PROGNOSIS OF BREAST CANCER IN VERY YOUNG AGE (LESS THAN 30 YEARS)

Purpose: Breast cancer diagnosed at a younger age has aggressive biology being triple negative and high grade and is associated with poor prognosis.Materials and Methods: Retrospectively data of 121 patients age 30 years or younger registered during the year 2008 were reviewed. Data were extracted from the cancer registry department of the institute. Demographics studied were the age at diagnosis, gender, pregnancy or lactation association, family history of breast cancer, histopathological diagnosis, and stage of the disease, receptors, type of treatment, response, local recurrence, distant relapse, and survival. Results: A total of 121 patients with age 30 years or less were included. An only a single patient was male. The age range was from 20 to 30 years; bilateral involvement was seen in a single patient. Almost half 50.4% (n = 61) patients had locally advanced disease at presentation. Pregnancy/lactation-associated breast cancer was seen in 29.8% (n = 36). The most common stage was Stage III (52.1%) and Stage II (33.9%). Invasive ductal carcinoma was the most common histology 94.2% (n = 114) of patients; triple negative was the most common molecular subtype present in 46.3% (n = 56). Chemotherapy was received by 92.6% (n = 112), 88.4% (n = 107) patients received radiation therapy. Modi ed radical mastectomy was performed in 57% (n = 69), breast conservation surgery in 35.5% (n = 43), follow- up period was 5 years, local recurrence was observed in 12.4% (n = 15) and cancer related deaths were 42.1% (n = 51). Conclusions: Breast cancer in very young has very aggressive tumour biology, needs aggressive treatment with surgery, chemotherapy, radiation therapy and hormonal therapy. Key words: Breast cancer, pregnancy-associated aggressive tumour biology, triplenegative, young

PRIMARY BILATERAL BREAST LYMPHOMA: A REVIEW OF LITERATURE AND REPORT OF FOUR CASES FROM A SINGLE CENTRE

Primary breast lymphoma is a rare entity and carries poor prognosis, bilateral breast lymphoma is even rarer and carries worst prognosis. Bilateral breast lymphoma is a rare disease and lacks treatment. Out of the 2766 cases of non- Hodgkin’s lymphoma registered at our institute from 1994 to 2013, 31 cases of breast lymphoma were found, of which four cases had bilateral involvement. In this review, we describe clinical presentation, histopathological subtypes, treatment administered and outcome of those four cases retrospectively. All patients were female with a median age of 31 years (range 24–64 years). Three patients were diagnosed with diffuse large B-cell lymphoma and mucosa associated lymphoid tissue lymphoma detected in one patient. Chemotherapy remained the main treatment modality and surgery (excision biopsy) was reserved for diagnostic purpose only, none of the patients received radiation therapy. Key words: Breast lymphoma, histopathological subtypes, palliation

THE ROLE OF INTRAOPERATIVE FROZEN SECTION OF SENTINEL LYMPH NODES IN UPFRONT BREAST CONSERVATION CANCER SURGERY

Objective: Sentinel lymph node biopsy is the standard of care in clinically negative axilla in breast cancer patients for which frozen section (FS) is routinely performed intraoperatively. The objective of this study was to justify the use of FS in terms of number of tests performed and their impact on decision-making and cost saving. Materials and Methods: We retrospectively reviewed our prospectively maintained data from January 2014 to January 2018 for intraoperative FS in upfront breast conservation surgery patients. Results: A total of 357 patients were studied. All were female. Median age was 50 years (24–84). Mean tumour size was 29.11 mm. Numbers of sentinel lymph nodes identified were 1 in 50 (14.2%) patients, 2 in 121 (33.89%) patients and ≥3 in 186 (52%) patients. Number of positive sentinel lymph nodes was 0 in 264 (73.9%) patients, 1 in 62 (17.4%) patients, 2 in 20 (5.6%) patients and ≥3 in 11 (3.08%) patients. Axillary lymph node dissection (ALND) was offered to 30 (8.4%) patients as per the American College of Surgeons Oncology Group Z0011. The results for ALND showed that only 8 (2.3%) out of 30 patients had positive nodes identified in the additional axillary nodes dissected. Sensitivity of FS was 97% and specificity was 98.86%. False-negative rate was 3.22%. Conclusion: Intraoperative FS can be safely omitted in early breast cancer patients undergoing upfront breast conservation cancer surgery due to high sensitivity and specificity leading to low false-negative rates. ALND can be performed as a second operation as warranted only in a minority of patients. Key words: American College of Surgeons Oncology Group Z0011 trial, axillary lymph node dissection, intraoperative frozen section, sentinel lymph node biops

