Patterns of drug resistance in case of smear positive pulmonary tuberculosis in Giza and Cairo governorate

Pulmonary tuberculosis is a major cause of morbidity and mortality World Wide, resulting in the greatest number of deaths due to any other single infectious agent. Drug resistance threatens global tuberculosis control efforts. Multi drug resistance means drug resistance to at least rifampicin and isoniazid. One hundred and nineteen sputum and culture positive patients underwent drug susceptibility to the first line drugs [Isoniazid, Rifampicin, Streptomycin and Ethambutol]. 79/119 patients in addition underwent drug susceptibility to Pyrizinamide, Ofloxacin, Amikacin and Levofloxacin. The susceptibility test shows that 35/119 patients [29.4%] were sensitive to all the tested drugs. 84/119 of the included patients [70.6%] showed drug resistance to at least one of the first line drugs by different patterns. 29/119 patients were diagnosed as MDR cases with a percent of 31% [resistant to both INH and Rifampcin]. This study shows increase incidence of resistance to first line drugs as well as increase incidence of MDR

Utility of preoperative serum Carcinoemberyonic antigen in colorectal cancer patients

The usefulness of preoperative Carinoembryonic antigen [CEA] in colorectal cancer [CRC] remains unsettled as regards its role in management and follow up of CRC patients. Efficacy of basal CEA in the diagnosis, prognosis, follow up and therapy of CRC patients will be assessed in this study. Patients and Methods: 200 CRC patients and 100 persons as a healthy control were included in the study. Basal CEA was done before resection. Postoperative Duke's staging was adopted. Routine follow up and CEA estimation were done. Results: The mean CEA in CRC patients [17.3 ng% +/- 1.67] was significantly higher than control [3.41 ng% +/- 1.1]. A significant association between mean basal CEA and Dukes' classes was evident [it was 7.8, 12.7, 25.8 ng% for Dukes' A, B, C]. The validity of basal CEA in primary CRC diagnosis was highly positive, with higher efficacy in advanced disease detection and negative exclusion power for DFS prediction. Basal CEA was a diserinainant factor in prognosis. DFT and DFS were higher in patients with CEA 5 ng%. Conclusion: The preoperative CEA identifies subsets with favorable, indolent and uneven biological behavior [<5, 15, > 15 ng%]. With conventional staging, it forms strong prognostic tool that supplies practice guideline for follow up and therapy

Local and systemic anti-tumor immune response for breast cancer is there. Why it fails in eradication of the disease?

A new model for breast cancer is needed to define the fine dynamic balance between the tumor and the host including various autocrine and endocrine factors which influence proliferation, apoptosis and angiogenesis. Aim of the study was to measure the systemic and local anti-tumor immune response for breast cancer, to study cytokine network modification [IL-10] [anti-inflammatory] and IL-12 [pro-inflammatory] and to evaluate its correlations with other histopathological parameters. The study was done on 17 female patients with breast cancer and another control group of 10 patients. The patients were followed-up for two years. Significant correlations of studied peripheral blood immune parameters were: Natural Killer [NK] numbers, NK activity [NKA] and peripheral T-lymphocytes in count per minute [0pm] with tissue NK [TNK] and tissue natural Killer Activity [NKA]. Significant correlation between NKA and IL-12, and peripheral blood T-lymphocytes with NK and tissue NK activity [T-NKA] was detected. Significant correlations between IL-10, IL-12 and the other parameters were detected. Significant correlation was noticed between [Local immune response]: tumor infiltrating lymphocytes [171.3] and tumor Stage, also between other studied parameters of local immune response. The degree of fibrosis [mechanical tumor control] was correlated negatively with the tumor grade and lymph node number. The disease free survival [D.F.S] was significantly related to tissue local immune response and systemic immune response through IL-12 modifications. Significant correlation between high levels of IL-10 with NKA and TILs was detected Recurrence was closely related to the number of positive axillary lymph nodes. On conclusion: proper function of peripheral T-lymphocytes was crucial for effective destruction of breast cancer cells. NKA Was involved in breast cancer disease progression and it depended on levels of IL-12 and the antigen presenting cell [APC]. IL-10 had a predictive role in breast cancer response and exogenous anti-IL-10 may be useful. The amount of IL-12 available was critical for tumor progression. TIL: correlates with the tumor stage but failure of tumor eradication may be due to higher levels of IL-10. The mechanical arm was involved in the immune response disease. Free Survival [DIES] was related to KA and SNKA through the lL-12. Lastly the discriminate factor in DFT was the TNKA

Comparative retrospective study of bleeding esophageal varices management chronic injection sclerotherapy versus splenectomy and devascularization

This study was conducted to evaluate and compare between chronic Injection sclerotherapy in 63 patients and splenectomy and devascularization in 37 patients in the management of bleeding esophageal varices in Egyptian patients suffering from schistosomiasis hepatosplenic fibrosis. It was found that the most common grade that causes bleeding varices was grade III. The study reported complete disappearance and obliteration of varices in 63 patients via 180 sessions of injection sclerotherapy. A rate of 6.3% of rebleeding attacks in those patients was also reported. While, a rebleeding rate of 10.8% in the second group of splenectomy and devascularization was reported. The study also reported two deaths in the sclerotherapy group from 63 patients and no deaths in the second operative group [37 patients]; so, the total mortality rate was 2% only from 100 patients

Comparative study of minimal invasive cholecystectomy versus laparoscopic cholecystectomy

A total of 133 patients complaining of gallbladder disease was operated upon; 75 patients for minimal invasive cholecystectomy [MIC] [incision 5 cm] and 58 patients for laparoscopic cholecystectomy [LC]. The study relied on US examination. The severity of GB disease, requirements of analgesia, hospital stay, conversion and complication rates were compared in both groups. It was found that MIC was comparable with LC in terms of postoperative analgesia and significantly less operative time. MIC could be easily performed in the developing countries where facilities for LC may not be available. Although, LC has a simple postoperative course and has the advantage of full abdominal exploration, there are still other contraindications to it as the absolute refusal of the patient, hemorrhagic syndrome or massive cirrhosis and fistula between the liver and gut. MIC is preferred as it represents a safe, inexpensive method for treating non-complicated gallstones, especially in the developing countries