disappear, even if humans are still around” - Evolutionary geneticist, Jenny Graves Australian National university

10. Y chromosome is active mostly making sperms in the testes, which is a "very dangerous" place owing to the constant division of cells With every cell division, there is a chance for a mutation or gene loss The Y chromosome is all alone in the male, but in the female, the 2 Xs can swap bits and repair themselves If the Y gets a hit it's a downward spiral Why will ‘Y’ disappear?

11. " Three hundred million years ago the Y chromosome had about 1,400 genes on it, and now it's only got 45 left, so at this rate we're going to run out of genes on the Y chromosome in about five million years The Y chromosome is dying and the big question is what happens then"  - Graves

12. Dragan Tadic is showing off "Adam's Leaf" underpants he invented According to Tadic, the underwear is designed with a special "pocket" where genitals are placed to keep cool thanks to better air circulation He claims it prevents sterility and improvess greater sexual desire and potency ‘Adam leaf’ underpants

13. Fallopian tube & Ovarian cancer

14. Recently, the distal Fallopian tube has attracted considerable attention not only as site of origin for serous cancer in women with BRCA mutations, but also as the anatomical location where the majority of serous ovarian cancers apparently develop

15. Bilateral salpingectomy at the time of ovarian-preserving hysterectomy is becoming more accepted as a risk-reducing strategy for both serous carcinoma and adnexal masses • It is estimated that there will be a 50% reduction in ovarian cancer in 20 years if salpingectomy is performed at the time of hysterectomy or tubal sterilization -The ongoing British Columbia Ovarian Cancer Prevention Project

16. Are stitched

17. Gold is making a come back! • A gold-based plasmonic nanocomposite wrapped in elastic material is soldered to wound edges using laser for approximation • It creates a 'liquid-tight' seal that could prevent harmful internal fluid leaks • This “Laser Tissue Welding” may bid ‘good bye’ to sutures & staples in future

18. The comparison

19. Gold as Anti cancer Agent

20. "In the past few years, there has been a resurgence of interest in the medicinal chemistry of gold compounds, particularly as anticancer agents. • Certain gold compounds are selectively toxic to cancer cells but not to normal cells. • Using gold as a potential treatment for cancer could soon become a reality, thanks to a combination of imaging techniques.

21. Technology • Nanoscale secondary ion mass spectrometry - enables the visualisation of the gold at a subcellular level • Energy filtered transmission electron microscopy – which gives element maps for the gold allows one to see nuclear and mitochondrial morphology -University of Western Australia and Griffith University

22. Cost of having a baby in US • Average total payments for maternal and newborn care with cesarean births were about 50% higher than average payments with vaginal births. • Commercial payers: $27,866 (Rs 15.35 Lac) for Cs vs $18,329 (10.0 Lac) for vaginal delivery and Medicaid paid: $13,590 (7.5 Lac) vs. $9,131 (5.0 Lac) • Commercial payers paid an extra $1,464 (Rs 82000) to clinicians and $7,518 (Rs 41000) to facilities for cesarean versus vaginal births.

23. Have a Good Day!