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

study on prevalence of drug resistance in drug default pulmonary tuberculosis

The emergence of resistance to drugs used to treat tuberculosis [TB], and particularly multidrug-resistant TB [MDR-TB], has become a significant public health problem in a number of countries and an obstacle to effective global TB control. This is a prospective randomized cross sectional study to estimate the magnitude of MDR tuberculosis in two hospitals in Khartoum, Sudan. 111 patients who had defaulted their tuberculosis treatment on previous occasions and had presented to the hospital with several symptoms were studied. All patients provided sputum, which was examined for the presence of acid fast bacilli [AFB] by Ziehl- Neelsen stain. Sputa were also sent to the reference laboratory for mycobacterial culture and drug susceptibility testing. All culture positive sputa had drug sensitivity tested to the first line anti-TB drugs used in Sudan namely Streptomycin, Isoniazid, Rifampicin and Ethambutol. Out of the 111 patients, 297% [n=33] were AFB sputum smear positive and 40.5% [n=45] were sputum culture positive for mycobacterium. Sensitivity testing revealed that 48.9% [n=22] were resistant to Streptomycin, 62.2% [n=28] were resistant to Isoniazid, 55.6 [n=25] were resistant to Rifampicin and 37.8% [n=17] were resistant to Ethambutol. 42% [n19] of the patients were resistant to Rifampicin and Isoniazid only, while 26.6% [n=12] were resistant to all the first line drugs [Streptomycin, Isoniazid, Rifampicin and Ethambutol] this study showed that the prevalence of MDR tuberculosis among the defaulters in Kartoum is much higher than what was reported previously. This study highlights the extent of the problem of drug resistance in Khartoum and emphasizes the need for proper treatment and strengthening of the short course direct observed therapy strategy