Study the Influence of Treatment Interruptions in the Radical Irradiation of Breast Cancer

Hypofractionated radiotherapy (HFRT) in breast cancer treatment regimen (40 Grey /15 fractions/3 weeks) is more convenient for patients, especially those coming from remote areas to radiotherapy facilities and for healthcare providers, than conventional fractionation (50 Gy/25 fractions/5weeks). So the effect of radiotherapy interruption on treatment outcome (loco-regional control (LRC)& overall survival (OS)) during hypofractionated schedule is the issue of our study. Materials and Methods: We studied retrospectively 174 female patients with breast cancer who received PORT at the Clinical Oncology & Nuclear Medicine Department, Faculty of Medicine, Mansoura University, Egypt, from January-2012 to December-2016. We determined the treatment outcome (OS&LRC) from the follow-up (FU) of the studied patients, as the patient still survived or died, and recurrence till now occurred or not, and were estimated with the Kaplan-Meier (K-M) method and Logrank test, respectively. Then we calculated surviving fraction (SF) and tumor control probability (TCP) with regard to biologically effective dose (BED), for all patients, using breast cancer radiobiological parameters. Results: When comparing patients without radiotherapy gap with patients with radiotherapy gaps, the results showed a decrease in LRC rate in patients with radiotherapy treatment interruptions by 15 % (P=0.019, a significant value), but no detrimental effect on OS because of the very limited number of the studied patients. Curves of the relationship between (SF&OTT) and (TCP&OTT) confirmed the detrimental effect of unscheduled gap during radiotherapy fractions on the treatment outcome. Also we found a significant-P value for (marital status, start day of radiotherapy fractions, time, number, and duration of gaps); it means these factors affect LRC during radiotherapy interruptions.Conclusions: Interruptions during postoperative hypofractionated irradiation of 7breast cancer (40 Gy/15 fractions/3weeks) should be avoided and if they are inevitable, they should not be prolonged more than two days, as they will adversely affect the treatment outcome (LRC)

Substantial and sustained reduction in under-5 mortality, diarrhea, and pneumonia in Oshikhandass, Pakistan : Evidence from two longitudinal cohort studies 15 years apart

Funding Information: Study 1 was funded through the Applied Diarrheal Disease Research Program at Harvard Institute for International Development with a grant from USAID (Project 936–5952, Cooperative Agreement # DPE-5952-A-00-5073-00), and the Aga Khan Health Service, Northern Areas and Chitral, Pakistan. Study 2 was funded by the Pakistan US S&T Cooperative Agreement between the Pakistan Higher Education Commission (HEC) (No.4–421/PAK-US/HEC/2010/955, grant to the Karakoram International University) and US National Academies of Science (Grant Number PGA-P211012 from NAS to the Fogarty International Center). The funding bodies had no role in the design of the study, data collection, analysis, interpretation, or writing of the manuscript. Publisher Copyright: © 2020 The Author(s).Peer reviewedPublisher PD

A cross-sectional study on the level of knowledge,attitude and practice on diabetes mellitus among population aged 18 years old and above in Rumah Baseh, Bawang Assan, Sibu from 25th May until 7th August 2009

Diabetes mellitus is now recognized as an escalating non communicable disease at phenomenal scale in which WHO estimated that the nwnber of diabetics will increase to as high as 366 million people by 2030. In order to cope with the levitating prevalence of diabetes mellitus in Malaysia, level of knowledge and awareness among the population should be assessed and appropriate interventions should be employed. The purpose of this study was to identify the level of knowledge, attitude and practice concerning diabetes mellitus among the community of Rwnah Baseh, Bawang Assan, Sibu. Results obtained were then implemented to conduct an intervention beneficial to the community in order to establish effective prevention as well as promote early diagnosis and good diabetic control. Data collection was done via questionnaire based interview with the aid of set of questions constructed on basic infonnation of the respondents, their knowledge on diabetes mellitus, attitude towards the disease and practices done. The sample populations are those above 18 years of age. Data collected are analyzed with parametric & nonparametric tests. The majority of the respondents are non-diabetic. Although, their knowledge on the disease was not satisfactory as there were only 54% of respondents with good knowledge, their attitude was very good indeed with 61 %. However, total score for practice was very unsatisfactory with 72% of the respondents showed poor practice. There was significant relationship between total knowledge score and household income (p=O.013) as well as level of education (p=0.046). However, there was no significant relationship noted between total level of attitude and practice with any socio demographic factors. There was also significant positive correlation between the respondents' level of knowledge and attitude (p<0.05). In conclusion, there is great need for intervention particularly focusing on aspects o(knowledge and practice concerning diabetes mellitus in aim to ensure healthy lifestyle among the community to prevent this multi-factorial disease

Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry

Aims The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. Methods and results Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (inhospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, prehospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. Conclusion The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality

Students' participation in collaborative research should be recognised

Letter to the editor