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Phyto-pharmaceuticals and biological study on graviola (Annona muricata L.) fruit and dietary supplement of graviola sold on the Libyan market as a cancer cure against TCA induce hepatotoxicity in mice

Ajlal A. A. Alzergy¹, Mukhtar R. Haman ^2, Muftah A. Shushni², and Fairouz Albasheir Almagtouf ²

¹Department of Anatomy and Pathology, Faculty of Veterinary Medicine, Omar Al Mukhtar University, AL Bayda Libya

²Department of Pharmacognosy, Faculty of Pharmacy, Tripoli University, Tripoli Libya

aglalalzergy@yahoo.com

Abstract: Annona muricata (Graviola) has many medicinal properties and used widely in traditional medicine for treatment various disorders. The present study was conducted to evaluate phytochemical and quality control (QC) of random sample of graviola dietary supplement capsules (DS) which sold in the Libyan market as anticancer product. As well as the present work designed to evaluate heatoprotective effects of aqueous extract of graviola fruit pulp or aqueous DS of graviola capsules against trichloroacetic acid (TCA) induced hepatotoxicity in albino mice. Quality control parameters were determined on random samples of graviola DS using standard methods. A total of 120 female mice were divided into 6 groups and were used for biological screening to determine biochemical and histopathological alteration in liver of mice treated with TCA with or without aqueous extract of A.muricata fruit pulp or DS of graviola. The results of quality control and phytochemical screening revealed that all quality control tests conducted on the random sample of DS capsules of graviola were within normal values according to the standards of the Quality Control Center for Pharmaceuticals in Tripoli, only few samples showed slight increase in the moisture content. However, all samples appeared free from microbial contamination. While, growth of fungal contamination (Pencillium Spp) in the same samples were detected but all samples appeared free from aflatoxins contamination. Also, all samples were free from industrial radioactive contamination. Phytochemical study revealed presence of alkaloids, tannins, steroids, glycosides, falvonoids, anthraquinones, saponin and coumarins in extracts of graviola fruit pulp and graviola DS capsules. However, absence some phytochemical components in DS capsules was detected. The result of biological screening revealed that no clinical signs and abnormalities in behavior and external feature in mice treated with aqueous extract of graviola fruit pulp or aqueous extract of graviola DS capsules. However, the treatment with aqueous extract of graviola fruit pulp and DS of graviola reduced the abnormal changes in behavior and external features in female mice intoxicated with TCA, markedly reduced the mortality in TCA administrated mice and induced slight improvement in the final body weight comparing to TCA only intoxicated group. Biochemical study revealed that administration of aqueous extract of graviola fruit pulp or aqueous extract of DS of graviola significantly decreased the elevated serum activities of AST and ALT compared to TCA only intoxicated mice. Histological examination revealed that administration of aqueous extract of graviola fruit plup or aqueous extract of DS of graviola with TCA induced ameliorative changes and disappearance of the most pathological changes in the liver tissue compared to of TCA only intoxicated mice and the ameliorating changes were more obvious in the mice treated with aqueous extracts of DS of graviola and TCA. The present results demonstrate that A. muricata play an important role in the protection against TCA induced hepatotoxicity. It can be concluded that the present study provide some pharmacological and therapeutical informations about extract of the graviola fruit pulp and DS of graviola capsules which can use in future investigations and applications and demonstrated presence of important phyochemical constituents in the graviola fruit pulp extract and DS of graviola capsules. The extract of the graviola fruit pulp and DS of graviola capsules have protective effects against TCA induced liver toxicity in mice.

[Ajlal A. A. Alzergy, Mukhtar R. Haman Muftah A. Shushni, and Fairouz Albasheir Almagtouf. Phyto-pharmaceuticals and biological study on graviola (Annona muricata L.) fruit and dietary supplement of graviola sold on the Libyan market as a cancer cure against TCA induce hepatotoxicity in mice. Cancer Biology 2018;8(2):1-23]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 6. doi:10.7537/marscbj080118.06.

Key words: Annona muricata fruit (graviola), Dietary supplement of graviola, Quality control, Phytochemical, histological, trichloroacetic acid, Liver and mice.

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Double primary malignant colonic lesions, report of a case

Wael Al Shelfa¹, Bilal Al Jiffery ², Shymaa Yahia³, Amal farid ⁴

¹ Ass. Professor, Zagazig University, Egypt. SGH Jeddah, KSA.

² Professor of surgery, Taif University, KSA.

³ Lecturer of microbiology, Zagazig University, Egypt.

⁴ Lecturer of pathology, Monofia University, Egypt.

waelshel74@yahoo.com

Abstract: Neuro-endocrinal tumors ore found in the wall of gastrointestinal tract and arises from Kulchitsky cells located in the crypts of Lieberkuhn, historically have been referred to as (amine precursor uptake and decarboxylation) or APUD cells. Primary lymphoma of the colon is a rare malignant tumor of gastrointestinal tract, and comprises only 0.2-1.2% only of colonic malignancies. 76 years old male patient from Yemen was treated after his complaints with abdominal distension, pain, and vomiting. The histological diagnosis of double lesions affecting hepatic flexure; neuro-endocrine tumor and lymphoma was determined after surgery, with exclusion of any other malignant lesion affecting gastrointestinal tract, oncological resection was performed. No carcinoid features were found, and the prognosis seems to be favorable.

[Wael Al Shelfa, Bilal Al Jiffery, Shymaa Yahia, Amal farid. Double primary malignant colonic lesions, report of a case. Cancer Biology 2018;8(2):24-26]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 2. doi:10.7537/marscbj080218.02.

