Immunohistochemical Study of Androgen Receptor Expression in Estrogen Receptor-Negative Invasive Breast Carcinoma and its Relation with Clinicopathologic Factors

BACKGROUND: Estrogen receptor (ER)-negative breast carcinomas lack the expression of ER and they have no targeted hormone therapies. The androgen receptor (AR) is a newly emerge biomarker. Detecting AR in these tumors may provide a target for future therapies. AIM: The aim of the study is to examine the immunohistochemical expression profiles of AR protein in ER-negative invasive breast carcinomas and to assess the relation between AR expression and the clinicopathologic factors such as age, tumor size, tumor grade, tumor type, immunohistochemical type, lymph node status, and Ki67 expression. METHODS: Sixty paraffin blocks of ER-negative invasive breast carcinoma cases were stained immunohistochemically by AR. Positive expression was defined as ≥1% nuclear staining. RESULTS: AR positivity was detected in 55% of the studied cases. The positive cases were scored by H-score with a median=117, and a range of 3–285 and by Allred score with a median=7, and a range of 3-8. AR is expressed in 60.9% of triple-negative breast carcinoma cases. AR expression was higher in older age, and there were significant positive correlations between the degree of AR expression (AR%, AR intensity, and H-score) and age (p=0.050, 0.007, 0.033, respectively). There was non-significant negative correlation between Ki67% and the degree of AR expression (AR%, AR intensity, H-score, and Allred score). Regarding different histological types, tumor grade, tumor size, lymph node status, and immunohistochemical types, there was no significant difference between AR positive and AR negative cases. CONCLUSION: AR is frequently expressed in ER-negative invasive breast carcinoma; especially in older age, and in a large number of triple-negative subtypes. This may give chance to benefit from future AR target therapy. We recommend further research work on AR expression in the special histologic subtypes of ER-negative breast carcinoma and in the triple negative group

Mild Cognitive Impairment among Type II Diabetes Mellitus Patients Attending University Teaching Hospital

BACKGROUND: Type II diabetes mellitus (TIIDM) has been associated with structural and functional changes in the brain. TIIDM is commonly associated with obesity, insulin resistance, hypertension, and dyslipidemia, all of which can have negative impact on brain. AIM: The aim of the study was to study the risk of mild cognitive impairment (MCI) among both diabetics and non-diabetics and to identify risk factors to MCI among both groups. METHODS: Two comparative cross-sectional studies were carried out enrolling 100 diabetics and 100 age, sex, and education matching non-diabetics. Cognitive function was assessed using Montreal Cognitive Assessment (MoCA) test and risk factors for MCI were assessed. RESULTS: The subjective complaint of memory impairment among diabetics was significantly higher (34%) compared to non-diabetics (13.0%), p < 0.05. The mean of objective MoCA score was significantly lower among diabetics (25.9 ± 2.5) compared to non-diabetics (27.4 ± 2.4), p < 0.001. The rate of MCI was significantly higher among TIIDM patients (22%) compared to non-diabetics (9%), p < 0.01 and odds ratio (OR) 2.8 (95% confidence interval 1.2–6.5). Among the two studied groups, the rate of MCI was significantly higher among those aged over 50 years compared to younger age as well as among hypertensive compared to non-hypertensive persons, (p < 0.05). Among diabetics, the MCI was significantly higher among those with secondary education, having heart diseases, longer duration of DM, or repeated hypoglycemia attack, p < 0.05. A healthy diet, brain training, and social activities were found to be significantly associated with normal cognition. Logistic analysis revealed that diabetics aged above 50 was the only significant predicting factor for MCI with an OR 2.9 (95% CI: 3.8–123.3), p < 0.001. CONCLUSION: TIIDM is significantly associated with 3-times increasing risk of having MCI compared to non-diabetics. The age, hypertension, cardiovascular diseases, duration of diabetes, and frequency of hypoglycemic episodes are risk factors for cognitive impairment. A healthy diet, brain training, and social activities were associated with better cognitive function

