Effect of Chemotherapy on Zinc, Copper, Vitamin D levels and inflammatory marker in adult acute lymphoblastic leukemia

Background: In acute lymphoblastic leukemia [ALL] the bone marrow loses its ability in the differentiation and maturation of blood cells at different stages. Zinc and copper are important co-factors for several enzymes and play an important role in maintenance of DNA integrity. Changes in serum levels of zinc and copper have been found in lymphoproliferative disorders. In the present study, the aim was to compare serum levels of zinc, copper, vitamin D, and inflammatory markers after eight courses of chemotherapy

Methods: Participants of this study included 30 ALL patients in the age range of 15 to 65 years. A 10 mL blood sample was taken before and after eight courses of chemotherapy. The concentration of Zinc, Copper, hs-CRP, vitamin D and malondialdehyde [MDA] were measured

Results: There was a significant increase in serum zinc [121.7 +/- 18.05 microg/dL before chemotherapy and 156.6 +/- 25.00 microg/dL after chemotherapy] and a significant decrease in serum copper [661.9 +/- 190.1 microg/dL before chemotherapy and 402.2 +/- 93.5 microg/dL after chemotherapy] and a significant decrease in Malondialdehyde and serum vitamin D were observwd. Further, no significant differences were observed in hs-CRP after chemotherapy

Conclusion: Results showed that chemotherapy could decrease the burden of disease by increasing serum zinc and decreasing serum copper

[Comparison between intrathecal midazolam and tramadol with conventional method for postoperative pain and shivering control after elective cesarean section]

Adding new supplements when performing spinal anesthesia can increase the duration of analgesia. The aim of the present study has been to compare intrathecal midazolam and tramadol with the conventional method for postoperative pain and shivering control after elective caesarean section. In this double-blind clinical trial, 210 ASA class I, II women, aged 20-35 years, candidate for elective caesarean section were randomly allocated to three groups. All patients received hyperbaric intrathecal lidocaine and additionally group I received 2 mg subarachnoid midazolam, group II received 25 mg subarachnoid tramadol and the control group received 5cc normal saline. Postoperative pain score, the painless duration and postoperative shivering were assessed in the three groups. The mean painless duration in tramadol, midazolam and the control group were 192.5 +/- 12.2, 111.3 +/- 16.6 and 86.1 +/- 9.9 minutes, respectively [p<0.001]. The mean painless duration in the midazolam group was significantly more than two other groups and this duration in the tramadol group was also more than the control one. The mean postoperative pain score, shivering occurrence and the frequency of requested painkiller in the first 24 hours, were also compared. In the midazolam group, they were all significantly less than the two other groups. In the meanwhile, these indexes in the tramadol group were less than the control one [p<0.001]. Adding intrathecal midazolam and tramadol to lidocaine 5% in elective caesarean section can increase the painless duration and lead to a reduction in postoperative shivering. Midazolam demonstrates a stronger effect

Clinico-pathologic manifestations of Iranian patients with breast cancer

Breast cancer is the most common malignancy in women and is the second cause of cancer death in female population. The objective was to find out different clinical manifestations and epidemiology of breast cancer among various ethnics groups to help improve health system in the country. In this retrospective cross sectional study, we evaluated clinical and pathologic features of one thousand Iranian women with breast cancer. The data including age, type of surgery, pathology report, tumor size, lymph node involvement, tumor stage and receptor status were extracted from medical records and were analyzed. The highest prevalence of breast cancer was in patients in 40-49 years age group [37.4%]. The most common performed surgery was modified radical mastectomy and the most common pathology report was intra-ductal carcinoma. Tumor size was 2-5 cm in most of patients. Sixty percent of patients had lymph node involvement. Finally, 49.1% of patients were diagnosed when they were in stage II and 36.7% were in stage III. In 72.9% of patients, estrogen receptor, progesterone receptor or both receptors were positive and of 116 patients who were checked for Her-2, 27 patients [23.2%] were 3+ positive. Our findings suggest that Iranian breast cancer patients are relatively younger than patients in western countries and mostly present at higher pathologic stages. We highly recommend screening test to be performed at lower ages [at least 40 years old]

