Cardiac toxicity in breast cancer patients

To asses cardiac toxicity post radiotherapy in left cancer breast patients with different fractionations. This is a prospective randomized study conducted at Kasr El-Ainy Center of Clinical Oncology and Nuclear Medicine [NEMROCK]. Cardiological assessment using RTOG toxicity criteria was done for left sided breast cancer patients after at least five years of conformal radiation therapy. There were two arms of radiation, conventional [50Gy/25sttt/5 Ws] and hypofractionation [42.5 Gy 716 fractions /3 1/5 weeks]. Thirty patients were included in each arm. After a median follow up of 62 months [range 60 to 72], cardiac dysfunction developed more in the conventional arm but was insignificant [P value =0.36]. Grade I and II toxicity was 83.3 vs 70% and grade III was 3.3% in the hypofractionated arm only. The rate of local-regional tumor relapse at 5 years was similar [3.3%]. Hypofractionated radiotherapy decreased cardiac toxicity though not statistically significant, however it is more cost effective and time consuming

Manufacture of soft cheese with multiple health benefits 1- Fortified with vegetables oils and parsley juice [as natural antioxidants]

UF-soft cheese was prepared from UF milk retentate containing either 3% milk fat or mixed milk fat + vegetable oils [1:1] and fortified with 1-5% parsley juice and cold storied for 30 days. The total phenolic [TPC] and carotenoids [TCC] contents were determined and antioxidant properties were measured using DPPH and FRAP methods in retentates and cheeses. Also, the chemical composition was evaluated and sensory properties evaluation of fresh and storied cheese were evaluated. Fortification of retentate with different concentrations of parsley juice increased significantly its content of phenolic compounds and carotenoids and consequently its antioxidant activity. Partial replacing milk fat with mixed olive + sunflower oils [1:1] increased markedly TPC and TCC. Pasteurization of retentates increased its TPC, RSA% and FRAP values, but TCC was not greatly affected. Addition of 3% NaCI to retentates reduced slightly its TPC, TCC, and RSA% and FRAP values. On the other hand there was noticeable increase in the TPC, TCC, RSA% and FRAP values of the fresh fortified cheese especially those made with mixture of milk fat and vegetable oils. However, the antioxidant activity and scores for sensory attributes decreased gradually in all cheeses during storage, but UF-soft cheeses with parsley juice gained higher flavour scores and general acceptability than control when fresh and throughout the cold storage

Extracapsular cataract extraction and posterior chamber intraocular lens implantation in eyes with pre-exiting trabeculectomy

The purpose of this study is to evaluate the effects of extra capsular cataract extraction with posterior chamber intraocular lens implantation [ECCEePCIOL] on the intraocular pressure [IOP] control in eyes having previous trabeculectomy operation. Forty five eyes of 45 patients that underwent ECCEePCIOL after previous trabeculectomy operations are included in the present study. Evaluation of preoperative, intraoperative, and postoperative factors and their effects on IOP control after ECCEePCIOL was done. Follow-up period after surgery ranged from 8 to 24 months. Complete success was achieved in 25 eyes [55.5%] [with no need for antiglaucoma medications or surgery to control IOP], qualified success [using antiglaucoma medications to control IOP] in 16 eyes [35.5%], and failure [e needing for antiglaucoma surgery to control IOP] in 4 eyes [8.88%]. The study showed the factors associated with less control of IOP were: younger patients [with age less than 45 years], uveitic and neovascular glaucoma, intraoperative iris manipulation, preoperative IOP more than 15 mmHg and maximum postoperative IOP more than 25 mmHg. To evaluate the effects of cataract extraction on the intraocular pressure [IOP] control in eyes having previous trabeculectomy. A total of 45 eyes of 45 patients who underwent extracapsular cataract extraction [ECCE] with posterior chamber intraocular lens [PCIOL] implantation after previous irabecidectomy operations are included in the present study. Evaluation of preoperative, intraoperative and postoperative factors and their effects on IOP control after cataract extraction was done. After mean post operative follow up of 8-24 months, 16 eyes [35.5%] were in need for additional glaucoma medications [qualified success], and 4 eyes [8.88%] needed another filtering operation [failure] to control the IOP, Complete success obtained in 25 eyes [55.5%]. Mean IOP at the last visit had increased 2 mmHg above the preoperative level. The median interval from the ECCE to the addition of antiglaucoma medication was 2 months, and to further glaucoma surgery was 5 months. Postoperative hypotony was noticed in 4 eyes [8.88%] that improved in 3 and persisted in one eye. When doing ECCE in eyes with preexisting trabeculectomy, some factors are associated with less control of IOP these factors include: younger patients with age less than 45 years, uveitic and neovascular glaucoma, intraoperative iris manipulation, preoperative IOP more than 15 mmHg and maximum post operative IOP more than 25 mmHg

