Malignant phylliodes tumours: Results of breast conserving surgery and immediate reconstruction

Malignant phylliodes tumour [MPT] is a rare breast tumor. Surgery is the mainstay in treatment but varies from local resection to modified radical mastectomy. In this study, we present our experience using wide local excision or subcutaneous mastectomy and immediate breast reconstruction in the management of MPT. Twenty-three recurrent MPT and ten patients with histological evidence of MPT were included. All patients with recurrent MPT [n=23] had subcutaneous mastectomy, two centimeter wide excision of the scar and immediate breast reconstruction with either Latissimus Dorsi [LD] myocutaneous flap [n= 10] or Latissimus Dorsi muscle flap [n=13]. Seven of the newly diagnosed patients had wide local excision of the tumor, reconstruction with LD muscle flap, two had wide local excision and reduction of contra lateral breast, and one had subcutaneous mastectomy and silicon implant. The margin resection varied between five and fifteen centimeter in wide local resection group and subcutaneous mastectomy group respectively and the size of tumors varied between five and fifteen centimeters in diameter. During the follow up period, which ranged between twenty-four and eighty-four months one local recurrence, was recorded [3.03%] and none of the patients had distant metastasis or regional lymph nodes involvement. This approach has secured wider excision of MPT, offered breast reconstruction, and has reduced the chances of recurrence in our patients

In vitro antimicrobial activity of Borreria seniensis

The antimicrobial activity of the chloroformic, methanolic and aqueous extracts of Borreri seniensis were studied in vitro against. five standard bacterial species [Bacillus subtilis. Staphylococcus aureus. Escherichia coli, Proteus vulgaris and Pseudomonas aeruginosa] and two fungal species [Aspergillus niger and Candida albicans] by the agar diffusion method. The results indicated that the stem chloroformic extract was active against both Gram -positive and Gram-negative organisms. The stem methanolic extract showed high activity against Bacillus subtilis, low activity against Escherichia coli and no activity against Staphylococcus aureus, Proteus vulgaris and Pseudomonas aeruginosa. The stem aqueous extract showed high activity against both Gram-positive organisms, two Gram-negative organisms, namely Escherichia coli and Proteus vulgaris, and was inactive against Pseudomonas aeruginosa. All the extracts were inactive against the two standard fungi. Aspergillus niger and Candida albicans. The active extracts were further tested against a total of sixty clinical isolates, fifteen of each of Staphylococcus aurcus, Escherichia coli. Proteus vulgaris and Pseudomonas aeruginosa, collected randomly from specimens from Sudanese patients. The stem chloroformic extract of Borreria seniensis at 200 mg/ml was more effective than Ampicillin 40 micro g/ml against Bacillus subtilis and Proteus vulgaris. Compared to Gentamicin at the same 40 micro g/ml concentration, the extract was more effective against Staphylococcus aureus, Escherichia coil and Pseudomonas aeruginosa. The stem methanolic extract of Borreria seniensis at 200 mg/ml was almost similar to Gentamicin 15 micro g/mi against Bacillus subtilis and Geamicin 5 micro g/ml against Escherichia coil. The stem aqueous extract at the same 200 mg/ ml concentration was found to be more effective than Ampicillin 40 micro g/ml against Bacillus subtilis, Staphylococcus aureus. Escherichia coli and Pseudomonas aeruginosa. This aqueous extract was found to be similar in action to Gentamicin 15 micro g/ml against Bacillus subtilis and Escherichia coli and to Gentamicin at more than 40 micro g/ml against Staphylococcus aureus and Proteus vulgaris. The clinical isolates exhibited low susceptibility compared to the standard organisms