Infectobesity in Egyptian adolescent women and its relations to carotid intima-media thickness

Background: ‘Infectobesity' is a new term to describe obesity of infectious origin, such as infection by human adenovirus-36 [Adv36]. It appears to be a new concept, evolved over the past 20 years. Visceral obesity is associated with a higher risk of cardiovascular disease. Increased carotid intima-media thickness [CIMT], a marker of early-onset atherosclerosis, has been observed in obese children and adolescents. The present study aims to investigate the relationship between visceral obesity, CIMT, and Adv36 in female Egyptian adolescents

Patients and methods: The present study included 90 women aged 12-15 years. It was conducted at the Medical Excellence Research Center of the National Research Centre, Cairo, Egypt, during the period between September 2016 and November 2017. Anthropometric assessment was done. Fasting blood samples were withdrawn for the measurement of Qualitative Human Adv36 antibody using a sandwich enzyme-linked immunosorbent assay. Fasting plasma glucose was determined calorimetrically, by the glucose oxidase method and insulin level using the solid-phase enzyme-linked immunosorbent assay and lipid profile. Visceral obesity was measured by an abdominal ultrasound. CIMT for both carotid arteries were measured by high-resolution echo Doppler

Results: Girls with visceral obesity [n=26] had higher frequency of increased CIMT at left [96.2 vs. 75%], right carotid artery [84.6 vs. 73.4%] and Adv36 sero-positive antibody [69.2 vs. 56.2%] than among those without visceral obesity [n=64]. Among the total samples, visceral obesity had significant positive correlations with BMI, waist and hip circumference, while it had insignificant correlations with age, blood pressure [BP], CIMT at right and left carotid arteries, adenovirus and laboratory findings. CIMT had a significant positive correlation with each other, insulin resistance and total cholesterol, and significant negative correlations with high-density lipoprotein and waist circumference. Adv36 had significant negative correlations with BP [both systolic and diastolic] and significant positive correlation with insulin level. Adv36 and CIMT had insignificant correlations with each other and with the anthropometric measurements, BP, visceral obesity, triglycerides, and low density lipoprotein

Conclusion: The frequency of Adv36 and increased CIMT at left carotid artery were higher among girls with visceral obesity than among those without visceral obesity. However, visceral obesity, CIMT at both right and left carotid arteries, and Adv36 had insignificant correlations with each other

Breast conservation therapy in treatment of cancer breast

Breast conservation therapy [B.C.T.] comprises local excision, axillary dissection and post operative radiotherapy. Numerous studies have now shown that although local recurrence may be slightly more common after breast conservation than mastectomy, disease-free survival and overall survival are the same. The primary goals of breast conservation therapy are tumour control and acceptable appearance of the breast. Twenty female patients were included in this study. All patients were suitable for B.C.T. Their ages ranged from 25 to 60 years [mean age 41.3 +/- 8.8 years]. All patients were subjected to mammography, fine needle aspiration cytology [FNAC] and metastatic work up [chest x -ray, abdominal ultra sonography and bone scans].The study included 4 patients [20%] in stage I, 14 patients [70%] in stage II and 2 patients [10%] in stage III One patient showed positive safety margin of the lumpectomy specimen and for whom mastectomy was done. The remaining 19 cases were followed up for two years. The study showed an excellent cosmetic appearance however, local recurrence occurred in 3 cases [15.78%]. The higher incidence of total recurrence in the present study may be related to the histopathological nature of the tumour, the biological behavior of breast cancer in Egypt or even the sample is so small in number

Laparoscopic management of patients with acute biliary symptoms. Factors predictive of Failure of a laparoscopic technique

Laparoscopic cholecystectomy has become the standard elective management of cholelithiasis. Little information exists, however, regarding the appropriateness of this procedure in the setting of acute symptomatology. We reviewed our results with 26 patients with acute biliary symptoms managed laparoscopically. There were 18 females and 8 males with their ages ranging from 22 to 70 years with an average of 46 years. Laparoscopic cholecystectomy was attempted in all patients, and was successful in 22 of 26 patients, four procedures were converted to open cholecystectomy because of difficulty in dissection precluding laparoscopic cholecystectomy. Patients requiring open cholecystectomy were older, more likely to be febrile [mean temperature of 37.9 +/- 0.6 versus 37 +/- 0.7] and were more likely to have a significant leukocytosis [mean white cell Count 12.8 +/- 5.2 +/- 10[3] cells/mm[3] versus 9.2 +/- 2.8 +/- 10[3] cells/mm[3]] than were those undergoing successful laparoscopic cholecystectomy. Laparaoscopic cholecystectomy can be performed safely in the majority of patients presenting with acute biliary symptoms. Patients presenting with a triad of right upper quadrant pain, fever and elevated white cell count who are especially males, elderly and morbidly obese are more likely to require conversion to a standard cholecystectomy and should be informed accordingly