Consolidation chemotherapy with docetaxel after platinum-based chemotherapy in patients with non- small cell lung cancer: a preliminary report

The efficacy of second line chemotherapy for relapsed non small cell lung cancer has been established. In this study, we evaluated the efficacy and toxicity of maintenance therapy with docetaxel in patients with non-small cell lung cancer who were stabilized with first line chemotherapy and had good performance status before relapse. The primary objective was to determine one-year survival and the other objectives were evaluation of adverse effects and time to progression. Eighteen patients with lung cancer were included in this study. All patients were at stage III and IV, without distant metastasis or neuropathy. All patients had been treated with platinum based regimen initially and were responsive or stable with no progression. The patients were treated with docetaxel 75 mg/m[2] for a total of 4 cycles repeated every 3 weeks. All patients accomplished 4 chemotherapy cycles and a total of 72 cycles were administered. The mean time of progression free survival [PFS] was 9-10 months and one- year survival [OS] was 94.4% without any significant adverse effect necessitating medical intervention. The mean survival time of patients was 18 [12-20] months. Using docetaxel as consolidation chemotherapy in patients with non small cell lung cancer can prolong time to progression of disease and probably patients' survival without significant adverse effects or negative impact on the quality of life

[Frequency and importance of jak2v617f mutation among Iranian patients with polycythemia vera, essential thrombocythemia and primary myelofibrosis]

Detection of JAK2V617F mutation was widely used in the diagnosis and classification of myeloproliferative neoplasms. In this study, frequency of JAK2V617F mutation among Iranian patients with polycythemia vera [PV], essential thrombocythemia [ET] and primary myelofibrosis [PMF] was studied. In this basic study, blood samples of 174 patients with polycythemia vera [n=57], essential thrombocythemia [n=84] and primary myelofibrosis [n=33] were evaluated for JAK2V617F mutation. Genomic DNA was extracted from peripheral blood. After quality control of extracted DNA, the JAK2-V617F mutation was analyzed using allele-specific PCR. All PCR products were analyzed by polyacrylamide gel [5%] electrophoresis and silver staining. One hundred and eleven out of 174 patients [63.8%] were positive for the presence of the JAK2V617F mutation. Frequency of mutation was 82% [47/57] in PV, 57% [48/84] in ET and 48% [16/33] in PMF. This study showed that detection of JAK2-V617F mutation using allele-specific PCR lead to better diagnosis and treatment of Iranian patients with different MPNs

[Is serum testosterone level higher in patients with breast cancer with unfavorable histopathologic factors?]

Breast cancer is more common in women with high serum testosterone level. Few studies showed that high level of serum testosterone is associated with poor prognosis. The association of testosterone level with histopathological findings has not been studied yet. In this study we investigated this association. Patients referred to a medical oncology clinic with no history of previous chemotherapy, hormone therapy, oophorectomy, or other cancers enrolled in the study. Morning serum testosterone was checked. Histopathologic findings were extracted from pathologic reports. Relationship between testosterone level and histopathologic types was analysed. 106 patients were studied whose mean age was 47 +/- 10 years. 63.2% of our patients were premenopausal. Histopathologic factors were unfavourable in 50%. The rate of vascular invasion was 56.4% and 73% were receptor positive. Mean level of serum testosterone was 0.56 +/- 0.52 ng/ml in patients with favourable histopathology and 0.70 +/- 0.77 ng/ml with unfavourable histopathology [p<0.4]. No testosterone level was above normal range. There was no relation between serum testosterone level and histopathologic findings; viz. serum testosterone level was not higher in breast cancers with unfavourable histopathologic factors. So we need to conduct more studies to figure out the reasons for the poor prognosis observed in patients with higher levels of serum testosterone