IMPACT OF MANAGEMENT SYSTEMS ON SOME SOILS QUALITIES IN EGYPT

The current work aims to evaluate the effect of different periods of organic farming on some soils qualities compared with the traditional system. Several farms varied in their soil nature and periods of practicing organic farming system were chosen. The farms are located in Belbes, El-Manayef, El-Fayoum and El- Behera areas. Moreover, the study also involved adjacent traditional managed farms. The evaluation was based on the weighted values of the physical, chemical and biological properties of the 0-50 cm and 0-100 cm soil depths. The considered soil properties weresoil organic matter (SOM); bulk density; porosity; available water; penetration resistance, mean soil particles weight diameter (MWD), cation exchange capacity and total microbial count. The obtained results indicated that soilbiological parameters were less important than the physical or thechemical factors. Principle component1, (PC1) scores indicated that 79.97% and 78.05 % of total variance are attributed to the 0-50 cm soil depth of the organic and conventional managed soils, respectively. In the meantime, 75.72 and 71.94 % are related to the 0-100 cm soil depth for the two farming systems, (Organic and conventional) in the same sequence. The only significantfactor contributing to PC2 was total count; PC2 indicatedthat (10.29 and 10.87% of the totalvariance are accounted for 0-50 and 0-100 cm soil depth of organic farming as well as 15.3 and 16.68% of the totalvariance for 0-50 and 0-100 cm soil depth of conventional farming system, respectively

Cytokeratin 18 as a non invasive marker in diagnosis of NASH and its usefulness in correlation with disease severity in Egyptian patients

Background: A simple noninvasive test that accurately distinguishes NASH from NAFL as well as determines the disease severity is urgently needed. Recently, it was found that determination of cytokeratin-18 (CK-18) fragments in the blood, predicts and correlates with histological NASH in which there is development of lobular inflammation, cell ballooning and fibrosis, supporting its usefulness in clinical practice. Aims: To evaluate the role of CK-18 as a non invasive marker in diagnosis of NASH and its usefulness in correlation with disease severity in Egyptian patients. Patients and methods: 90 subjects were divided into 3 groups: group I: including 30 patients with NASH, group II: including 30 patients with NAFL, and group III: including 30 healthy subjects as control. Diagnosis of NASH and its discrimination from NAFL was done by liver biopsy. CK-18 level in plasma was measured for all subjects using ELISA. Results: CK-18 was significantly elevated in patients of group I in comparison to group II and III patients, with mean ± SD: 460 ± 279, 167 ± 56 and 149 ± 57, respectively, and P value: 0.001. The (ROC) curve diagnostic performance of CK18 in diagnosis of NASH shows: cutoff value of >240 U/L, with sensitivity 76.7%, specificity 95.0%. Ck-18 was found to correlate with disease severity assessed by NAS scoring system with P value: 0.001. Conclusion: Measurement of CK18 in NASH is a useful screening, diagnostic and staging biomarker

Toxicity and feasibility of total neoadjuvant therapy using short course radiation followed by chemotherapy

Introduction:Upfront neoadjuvant chemoradiation followed by surgery and adjuvant chemotherapy remained a standard of care for locally advanced rectal cancers. However this strategy is associated with high rates of distant failure. Total neoadjuvant therapy with short course radiation therapy (SCRT) followed by full course of chemotherapy is investigated to assess toxicity&feasibility. Patients and methods: Fifty-one patients with locally advanced rectal cancer who presented to the National Cancer Institute (NCI), Cairo University, in the period from March 2018 to December 2020 were enrolled. Patients were assigned to neoadjuvant short course radiation therapy (25 Gy/ 5 fractions/1 week), then 2 weeks from the end of radiation they were commenced to full course chemotherapy CAPOX (capecitabine1000 mg/m2 BID, D1-14 and oxaliplatin 130 mg/m2 D1) for 6 cycles, followed by surgery within 4-6 weeks from the last chemotherapy cycle. Type of surgery was decided upon surgeon’s discretion. Results: All patients completed their planned radiation therapy. Only 1 patient had grade III radiation related diarrhea. Forty three patients completed their planned chemotherapy course, 8 patients had grade III diarrhea. As regard hematological toxicity, 6 patients developed grade 3 toxicity and only one patient developed grade 4 toxicity.&nbsp