epidemiological study on survival of oropharyngeal cancer cases in Alexandria, Egypt

A retrospective cohort study was conducted to determine the 5-year survival and prognostic factors for survival for 407 oropharyngeal cancer cases registered in the 3 main hospitals in Alexandria, Egypt, from 1996-2000. Survival analysis was conducted using Kaplan-Meier curves, and multivariate Cox regression analysis. The overall 5-year survival rate was 30.8%. Multivariate analysis showed that significant prognostic factors for survival were tumour stage [hazard ratio = 2.39; 95% CI: 1.41-11.72], tumour site and patient's age. Secondary prevention of oral cancers can be conducted through examination of the oral cavity to find precancerous and early cancerous lesions and hence improve survival

Neonatal screening program in Dakahlia: hypothyroidism in clinically suspected cases

In the line with the priorities of the national health services towards preventive medicine early diagnosis and treatment of CH is emphasized. The aim was to assess thyroid status in clinically suspected cases. Subjects and The present study included two groups, the first is a set of neonates [800] attending the general health units in some villages in Dakahlia complaining of prolonged jaundice, constipation, abdominal distention, chocking and/or umbilical hernia. Neonatal TSH levels in filter paper spots taken from heels were assessed for this group. The second group included 114 infants suspected clinically as congenital hypothyroidism by pediatricians. Serum TSH and T4 were estimated for this second group. In the first group 690 neonates [86.25%] had TSH less than 20 micro IU/ml, 88 neonates [11%] had TSH of between 20 and less than 40 micro IU/ml and 22 [2.75%] has TSH more than 40 micro IU/ml. All neonates [110] with TSH more than 20 micro IU/ml [13.75%] had to be recalled after two weeks for reevaluation by serum TSH and T4 levels estimation. Transient hypothyroidism were detected in 70 cases [8.8%] and their serum T4 and TSH levels two weeks after, were normal. Forty neonates [36.4%] were missed and did not respond to our call. Effect of storage on neonatal TSH levels were evaluated in blood spots collected on preserved filter papers. The results revealed that there were gradual increases in the missed cases as zero when estimated with prolonged period of preservation. The results of the second group: Ninety cases [79%] were euthyroid with normal serum TSH and serum T4,17 cases [15%] were with mild elevated serum TSH [7-20 micro IU/ml] and normal serum T4. 7 cases [6.0%] were with elevated serum TSH [more than 20 micro IU/ml] and low serum T4 [less than 96 nmol/L]. second samples, two weeks after the first revealed normalized serum TSH and T4 in 23/24 case. One case presented with prolonged jaundice was diagnosed as overt congenital hypothyroidism. Prolonged jaundice is the presenting complain among 53/114 infants referred by pediatricians as suspected CH [46.49%]. One case Out of 114 studied infants was detected as true CH, while no case of true CH was detected among the neonatal cases. Serum confirmation tests [TSH and T4 levels] should be done in any infant who is suspected to have congenital hypothyroidism. The study assures the importance of public education and awareness in contributing to the cost effectiveness of screening program using filter paper blood spotting and supports the necessity of the rapid assay of filter paper spots within few days in large common collecting center for screening

Serum interleukin-6 and lactic dehydrogenase levels in hematologic malignancies

Objective: to assess the prognostic value of serum IL-6 and LDH in chronic lymphocytic leukemia [CLL] and acute myclogenous leukemia [AML] and to investigate whether the two markers correlated with other known prognostic factors such as Beta- macroglobulin

Patients and Methods: this study included 25 leukemia patients, in addition to 10 healthy subjects matched for age and sex [controls]. Total leucocytic count, absolute lymphocytic count and blast cell count were performed by flow-cytometry based haematology analyzer. Serum interleukin-6 [IL-6] was determined by enzyme immunoassay. Serum lactate dehydrogenase and albumin were measured by colorimetric methods. Beta2-microglobulin [Beta2- MG] and C-reactive protein [CRP] were measured by AXSYM[TM] system

