Management of gastric carcinoma; comparative analysis of various treatment modalities

To find the best treatment modality for carcinoma stomach. Case series study. Combined Military Hospital Rawalpindi. From January 1996 to December 1999. 42 cases of gastric carcinoma are included in this study. The mode of treatment predominantly remained surgical with the aim to cure the patient of this disease. The disease occurred mostly above the age of 50 years. Common clinical features were unexplained weight-loss, malnourishment and anaemia, respiratory tract infections. No specific etiological factor was detected except that, out of 42 patients 35 were smokers or had quit smoking during the past six years. Nearly all were having at least 8-10 cups of hot tea per day. Adenocarcinoma was the most frequently encountered histological type. 03 patients could not be operated upon because of extremely poor prognosis due to multi-organ failure. 12 patients were selected for surgery curative resection was carried out, whereas the remaining 27 were subjected to palliative resections. Five patients died during or within one month of surgical intervention. Out of the remaining 34, only 21 patients reported for follow up. In most of the patients in whom curative resection was performed, the quality of life was reasonably good. At the end of one year, another eight patients had died of tumour dissemination and cachexia, three patients developed tumour recurrence at the anastomotic site, and one patient developed stricture at anastomotic site. Patients with recurrence were sent for radiotherapy. It is concluded that for carcinoma of stomach the only possible treatment is surgery either alone or in combination with radiation and chemotherapy, the most common, preventable etiological factor is smoking, probably in combination with hot beverages in excess. The most common presentation remains weight loss with dyspepsia or weakness and anorexia, commonly effected age group is middle and old age, preoperative nutritional build-up achieves good postoperative results, palliative surgical procedures made the quality of life of the patient better. The prognosis remains extremely poor, in terms of morbidity and mortality

[Clinical characteristics and risk profile of individuals referred to familial breast cancer clinic of Tehran: the necessity of genetic counselling]

Genetic counseling represents the main basis of breast cancer risk assessment. During consultation, the major risk factors of breast cancer, the probability of developing breast cancer and prior probability of germ line mutation in predisposing genes are evaluated. In this study, we assessed the clinical characteristics and risk profile of breast cancer in patients referred to familial breast cancer clinic at Tehran. This study was conducted as a cross sectional research on patients with the positive family history of breast cancer in at least one of their first or second degree relatives who referred to familial breast cancer clinic. During the consultation in familial breast cancer clinic, the pedigree was drawn at least in 3 generations and the history of the breast, ovary and other cancers in the family was assessed. Breast cancer risk factors were evaluated according to the Gail and Claus models and the probability of germ line mutation in BRCA1/2 genes was estimated using the BRCAPRO model. Data analysis was performed by SPSS 13. During the study period, 220 individuals from 45 families were evaluated. At the time of genetic conselling, 84 patients [38.2%] were affected by breast cancer and 6 patients by ovarian cancer. The mean number of breast cancer patients in each family was 1.87. In 14 patients breast cancer occured bilaterally. There was not any history of male breast cancer in the studied families. The average risk of developing breast cancer for breast cancer unaffected individuals was estimated at 17.84% and 19.12% according to the Claus and Gail models respectively. According to BRCAPRO model, the average prior probability of germ line mutation in BRCA1/2 genes was 13.74%. About 1/3 of study population had mutation probability of greater than 10%.The results of this study showed that in the majority of the consulted individuals the family history of breast, ovarian and other cancers was positive and in the most families, the risk factors for hereditary breast cancer were observed. According to mutation probability of 10%, genetic testing was indicated in 62 [32%] individuals. This represents the necessity of paying more attention to susceptible individuals for hereditary breast cancer and providing the facilities of genetic testing for them. It seems necessary to conduct more studies in order to determine the role of germ line mutation in BRCA1/2 genes at developing breast cancer in Iranian population

Development of 19-plex Y STR system and polymorphism studies in Pakistani population / 药物分析学报

