Incidence of local breast cancer recurrence with delayed radiation therapy.

BACKGROUND: The purpose of this research was to examine the probability of ipsilateral breast cancer recurrence in individuals whose RT was delayed after the first chemotherapy and surgery. PURPOSE: To analyze the effect of delaying RT for breast cancer patients (by more than 6 weeks after treatment). METHODOLOGY: A retrospective analysis comprised 136 female breast cancer patients treated at the Baghdad Centre for Radiation Oncology and Nuclear Medicine from 2021 to May 2022. External beam radiation was started more than 6 weeks after chemotherapy was finished for all patients who also had surgery. Clinical examination and ultrasound were part of the follow-up process. RESULTS: Patients' ages varied from 28 to 71, and the majority (83%) had a mastectomy. The majority of cases (95.5%) were diagnosed as invasive ductal carcinoma on histopathology, with 49.6% being at stage 2 and 42.6% being at stage 3. Seventy-six percent of patients tested positive for hormones. Although 10 patients (7.35%) acquired distant metastases within 5 years, only 2 (1.47%) had local recurrence because of the delay in RT. Specifically, 91.1% had complete local control with no evidence of disease spread. CONCLUSION: Delaying RT by more than 6 weeks in patients with breast cancer did not substantially affect local control, according to the results of a new research, the first of its type in Iraq.

Subjective and objective financial toxicity among colorectal cancer patients: a systematic review.

BACKGROUND: Colorectal cancer (CRC) is the third most common cancer type worldwide. Colorectal cancer treatment costs vary between countries as it depends on policy factors such as treatment algorithms, availability of treatments and whether the treatment is government-funded. Hence, the objective of this systematic review is to determine the prevalence and measurements of financial toxicity (FT), including the cost of treatment, among colorectal cancer patients. METHODS: Medline via PubMed platform, Science Direct, Scopus, and CINAHL databases were searched to find studies that examined CRC FT. There was no limit on the design or setting of the study. RESULTS: Out of 819 papers identified through an online search, only 15 papers were included in this review. The majority (n = 12, 80%) were from high-income countries, and none from low-income countries. Few studies (n = 2) reported objective FT denoted by the prevalence of catastrophic health expenditure (CHE), 60% (9 out of 15) reported prevalence of subjective FT, which ranges from 7 to 80%, 40% (6 out of 15) included studies reported cost of CRC management- annual direct medical cost ranges from USD 2045 to 10,772 and indirect medical cost ranges from USD 551 to 795. CONCLUSIONS: There is a lack of consensus in defining and quantifying financial toxicity hindered the comparability of the results to yield the mean cost of managing CRC. Over and beyond that, information from some low-income countries is missing, limiting global representativeness.

Avascular necrosis of femoral head following COVID-19 infection.

Introduction: It is crucial to be aware of post-COVID-19 non-pulmonary complications. Avascular necrosis (AVN) is one of these complications. It should be noted that the risk of AVN persists in individuals who have recovered from the COVID-19 infection. The current study aims to report several cases of AVN after being infected with SARS-CoV-2. Materials and methods: This is a single-centre retrospective case series conducted over a 2-year period (January 2021-December 2022) involving individuals who developed AVN after being infected with COVID-19. Result: The study included a total of 17 patients. The mean age of patients was 38.65±6.1 years. Twelve of them were male (70.6%) and five were female (29.4%), with a ratio of 3:1. The mean BMI of the patients was 28.3±2.4 kg/m2. Eleven (64.7%) patients reported administering steroid injections throughout the infection course. The mean interval between COVID-19 infection and presentation to the clinic was 6.53 months. The majority of patients (82.3%) complained of bilateral hip pain. Limping was observed in 47% of the cases. MRI showed AVN in all cases. Bilateral core decompression was performed in five cases (29.4%), total hip replacement in three cases (17.6%), and conservative treatment in nine cases (53%). Conclusion: The ongoing pandemic may have many long-term sequelae. There is a risk of developing AVN after COVID-19.

Fabrication and Characterization of High-Quality UV Photodetectors Based ZnO Nanorods Using Traditional and Modified Chemical Bath Deposition Methods.

Ultraviolet (UV) photodetectors (PDs) based on high-quality well-aligned ZnO nanorods (NRs) were fabricated using both modified and conventional chemical bath deposition (CBD) methods. The modified chemical bath deposition (M-CBD) method was made by adding air bubbles to the growth solution during the CBD process. The viability and effectiveness of M-CBD were examined by developing UV PDs based on ZnO NRs. The ZnO nano-seed layer was coated on a glass substrate utilizing radiofrequency (RF) sputtering. The impact of the different growth-times on morphology, growth rate, crystal structure, and optical and chemical properties were investigated systematically using different characterization techniques, such as field-emission scanning electron microscopy (FE-SEM), X-ray diffraction (XRD) analysis, UV-VIS double beam spectrometer, and energy dispersive X-ray analysis (EDX), respectively. The Al/ZnO UV PDs based on ZnO nanorods were fabricated with optimum growth conditions through the two methods of preparation. This study showed that the synthesized ZnO NRs using the M-CBD method for different growth times possess better properties than the conventional method under similar deposition conditions. Despite having the highest aspect ratio and growth rate of ZnO NRs, which were found at 4 h growth duration for both methods, the aspect ratio of ZnO NRs using the M-CBD technique was comparatively higher than the conventional CBD method. Besides, the UV PDs fabricated by the M-CBD method at 5 V bias voltage showed high sensitivity, short response time, quick recovery time, high gain, low dark current, and high photocurrent compared with the UV PD device fabricated by the conventional CBD method.