Cyclin D1 expression predicts poor response to neoadjuvant chemotherapy and survival in late stage breast cancer patients

We evaluated the prognostic value of cyclin D1, epidermal growth factor receptor [EGFR] and MIB expression in Late Stage breast carcinoma, and their relationship with clinicopathologic response to neoadjuvant chemotherapy. We identified 45 patients who presented with locally advanced breast cancer [T2-T4], diagnosed with core needle biopsies, and treated with neoadjuvant chemotherapy, followed by conservative breast surgery [27/45,60%] with axillary lymph node dissection or modified radical mastectomy [18/45, 40%]. Complete pathologic response was defined as absence of invasive carcinoma at resection, while incomplete pathologic response was defined as having any invasive carcinoma. Cases were immunostained for cyclin D1, EGFR and MIB-1. Cyclin D1 ovcrexpression was found in 47% [21/45] of the cases and correlated with positive estrogen receptor [ER] expression [p < 0.01]. EGFR was positive in 16/45 [36%] of the cases which was expressed in the cytoplasm of the cancer cells, with occasional cell membrane staining. MIB-1 [>20%] was expressed in 15/45 [33%] of the cases. There were significant association between cyclin D1 overexpression and poor pathologic response [r=0.43, P=0.006], Cyclin D1 has significant adverse effect on overall survival and relapse-free survival [Log rank, p=0.05]. Overall, cyclin D1 overexpression was not associated with other clinicopathological features. EGFR was significantly expressed in ER and PR negative tumors [r=0.68 and 0.36, respectively]. Both EGFR and MIB-1 showed no significant correlation with pathologic response. Our findings indicate that cyclin D1 overexpression correlates with poor response to neoadjuvant chemotherapy and a worse survival in locally advanced breast cancer patients [T2-T4]

[ value of tumor markers in pulmonary tuberculosis]

In thoracic oncology, no tumor marker has yet shown sufficient sensitivity nor specificity to be usefull for lung cancer diagnosis. However, in some cases, monitoring of tumor marker blood levels provides useful evaluation of response to specific treatment and assessment of infracfinical tumor progression. To determine the value of umor markers in pu1monar tuberculosis. A prospective study was conducte in our department during 2 years 2005 through 2007. We included 40 men who presented confirmed pulmonary tuberculosis. Before starting antituberculous chemotherapy, serum assays were practiced for the following tumor markers: NSE, CA 12.5, ACE and Cyfra 21.1. Mean age was 37, 12 years [17-81]. The levels of NSE were high in 91, 66%of cases with an average value of 29,22 micro g/l [2,24 X normal]. This highest sensitivity was superior to those of other tumor markers: 55, 55%for CA125, 28, 94%for ACE and 7,6%for Cyfra 21.1. Analysis of the levels of NSE according to age, tobacco consumption, delay of consultation, type of the pulmonary lesions and negativation delay in smear did not show any significas difference, whereas levels of CA 125 were higher in bilateral lesions [P=0, 05].The highest sensitivity of the NSE in pulmonary tuberculosis, with no neoplastic pathology could be interesting diagnosis of smear negative tuberculosis, with small amounts bacilli

role of prophylactic laser iridotomy on the fellow eye in primary angle closure glaucoma

To evaluate the long-term efficacy of laser peripheral iridotomy [LPI] of fellow eye of patients with acute primary angle-closure glaucoma [APACG]. Retrospective non comparative case series. Forty six patients [46 eyes] with APACG at presentation to Assiut University Hospital from January, 2005 to December 2008 were included. All fellow eyes were initially treated with prophylactic pilocarpine 2% eye drops four times daily before LPI which was done within 2 weeks. All patients were followed to detect development of acute angle-closure and rise of IOP. No cases developed APAC after LPI during the follow-up of 37.3 +/- 7.1 months. Thirty eight eyes [82.8%] did not develop rise of lOP during the follow-up period, while the remaining eight eyes [17.2%] developed chronic rise of lOP and required additional treatment. LPI is effective in preventing angle-closure in fellow eyes. Long-term follow-up is recommended to detect any rise of lOP that may occur and required additional treatment