Results: the levels of IL-6, LDH, Beta[2]- MG and CRP were significantly increased in both CLL and AML compared to controls [p<0.001 for IL-6 and LDH p < 0.0001 for CRP and Beta2- MG in CLL patients. p < 0.0001 for IL-6. LDH and CRP, p<0.0026 for beta[2]- MG in AML patients], whereas serum albumin levels in both diseases were decreased significantly than that of controls [p<0.0001 for each]. Total leucocytic and absolute lymphocytic count were increased significantly in CLL patients compared to control [p

Conclusion: results demonstrated that serum IL-6 and LDH may be used as reliable markers for monitoring the disease activity and were found to have prognostic significance for disease stage and outcome

Trace elements and antioxidants status in the development of vascular complications in type II diabetes mellitus

Objective: to determine the levels of trace elements and antioxidants in type II diabetic patients with and without vascular complications

Subjects: the study was carried out on 30 patients with type II diabetes mellitus and were divided into two groups according to fundus examination either with and without vascular complications. Fifteen healthy voluntary subjects were chosen as controls

Setting: department of Biochemistry, Faculty of Science. Ain Shams University and Clinical Pathology Department, Maadi Armed Forces Hospital, Cairo, Egypt

Patients and Methods: sera of control and diabetic patients were analyzed for determination of trace elements by Inductively Coupled Plasma Mass Spectrometry [ICP-MS], a very powerful and reliable analytical method for trace elements determination. Blood samples were used for determination of glutathione [GSH], superoxide dismutase [SOD]. Plasma samples were used for determination of nitric oxide [NO] and ascorbic acid [vitamin C] using spectrophotometer

Results: serum trace elements levels [Zn, Cr, Se and Mn] in type II diabetic patients with and without vascular complications were significantly decreased when compared to the corresponding levels of controls. Significant reductions in the levels of SOD, GSH and NO were encountered in diabetic patients with and without vascular complications as compared to controls. Serum vitamin C levels were markedly decreased in the two diabetic groups and the decrease was more pronounced in patients with vascular complications. There were negative correlations between serum Zn and SOD as well as Cr and NO in type II non vascular diabetic patients without vascular complications, whereas positive correlation was found between serum Se and vitamin C in type II diabetic patients with vascular complications

Conclusion: the decrease of antioxidants and trace elements may indicate that diabetic patients a e subjected to oxidative injury. Antioxidant supplies may helpful to protect against vascular complications of diabetes mellitus

Clinical significance of enhanced production of interleukin-6 and oncostatin M by cultured systemic sclerosis patients peripheral blood mononuclear cells from patients with systemic sclerosis

To determine whether the spontaneous production of interleukin-6 [IL-6] and oncostatin M [OSM] from peripheral blood mononuclear cells [PBMCs] in patients with systemic sclerosis [SSc] is increased and whether they are correlated with the clinical or serological features of the disease. The culture supernatants of PBMCs from patients with SSc [n = 22] and healthy controls [n = 10] were examined by enzyme- linked immunosorbent assay [ELISA] for detection of IL- 6 and OSM, also pulmonary function tests were done for all patients and controls. The production levels of IL-6 and OSM were significantly higher in patients with SSc than controls [p < 0.05 and p < 0.01 respectively]. High IL-6 levels correlated negatively with% the diffusion capacity for carbon monoxide DLco [r = -0.5; p < 0.05], and high OSM levels correlated negatively with% vital capacity [Vc] and DLco [r = -0.53; p < 0.05 and r = -0.87; p < 0.01 respectively]. The enhanced production of IL-6 and OSM may cooperatively contribute to the disease process in SSc. Enhanced IL-6 and OSM production from PBMCs may be related to the development of pulmonary fibrosis