Keywords: Double; primary; malignant; colonic; lesions; report; case.

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Totally laparoscopic versus open radical gastrectomy for gastric cancer; a comparative study

Mahmoud H. Elshoieby; M. D¹; Mostafa M. Sayed², Ayman Kamal², Abdallah M. Taha³, Zainelabdeen M. Sayed MD⁴ and Mohamed El-Masry⁴

¹Assis. Prof. of Surgical Oncology at Surgical Department South Egypt Cancer Institute Assuit University, Egypt

²General Surgery at General Surgery Department Assuit University, Egypt

³General Surgery, General Surgery Department, Faculty of Medicine, South Valley University, Egypt

⁴ Internal Medicine Department Assuit University, Egypt

elshoieby@live.co.uk

Abstract: cancer stomach is the fifth killer cancer worldwide. Radical gastrectomy for tumor resection is the gold standard for potential cure of resectable gastric cancer. Recent advances in laparoscopy especially high resolution of imaging and energy dissection/vessel sealing devices have allowed laparoscopy to have a role in gastrectomy even radical ones that necessitate lymph nodes dissection. This gives advantages of minimal invasiveness but shouldn’t be on expense of safety and oncologic efficiency of the resection. Several recent studies have discussed the role of laparoscopy in radical gastric resection for cancer. Still further studies are needed in this field. Objective: retrospective comparison between laparoscopic and open radical gastrectomy for resectable gastric cancer, regarding oncologic efficiency (safety margin, number of LNs, tumor free survival, and overall survival) and safety (operative blood loss, viscus or organ injury, anastomotic leakage, wound infection, incisional hernia, and operative and early postoperative mortality) for patients operated upon in the Surgery Department, Assuit University Hospital. Patients and methods: This retrospective study involved 47 consecutive patients who had radical gastrectomy for gastric adenocarcinoma. All patients were admitted to the Surgery Department Assuit university Hospital between January 1^st, 2014 and December 31^st 2016. Patients were divided into 2 groups. Group A; included patients who had totally laparoscopic radical gastrectomy (No 13) and group B; included patients who had open radical gastrectomy (No 34). The two groups were compared regarding pathologic safety margin from the excised tumor, number of LNs, tumor free survival, and overall survival. Also, they were compared regarding operative blood loss, viscus or organ injury, anastomotic leakage, wound infection, incisional hernia, and operative and early postoperative mortality, and postoperative hospital stay. Results: in group A (n= 13) all operations were completed laparoscopicaly. There were 7 females and 6 males. Mean age was 49 years old (range 38-59). The clinical TNM stages were stage II in 8 patients (8/13) and stage III in 5 (5/13). Negative safety margin was achieved in 10 (10/13) patients, while margin was close (<1 cm) in 3 (3/13) patients. A mean of 19 LNs was harvested (range 11-26). During the follow up period 10-34 months (mean 19) the tumor recurred in 5 patients with a mean tumor free survival of 15 months (range 8-24 months). One year survival was 11/13. Mean operative time was 250 minutes (180-320). Mean blood loss was 230 mL. Postoperative leakage occurred in 2 patients where the leakage trickled out through the tubal drains. In the two patients no operative intervention was needed. No other operative complications had occurred, nor wound infection or incisional hernia. No operative or early postoperative mortality had occurred. In group B (n=34), there were 19 females and 15 males. Mean age was 58 years (range 37-71). The clinical TNM stages were stage II in 19 patients (18/34) and III in 16 (16/34). Negative safety margin was achieved in 29 (29/34) patients, while margin was close (<1 cm) in 5 (5/34) patients. A mean of 26 lymph nodes was harvested. During the follow up period (12-31, mean 20 months) the tumor recurred in 9 patients with a mean tumor free survival of 14 months (range 10-24 months). One year survival was 30/34. Mean operative time was 160 minutes. Mean blood loss was 540 mL. No postoperative leakage had occurred. Total number of postoperative complications was 14, and occurred in 6 (6/34) patients. Postoperative bleeding through the drain that stopped spontaneously occurred in 3 patients. Wound infection occurred in 4 patients and incisional hernia occurred in 7 patients. No operative or early postoperative mortality had occurred. Conclusions: the absence of mortality or major complications that necessitate surgical intervention together with the accepted oncologic results regarding safety margin, number of LNs removed, and tumor free survival indicate that totally laparoscopic radical gastrectomy is not only feasible and safe, but it is also oncologically efficient. However, still larger randomized controlled studies are needed for more solid conclusions.

[Mahmoud H. Elshoieby; M. D; Mostafa M. Sayed, Ayman Kamal, Abdallah M. Taha, Zainelabdeen M. Sayed MD and Mohamed El-Masry. Totally laparoscopic versus open radical gastrectomy for gastric cancer; a comparative study. Cancer Biology 2018;8(2):27-33]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 3. doi:10.7537/marscbj080218.03.