Infantile cataract surgery and intraocular lens implantation

To assess the long term results of cataract extraction and intraocular lens [IOL] implantation for congenital cataract. Prospective hospital based study of 39 children [age 6-13 months] underwent cataract extraction and lOLs implantation for congenital cataract in Assiut University Hospital and followed-up for 21 months [range 16-33 months]. Posterior capsulotomy and generous anterior vitrectomy was performed in all eyes. Forty nine eyes of 39 patients were included. At surgery, the mean age was 8.3 months [range 6 to 13 months]. The mean follow-up was 21 months [range 16 to 33 months]. At the last follow-up, 82.1% of children had central steady vision. Postoperative complications included anterior pupillary membrane [n=8], deposition on the anterior surface of the IOL [n=4], posterior pupillary membrane [n=3], pupil capture [n = 6], pseudophakic glaucoma [n=2], posterior synechia [n=3] and squint [n=13]. Implantation of lOLs in infants with congenital cataract is safe and effective and without serious postoperative complications

Posterior capsule opacification in pseudophakic eyes

To report the incidence of posterior capsule opacification with different types of intraocular lenses. 72 patients [72 eyes] with senile cataract were divided into 3 groups. Their ages ranged between 65 and 72 years. Group I underwent large incision extracapsular cataract extraction [ECCE] and received all PMMA IOL, group II underwent phacoemulsification and received polyacrylic IOL, and group III underwent phacoemulsification and received silicon IOL. All patients were followed up for 2 years to detect PCO. At 2 years PCO was less significant in patients who had implanted polyacrylic IOL than those with silicon or PMMA [P < 0.001]. The lower incidence of PCO with polyacrylic IOL suggests that the IOL material may reduce the incidence of PCO

Peritumoral lymphatic microvessel density as a prognostic parameter in endometrial carcinoma

Lymphatic invasion and nodal metastasis play a major role in the spread and prognosis of endometrial adenocarcinoma [EC]. In this study, we investigated tumor lymph-angiogenesis, detected by D2-40, as a predictive marker for the risk of lymph node [LN] metastasis and its relation to other prognostic parameters in EC. Fifty-five cases of EC treated with total hysterectomy and pelvic LN dissection were reviewed. All cases were immunostained for D2-40. Positively stained microvessels [MV] were counted in densely lymphovascular foci [hotspots] at X400 field [0.17 mm[2]]. Lymphovascular invasion was detected in 20/55 patients by D2-40 and 14/55 by routine hematoxylin and eosin. Peritumoral lymphatic vessel [LV] count was significantly higher than intratumoral LV count [17+7 versus 5+4/0.17 mm[2], P< 0.01]. Peritumoral D2-40 lymphovascular count correlated significantly with FIGO grade [P <0.001], lymphovascular invasion [P=0.001] and lymph node [LN] metastases [P=0.005]. However it showed non-significant correlation with peritoneal wash positivity [P=0.830] and stage of the disease [P=0.341]. Lymphovascular invasion detected by D2-40 showed significant correlation with LN metastases [P<0.01]. Our study showed that assessing LVD with D2-40 in the endometrial carcinoma might be a valuable parameter for predicting patients having an increased risk of developing metastatic disease. In addition, D2-40 increases the frequency of detection of lymphatic invasion relative to routine hematoxylin and eosin stain

Distribution of basal / myoepithelial cells in well-differentiated adenocarcinoma and bronchioloalveolar proliferations of the lung