Feeding Ecology of Reintroduced Blackbucks in Lal Suhanra National Park, Bahawalpur

The study was conducted in Lal Suhanra National Park, Bahawalpur, in June 2021. This study aimed to explore the food habits and dry matter intake of reintroduced blackbuck in Lal Suhanra. The critical methods employed in this study were the direct observation of food, bite rate, and fecal output of blackbuck aided with binoculars (8 × 50). A total of 3840 bites in the RD 65 enclosure and 3929 edges in the RD 65 enclosure were recorded, accounting for the average bite rates of 43.5 bites/min in RD 25 and 44.03 bites/min in RD 65. The average dry weight of the bite was 0.067 g in the enclosure RD 25 and 0.081g in RD 65. Total dry matter intake for an adult blackbuck was 1.07 kg/day in RD 25 and 1.09 kg/day in RD 65. The average daily defecation rate was 7.34 times and 7.89 times in both enclosures. Daily fecal output in average dry weight was 362g for RD 25 and 340 g for RD 65. Dry matter digestibility was, on average, 66.32 % for RD 25 and 68.97 % for RD 65. The blackbuck at RD 65 are more healthy, with a high birth rate and less mortality. The blackbuck preferred 8 plant species and 10 plant species for feeding at RD 25 and RD 65 respectively. For their long-term survival in LSNP, control of diseases, cultivation of seasonal food, plantation of edible plants, habitat extension, and proper management should be considered

Electro-Catalytic process for the Synthesis of Organic Compounds and their Biological Applications.

In fact, electrochemical method (EC) is a specific and eco-friendly technique with several advantages over common organic synthesis methods. During EC no as such external catalysts are required to initiate the reaction, the current potential in itself acts as a catalyst. Most of the inactive organic compounds can be converted to active species by EC method. This method results in the synthesis of compounds with high yield and purity. This method is also good to be applied for the synthesis of thermally sensitive organic compounds. Such synthesis has significant selectivity and reactivity which enable the synthesis of such compounds that are not feasible while using the conventional methods. This review provides insight into the utilization of EC method in the synthesis of organic compounds and their derivatives. Various prerequisites for such synthesis have been highlighted. The EC method application for preparation of derivatives of benzofuran, and benzoxazole, oxidation of N, N, N\u27, N\u27tetramethyl-1,4-phenylenediamine, 5-diethoxy-4-morpholinoaniline, organic compounds containing C=N, benzyl alcohol to benzaldehyde and tetratomic Thioethers have been discussed in detail. In addition, the electrochemical synthesis of biomedical important compounds has been presented. The compounds synthesized through EC methods shows potential antimicrobial activity. Deferent researchers work to study the potential biological application of organic compounds synthesized through EC process. The anti-cancer, anti-bacterial, anti-fungal and other important biological activities has been investigated

Detection and comparison of light metals in hair among workers of different industries using Particle Induced X-Ray Emission (PIXE) for forensic casework

