Antioxidant intake and status, and oxidative stress in relation to breast cancer risk: a case-control study.

A case control study was carried out to investigate associations between breast cancer risk, antioxidant status and oxidative stress among women in Klang Valley and Selangor. A total of 57 newly diagnosed cases aged 30 to 66 years old participated and were matched for age and ethnicity with 139 controls with no diagnosis of cancer or other chronic diseases. An interview based questionnaire designed to collect information on demographic and socioeconomic status, as well as reproductive, medical and dietary history was used. Anthropometric measurements including weight, height, waist and hip circumference were made and a 10 ml fasting venous blood sample was taken for glucose testing and analysis of plasma vitamin antioxidants and malondialdehyde. Hair and toenail samples were taken for selenium analysis. Results showed that the mean intake of vitamin A, vitamin E and selenium among cases (606.8 +/- 334.8 microg/d, 6.1 +/- 2.4 g/d, 56.9 +/- 16.2 microg/d) was lower than controls (724.7 +/- 414 microg/day, 6.9 +/- 3.0 g/d, 60.8 +/- 17.5 microg/d, respectively) (p<0.05 for all parameters). A similar trend was noted for plasma vitamin A and E and also selenium in hair and toenails. Poor antioxidant status as indicated by low plasma vitamin A (<284.3 microg/l or <366.3 microg/l) increased risk of breast cancer by approximately two fold, whilst low plasma vitamin E (<2.5 mg/dl, <2.8 mg/dl and <3.1 mg/dl) increased the risk by two to three fold [Adjusted OR 2.97 (95% CI 1.38-3.48), 2.32 (95% CI 1.07-2.41) and 2.12 (95% CI 1.00-4.21)]. Cases had a greater level of malondialdehyde 4.4 +/- 1.1 mmol/g protein), an indicator of oxidative stress, as compared to controls (3.2 +/- 1.7 mmol/g protein) (p<0.05). A high level of MDA (> or = 4.8 mmol/g protein) was associated with breast cancer [Adjusted OR 6.82 (95% CI 1.95-23.9)]. It is concluded that a poor antioxidant status and high oxidative stress are associated with breast cancer risk. Thus, it is essential for Malaysian women to obtain a good antioxidant status by consuming a diet rich in vitamins A and E as well as selenium and adopt healthy behaviour to reduce oxidative stress in order to prevent breast cancer.

Manometric and ultrasonographic assessment of anal sphincter function following forceps or vacuum assisted vaginal delivery

To compare differences in anal sphincter function following vacuum or forceps assisted vaginal delivery. Prospective, r and omized controlled trial. Al-Azhar University Hospitals in Damietta and Cairo.One hundred and thirty primiparous women were recruited antenatally and if an instrumental delivery was indicated, were r and omized to either a vacuum or low-cavity, non-rotational forceps assisted delivery. Follow-up consisted of a symptom questionnaire, anal manometry, and endoanal ultrasonography. Faecal continence scores, anal manometry and endoanal ultrasonography. Sixty-one women delivered with forceps assistance [42 for failure to progress in the second stage] and 69 with vacuum assistance [50 for failure to progress]; 16/69 vacuum deliveries proceeded to a forceps assisted delivery [23%]. There were no statistical differences in the antecedent antenatal factors between the two groups. A third degree perineal tear followed 7 [11%] forceps and 3 [4%] vacuum deliveries. Based on intention-to-treat analysis, 32 [52%] women complained of altered faecal continence after forceps delivery compared with 21 [30%] following vacuum delivery three months postpartum. Endoanal ultrasonography was reported as abnormal following 34 [56%] forceps deliveries and 34 [49%] vacuum deliveries. After exclusion of 'failed vacuum', median anal canal resting pressure was significantly lower following forceps delivery compared with vacuum delivery alone [p<0.001]. There were no significant differences in degree of ultrasound abnormality between the two groups. Symptoms of altered faecal continence are significantly more common following forceps assisted vaginal delivery. Based on continence outcome, when circumstances allow, vacuum should be the instrument of first choice in assisted delivery

Hydatid cyst treated by benzimedazole compounds

Nine cases of hydatid cyst treated by the authors by the benzimedazole compounds with or without surgery are reported. It is good tool in the hands of a surgeon. If given alone initially it gives a dramatic effect but complete eradication is unpredictable, so it is no alternative to the surgery