We investigated the staining pattern of commonly used basal cell/ myoepithelial markers such as p63 [a p53-homologous nuclear protein], basal cell-specific cytokeratin antibody [34 [3E12, K903] and smooth muscle myosin heavy chain [SMMHC] in benign and malignant bronchioloalveolar proliferations of the lung. Eighty-five lung lesions were included in the study, consisting of 35 bronchioloalveolar carcinoma, 30 well differentiated adenocarcinoma and 20 cases of benign lung lesions. In normal lung, p63, K903 and SMMHC decorated the basal cells of large and small airways and occasional cells of terminal bronchioles. In reactive processes, a distinctive staining pattern was present in 19/20 [95%] of the cases, characterized by staining of basal cells of the airways as well as bronchiolar-and squamous metaplastic epithelium for p63 and K903, while 12/20 [60%] stained with SMMHC. Respiratory ciliated cells, alveolar epithelial cells and nonepithelial cells were negative. In bronchioloalveolar carcinoma, a discontinuous peripheral rim of p63-immunoreactive cells was retained surrounding and intermingled with the malignant bronchioloalveolar proliferation in 31/35 [88.5%] cases, SMMHC in 28/35 [80%] and K903 in 20/35 [57%] cases. For adenocarcinoma, the majority of cases [28/30, 93%] were negative for p63 and K903; however, SMMHC showed artifactual staining in the desmoplastic stroma in 6/30 [20%] cases. Our results highlighted the differential expression of basal cell markers across various bronchioloalveolar lesions. The staining pattern of basal cells in bronchioloalveolar carcinoma support that these neoplasms may actually be carcinoma in-situ, which would explain their good prognosis and their tendency not to metastasize

effect of fasting on QT Interval

QT interval reflects the total duration of ventricular depolarization and repolarization in the ECG. Experimental hypoglycaemia and spontaneous clinical episodes of hypoglycaemia lead to the lengthening of the heart rate corrected QT interval or QTc. This is associated with elevated risk of sudden death. To find out the effect of fasting blood glucose levels on QT interval and the corrected QT interval [QTc]. Fasting and post prandial blood glucose levels and ECG of healthy young adults were studied and QT interval, RR interval and QTc were determined. The fasting QTc came out to be 0.408 +/- 0.020 as compared to the post prandial value of 0.380 +/- 0.019. The student's t test showed a highly significant value [p<0.0001]. There is significant prolongation of QT interval and QTc during fasting but within normal physiological limits

Sonographic and bacteriological evaluation of cases likely to progress to preterm labor

The aim of the work is evaluation of bacteriological and sonographic role in the assessment of cases likely to progress to preterm labour and setting the management plan. This study included 30 pregnant ladies selected from the Shatby Maternity University Hospital between 20-30 years, primigravida or multigravida, and pregnant between 26 to 34. Presenting with threatening preterm labor, with intact membrane, with two or more of the following criteria: persistent menstrual like cramps and low dull backache, persistent heaviness, abdominal cramping, increase or change in vaginal discharge. All cases were subjected] 1-Complete history taking 2-Complete physical and obstetrical examination included a] inspection of the vulva, urethra, and perineum to detect the presence of any discharge or local inflammatory signs b] Speculum examination: for the presence of any pathological lesion and the type and character of any discharge [amount, color, and odor] c] Digital vaginal examination is performed with sterile glove if established preterm labour is suspected.3-Investigations:-1] Vaginal specimens: Sterile cotton-tipped swabs were used, inserted into the upper part of the vagina and rotated there before withdrawing it. For each case, two swabs were collected: one was placed in a transport medium for culture of aerobes and anaerobes; the other was rolled into a clean glass slide to make a smear.2] Specimens of urine were collected to detect and treat urinary tract infection if present.3] Detailed abdominal ultrasonography.4] Trans-vaginal ultrasound to determine: i] Cervical length. ii] Cervical width iii] The presence of funneling iv] Condition of the membranes. Cases were followeA up till either labor or complete 34 weeks was reached. The study -started with 54 cases, 24 cases dropped out, while 30 cases completed the study till the end-point. Initial pregnancy duration of the selected cases ranged between 26 - 33 weeks with a mean of 28.8 +/- 2.1. Culturing vaginal swabs recovered pathogens in a total of 18 of the studied 30 cases [60%]. Gardnerella virginals was found in 9 cases [30%], Klebsiella spp.5 cases [16.6%] and anaerobic streptococci spp. in 3 cases [10%] and pseudomonas spp.1 case [3.3%]. In the remaining 12 cases [40%], the recovered organisms were encountered as vaginal flora. Six cases with positive vaginal swabs showed clinical manifestations of vaginal infection mainly itching and vaginal discharge, while the remaining 12 cases are asymptomatic. Urine culture showed 3 cases of the study to have urinary tract infection [UTI], one of t em had Escherichia Coli [E.coli], and the other 2 cases had asymptomatic bacteriuria. All cases with viable singleton pregnancy between 26 -33 weeks, with adequate amount of liquor, placenta was fundal anterior in 25 cases and fundal posterior in the remaining 5 cases. Cephalic presentation in [16] cases, breech in [6] cases, and the remaining [8] cases with unstable lie. Ten cases out of 30 [33.3%] showed positive cervical changes on ultrasonography [cervical length<27 mm and diameter >17 mm], while 20 cases [66.7%] showed no changes.18 cases out of 30 showed positive vaginal infection, the cases with mean gestational age 27.09 +/- 1.30 weeks at the beginning of the study [11 cases], they continued their pregnancy till the end-point of the study[completed 34 weeks,] while cases with mean gestational age of 29.71 +/- 2.14 weeks at the beginning of the study [7 cases], they progressed to preterm labour, in spite of the same management plan. This difference showed a statistical significance [X[2] 6.744, P>0.05]. Positive correlation was found between the presence of vaginal infection and the occurrence of cervical changes and between cervical changes as detected by ultrasonography [decreased cervical length less than 27 mm and dilatation of the internal os more than 17 mm] and the occurrence of preterm labor