The use of non-living animals as simulation models for cranial neurosurgical procedures: a literature review.

Simulation plays a pivotal role in neurosurgical training by allowing trainees to develop the requisite expertise to enhance patient safety. Several models have been used for simulation purposes. Non-living animal models offer a range of benefits, including affordability, availability, biological texture, and a comparable similarity to human anatomy. In this paper, we review the available literature on the use of non-living animals in neurosurgical simulation training. We aim to answer the following questions: (1) what animals have been used so far, (2) what neurosurgical approaches have been simulated, (3) what were the trainee tasks, and (4) what was the experience of the authors with these models. A search of the PubMed Medline database was performed to identify studies that examined the use of non-living animals in cranial neurosurgical simulation between 1990 and 2020. Our initial search yielded a total of 70 results. After careful screening, we included 22 articles for qualitative analysis. We compared the reports in terms of the (1) animal used, (2) type of surgery, and (3) trainee tasks. All articles were published between 2003 and 2019. These simulations were performed on three types of animals, namely sheep, cow, and swine. All authors designed specific, task-oriented approaches and concluded that the models used were adequate for replicating the surgical approaches. Simulation on non-living animal heads has recently gained popularity in the field of neurosurgical training. Non-living animal models are an increasingly attractive option for cranial neurosurgical simulation training. These models enable the acquisition and refinement of surgical skills, with the added benefits of accessibility and cost-effectiveness. To date, 16 different microneurosurgical cranial approaches have been replicated on three non-living animal models, including sheep, cows, and swine. This review summarizes the experience reported with the use of non-living animal models as alternative laboratory tools for cranial neurosurgical training, with particular attention to the set of tasks that could be performed on them.

Khat chewing and cirrhosis in Somaliland: Case series.

BACKGROUND: Khat chewing is common especially among men in East Africa and Yemen. It is generally viewed by the populace as a benign social custom. Several studies of ethnic Somali immigrants to Western countries suggest an association between khat chewing and hepatotoxicity, but the risk of hepatotoxicity related to khat chewing within African settings is not documented. AIM: To identify and describe liver disease without evidence of alcohol exposure or infectious etiology in khat chewers. SETTINGS: A university-affiliated teaching hospital in Somaliland. METHODS: Cases of cirrhosis of unknown cause were identified from the clinical practice of Al Hayatt Hospital in Borama, Somaliland, during 14 months beginning December 2012. RESULTS: Eight Somali men aged 27-70 years living in Somaliland were identified with cirrhosis of otherwise unknown cause. All chewed khat habitually for many years (15-128 bundles per day times years of use). A liver biopsy of one man was consistent with khat hepatotoxicity. Four of the eight men died during the study period. CONCLUSION: Khat chewing may be associated with health consequences including severe hepatotoxicity with cirrhosis.

The effect of age at cochlear implantation outcomes in Saudi children.

OBJECTIVES: To determine for the effect of age (late versus early age) on the cochlear implant outcomes; in terms of language development, auditory skills, speech perception, and production outcomes). METHODS: 67 children were included in the study out of 93 implanted cases in the study period. Children were classified into 2 groups according to age at time of implantation. Group 1 contained 43 children who were implanted before the age of 5 years. Group 2 contained 24 children who were implanted after the age of 5 years. All children were evaluated pre-operatively and at 3, 6, 12, 24 months device experience using the language screening test, Standardized Arabic Language test, Listening Progress Profile (LiP Test), the Monosyllabic-Trochee-polysyllabic Test (MTP), and the meaningful Auditory Integration Scale (MAIS) Test. Charts with incomplete data were excluded. RESULTS: Only 67 children had complete data out of 93 patients. The mean age (in months) for Group 1 was (43.37±8.63) and for Group 2 was (70.38±9.97) at time of implantation. Significantly higher mean values were detected for Group 2 in comparison to Group 1 in the pre-operative period. No significant difference was detected after 2 years evaluation using the test battery for language development and auditory skills. CONCLUSIONS: Children who were implanted under the 5 years of age had a better outcome in the form of better auditory skills, speech perception, and language production. Limited resources and the absence of a national hearing screening program in Saudi Arabia result in the late presentation of children for evaluation and intervention of hearing problem; this late intervention reduces the benefits the late - implanted children derive from cochlear implantation.