Cryosurgery versus pulsed co[2] laser in treatment of basal cell carcinoma

Basal cell carcinoma [BCC] is the most common human malignancy and the most common malignant skin tumor. Although BCC has a low mortality, it has a large morbidity. Several modalities have been used in the treatment of BCC, however, it remains to be established which one is the best in terms of safety, cosmetic outcome and cost-effectiveness. Cryosurgery for BCC treatment is an approach currently in progress, with many technical and prognostic advantages. Also, CO2 laser ablation has been advocated as an alternative therapeutic modality for basal cell carcinoma. The present study was designed to evaluate and compare the outcome of two of the most commonly used modalities, the cryosurgery and pulsed CO2 laser, in treatment of superficial [S] and nodular [N] BCCs. Thirty-two patients with histopathologically verified BCCs, 17 superficial and 15 nodular lesions were selected and included in 2 equal groups: group I, treated by cryosurgery and group II by pulsed CO2 laser. Follow-up period was restricted to 1 year with close follow-up for the first 3 months. The efficacy, tolerability, and cosmetic outcome were all assessed. While complete [100%] cure was reported with either procedures in treatment of superficial types of BCC, cryosurgery was found significantly more successful in treating nodular BCCs [P=0.04] and the overall efficacy was significantly better with cryosurgery than CO2 laser [P=O.04]. The healing time was shorter with cryosurgery than CO2 laser, with less erythema [P<0.001] and less wound leakage [P<0.008]. No statistically significant difference was found between either procedures concerning the cosmetic outcome. In conclusion, cryosurgery is an easy, quick, low-cost and well-tolerated therapeutic modality that offers an acceptable cure rate with good functional and cosmetic results in BCCs treatment

Cyclophosphamide and cisplatin VS pacltitaxel and cisplatin in patients with advanced-stages ovarian carcinoma

Treatment plan: Sixty women refered to Oncology Department, Zagazig University Hospitals and Alexandria university Hospital with stages III and IV ovarian cancer and with measurable disease at least one centimeter as a residual after any surgical procedure. Thirty patients in the historical standard-therapy group [group A] were previously received cyclophosphamide [750mg/rn2 I. V] and cisplatin [75 mg/m2 I. V. infusion] every three weeks for a total of six cycles. Data were collected from files and from survived patients under follow up. Thirty patients in the experimental group [group B] received paclitexel [135 mg/m2 I. V. infusion over a period of three hours] and cisplatin [75mg/m2 I. V infusion] every three weeks for a total of six cycles. The overall response rate 83.4% was in group "B" versus 66.7% in group "A" [P.>0.05] Complete clinical responses were more frequent among women in group "B" [56.7%] than among those in group "A" [26.7%] P.>0.05. Seven women out of 17 [41.2%] in group "B" showed negative pathological results after laparotomy versus 2 out of 8 [25%] in group "A The overall survival rate was found to be 46.7% in group "A" versus 63.3% in group "B" with a median follow-up period of 28 months and 26 months respectively [P>0.05]. The progression-free survival in the same periods was 13.3% in group "A" versus 36.7% in group "B" [P<0.05]. Paclitaxel and cisplatin used as a first line therapy improves complete clinical response, overall survival, and progression-free survival rates in women with advanced stages [III and VI] ovarian cancer who have neasurable residual masses

Ovarian cancer in Alexandria from 1988 to 1997: trends and survival

The trend of incidence of ovarian cancer was studied, the 5-year survival rate calculated and prognostic factors for survival determined. Data were collected from the Alexandria Cancer Registry and medical records in various hospitals. A total of 358 cases of ovarian cancer were diagnosed from 1988 to 1997. A significant increasing trend in incidence of ovarian cancer from 1.23/100 000 in 1988 to 3.16/100 000 in 1997 was found. The overall 5-year survival rate was 46%. The 5-year survival rates for tumour stages I to IV were 85%, 71%, 41% and 22% respectively, which was statistically significant. Survival rates with poorly differentiated tumours were significantly worse than with moderate or well differentiated tumours