Keywords: laparoscopic versus, open radical gastrectomy, gastric cancer;

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Oncologic Outcome to Neoadjuvant Chemoradiation for Rectal Carcinoma after Surgery (NCI -Cairo and Minia Oncology Center Experience)

Amani Saber^1,3, Ahmed Abdel -Latif², Hisham El-Hossieny², Hani Habashy⁴

¹Faculty of Medicine, Minia University, Egypt

²National Cancer Institute, Cairo University, Egypt

³Minia Oncology Center, Egypt

⁴Faculty of Medicine, Fayoum University, Egypt

amanisaber@yahoo.com

Abstract: Background: Surgery is the mainstay of curative treatment for carcinoma of the rectum. Neoadjuvant chemoradiotherapy (CRT) and an 8week hiatus may give a chance to spare a major surgical procedure in a subset of patients with rectal carcinoma. The current retrospective study studied the correlation between the clinical response assessment after neoadjuvant therapy and tumor regression grade in post-operative pathological examination. We tried to identify the category of patients who may benefit from” watch and wait “protocol to avoid the morbidity of surgical intervention. Patients and Methods: The current retrospective study included 124 patients with histologically proven stage II-III rectal adenocarcinoma treated at NCI-Cairo and Minia Oncology Center during the period between January 2010 and December 2015. All patients were to be treated by neoadjuvant CRT followed by surgical intervention. Post-operative pathological response was compared with the clinicopathologic characteristics as well as the pre-operative clinical response after neoadjuvant CRT. Results: Among the study group, 120 patients were subjected to surgery. In 30 patients (25%) there was no viable tumor cells in the surgical specimen (Group 3). Pathological examination documented mild response (Group 2) in 56 patients (46.7% ) and no response (Group 1) in 34 patients (28.3%). There was no statistically significant difference as regards the clinicopathologic characteristics of patients according to the degree of pathologic response to neo -adjuvant therapy. The correlation between the clinical response after neoadjuvant therapy and the pathologic response after surgical intervention was studied. It was found that out of the 6 patients who showed complete clinical remission, no viable tumor cells were documented in only one patient (17%). Moreover, out of the 54 patients who showed partial clinical remission, no viable tumor cells were documented in 24 patients (44 %). Among the 48 patients who showed clinically stable disease, no viable tumor cells were documented in 5 patients (11%). Thus, the majority ( 80% ) of patients with no viable tumor cells had partial clinical response while only 3.3 % had clinical complete remission and 16.7% had clinically stable disease after neo adjuvant therapy. As regards the overall survival rates, there was no significant difference in survival according the clinical response after neoadjuvant therapy. On the other hand, the degree of pathologic response significantly affected the survival (p-value 0.002). Conclusions: The extent of clinical response after neoadjuvant therapy is not always a true indicator for the pathologic response after surgical intervention. The “watch and wait” approach may be a valid option not only for patients achieving complete clinical remission but also for some patients, who show partial or even stable disease after neoadjuvant therapy if properly evaluated.

[Amani Saber, Ahmed Abdel -Latif, Hisham El-Hossieny, Hani Habashy. Oncologic Outcome to Neoadjuvant Chemoradiation for Rectal Carcinoma after Surgery (NCI -Cairo and Minia Oncology Center Experience). Cancer Biology 2018;8(2):34-41]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 4. doi:10.7537/marscbj080218.04.

Keywords: Rectal cancer, pre-operative concurrent chemoradiotherapy, surgical outcome

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The Role Of Stat3 As A Prognostic And A Predictive Factor In The Management Of Anaplastic Large Cell Lymphomabased On ALK Exepression

Nessren Sabery1, Dareen A. Mohammed2, Duaa S. Helal2

1Oncology Department, Faculty of Medicine, Tanta University, Egypt
2Pathology Department, Faculty of Medicine, Tanta University, Egypt
nesreensabry1eg@yahoo.com

Abstract: Purpose: The aim of this study is to investigate the role of STAT3 as a prignostic factor in ALCL and the predictive role in survival based on ALK expression. Patients and Methods: Between January 2014 and January 2017, 55 patients with patholigically prived ALCL, received their treatment in Clinical Oncology Department, Tanta University Hospital, and Tanta Insurance Hospital, were included. ALL the patients received CHOP. Assesment was done before and after 3 cycles chemotherapy and after finishing treatment, then every 3 months. Results: Thirty-nine cases (70%) were positive for STAT3( among them 36 cases (92%) were ALK +ve), while 16(30%) of cases were negative ( among them there were 8 cases (50%) were ALK -ve), with sig p value. Forty four percent patients in STAT3 +ve group achieved CR, while 62% of patients in STAT3 –ve group achieved CR. 48%, 8 % achieved PR and SD in group A respectively, while 25%, 12% achieved PR and SD in group B respectively. p value not sig. The two years OS s were 84% for the STAT3+ve group and 94 % for the STAT3 –ve. P value sig. The two years DFS were 54% and 85% for both groups respectively. P valuesig. We also asses the relation between the ALK and the STAT3, patients with ALK -ve STAT3 -ve shows 2 years OS better than ALK -ve STAT3 +ve with 88% versus 67%. While the 2 years OS in ALK +ve patients with STAT3 -ve, and ALK +ve STAT3 +ve was 100% versus 86%. with non sig P value. Conclousion: In our study STAT3 was a prognostic marker for patients with ALCL, and has apredictive rule in response and survival, irrespective to ALK, to confirm the data, a multicenter, meta-analysis and a randomized trial with a large number of patients are required in the near future.
[Nessren Sabery, Dareen A. Mohammed, Duaa S. Helal. The Role Of Stat3 As A Prognostic And A Predictive Factor In The Management Of Anaplastic Large Cell Lymphomabased On ALK Exepression. Cancer Biology 2018;8(2):42-50]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 5. doi:10.7537/marscbj080218.05.

