ABSTRACT
Breast cancer is among the leading cause of cancer related deaths in women. The treatment of locally advanced breast cancer requires a combination of systemic chemotherapy, surgery, and radiotherapy to optimize the chance of cure. The aim of present study is to compare the effect of Adjuvant Chemotherapy and Neo-adjuvant Chemotherapy on Locally Advanced Breast cancer (LABC). Methods: The study included 35 female patients presenting to the surgery OPD of SVBP hospital with locally advanced breast cancer proven on biopsy out of which 17 patients received Neoadjuvant chemotherapy based on high tumour breast ratio, fixed lymph nodes in the axilla, fixed to the chest wall and multiple sattelite lesions. And 18 patients were operated as modified radical mastectomy and then they received the six cycle of adjuvant chemotherapy. The data collected was statistically analysed by WILKOXONS SIGNED RANK TEST for neoadjuvant chemotherapy and percentage evaluation for results of adjuvant chemotherapy. Results: Clinically measured size of tumour correlates well with the radiological assessment of the same. There was significant reduction of tumour size both clinically and radiologically. There was significant reduction of tumour size both clinically and radiologically in ER/PR+ve as well as ER/PR-ve patients but more decrease in ER/PR+ve patients means receptor positivity is a good prognostic sign. 88.9% of patients who have receive adjuvant chemotherapy showed no local recurrence both clinically and radiologically. 88.9% of patients who have receive adjuvant chemotherapy showed no recurrence of axillary Lymphadenopathy. 94.45% of patients who have receive adjuvant chemotherapy showed no involvement of liver, brain, lung and bone both clinically and radiologically. Conclusion: It is concluded that both Radiological and Clinical response are same by both therapies. But, local recurrence, recurrence of axillary Lymphadenopathy and involvement of liver, brain, lung and bone both clinically and radiologically are less with adjuvant chemotherapy.
ABSTRACT
BACKGROUND & OBJECTIVE: Very few studies regarding production of virulence factors in different predominant serotypes of uropathogenic Pseudomonas aeruginosa are available and they have not been correlated to in vivo pathogenicity in the urinary tract. This study was carriedout with the objective to analyze the phenotypic characters of uroisolates of P. aeruginosa in vitro and to study the association of these virulence traits with their ability to cause nephropathogenicity in mouse model of ascending urinary tract infection (UTI). METHODS: Protease, elastase, alginate, haemolysin, pyochelin, pyoverdin and phopholipase C were measured using standard protocols in 18 uroisolates of P. aeruginosa isolated from patients suffering from complicated UTIs. An ascending model of pyelonephritis was established in Swiss Webster (LACA) female mice with these isolates. Quantitative bacterial count and histopathological evaluation of mouse renal tissue was done which were then assessed for a possible association with elaboration of virulence factors. RESULTS: All isolates of P. aeruginosa were able to colonize renal tissue of mice. However, renal counts varied amongst different isolates producing different virulence factors. Isolates producing high levels of haemolysin along with other virulence factors were able to colonize and multiply more in mouse renal tissue as compared to those producing low levels of haemolysin. INTERPRETATION & CONCLUSION: The findings of this study indicated an association between haemolysin production and renal colonization. High level of haemolysin production in vitro could be used as surrogate information for assessing pyelonephritic potential of P. aeruginosa.