Clinco-biochemical, virological and histopathological evaluation of dimethyl biphenyl dicarboxylate [DDB] in treatment of chronic HCV infection in Egyptian patients

The present study was designed to evaluate the efficacy and safety of DDB and DDB- amantadine HCL combined therapy in treatment of patients with chronic HCV infection for 6 months. The study included 90 patients with chronic HCV were selected and divided into three groups: Group 1: [Control group] included 30 patients of chronic HCV infection treated by silymarin for 6 months in a dose of 420 mg / day in three divided doses. Group II: [DDB group] included 30 patients of chronic HCV infection treated by DDB for 6 months in a dose of 15 pilules bid, each pilule 1.5mg Group III: [Combined group] included 30 patients of chronic HCV infection treated by DDB and amantadine HCL for 6 months. Amantadine HCL was given in a dose of 100mg twice daily. Good history taking and clinical examinations, also laboratory investigations including complete liver functions [AST, ALT, S. Bilirubin, S. Albumin, alpha fetoprotein and prothrombin time and concentrations], kidney functions tests, Quantitative HCV RNA PCR and histopathological examination before and at the end of therapy for some selected cases. Follow up of these cases 3 and 6 months revealed that:- there was statistically significant in the main clinical symptoms [Fatigue, Rt hypochondrial pain and epistaxis] and in the mean serum, transaminasis [ALT and AST] more in group III than G II in comparison to the control group. In addition, there were no improvements statistically significant between groups in the mean serum albumin, alpha feto-protein, prothromibin time and concentration, serum bilirubin, hematological parameters and kidney function before and after treatment. The results showed that there was decrease in the viral load at the end of treatment in group III than group II in comparison to the control group but no patients turned negative for HCV RNA PCR. Also, there were improvements statistically at the end of treatment in the degree of the histological criteria [Steatosis, lymphocytes infiltration and bile duct injury] in g II than G II in comparisons to the control group. Finally, it has concluded that DDB is beneficial drugs for treatment of chronic HCV patients and the additive value of DDB as immunomodulorty to amantadine HCL as anti viral as a combined therapy in chronic HCV infections is a new beneficial strategy

value of soluble transferrin receptor in early diagnosis of iron deficiency anemia in chronic renal failure

