The Relation of VEGFA, VEGFR2, VEGI, and HIF1A Genetic Variants and Their Serum Protein Levels with Breast Cancer in Egyptian Patients.

Breast cancer is the most common type of cancer in Egyptian females. Polymorphisms in the angiogenesis pathway have been implicated previously in cancer risk and prognosis. The aim of the current study was to determine whether certain polymorphisms in the genes of vascular endothelial growth factor A (VEGFA), vascular endothelial growth factor receptor 2 (VEGFR2), vascular endothelial growth inhibitor (VEGI), and hypoxia-inducible factor-1α (HIF1A) associated with breast cancer development. The study included 154 breast cancer patients and 132 apparently healthy age-matched females as a control group. VEGFA rs25648 genotyping was performed using (ARMS) PCR technique; while VEGFR2 rs2071559, VEGI rs6478106, and HIF-1α rs11549465 were genotyped by the PCR-RFLP method. Serum levels of VEGF, VEGFR2, VEGI, and HIF1A proteins in breast cancer patients and controls were measured by ELISA. There was a significant association between the VEGFA rs25648 C allele and breast cancer risk (OR 2.5, 95% CI 1.7-3.6, p < 0.001). VEGFA rs25648 C/C genotype was statistically significantly higher in breast cancer patients vs. control (p < 0.001). Participants with the T/T and T/C VEGFR2 rs2071559 genotypes had 5.46 and 5 higher odds, respectively, of having breast cancer than those with the C/C genotype. For the VEGI rs6478106 polymorphism, there was a higher proportion of C allele in breast cancer patients vs. control (p = 0.003). Moreover, the C/C genotype of VEGI rs6478106 was statistically significantly higher in breast cancer patients vs. control (p = 0.001). There was no significant difference in genotypes and allele frequencies of HIF1A rs11549465 polymorphism between breast cancer cases and control individuals (p > 0.05). Serum levels of VEGFA, VEGI, and HIF1A were considerably greater in women with breast cancer than in the control (p < 0.001). In conclusion, the genetic variants VEGFA rs25648, VEGFR2 rs2071559, and VEGI rs6478106 revealed a significant association with increased breast cancer risk in Egyptian patients.

The Pattern of Antimicrobial Prescription at a Tertiary Health Center in Egypt: A Point Survey and Implications.

Background: The misuse of antimicrobials has major consequences, particularly antimicrobial resistance (AMR) and antimicrobials' related adverse effects. So, the WHO proposed antimicrobial surveillance to improve antimicrobials use. This point prevalence survey (PPS) was conducted to illustrate the prevalence of antimicrobial use at Mansoura University hospitals (MUH), Egypt. Methods: The survey process used was adapted from the European survey of antimicrobial resistance with modifications. The survey was conducted from 8 AM to 8 PM daily within 2 weeks. Results: A total of 300 patients received antimicrobials and the prevalence rate of antimicrobial prescription was 79.15%. The major indications of antimicrobials were surgical prophylaxis followed by the treatment of community-acquired infection. The most commonly prescribed initial antimicrobial group was Aminopenicillin ± ß-lactamase inhibitors. Although the purpose for antimicrobial administration was recorded in all cases, the stop/review history was recorded only in 19.6% and local guidelines were not available for 77.6% of antimicrobial prescriptions. The use of combined antimicrobials was common (46.6%), particularly in orthopedic and cardiothoracic surgery. Conclusion: The prevalence of antimicrobial prescription at MUH was high which requires serious actions including reviewing the antimicrobial indication, implementing local prescription guidelines, initiating an antimicrobial stewardship program (ASP), and optimizing infection control measures.

Gigantic submandibular pleomorphic adenoma: A rare case report.

INTRODUCTION: Pleomorphic adenoma (PA) is the most common benign salivary gland tumor. When neglected on some occasions, its size and weight can enormously augment. CASE PRESENTATION: We report a case of a giant submandibular pleomorphic adenoma in a 75 years old female patient which measured 34 × 26 × 20 cm and weighed 8.1 kg. CONCLUSION: Neglecting such tumors without treatment, can cause severe facial disfigurement and can even hinder the airway.

Breast fibromatosis, an unusual breast disease.

Fibromatosis is a benign tumor that rarely affects the breast and is an unusual site for its occurrence. Whilst the definite etiology of breast fibromatosis is unclear, it may present itself following surgical trauma or silicone implant. Wide local excision with adequate safety margins is considered the standard of care. We review three cases of breast fibromatosis who were presented to and operated in the Oncology center, Mansoura universty (between April 2014 and August 2016). Two of these cases underwent wide local excision and primary closure of the defect whilst the other one was reshaped by mini latismuss dorsi flap.