RESUMEN
Breast cancer in young women (BCYW) is showing an increasing trend in incidence among women of India and other Asian countries compared to western countries. Methods: A retrospective study was carried out on total 579 patients treated between January 2010 and December 2017 to evaluate the clinico-epidemiological and pathological characteristics in BCYW. Cases were divided into two groups i.e the younger (<40 years) and the older (≥40 years) age group. Data were analyzed by chi square test using IBM SPSS version 21 for windows. P value less than 0.05 was considered significant. Results: The breast cancer in younger women (<40 years) was found in 20.2% of cases and was found to have greater proportion of unmarried women (p=0.002), higher frequency of nulliparity (p=0.006), greater incidence of bilateral breast cancer (p=0.017), greater incidence of multifocal or multicentric tumour (p=0.033), higher grade tumours (p=0.007), advanced T stage (p=0.003), advanced N stage (p=0.012) and overall advanced TNM stage (p=0.011) at diagnosis, higher frequency of lymphovascular invasion (p=0.00013), higher frequency of estrogen and progesterone receptor negativity (p=0.0005 and 0.0001 respectively). HER-2 expression rate was not found different between the two groups, whereas its expression rate was found significantly lower among women of age >50 years at diagnosis (p=0.001). Higher frequency of triple negative breast cancer was found in the younger age group (33.3% vs. 19.3%, p=0.001). Conclusions: Advanced stage presentation of BCYW warrants inclusion of younger age women in breast cancer screening and encouraging for breast self-examination.
RESUMEN
Acanthamoeba, one of free-living amoebae (FLA), remains a high risk of direct contact with this protozoan parasite which is ubiquitous in nature and man-made environment. This pathogenic FLA can cause sight-threatening amoebic keratitis (AK) and fatal granulomatous amoebic encephalitis (GAE) though these cases may not commonly be reported in our clinical settings. Acanthamoeba has been detected from different environmental sources namely; soil, water, hot-spring, swimming pool, air-conditioner, or contact lens storage cases. The identification of Acanthamoeba is based on morphological appearance and molecular techniques using PCR and DNA sequencing for clinico-epidemiological purposes. Recent treatments have long been ineffective against Acanthamoeba cyst, novel anti-Acanthamoeba agents have therefore been extensively investigated. There are efforts to utilize synthetic chemicals, lead compounds from medicinal plant extracts, and animal products to combat Acanthamoeba infection. Applied nanotechnology, an advanced technology, has shown to enhance the anti-Acanthamoeba activity in the encapsulated nanoparticles leading to new therapeutic options. This review attempts to provide an overview of the available data and studies on the occurrence of pathogenic Acanthamoeba among the Association of Southeast Asian Nations (ASEAN) members with the aim of identifying some potential contributing factors such as distribution, demographic profile of the patients, possible source of the parasite, mode of transmission and treatment. Further, this review attempts to provide future direction for prevention and control of the Acanthamoeba infection.