Extraction, indentification and biological activities marjoram essential oil

Extraction of essential oil Marjoram plant [Origanum majorana] was carried out on seasonal basis. Three cuts of the herb viz: November, February and April were obtained, steam distilled and identified by gas liquid chromatography. The highest content of phenolics mainly carvacrol and thymol were recorded in April cut. The most effective fraction showed remarkable inhibitory effect towards various Gram positive and Gram negative bacteria. The mode of action on selected bacteria viz: Escherichia coli and Bacillus megaterium was then investigated in terms of inhibition of enzyme synthesis, nucleic acids, total cellular nitrogen, nuclease activity and dry weight

Stability of digestive enzymes in the formulated and commercial tablets

The stability of amylase and lipase in formulated pancreatin tablets prepared by direct compression using Avicel PH 101 and Zeparox were studied at four temperatures [50, 37, 25 and 4C] for 6 months. Pancreatin-Avicel tablet coated with HPMC and CAP as non-enteric and enteric coats was also investigated. Commercial pancreatin containing tablets from different sources were also selected in this study for comparison. The enzymatic degradation at the selected temperature obeyed the first order reaction kinetics. The degradation rate constants of enzymes in all tablet formulations were markedly decreased with temperature lowering. Zeparox tablets showed the highest degradation values, while those coated with CAP were the most stable formulations. Festavital tablets gave the highest stability data within the commercial brands. After 6 months of storage, amylase suffered greater losses of its activity than lipase, specially at 50 and 37C. At 4C tablets prepared with Avicel exhibited about 96, 21 and 3.6 times decrease in their degradation rate relative to those stored at 50, 37 and 25C, respectively

psychosexual evaluation of hydroflex penile prosthesis implantation for patients with erectile dysfunction

An attempt to assess satisfaction and current sexual function for those who underwent surgery of hydroflex penile prosthesis implantation was made 88.2+ACU- excellent satisfaction rate was noted in these patients, with other 11.8+ACU- expressing some degree of satisfaction. They also denoted improvement of sexual desire and ejaculation in 29.4+ACU-, better erection power mostly with moderate extent [76.4+ACU-] and regained orgasm in 41.2+ACU-. Both satisfaction and improvement were positively reflected on sexual performance and willingness to recommend the implantation surgery to others [58.8+ACU-]. Discussion of the results was followed by suggestions for securing the best responses in recipients of such specialized operation from the psychological standpoint

Study of effects of insulin on haemostatic system in obese and control subjects

The haemostatic effect of intravenous insulin administration was investigated in obese and control subjects. A hypercoagulability state was elucidated by enhancement of thromboplastin generation and increase of platelet adhesiveness. Stimulation of catecholamine release is supposed to be an underlying factor. An associated enhancement of fibrinolysis was observed and was less marked in obese than control subjects. Such findings point to paradoxical effects of insulin on the haemostatic parameters

Histochemical and histopathological changes in diabetic gingival tissues

120 diabetic and prediabetic gingivae were studied histopathological and histochemically and compared with non-diabetic gingivae, PAS + ve substance was deposited in the epithelial cells and the vascular wall [subendothelially] leading to narrowing and even occlusion of vascular lumen in severe diabetic cases [uncontrolled late onset diabetic] a mirror of the micro-angiopathy occuring in diabetes. Succinic dehydrogenase and acid phosphatase activities showed increase in the epithelial cells and lamina propria cells. The increase in the first enzyme might be due to the abnormal C.H.O. metabolism in diabetes; but the increase in the latter was due to the increased phagocytic function of these cells accompanying the degenerative process in the cell and also as a reaction to the inflammatory processes usually accompanying this disease. The decrease in alkaline phosphatase activity in the capillary endothelial cells might be due to disturbed active ion-transport function of these cells, a condition which usually accompany microangiopathy. From this research it was found that by gingival biopsy one could diagnose and correlate diabetes especially in its presymptomatic or preclinical stage [prediabetic] where easier treatment and control could be done

lypmh nudes changes in mice in response to schistosomal infection

White albino mice were infected with circa ria of Schistosoma Mansoni. The mesenteric lymph nodes were examined both histologically and histo chemically for demonstration of cytoplasmic RNA granules using methyl green pyronin, as well as for some enzymes namely succinic dehydrogenase, alpha esterase and acid phosphatase. The histopathological changes suggested an immunological reaction. The histochemical examination revealed an increased activity of succinic dehydrogenase, alpha esterase and acid phosphatase enzymes suggesting that they are evolved in these immunological reactions

effect of gatroesophageal decongestion on serum lipids in patients with schistosomal hepatic fibrosis