For the development of 19-plex Y STR system and polymorphism studies in locl ethnic populations sixteen markers of non-recombining regions (NRY) of Y chromosome, which show high power of discrimination among individuals, were selected in this study. Blood samples (600) were e.ollected from the males of three most common castes of Pakistani population (Arnin, Awan and Rajput) with different parent lineages. Three markers (DYS385a/b, DYS389Ⅰ/Ⅱ and YCAⅡa/b) among 16 Y STRs are double-targeted regions of the Y chromosome and thus provide two polymorphie peaks for each respective primer set. These 16 Y-STRs were developed into Megaplex system for simultaneous amplification of all markers within the population. The overall power of discrimination observed in focused populations was 60.5%, 66.5% and 55% in Rajput, Awan and Arain casts respectively. This discrimination power will be helpful in haman identification for forensic casework studies including sexual assaults and paternity testing.

Aposthia: a birth defect or normal quantitative recessive human genetic trait?

Aposthia [natural circumcision] is the condition of being born without a prepuce. Usually sporadic cases are reported in the medical literature. In this paper for the first time we present the genetic profile of 3 families with aposthia trait and discuss the possible genetics

[ rare case report of musculocutaneous nerve]

Knowing the variations of the brachial plexus is of high importance during the surgery of axilla for surgeons. A rare case was observed in the left upper limb of a 55- year old female's cadaver, during the routine dissection in Gilan Medical University. In this case the musculocutaneous nerve that normally arises from the lateral cord of brachial plexus, originated from median nerve, without perforating coracobrachialis muscle, and was located between biceps brachii and brachialis muscles and innervated them. Then, it pierces the deep fascia just below the elbow and extends as lateral cutaneous nerve of forearm. The nerve of coracobrachialis muscle is a branch directly isolated from lateral cord and enters into the muscle

Study of blood pressure patterns versus serum lipid parameters in obese human subjects

A study was conducted to determine relationship of obesity with the blood pressure patterns and lipid parameters in preview of its unique local diet patterns. A total of 200 non-diabetic human subjects of either sex were included in the study. They were categorized on the basis of body mass index [BMI] as obese and non-obese. Each group was further divided into 2 subgroups; hypertensive and normotensive. Fasting lipid profile [total cholesterol, LDL-and HDL-Cholesterols and total triglycerides] in each group was determined to compare the levels among various groups. BMI was calculated from height and weight, while blood pressure was measured with a sphygmomanometer. Lipid profile was determined with Merck kits. Diet and related information was also collected from the patients directly. Means of all parameters, except LDL-C, were higher in females than males; among these BMI and HDL-C showed significant difference. There was a significant negative correlation of diastolic blood pressure with HDL-C in obese subjects; all the other parameters were non-significantly correlated. In the non-obese subjects, there was a significant positive correlation between systolic [SBP] and diastolic [DBP] blood pressures and LDL-C. All other parameters were found non-significantly correlated. The analysis of variance was done in four groups namely, obese non-hypertensives, obese hypertensives, non obese non-hypertensives and non obese hypertensives. BMI, SBP, DBP, LDL-C and total cholesterol had significantly different means in the above four groups, while HDL-C and total triglycerides were statistically non-significant [p>0.05] among four groups

Assessment of the prophylaxis by iodized salt of populations of the region of Rabat-Kenitra in 1998

This survey has been achieved to evaluate the salat consumption [iodized and non-iodized salt] and the state of iodine nutrition by the assay of the urinary iodine of populations of the region of Rabat-Kenitra. In this work, we analyzed 225 samples of salt and the urinary iodine of 450 subjects. The average age of subjects is 24.3 years [2 - 80 years], of which 52% are maleline sex and 48% of feminine sex. The iodized salt represents 9,8% of all the salt analyzed. The mean iodine content of iodized salt is 32,4 mg/kg [8,5-66,7 mg/kg]. The mean urinary iodine at users of iodized salt is 22,2 mirco g/dl whereas it is 10,8 mirco g/dl for users of non-iodized salt Among all the iodized salt analyzed, no sample answers to the norm [80 +/- 10 mg of iodine/kg] and only 17.8% are compliant to the minimal value required by legislation at the distribution [50 mg of iodine/kg]