Keywords: Role; Stat3; Prognostic; Predictive Factor; Management; Anaplastic Large Cell; Lymphomabase; ALK Exepression

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A Dosimetric Analysis Study of Coplanar vs. Non Coplanar field Intensity Modulated Radiotherapy for Maxillary Sinus tumors

Rabab Abdel Moneim1, Moustafa Abdul Moez2, Maha Kamal2

Department of Clinical Oncology1 and Physics Unit2, Faculty of Medicine, Cairo University, Egypt
dr.rababahmed2014@hotmail.com

Abstract: Background and Purpose: Proximity of critical organs and Radiosensitive structures in planning maxillary cancers is challenging. This can be done using the intensity modulated radiation therapy (IMRT) technique with better achieving isodose distribution in the paranasal sinus area, while sparing adjacent critical organs. The aim of the current dosimetric study was to compare coplanar field (CF) with non coplanar field (NCF) - IMRT planning for cancer maxilla as regards target dose distribution, dose homogeneity and doses received by organs at risk (OAR). Patients and Methods: Twelve patients with histologically proven tumors of the maxillary sinuses were planned using NCF and CF intensity modulated radiotherapy techniques using the same optimization constraints template. Dose volume histograms (DVHs) were calculated for the targets and OAR. The distribution of the dose in the target volume and in the critical structures were compared between the two techniques, as well as the homogeneity Index (HI) in the target volume. The total monitor units and the total number of segments for each plan were also revised. Results: Higher doses delivered to the optic pathway, tempromandibular joint, cochlea, parotid and skull base with the CF technique than NCF The average maximum dose delivered to the brain stem for the CF and NCF plans were the same. Furthermore, the contralateral OAR received higher doses with CF technique. For the PTV, the average mean dose delivered was almost the same. The homogeneity index reveals no difference between both techniques (0.23 and 0.24 for the CF plans and NCF plans, respectively). Comparison of dose distribution in OAR for the CF and NCF techniques showed no significant difference. Conclusion: IMRT is one of the treatment options for cancer maxilla. The PTV coverage is optimal without compromising the protection of the OPS. The impact of non coplanar versus coplanar set up is very slight with no statistical significant.
[Rabab Abdel Moneim, Moustafa Abdul Moez, Maha Kamal. A Dosimetric Analysis Study of Coplanar vs. Non Coplanar field Intensity Modulated Radiotherapy for Maxillary Sinus tumors. Cancer Biology 2018;8(2):51-55]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 6. doi:10.7537/marscbj080218.06.

Key Words: Maxillary Sinus Cancer, IMRT, non coplanar field, coplanar field

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Major Poisonous Plants and Their Impact on Livestock

1Elias Adege (DVM), 1, 2*Abraham Jemberu (DVM)

1 Addis Ababa University, College of veterinary Medicine, Bishoftu, Ethiopia
2 Mekelle University, College of Veterinary Medicine, Mekelle, Ethiopia. P.O. Box. 2084
abrishjvmd@gmail.com

Abstract: Poisonous plants are plants that contain harmful toxins in high enough concentration that can cause serious problem on health as well as may cause death if they are consumed or ingested by livestock. Poisoning is usually associated with management errors, starvation, accidental eating and browsing habits of animals, lack of forage due to range conditions, and other events that would cause livestock to consume vegetation normally unacceptable. The severity of poisoning is related to the quantity of material eaten, the species of animal eating the plant, portion of the plant and condition of the plant eaten, level of ground moisture, general health of the animal prior to ingesting the substance and the age of the animal. Economic losses due to livestock poisoning by plants can be either direct losses or indirect loss. Direct losses of livestock involve the economic impact of poisonous plants on the animal. Poisonous plant causes losses by reducing in the reproductive efficiency of livestock. Indirect losses include those activities or costs that are incurred by a livestock operation to prevent losses or costs incident to livestock poisonings by plants.
[ Elias Adege, Abraham Jemberu. Major Poisonous Plants and Their Impact on Livestock. Cancer Biology 2018;8(2):56-64]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 7. doi:10.7537/marscbj080218.07.

Major Poisonous Plants and Their Impact on Livestock

1Elias Adege (DVM), 1, 2*Abraham Jemberu (DVM)

1 Addis Ababa University, College of veterinary Medicine, Bishoftu, Ethiopia
2 Mekelle University, College of Veterinary Medicine, Mekelle, Ethiopia. P.O. Box. 2084
abrishjvmd@gmail.com
 

Abstract: Poisonous plants are plants that contain harmful toxins in high enough concentration that can cause serious problem on health as well as may cause death if they are consumed or ingested by livestock. Poisoning is usually associated with management errors, starvation, accidental eating and browsing habits of animals, lack of forage due to range conditions, and other events that would cause livestock to consume vegetation normally unacceptable. The severity of poisoning is related to the quantity of material eaten, the species of animal eating the plant, portion of the plant and condition of the plant eaten, level of ground moisture, general health of the animal prior to ingesting the substance and the age of the animal. Economic losses due to livestock poisoning by plants can be either direct losses or indirect loss. Direct losses of livestock involve the economic impact of poisonous plants on the animal. Poisonous plant causes losses by reducing in the reproductive efficiency of livestock. Indirect losses include those activities or costs that are incurred by a livestock operation to prevent losses or costs incident to livestock poisonings by plants.
[ Elias Adege, Abraham Jemberu. Major Poisonous Plants and Their Impact on Livestock. Cancer Biology 2018;8(2):56-64]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 7. doi:10.7537/marscbj080218.07.