Fasting levels of blood lipids were studied in 41 patients with schistosomal hepatic fibrosis and 81 controls. The effect of gatroesophageal decongestion operation [Hassab's operation] on two groups of S.H.F. patients: group A of 18 patients with evident collaterals and group B of 14 patients without, were investigated. The means of fasting total lipids [TL], cholesterol [CH], cholesterol esters [CE], percent esterification of cholesterol, triglycerides [TG], phospholipids [PL] and alpha lipoproteins were found to be significantly lowered in the S.H.F. patients than controls. This was much more marked in group A. Hassab's operation was followed by a significant increase in TL, CH, CE and PL in group A, and not in group B. TG, alpha lipoprotein per cent and percent esterification of cholesterol were not affected in both groups. The possible mechanisms responsible for the above data are discussed

Glucose tolerance, plasma insulin, growth hormone, and free fatty acids in hepatic schistosomiasis

The purpose of the present study was to examine glucose tolerance in hepatic schitosomiasis together with some factors which may affect this tolerance. In forty-nine patients, the glucose disappearance rate was slower than in controls [1.27 + 0.28 and 1.64 +/- 0.26 per cent per minute, means +/- S.D., respectively]. The exogenous insulin sensitivity tests were normal and the insulin response after intravenous glucose administration was comparable to controls except after 90 minutes when it was significantly higher in hepatic schistosomiasis patients than controls [24.45 +/- 14.6 and 16.44 +/- 7.8 uU/ml. mean +/- S.D., respectively]. The growth hormone response to intravenous insulin administration was also comparable to controls. The plasma free fatty acids [FFA] were significantly higher in schistosomal patients than controls 592 +/- 172 and 209 +/- 97 ueq/1, mean +/- S.D., respectively.]. It is suggested that the glucose intolerance demonstrated in hepatic schitosomiasis might be due to a relative decrease of insulin secretion. Raised plasma FFA may also play a part

Plasma cortisol and synacthen test after oral contraceptives

Thirty women receiving Gyn-Anovlar were studied for plasma cortisol level. Ten of them were examined before and after Gyn-Anovlar therapy for basal cortisol and were injected intramuscularly with 250 mg mg of Synacthen. There was a significant rise of plasma cortisol and the patients responded normally to the injection of Synacthen indicating a good adrenal reserve function. The remaining 20 patients were already taking the pills for periods ranging from 8 to 9 months. Their plasma cortisol level was not statistically different from those taking the pills for six months

Gastric acidity in rheumatoid arthritis

Basal and maximal histamine stimulated gastric acidity was determined in 24 patients with classical rheumatoid arthritis. Gastric acidity was found to be significantly lower than in normal controls. This was especially marked in female patients, in old patients above 40 years of age, and in severe rheumatoid arthritis. Parenteral methysergide, an anti-serotonin, produced significant augmentation of basal acidity [210 percent], while the increase in maximal acidity varied according to the underlying defect whether functional or organic. The underlying mechanisms of diminished gastric acidity in rheumatoid arthritis were discussed. A pathologic mucosa as a part of the systemic involvement of rheumatoid disease was postulated in some cases. Diminished gastric secretion secondary to reduced gastric mucosal blood flow because of wide spread vaculitis may be a factor. Gastric parietal cell antibodies may be another possibility. Disturbed serotonin metabolism may play a part in inhibition of gastric acidity in some patients