Relation between serum levels of vitamin D and echocardiographic determinants of systolic and diastolic functions in patients with and without cardiorenal syndrome

Background: vitamin D is a fat-soluble vitamin; it has skeletal and non-skeletal functions. The effect of Vitamin D on CV disease had several mechanisms including elevated PTH and Calcium-phosphate metabolism. It decreases the pro- remodeling of Angiotensin II on the cardiomyocytes

The Objectives: To study relation between serum levels of vitamin D and echocardiographic determinants of systolic and diastolic functions in patients with and without cardio-renal syndrome

Patients and Methods: Prospective study was conducted on 90 patients of all age groups and both sexes, admitted to Ain-Shams University hospital. The study included 3 groups of patients: Group 1: systolic dysfunction and renal insufficiency [30 patients], Group 2: systolic dysfunction only [30 patients]. Group 3: renal insufficiency only [30 patients], in addition 10 healthy controls were taken as controls. Patients were subjected to full comprehensive echocardiography and KFT with estimation of creatinine clearance, and Vitamin D level that was statistically studied against echocardiographic parameters of cardiac systolic and diastolic function

Results: Our study found that, compared to patients with normal vitamin D level, patients with vitamin D deficiency [defined as having vitamin D level <20 ng/ml] had significantly higher ventricular thickness [IVS, PW and mean wall thickness] [P value < 0.001], and higher LV mass which seems to be linked eventually to worse outcomes with no significant impact on worsening Diastolic dysfunction. A ROC curve was done revealing a sensitivity of 80% for the mean wall thickness [>/= 10 mm] to identify patients with vitamin D deficiency

Conclusion: Vitamin D deficiency was associated with ventricular hypertrophy with worsening outcomes with no impact on diastolic function

Prognostic and predictive value of HER-2/Neu over expression in primary breast cancer

To investigate the presence of HER-2 over expression by immunohisto-chemistry in 81 archival breast cancer specimens and its impact on survival in relation to other prognostic factors. Paraffin embedded primary breast cancer specimens from 81 patients with stage I-III breast cancer, treated in Clinical Oncology and Nuclear Meadicine and surgical Oncology Dpartment, Mansoura University Hospital, were studied immuno-histochemically. All patients were subjected to modified radical mastectomy with axillary dissection. Locoregional postoperative radiotherapy was given to all patients with lymph node metastases or primary tumors large than 2 cm located in the medical or central area of the breast. Primenopausal node positive patients were treated with six courses of either CMF or FAC regimens. Postmenopausal node positive patients were given tamoxifen with or without CMF. HER-2neu protein over expression was detected in 28% of tumors. A significant correlation was noted between HER-2 expression, poor histologic grade and higher number of mitosis. Also, HER-2 expression was associated with shorter 5-year over all survival and disease free survival rates compared with HER-2 negative cases [52.8% V 84.8% and 44.8% V 73.9% respectively]. In a multivariate analysis, HER-2 over expression was found to be a significant predictor factor of overall and disease free survival [p=0.004 and 0.01 respectively]. HER-2/nen overxpression is an independent prognostic factor for risk of recurrence. Women with tumours without HER-2 overxpression have a good prognosic; aggressive therapy n this group in therefore difficult to justify. On the other hand, even with adjuvant chemotherapeutic treatment whose tumours exhibit HER-2 over expression have an increased risk of recurrence. Randomized trials to compare more aggressive adjuvant chemotherapy versus standard chemotherapy for women whose tumor exhibit HER-2 protein over expression are recommended

case of ectopic fascioliasis in a farmer from Mansoura city, Dakahlia, Egypt

Human fascioliasis is a new parasitic health problem in Egypt. This paper reports a case of ectopic fascioliasis in the right side of the pleural cavity of a farmer