old dietary regimen as a new lifestyle change for Gastro esophageal / reflux disease: a pilot study

Treatment of gastro esophageal reflux disease [GERD] is becoming a challenge for medical profession. Proton pump inhibitors [PPIs] are commonly recommended but many disadvantages of these drugs are being reported, particularly when used for long term. Transient lower esophageal sphincter relaxations [TLESRs] are important cause of acid reflux. Gastric distention in upper stomach is the strongest stimulus for generation of TLESRs and is aggravated by intake of food in between meals. In an earlier cases report, two meals a day with intake of only fluids in between was suggested as a remedy for GERD. Present pilot study was conducted on 20 patients with endoscopically proven reflux esophagitis [Los Angles Grade a, b or c], who followed our advice to take meal twice a day with consumption of only soft drinks [fruit juices, tea, coffee, water, etc] in between and no medication for two weeks. On 14[th] day 15 patients [75%] were free of reflux symptoms, 2 [10%] had partial improvement and 3 [15%] reported no difference. It is concluded that two meals a day with intake of only fluids in between, whenever the patient feels hungry or thirsty, is a useful dietary regimen for the management of GERD. Further investigations are needed to confirm the benefits of this physiological lifestyle change

Insulin-like growth factor I and bone turnover markers in young male patients with non alcoholic chronic liver disease

Low bone mass has been described in patients with chronic liver disease. Reduced osteoblastic function with diminished bone formation has been suggested as the main factor responsible for osteoporosis in liver cirrhosis. Insulin like growth fact or 1, [IGF-1] has been linked to idiopathic osteoporosis, so this study aimed to evaluate the role of IGF-1 in bone remodeling in non alcoholic liver cirrhosis and to detect the presence of low or high bone turnover in those patients. Subjects and Thirty male patients with chronic non-alcoholic, liver disease and 10 age matched healthy male subjects as a control group, were included in this study. The patients were classified according to Child-Poitgh into 3 groups, A, B and C. Both patients and control were subjected to assessment of their liver function, fasting and postprandial blood glucose, blood urea and serum creatinine, serum levels of parathormone, insulin like growth factor, [IGF-1], osteocalcin and urinary levels of deoxypyridoline [DPD], in addition to abdominal ultra-sonography and upper gastrointestinal endoscopy for patients only. Patients showed significantly lower serum levels of both IGF-1 and osteocalcin, [the marker of bone formation] than controls and significantly higher levels of urinary deoxypyridinoline [DPD] [the marker of bone resorption]. The mean value of IGF I was 33.44 +/- 34.41 ng/dL in patients and 256.69 +/- 96.67 in control [p value=0.01]. The mean value of osteocalcin was 2.70 +/- 1.79 ng/ml in patient whereas it was 6.59 +/- 2.13 ng/ml in control subjects [p value<0.0l]. Urinary DPD was 13.52 +/- 650 NM DPD/mm in patients whereas, it was 6.75 +/- 1.47 in control subjects [p value<0.0l]. Definite osteoprosis has been found in all the examined patients [100%] mostly in the lumbar spines by dual x-ray absorptiometty [DXA] scan. No correlation has been found between IGF-1 level and severity of liver cirrhosis

Multicenter open labeled clinical study in advanced breast cancer patients. a preliminary report

Twenty-six patients of advanced breast cancer from nine Egyptian oncology centers received viscum fraxini 2 [VF2]. All patients had exhausted all other lines of treatment [surgical, radiotherapy, chemotherapy and hormonal therapy] and were complaining of various degree of severity of symptoms. Those patients had a life expectancy not less then six months. VF2 was given through subcutaneous injection of 30.000 ngm around or/and intralesional in the site of the primary or recurrent breast lesions. The clinical and laboratory examinations were conducted once weekly. During the treatment trial, no pain controlling or sleeping drugs were used. The end point of assessment was 16 weeks, however, 18 cases continued treatment by viscum for different periods [18-136 weeks]. The total response rate [TRR] at the end of the 16 weeks of treatment was 15/26, while, TRR of cases that continued the treatment more than 16 weeks up to 136 weeks showed an average of 13/18. No TRR difference was noted between pre- and postmenopausal cases

Adjuvant single agent chemotherapy in the management of glioblastoma multiforme in Kasr El Aini center of radiation oncology and nuclear medicine, Cairo university Nemrock

Adjuvant chemotherapy in the form of single agent CCNU 120 mg/m.S.A. every 6 weeks for 6 cycles conditioned to patients haemopoitic reserve was applied in 35 cases. A response rate of 66.7% and 18 months survival of 41% compared to 50% response rate and 17%, 18 months survival in the other arm of surgery and radiation therapy only. A retrospectively clinicoepidemiological study of 109 cases of glioblastoma multiforme treated in "NEMROCK [1982-1986] was done. The relative frequency incidence was 1.2%. It accounted for 23.2% of primary CNS tumours and 32.8% of all malignant gliomas. The mean age incidence was 32 +/- 17.1 years. The male to female sex ratio was 2:1. 79.8% of the lesions were in the supratentorial region. Symptoms of increased I.C.P were commonest symptoms and were met within in 86.2% whereas epileptic seizures were the least frequent in 11% of cases