Keywords: Economic loss, Livestock, Poisoning, Poisonous plant, Economic loss, Livestock, Poisoning, Poisonous plant

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Cardiac toxicity of hypofractionated radiotherapy in left breast cancer

Tamer M Samy1, Samia Abdelkareem2, Marwa Abdelgawad2, Shimaa Ahmed1.

1 Radiation Oncology, South Egypt Cancer Institute (SECI), Asyut University, Egypt.
2 Clinical Oncology, Faculty of Medicine, Asyut University, Egypt.
shimaayoussif04@gmail.com

Abstract: Background: Adjuvant postoperative breast radiotherapy improve local control and overall survival. Based on radiobiological and clinical data analysis, hypofractionated radiotherapy had comparable survival to conventional regimen radiotherapy. One of the major limitations of breast radiotherapy is cardiac toxicity that more significant in patients has left breast cancer. Methods: This retrospective study recruited 200 patients with left non-metastatic breast cancer. All patients underwent surgery followed by adjuvant 3D hypofractionated radiotherapy with different hypofractionation schedules with no cardiac or other comorbidity, Patients ≥18 years, were eligible. Patients with tumor size more than 1 cm or with lymph node involvement received adjuvant chemotherapy and those with positive estrogen and/ or progesterone receptors received hormonal therapy with either estrogen receptor modulator like tamoxifen or aromatase enzyme inhibitors like letrozole according to patient menopausal state and those with Her2neu Over-expression received trastuzumab. The cardiac toxicity was evaluated by measuring the left ventricular ejection fraction (LVEF) prior to treatment and repeated 3 years after radiation therapy or when indicated. Results: Median age was 55 years, 25% less than 50 years, T2 detected in 47.5% of patients, N1 in 40%, while positive hormonal receptors reported in 75%. Her2neu Over-expression reported in 20% and these patients received trastuzumab. At 94 months median follows up period, ten-year LRR-FS was 93.9%, DM-FS was 80.8%, and OAS was 88.9%. Grade I cardiac toxicity reported in 12 patients (6%), the univariate analysis of factors associated with significantly increased cardiac toxicity is only concurrent trastuzumab and none other factors were significant. Conclusion: The results of our study suggest that hypofractionation radiotherapy not associated with increased risk of cardiac toxicity in left-sided breast cancer patients and there is no difference between different hypofractionation radiotherapy protocol as regard cardiac toxicity with the comparable result as regard LRR, DM and survival. Trastuzumab increased cardiac toxicities during hypofractionated radiotherapy and this should study in large randomized trials with long-term follow-up to confirm these findings.
[Tamer M. Samy, Samia Abdelkareem, Marwa Abdelgawad, Shimaa Ahmed. Cardiac toxicity of hypofractionated radiotherapy in left breast cancer. Cancer Biology 2018;8(2):65-72]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 8. doi:10.7537/marscbj080218.08.

Keywords: left sided Breast cancer, Hypofractionation radiotherapy, cardiac toxicity.

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Risk Index Evaluation of the Levels of Trace Metals in Callinectes amnicola Obtained from Qua Iboe River Estuary, South - South, Nigeria

1George, Ubong, 2Inyang-Etoh, Aniema

1Department of Fisheries and Aquaculture, Akwa Ibom State University, Akwa Ibom State, Nigeria.
2Faculty of Oceanography, University of Calabar, Calabar, Cross River State, Nigeria.
talk2georgeubong@gmail.com

Abstract: Trace Metals concentration in Callinectes amnicola Obtained from Qua Iboe River estuary, South - South, Nigeria was studied from (May, 2015 – April, 2016). Samples were collected monthly from three locations (Iwuokpom, Mkpanak and Iwuochang) and analyzed using standard procedures. Mean values of parameter in wet and dry seasons were as follows: Cadmium (0.01±0.00 and 0.01±0.01 mg/kg), Chromium (0.00±0.00 and 0.00±0.00 mg/kg), Copper (12.94±0.41 and 13.49±0.55 mg/kg), Iron (43.83±1.27 and 42.94±1.80 mg/kg), Lead (0.03±0.00 and 0.02±0.00 mg/kg), Cobalt (0.04±0.01 and 0.06±0.01 mg/kg) and Zinc (14.66±0.67 and 16.22±0.23 mg/kg) respectively. Vanadium and arsenic were below detectable limits throughout the study duration. The elemental concentrations of trace metals observed in the tissues of C. amnicola during the study were above WHO permissible limit for Iron, Copper and Zinc. Transfer factor index showed evidence of bioaccumulation of heavy metals in the tissues of the studied organism. Trace metal pollution of aquatic ecosystem in Nigeria, notably the Niger Delta Region is on the increase due to augmented industrialization, population explosion, urbanization and crude oil exploration. C. amnicola are mud dwellers and may possibly bio-accumulate heavy metals. However, the studied organism showed evidence of bioaccumulation, therefore continuous consumption of contaminated aquatic foods like C. amnicola from Qua Iboe River Estuary may pose sub-lethal or chronic health problems to humans as the final consumers.
[George U, Inyang-Etoh A. Risk Index Evaluation of the Levels of Trace Metals in Callinectes amnicola Obtained from Qua Iboe River Estuary, South - South, Nigeria. Cancer Biology 2018;8(2):73-78]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 9. doi:10.7537/marscbj080218.09.

