Accreditation of Graduate Medical Education Programmes : One size fits all—or does it?

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Long-term Outcomes of Pregnancy-Associated Breast Cancer: A Single Institution Experience

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Spontaneous Tumor Lysis Syndrome in a Patient with Mantle Zone Cell Lymphoma

We describe a case of Mantle cell lymphoma, stage IV, who underwent spontaneous tumor lysis syndrome. The patient developed metabolic acidosis and acute renal failure, was managed with hyperhydration, and went on to receive subsequent chemotherapy. To our knowledge, this is the first report of spontaneous ATLS in a patient with MC

From Transplant to Tablets : A paradigm shift in Oncology

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What are our Options in the Fight against Breast Cancer?

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Screening for Anti-Cancer Compounds in Marine Organisms in Oman

Objectives: Marine organisms are a rich source of bioactive molecules with potential applications in medicine, biotechnology and industry; however, few bioactive compounds have been isolated from organisms inhabiting the Arabian Gulf and the Gulf of Oman. This study aimed to isolate and screen the anti-cancer activity of compounds and extracts from 40 natural products of marine organisms collected from the Gulf of Oman. Methods: This study was carried out between January 2012 and December 2014 at the Sultan Qaboos University, Muscat, Oman. Fungi, bacteria, sponges, algae, soft corals, tunicates, bryozoans, mangrove tree samples and sea cucumbers were collected from seawater at Marina Bandar Al-Rowdha and Bandar Al-Khayran in Oman. Bacteria and fungi were isolated using a marine broth and organisms were extracted with methanol and ethyl acetate. Compounds were identified from spectroscopic data. The anti-cancer activity of the compounds and extracts was tested in a Michigan Cancer Foundation (MCF)-7 cell line breast adenocarcinoma model. Results: Eight pure compounds and 32 extracts were investigated. Of these, 22.5% showed strong or medium anti-cancer activity, with malformin A, kuanoniamine D, hymenialdisine and gallic acid showing the greatest activity, as well as the soft coralSarcophyton sp. extract. Treatment of MCF-7 cells at different concentrations of Sarcophyton sp. extracts indicated the induction of concentration-dependent cell death. Ultrastructural analysis highlighted the presence of nuclear fragmentation, membrane protrusion, blebbing and chromatic segregation at the nuclear membrane, which are typical characteristics of cell death by apoptosis induction. Conclusion: Some Omani marine organisms showed high anti-cancer potential. The efficacy, specificity and molecular mechanisms of anti-cancer compounds from Omani marine organisms on various cancer models should be investigated in future in vitro and in vivo studies

The spectrum of bacterial infections in febrile neutropenic patients: effect on empiric antibiotic therapy

The aim of this retrospective analysis was to look at the spectrum of bacterial isolates and their resistance patterns to the commonly used antIbiotics in the settmg of febrile neutropenia. A total of 127 bacteria were isolated from patients with acute leukemias, lymphoproliferative disorders, aplastic anaemia and various solid tumours. Fifty-four percent organisms were gram negative; while the rest were gram positive. E. coli, pseudomónas aeruginosa, staphylococcus aureus, enterococcus and streptococci were the commonly isolated organisms. Forty-eight percent organisms were isolated from blood, 16% from urine, 13% from wounds and superficial abscesses and 11% from respiratory tract. E. coli exhibited a great degree of resistance to the commonly used antibiotics, such as pipericillin (70%), ofloxacin (50%) and aztreonam (50%). Pseudomonas and kiebsiella also showed varying degree of resistance against the antibiotics. Staphylococcus aureus and staphylococcus epidennidis were almost universally resistant to penicillin and showed a variable degree of resistance to other antibiotices too. Compared to the previous reports, the pattern of bacterial isolates and their resistance to antibiotics has changed over the past years. Aminolgy­cosides and third generation cephalosporins seem to be the choice of antibiotics for the upfront manage­ment of febrile neutropenic patients (JPMA 48:364,1998)

Successful Treatment of a Case of Crescentic Glomerulonephritis in a Patient with Primary Peritoneal Carcinoma: A case report

Crescentic glomerulonephritis (CGN) has been associated with several solid tumor malignancies. Only a few cases of nephropathy have been reported in association with tubo-ovarian/peritoneal malignancies. We describe a case of 55 years old female who developed combined immune complex-mediated glomerulonephritis and pauci-immune necrotizing crescentic vasculitis simultaneously with the diagnosis of tubo-ovarian/peritoneal cancer. The baseline estimated glomerular filtration rate (eGFR) was 13 ml/min. The patient received two doses of Rituximab and three doses of pulse corticosteroids, leading to significant improvement in renal function and the disappearance of her proteinuria. The eGFR improved to >60ml/min, and her proteinuria gradually resolved after 10 weeks of treatment. She was in a position to be given a combination chemotherapy treatment for tubo-ovarian/peritoneal cancer because of normalization of her CA-125 after three months of therapy. Keywords: tubo-ovarian/peritoneal cancer, Glomerulonephritis, Vasculitis, Chemotherapy

An Unusual Presentation of Choriocarcinoma in A postmenopausal woman: A case report

Choriocarcinoma (CC) is a malignant neoplasm of the trophoblastic tissue, with a potential to metastasize to distant organs. A limited case of gestational CC develops after a long latent period. We describe the case of a 52-year-old postmenopausal woman who developed metastatic choriocarcinoma presumably of gestational origin, 8 years after the last pregnancy, and 2 years after the last menstrual period. The patient was diagnosed with CC metastatic to the brain, spleen, lung and the kidney. The β-human chorionic gonadotrophin level was found to be raised (1,292,867 mIU/mL). The International Federation of Gynecologic Oncology (FIGO) risk score was calculated to be 14 (very high risk). The patient was initially treated with whole-brain radiotherapy (WBRT) and splenic artery embolization because of a hemoperitoneum. Afterwards the patient received systemic treatment using the standard EMA/CO regimen till complete serological remission. Keywords: Choriocarcinoma; Postmenopausal; Latent period; Brain; Oman