Journal of Current Oncology and Medical Sciences
Volume:3 Issue: 2, Spring 2023

  Breast cancer is the commonest malignancy among women worldwide. Despite a multidisciplinary approach, locally advanced breast cancer remains a clinical challenge as most of the patients have a high rate of locoregional spread and develop distant metastases. Neoadjuvant chemotherapy not only paves the way for a more conservative surgical option but also decreases the incidence of positive nodes. To assess the effectiveness of neo-adjuvant chemotherapy and its impact on clinical and pathological response in locally advanced breast cancer. To compare patient characteristics, histological type, and hormonal receptor status with response to neo-adjuvant chemotherapy.

 This is a prospective observational study over a one-year period on 30 locally advanced breast cancer patients from rural backgrounds who received neoadjuvant chemotherapy. All patients received a standard neoadjuvant treatment regimen and were evaluated clinically, radiologically, and pathologically pre- and post-chemotherapy. The clinical response was assessed by RECIST criteria, the pathological response was graded according to Chevalier classification, and the overall impact was assessed by AJCC response criteria.

 Most of the patients (46.7%) were in the age group of 35-48 years. The premenopausal and postmenopausal groups were 63% and 37%, respectively. In the present study, tumours expressing estrogen, progesterone, and HER 2 were 73%, 66%, and 27%, respectively. Patients showing clinically complete responses post-neoadjuvant chemotherapy were 4, partial responses were 21, stable disease was 3, and progressive disease was 2. A pathological partial response was achieved in 93% of patients.

 Neoadjuvant chemotherapy in locally advanced breast cancer not only downstages the disease but increases the scope of operability and thus makes it possible to resect the disease with a tumour-free margin in most cases.

 Conventional antifungals used to treat fungal infections are no longer as effective, leading to increased mortality. On the other hand, there is an emergence of multidrug-resistant (MDR) fungal strains and for this reason, finding new treatments or substances that have an antifungal effect is noticeable. Therefore, this study aimed to determine the antifungal effects of extracts of Arnebia euchroma on the growth of Candida species isolated from patients with COVID-19-associated oral candidiasis.

 In the present experimental study, watery and alcoholic extracts of Arnebia euchroma were prepared by the maceration method. The minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of alcoholic and watery extract of Arnebia euchroma were evaluated against clinical and standard isolates of Candida albicans, Candida glabrata, Candida tropicalis, Candida parapsilosis, and Candida krusei clinical isolates according to the Clinical and Laboratory Standards Institute document M27-A3 (CLSI M27-A3) broth microdilution protocol.

The results of the present study showed that all the investigated isolates were sensitive to watery and alcoholic extracts of Arnebia euchroma. The MIC and MFC of Arnebia euchroma watery extract for Candida albicans were 512 µg/mL and for Candida glabrata were 1024 µg/m, as well as the MIC and MFC of this extract for Candida tropicalis, Candida parapsilosis, and Candida krusei were 2048 µg/mL. Whereas the MIC and MFC of the Arnebia euchroma alcoholic extract for Candida albicans were 0.015625 µg/mL and for Candida glabrata were 256 µg/mL, also the MIC and MFC of this extract for Candida tropicalis and Candida parapsilosis were 512 µg/mL and for Candida krusei were 1024 µg/mL.

 All the studied Candida isolates were sensitive to both types of Arnebia euchroma root extract, and the alcoholic extract, compared with the watery extract, inhibited the growth of the tested Candida isolates at a lower concentration.

 Achalasia is a rare esophageal motility disorder that can require surgical intervention in some cases. This retrospective cross-sectional study aims to evaluate the clinical symptoms of patients with advanced achalasia who underwent laparoscopic Heller myotomy (LHM) and Dor fundoplication.

 The study included 86 patients (38 men, 48 women) diagnosed with achalasia between 2010 and 2020, of which 20 patients with advanced achalasia underwent LHM and Dor fundoplication. The median follow-up time was 48 months.

 The study found that LHM and Dor fundoplication surgery improved dysphagia in 12 patients, with four patients showing improvement in solid food dysphagia and two patients showing improvement in semi-solid dysphagia. Nocturnal cough and slow emptying sensation also improved in 16 cases. Additionally, barium stasis decreased significantly in 14 patients. However, two patients who underwent esophagectomy had hospital mortality.

 This study highlights the effectiveness of LHM and Dor fundoplication in reducing dysphagia, nocturnal coughing, regurgitation, and other obstructive symptoms in patients with advanced achalasia. However, the study also underscores the potential risks associated with esophagectomy, suggesting that surgical treatment for achalasia should be carefully considered on a case-by-case basis.