Keywords: Trace metals, bioaccumulation, Transfer Factor, Pollution, Shellfish

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Health Risk Index Assessment of the Impacts of Coastal Activities on Tympanotonus fuscatus Obtained from Qua Iboe River Estuary, South - South, Nigeria

1Inyang-Etoh, Aniema, 2George, Ubong,

1Faculty of Oceanography, University of Calabar, Calabar, Cross River State, Nigeria.
2Department of Fisheries and Aquaculture, Akwa Ibom State University, Akwa Ibom State, Nigeria.
talk2georgeubong@gmail.com

Abstract: Trace metal pollution of aquatic environments in the Niger-delta region of Nigeria is on the increase due to increased urbanization, industrialization, population explosion and crude oil exploration. Environmental pollution associated with heavy metal concentrations is an emerging issue in most developed and undeveloped countries. Qua Iboe River Estuary has been reported to be open to several inputs from industrial and agricultural activities within the environment. This research was therefore carried out to determine the levels of trace metal concentrations in tissues of Tympanotonus fuscatus obtained from Qua Iboe River, Estuary, South-South, Nigeria. Six hundred samples of periwinkles were collected for a period of twelve months (May, 2015 – April, 2016) from three sampling stations (Iwuokpom, Mkpaknak and Iwuochang) in the intertidal region of the estuary and were analyzed using Atomic Absorption Spectrophotometer. Mean values of parameter in wet and dry seasons were as follows: Cadmium (0.02 ± 0.00and 0.02±0.01 mg/kg), Chromium (0.02 ± 0.00and 0.02 ± 0.00mg/kg), Copper (133.79 ± 4.82and 158.1 ± 5.08 mg/kg), Iron (540.71 ± 11.55 and 551.18 ± 7.11 mg/kg), Lead (0.14 ± 0.01and 0.20 ± 0.03 mg/kg), Cobalt (0.21 ± 0.05and 0.45 ±0.04 mg/kg) and Zinc (39.39 ± 1.78 and 41.39 ± 0.59mg/kg) respectively. The mean values of trace metal concentrations in the tissues of the analyzed Tympanotonus fuscatus species sample from Qua iboe River Estuary, Ibeno showed a remarkable pattern. This follows the trend: Fe > Cu > Zn > Co > Pb > Cd > Cr. Vanadium and Arsenic were below detectable limit throughout the study period. The elemental concentrations of trace metals observed in the tissues of T. fuscatus during the study were above WHO permissible limit for all the studied trace metal exception of Chromium (Cr). Transfer factor index showed evidence of bioaccumulation of trace metals in the tissues of the studied organism. This implies that periwinkles from Qua Iboe River, estuary is not safe for human consumption as a food source for consumers who delight in this delicacy. T. fuscatus are mud dwellers and have shown evidence of bio-accumulation; therefore consumption of trace metal contaminated sea foods like periwinkle may pose lots of health hazards. However, this study emphasizes the essence of constant monitoring of trace metal levels in tissues of edible aquatic organisms to prevent sub-lethal poisoning to man as the final consumer of this seafood’s along the food chain.
[Inyang-Etoh A, George U. Health Risk Index Assessment of the Impacts of Coastal Activities on Tympanotonus fuscatus Obtained from Qua Iboe River Estuary, South - South, Nigeria. Cancer Biology 2018;8(2):79-86]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 10. doi:10.7537/marscbj080218.10.

Keywords: Health risk index, Coastal activities, Tympanotonus fuscatus, Qua Iboe River Estuary, Trace Metals

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Double primary malignant colonic lesions, report of a case.

Wael Al Shelfa ⁽¹⁾, shymaa yahia ⁽²⁾, Amal farid ⁽³⁾

⁽¹⁾     Ass. Professor, Zagazig university, Egypt. SGH Jeddah, KSA.

⁽²⁾     Lecturer of microbiology, Zagazig university, Egypt.

⁽³⁾     Lecturer of pathology, Monofia university, Egypt.

Wael Al sheaf, waelshel74@yahoo.com

Abstract: Neuro-endocrinal tumors ore found in the wall of gastrointestinal tract and  arises from Kulchitsky cells located in the crypts of Lieberkuhn, historically have been referred to as ( amine precursor uptake and decarboxylation) or APUD cells. Primary lymphoma of the colon is a rare malignant tumor of gastrointestinal tract, and comprises only 0.2-1.2% only of colonic malignancies. 76 years old male patient from Yemen was treated after his complaints with abdominal distension, pain, and vomiting. The histological diagnosis of double lesions affecting hepatic flexure; neuro-endocrine tumor and lymphoma was determined after surgery, with exclusion of any other malignant lesion affecting gastrointestinal tract, oncological resection was performed. No carcinoid features were found, and the prognosis seems to be favorable.

[Wael Al Shelfa, shymaa yahia, Amal farid. Double primary malignant colonic lesions, report of a case.. Cancer Biology 2018;8(2):87-89]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 11. doi:10.7537/marscbj080218.11.

