Clinical outcome of primary non‑metastatic breast cancer: A single institution experience.

BACKGROUND: We report on prognostic factors and long‑term survival of non‑metastatic breast cancer patients treated at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH and RC) in Pakistan. MATERIALS AND METHODS: This retrospective cohort study is based on a review of 2829 pathologically confirmed non‑metastatic breast cancer patients managed from January 1995 to May 2009. Median age was 45 years. Stage at presentation: Stage I (9%), stage II (59%), and stage III (32%). Infiltrating ductal carcinoma (92%) constituted the most prevalent histological subtype. Estrogen (ER), progesterone (PR) and Her2‑neu were positive in 49%, 50%, and 26%, respectively. A mastectomy was performed in 67% and conservative surgery in 33% of the patients. Post‑operative radiotherapy was delivered in 85% of the cases. Ninety percent of the patients received chemotherapy and mainly consisted of anthracycline‑based regimens + taxanes. Hormonal manipulation was done in ER/ PR positive patients. RESULTS: The 5‑ and 10‑year overall survival (OS) was 70% (95% confidence interval [CI]: 68.2‑71.8%) and 54% (95%CI: 51.2‑56.8%), while disease free survival (DFS) was 65% (95% CI: 63‑67%) and 52% (95% CI: 49.2‑54.8%), respectively. Recurrence following primary treatment was seen in 35% of the patients. On multivariate analysis T stage, number of axillary nodal involvement, tumor grade, ER status and family history, were found to be independent predictors for OS and DFS. CONCLUSIONS: Over 90% of non‑metastatic breast cancer patients present with stagesII and III disease and a significant proportion develop distant metastasis accounting for overall long‑term outcome inferior to developed countries. Efforts should be directed to raise the level of health awareness and screening programs to improve early detection in Pakistan.

A unique and profound effect of MgO and ZnO nanoparticles on some plant pathogenic fungi.

The antifungal activity of zinc oxide (ZnO) and magnesium oxide (MgO) nanoparticles prepared by bio-safe method was evaluated for Alternaria alternate, Fusarium oxysporum, Rhizopus stolonifer and Mucor plumbeus. It was observed from the study that all the nanoparticles at different concentrations brought about significant inhibition in the germination of spores of Alternaria alternata, Fusarium oxysporum, Rhizopus stolonifer and Mucor plumbeus. However, the highest inhibition in the germination of all the test fungi was observed at higher concentrations followed by lower concentrations of nanoparticles. The nanoparticles of MgO at highest concentration was found most effective in reducing the spore germination followed by nanoparticles of ZnO at the same concentration.

Antilymphocytic and immunosuppressive effects of Lantana camara leaves in rats.

Once daily administration of Lantana camara leaves juice at different dose levels (60, 300, 600 and 1500 mg/kg/day) for 14 days in rats resulted in alterations in various haemato- and biochemical parameters. Significant increase in blood urea nitrogen was observed with the doses of 600 and 1500 mg while significant increase in the relative weights of adrenals was observed at all the four dose levels. Total proteins, globulins, absolute lymphocyte count and per cent lymphocyte count were significantly decreased with 60, 600 and 1500 mg doses while a significant hypoglycemic effect was observed with 1500 mg only. Rats treated with 1500 mg dose did not exhibit any increase in alanine aminotransferase and aspartate aminotransferase activities or the alterations in relative kidney and liver weights. In another set of experiment, once daily oral administration of 1500 mg/kg/day for 14 days significantly inhibited the granulomatous tissue formation in rats and this effect was comparable to that of cyclophosphamide (10 mg/kg/day).

Histamine H2 receptor mediated relaxation of buffalo (Bubalus bubalus) ureter.

On the buffalo ureter, histamine did not elicit any direct effect. However, it caused concentration-dependent relaxation of the tissues precontracted by carbachol, phenylephrine, norepinephrine, KCI or BaCl2 and also inhibited the contractile effect of carbachol. Metiamide selectively antagonised the relaxation and inhibition of contractile response but mepyramine did not show this effect. Isoprenaline, dobutamine, salbutamol, verapamil and papaverine neither produced any direct effect nor relaxed the carbachol-contracted tissues; norepinephrine and epinephrine had contractile effects. Hence, the histamine-induced relaxation was mediated through the activation of H2 receptors and not through adrenergic mechanisms or blockade of Ca(2+)-channels or inhibition of cyclic nucleotide phosphodiesterase.

Use of aminocaproic acid (ACA) in extra-amniotic MTP in patients on anti-coagulant therapy.

A case of rheumatic heart disease (RHD) with prosthetic mitral valve endocarditis receiving anticoagulation with heparin, underwent medical termination of pregnancy in a second trimester. The following report entails the use of aminocaproic acid (ACA) in preventing excessive bleeding during and after the procedure, while the patient continued to receive anticoagulant therapy.