Diseases such as COVID-19 can be associated with the development of mental disorders such as PTSD in patients or their families, which can last for years. Therefore, this study investigated the prevalence and factors associated with post-traumatic stress disorder(PTSD) in patients with COVID-19 and their families admitted to 22 Bahman Hospital in Neyshabur in 2020. In this descriptive cross-sectional study,96 patients and 96 family members in Neyshabur were included using available and voluntary sampling.PTSD in individuals was assessed by completing the DSM-5(PCL-5)checklist and interviewing. Demographic information including gender, age, level of education and marital status was also collected. Information related to COVID-19 disease including the patient's pulmonary involvement, duration of hospitalization and ward was recorded. In both groups, the majority of participants were men (56%), married people (90%), and people with a diploma (49%). The mean score of PTSD in the patient group and the patient family group was 35.5 and 33.5, respectively. All subjects in the patient group and the patient group had PTST disorder (PTSD score>18).In the group of patients with COVID-19, the severity of post-traumatic stress disorder was severe in 14.6%, moderate in 21.9%, and mild in the rest. Also, the incidence of PTSD among patients' families was 16.7% severe,31.2% moderate and the rest mild. Regression analysis showed that the variables of hospitalization and duration of hospitalization could predict stress disorder in patients at 53.9% and 24.2%. Given the widespread coronavirus in communities as well as the prevalence of PTSD in patients and their families, control measures should be considered to improve the mental health of these individuals.

Evidence of increased serum uric acid (UA) levels during asthma exacerbations is still unclear. High levels of UA may lead to increased inflammation; in this regard, we aimed to investigate the level of UA and associated factors in patients with exacerbation of asthma attacks and those with controlled asthma.

In this study, demographical and clinical data from 300 patients (150 outpatients and 150 hospitalized patients) with asthma who were referred to Razi Hospital, Rasht, Iran, from August 2018 to March 2019 were collected. Also, the UA and spirometry parameters (FEV1, FEV1/FVC) were assessed for patients. All data were analyzed using SPSS version 21 considering a significant level<0.05.

Among 300 patients with asthma, 158 were male, and 142 were female. A significant association was reported between gender, body mass index (BMI), history of smoking, opium consumption, alcohol consumption, number of asthma attacks, family history of asthma, and history of atopy among hospitalized and outpatients (P<0.05). In addition, there was a significant difference between the level of UA in the two groups at the beginning of treatment (P<0.05). Also, a significant difference between the level of UA in hospitalized patients at the beginning and the end of treatment was observed (P<0.05). In addition, a significant difference between the oxygen saturation level among two groups of outpatients and hospitalized patients at the beginning of treatment was seen (P<0.001).

According to our results, the level of UA might be used as a relative predictive factor in the severity of asthma attacks.

 Alzheimer's disease (AD), the most common neurodegenerative disease in the world, appears in two forms, early and late. Pathologically, an amyloid beta peptide is the hallmark of this disease which is followed by synaptic dysfunction, brain atrophy, and accumulation of neuronal tangles. The purpose of this study is to review the researchers on astrocytes' role in the progress of AD.

 A comprehensive search was conducted in databases articles focusing on key terms "Inflammatory reactions", "Alzheimer's disease", "Inflammatory factors" and "Astrocytes" and Boolean operators. Articles before 2001 were removed.

 Finally, After analyzing the selected articles, 20 articles were extracted and included in this review.

 Astrocytes are a group of glial cells in the central nervous system. The inflammatory activity of astrocytes plays a role in the development and progression of Alzheimer's disease. They strengthen the function of synapses by secreting neurotrophic factors. They also clear amyloid beta peptides from nerve tissue. Amyloid beta peptides bind to specific receptors on these cells and change the activity of these cells from anti-inflammatory to inflammatory type.It seems that astrocytes play a pivotal role in the development and progression of AD, particularly at the late stage of the disease. Finding a rational strategy to suppress inflammatory A1 phenotype might be a promising tool to slow down the progress of AD.

Transversus abdominis plane block (TAPB) is now a well-established technique in postoperative analgesia for lower abdominal surgeries. We aimed to investigate the effects of adding dexmedetomidine to bupivacaine used in USG (TAP block on postoperative pain and complications in patients undergoing inguinal hernia repair.

 About 66 eligible patients enrolled in the survey. They were randomly assigned to one of the two groups of 20 CC of bupivacaine 0.5% + 1 CC Normal saline or 20 CC of bupivacaine 0.5% + 100µg dexmedetomidine. The amount of pethidine consumption, postoperative VAS score, and complications were measured. Patients were evaluated at the recovery ward (T0) and 2, 4, 6, 12, and 24 hours after surgery. Regarding the VAS score and if the patient's pain complained from a VAS≥3, pethidine 0.5 mg/kg was administered. The total dose, the average dose of pethidine used, and the first time of pethidine administration after the nerve block was recorded.

 Two groups had no significant difference regarding baseline characteristics. A significant difference was found at T4 about VAS (P=0.005). The amount of pethidine consumption was lower in the DEX group but not statistically significant except for T4 (P=0.006). The two groups showed no difference regarding side effects such as PONV.

Concussion:

 Injection of dexmedetomidine in combination with bupivacaine for TAPB is an effective and safe drug for controlling pain after hernia surgery.