Keywords: Double; primary; malignant; colonic lesions; report; case

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External Beam Radiotherapy versus High Dose Rate Brachytherapy plus External Beam Radiotherapy in locally advanced uterine cervical cancer

*Elumelu TN., *Oladeji A., *Adenipekun A., Elumelu T.N MBBS, DPC, FMCR, FWACS, MBA

*Department of Radiotherapy College of Medicine, University of Ibadan

Corresponding Author: Department of Radiotherapy, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria. Email- telumelu@com.ui.edu.ng, tessynek@yahoo.com 1

Abstract: Introduction: Prior to 2008 when High Dose Rate (HDR) Brachytherapy was installed in Radiotherapy Department of University College Hospital (UCH), Ibadan, patient with locally advanced cancer of cervix were treated with chemotherapy and External Beam Radiotherapy (EBRT), but with the advent of HDR brachytherapy facility, patients are treated now with chemotherapy, EBRT and brachytherapy. Aim: This a retrospective evaluation of the treatment outcome of patients with locally advanced squamous cell carcinoma of the cervix treated with external beam radiotherapy and high-dose-rate brachytherapy, compared with the patients that had external beam radiotherapy alone. Material and Methods: The treatment records of patients with locally advanced uterine cervical cancer (FIGO stage IIB-IVA), treated with EBRT alone (Group I) and those treated with High Dose Rate Brachytherapy and EBRT (Group II) were extracted from case notes and radiotherapy treatment cards for analysis. Results: 179 cases in all divided into Group I (109) and Group II (70). In Group I, 19(17%) had local relapse, 8(7.3%) suffered persistence disease, 4(3.7%) had distance metastases, hepatic metastasis (2), lungs (1) and pelvic bone (1), 3(2.8%) died from disease progression, while 75(68.8%) were disease free. For Group II 7(10%) recorded local failure, persistence disease in 3(4.3%), malignant pleural effusion in 1(1.48%) and 59(84.3%) of the patients were disease free. Conclusion: The results of this study demonstrated some degree of therapeutic advantage of combining EBRT and HDR over EBRT alone in the management of locally advanced cancer of cervix. However, the therapeutic ratio of EBRT/HDR is low, making the adverse effect to be more compared with EBRT only.

[Elumelu TN., Oladeji A., Adenipekun A., Elumelu T.N MBBS, DPC, FMCR, FWACS, MBA. External Beam Radiotherapy versus High Dose Rate Brachytherapy plus External Beam Radiotherapy in locally advanced uterine cervical cancer. Cancer Biology 2018;8(2):90-96]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 12. doi:10.7537/marscbj080218.12.

Key Words: Cancer of cervix, External Beam Radiotherapy, High Dose Rate Brachytherapy

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Mammographic Breast Density as a Predictive Factor of Local Recurrence in Female Patients with Invasive Breast Cancer

Emad Sadaka¹, Walid Almorsy², Amr Albadry³ and Alsiagy Ali Salama³

¹Clinical Oncology Department, Faculty of Medicine, Kafer Elsheikh University, Egypt

²Clinical Oncology Department, Faculty of Medicine, Tanta University, Egypt

³Radiology Department, Faculty of Medicine, Tanta University, Egypt

e_sadaka@hotmail.com

Abstract: Purpose: Mammographic breast density (MBD) is one of the strongest breast cancer risk factors. Dense breast tissue was demonstrated to increase the risk of local recurrence after modified radical mastectomy. The aim of this study was to evaluate MBD as a predictive factor for local recurrence in female patients with invasive breast cancer. Methods: Eighty seven female patients with local recurrence after mastectomy for invasive breast cancer were included in this study. Patient's data were recorded concerning mammographic density, age, menopausal status and tumor features (histological type, grade, size, nodal status, LVI, hormonal receptors status, Ki67 and Her-2/neu). Results: Among all patients, 23 (26.44%) patients had low dense breasts (<25%) while 64 (73.66%) patients had high dense breasts (≥25%). Analysis of risk factors associated with local recurrence according to the mean time (in months) showed a significant association between early local relapse (LR) and high MBD (p<0.001), age <50 (p=0.006), LVI (p=0.044), positive axillary nodes (p=0.014) and high Ki67 expression (p=0.007). In multivariate analysis, MBD was an independent risk factor for LR (p<0.001). Age and nodal status was near significant (p=0.07). Conclusion: mammographic breast density has a significant impact on local recurrence in female patients with invasive breast cancer. Further studies with large number of patients still needed to confirm the predictive value of MBD in the incidence of local recurrence in female patients with invasive breast cancer.

[Emad Sadaka, Walid Almorsy, Amr Albadry and Alsiagy Ali Salama. Mammographic Breast Density as a Predictive Factor of Local Recurrence in Female Patients with Invasive Breast Cancer. Cancer Biology 2018;8(2):97-101]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 13. doi:10.7537/marscbj080218.13.

Keywords: Mammographic Breast density, local recurrence, prediction

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Prognostic Impact of EGFR and CK5/6 as Basal-Markers in Triple-Negative breast Cancers

Rasha Abd El-Ghany Khedr¹, Emad Sadaka¹, Khairia Gawish¹and Safinaz H. El-Shorbagy²

¹Histopathology Department, Faculty of Medicine, Tanta University, Egypt

²Clinical Oncology Department, Faculty of Medicine, Tanta University, Egypt.

khedr_rasha@yahoo.com

Abstract: Background: Triple-negative breast cancer (TNBC) is defined by the loss of expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2neu). It is a high risk group of breast cancer that lacks the benefit of specific therapies and is classified into aggressive basal subtype and less aggressive non-basal subtype. Objective: To examine the expression of basal markers; including epidermal growth factor receptor (EGFR), cytokeratin 5/6 (CK5/6) among triple-negative breast cancer cases and correlate the results with those of Ki-67expression and with the clinic pathological parameters and survival for determining prognosis and therapeutic strategies Materials and Methods: A total of 97 TNBC cases from January 2012 to July 2015based on ER, PR, and the HER2neu negativities were included in the study. The tissue specimens were stained by immune histochemistry for detection of EGFR, CK5/6 and Ki-67. Statistical analysis was done using the SPSS software version 21 for comparison between basal and non-basal TNBC. Results: About 75out of the whole cohort (77.3%) of studied TNBC specimens showed positive basal markers EGFR and or CK5/6 together with high proliferation rate detected by Ki-67 and poor prognostic parameters including overall survival (OS) and progression free survival (PFS). Conclusion: The “Triple-negative” status cannot be used alone as a surrogate for the “basal expression”. Basal subtypes of TNBC show more aggressive behavior and could better predict breast cancer survival.