Decreased erythropoietin [EPO] production is the main pathogenic factor of anemia in chronic renal failure [CRF]. Iron deficiency is the most common cause of EPO resistance in dialyzed patients with renal failure. Subclinical or functional iron deficiency is difficult to diagnose in these patients. Aim: This study was designed to determine the sensitivity and specificity of serum iron, transferring, ferritin and soluble serum transferrin receptor [sTFR] in diagnosis of iron deficiency in chronic renal failure and the efficacy of recombinant human EPO [rHuEPO] treatment. Patients: This study was conducted on 70 patients with CRF divided into three groups: group [A] CRF patients predialysis [30 cases], group [B] CRF patients on regular dialysis > 5 years [30 cases], and group [C] CRF patients on dialysis and rHuEPO treatment with parentral iron supplementation [10 cases].Twenty healthy individuals age and sex matched were included as controls. Peripheral hemogram, serum urea and creatinine, serum iron [SI] and total iron binding capacity [TIBC], serum ferritin, serum transferring and [sTFR] were done for both patients and control group. There was highly significant reduction of RBCs, hemoglobin [Hb] and hematocrit [Hct] in different patients groups compared to controls; [P < 0.001] for each Serum iron [SI] was insignificantly reduced in groups A and B compared to controls while it was significantly increased in group C [P < 0.05]. Serw transferrin was significantly reduced in all patients groups compared to controls [P < 0.001] for each. Serum ferritin and sTFR were significantly increased in both group, A and B [P < 0.001] for each, while in group C, there was significant increase in serum ferritin [P < 0.01] and no significant difference in sTFR level compared to controls. sTFR is a sensitive [sensitivity 93%] and specific [specificity 100%] indicator for identifying iron deficiency and assessing the effect of rHuEPO treatment in CRF patients

Prevalence of Listeria species in meat and meat products

Four hundred and forty samples of meat and meat products, 40 each of fresh meat, frozen ground beef, frozen beef sausage, frozen beef burger, hotdog, frankfurter, luncheon and basterma, were collected from different supermarkets and shops at Sharkia Governorate. Listeria species could be isolated from all examined samples at different percentages ranged from 7.5 to 42.5%, except in luncheon and basterma samples could not be isolated. Listeria monocytogenes could be isolated at variable percentage [2.5-10%] of the examined frozen beef, frozen kofta, frozen ground beef, frozen beef burger and frozen sausage. From the nine isolates of Listeria monocytogenes isolated from examined samples, seven strains were belonged to L. monocytogenes type 1 and two strains were belonged to L. monocytogenes type 4. The highest count of L. monocytogenes recorded as 3x104/g in frozen beef sausage sample. The public health hazard as well as suggestive measures to reduce human listeriosis has been discussed

Predictors of surgery outcome for colorectal carcinoma in the United Arab Emirates

In this retrospective study, 72 patients with colorectal cancer were followed up for a mean period of 28.2 months. Predictors of recurrence and survival were determined using standard analyses. Univariate analyses identified a group of patients with a shorter time to recurrence. The mean overall survival time was 63.2 +/- 7.7 months and survival time was shorter for younger patients with palliative resection, lymph node metastasis and peritoneal nodules. In multivariate Cox proportional hazards analysis, the hazard ratio for positive lymph nodes was 2.54 [95% CI: 1.36-4.79] compared to negative nodes, and for Dukes' stages A and B compared to stage C it was 0.45 [95% CI: 0.25-0.81]

Proteus and other microorganisms causing urinary tract in infection children

A total of two hundred hospitalized children with symptoms suggestive of urinary tract infection were investigated. The cases with significant growth in mid stream urine cultures [>=10[5] CFU per ml] only were considered positive. From all patients 71.5% had significant bacteriuria [four candida isolates were included too]. Escherichia coli was significantly higher among girls while predominance of proteus was observed among boys. A higher incidence of UTI was observed among uncircumcised boys compared to circumcised boys. This was particularly noticed in UTI caused by proteus. This and the fact of low incidence of proteus in intestinal microflora suggest what proteus urinary pathogens in males should originate from sources other than the intestine. Most of the organisms isolated were sensitive to cefotaxime, kanamycin, nalidixic acid and nirtofurantoin

Role of modern and primitive dressing techniques on the sanitary condition of locally produced poultry

Fifty chickens dressed under modern and primitive techniques were collected and examined bacteriologically to illustrate the effect of sanitation on the wholesomeness and quality of their meat. All chickens prepared in the modern slaughterhouse were found to have microbial counts within the permissible limits reflecting the reasonable degree of sanitation under which they prepared. On the contrary, about 52% of the commercially dressed chickens were rejected for their high microbial load. Moreover, Staph. aureus and E. coli could also be detected in 48% and 60% of the examined samples, respectively. The public health importance of the isolated organisms and the suggestive measures to improve the quality of dressed chickens were discussed