[Rasha Abd El-Ghany Khedr, Emad Sadaka, Khairia Gawish and Safinaz H. El-Shorbagy, Prognostic Impact of EGFR and CK5/6 as Basal-Markers in Triple-Negative breast Cancers Cancer Biology 2017;7(X)]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net.

[Rasha Abd El-Ghany Khedr, Emad Sadaka, Khairia Gawish and Safinaz H. El-Shorbagy. Prognostic Impact of EGFR and CK5/6 as Basal-Markers in Triple-Negative breast Cancers. Cancer Biology 2018;8(2):102-109. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 14. doi:10.7537/marscbj080218.14.

Key words: TNBC, EGFR, CK5/6, Ki-67, Basal markers

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A Retrospective Study of Feto –Maternal Outcome in Premature Rupture of Membranes at Aswan University Hospital

Laila Ezzat

Department of Obstetrics and Gynecology, Faculty of Medicine, Aswan University, Aswan, Egypt

lailaezzat972000@gmail.com

Abstract: Background: Premature rupture of membranes (PROM) is a challenging problem to the obstetricians. In the last three decades it has taken a new dimension because of identification of clinical risk factors and improved fetomaternal outcome due to better management. Premature rupture of membranes is a common and important event in obstetrics. It has a major impact on fetal and maternal outcome, complicating the pregnancy leading to maternal and fetal complications, immediate risks such as cord prolapse, cord compression and placental abruptions, and later risks such as maternal or neonatal infection, as well as the use of interventions such as caesarean section and its complications. Material and Methods: A list of patients that had PROM admitted to Aswan University Hospital from January 1/2013 to December 31/2013. Diagnosed by history clinical examination and investigations. The case notes was retrieved from the medical records department. The data was entered in the computer for statistical analysis using one proprietary statistical package which is Statistical Packages for the Social Science (SPSS). Results: incidence 10.85%, the average age 28.5 year. The patient's parity primigravida (25.47%), multiparas patients (52.47%) and grand multi-paras represent (22.05%) patients. Average gestational age 34 weeks. Caesarean section (38.27%) vaginal delivery61.72%. About the indications for caesarean section fetal distress 25.28%, failure to progress (40.4%) and previous caesarean section (s) (34.2%) Fetal complications, (NICU) admission 10.07%, respiratory distress (RD) 2.28%, and neonatal sepsis 5.13%. maternal complications, Chorioamnitis 0.57%, postpartum heamorrage 11.59%, Puerperal pyrexia 8.55%. Conclusions: Individualized management of cases with Premature rupture of membranes depending on the gestational age and risk of complications is the best way to achieve a good fetomaternaloutcome.

[Laila Ezzat. A Retrospective Study of Feto –Maternal Outcome in Premature Rupture of Membranes at Aswan University Hospital. Cancer Biology 2018;8(2):110-113]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 15. doi:10.7537/marscbj080218.15.

Keywords: PROM, PPROM, Gestational age, Prematurity, chorioamionitis

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Arabic Language Translation and Initial Validation of the Functional Assessment of Cancer Therapy Quality of Life Questionnaire (FACT-C) in Egyptian Patients with Colorectal Cancer

Sara M. El-Badawy¹, Mohamed A. Alm El-Din¹, Ibrahim A. Kabbash² and Ashraf F. Barakat¹

¹ Department of Clinical Oncology, Faculty of Medicine, Tanta University, Egypt

² Department of Public Health, Faculty of Medicine, Tanta University, Egypt

almeldin@gmail.com

Abstract: Background: The aim of this study is translation of functional assessment of cancer therapy-colorectal questionnaire version 4 (FACT-C) into Arabic language and its Initial validation and correlation with psychometric properties of the Arabic version of the European Organization for Research and Treatment (EORTC) quality-of-life colorectal questionnaire (QLQ-CR29). Method: This cross sectional study included 80 patients with colorectal cancer. The FACT-C, version4 questionnaire was translated according to EORTC guidelines into its Arabic form through forward- backward translation and harmonization then pilot study of translated questionnaire was done on first 10 patients. The order of administration of the FACT-C and EORTC questionnaires was randomized to avoid any effects of order of presentation. Results: The FACT-C showed good acceptability, good reproducibility and excellent internal consistency 0.839 using Cronbach alpha statistics as compared to EORTC QLQ 29. The relative high internal consistency of FACT-C confirms the reliability of Arabic version of the questionnaire. Patients did not express a preference for one survey over another. Conclusion: Arabic version of FACT-C can be used to assess quality of life in colorectal patients. Validation on larger number of patients & future studies for the appropriate use of these measures in clinical research is recommended.

[Sara M. El-Badawy, Mohamed A. Alm El-Din, Ibrahim A. Kabbash and Ashraf F. Barakat. Arabic Language Translation and Initial Validation of the Functional Assessment of Cancer Therapy Quality of Life Questionnaire (FACT-C) in Egyptian Patients with Colorectal Cancer. Cancer Biology 2018;8(2):114-119]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 16. doi:10.7537/marscbj080218.16.

Key words: Quality of life, FACT-C, colorectal cancer, Egyptian patients

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