Background: The study was planned to evaluate the deposition of some metals in the scalp hair of the people working in the particular environment. Scalp hair samples were collected from different industry workers including pharmaceutical, textile and paint industry and analyzed for the determination of aluminum (Al), calcium (Ca), potassium (K) and sulfur (S). Hair analysis provides a better assessment of light metals present in the surroundings, as well as monitoring of variation of metals from place to place.Methods: The hair samples were collected from 21-55 years old employees working in industry for more than four years. Workers of the age less than 20 years and less than 4 years working experience were not including in this study. Particle Induced X-ray Emission (PIXE) system was used to detect the light metals from hair and probable matches were searched through National Institute of Standards and Technology (NIST) library.Results: The metals Al, S, K and Ca concentration was found maximum in the pharmaceutical industry workers. i.e., 575.1 µg/g, 190.7 µg/g, 11.1 µg/g and 9.1 µg/g respectively. The minimum concentration so these metals was found in paint industry workers i.e. 103.7 µg/g, 8.87 µg/g, 2.3 µg/g, and 1.7µg/g respectively.Conclusion: Light metal concentrations in hair samples showed a significant positive correlation. Our findings can play vital role for health departments and industrial environmental management system (EMS) authorities in policy making and implementation. Taken all together, the workers were facing minor health implications in these industries and need immediate protective measures to remediate the current situation. Keywords: Forensic, Scalp Hair Analysis, Particle Induced X-ray Emissio

Mucinous carcinoma of breast: A rare tumour with favorable prognosis - 10 years experience from a single center

Purpose: The purpose of this study was to describe the biological behaviour of mucinous breast carcinoma (MBC) regarding their clinical presentations, pathological features, prognosis and survival.Methodology: We conducted this retrospective study from 2006 to 2015 (10-year duration) and included all the patients who presented with mucinous carcinoma of the breast at any age. We excluded all the patients who presented with invasive ductal carcinoma or other rare breast tumours. Each patient with mucinous carcinoma breast was categorised in terms of diagnosis, surgery, chemotherapy and outcome. For categorical variables, Chi-square test was used. Kaplan–Meier curves were used to determine estimated overall survival. Data analysis was carried out using the SPSS 20.Results: In total, 8841 patients with breast carcinoma presented during the study period. Of these, 74 patients were diagnosed as cases of MBC, constituting <1%. Family history of breast carcinoma was positive in 20% of patients. Most of the women were postmenopausal (66.2%) falling in BIRADS Category 4 and 5 (32.4% each). Considering laterality tumours had almost equal distribution between the right and left side. Breast-conserving surgery was performed in 47.3% of women as compare to modified radicle mastectomy in 52.7% of women. Most of the patients had pathological T2 (51.4%), N0 (81.1%) and moderately differentiated (69%) mucinous carcinoma. ER was positive in 85% of patients, PR in 80% and H2N in 74.6% of patients. Neoadjuvant chemotherapy was given to 20 patients (27%) and adjuvant chemoradiotherapy was given to 51 patients (69%). Metastasis occurred in 12 (16.2%) of our patients while 62 (83.8%) were metastasis free on long-term follow-up, with bones being the most common site of metastasis, occurring in 6 patients (8.1%) followed by lungs, occurring in 4 patients (5.4%). A total of 32 (43.2%) patients are alive, and on regular follow-up, 3 (4.1%) died during the course of follow-up and 39 (52.7%) are lost to follow-up with a median survival of 60 months and an overall 5-year survival rate of >95%.Conclusion: Mucinous carcinoma is a rare breast carcinoma with a good prognosis.Key words: Breast cancer, mucinous carcinoma, prognosi

Biomedical and photocatalytic applications of biosynthesized silver nanoparticles: Ecotoxicology study of brilliant green dye and its mechanistic degradation pathways

© 2020 Elsevier B.V. The preparation of nanoparticles from biological materials is an economic and environmentally friendly strategy with several advantages. The current study is focused to synthesize silver nanoparticles using Petroselinum crispum plant extract. Various characteristics of biologically synthesized AgNPs were determined with UV–Visible (UV/Vis) Spectroscopy, X-ray Diffraction (XRD), Fourier Transform Infrared (FTIR) Spectroscopy, and High-Resolution Transmission Electron Microscopy (HRTEM). The plasmonic resonance peak at 425 nm ensured the formation of AgNPs. The FTIR analysis showed that the as-synthesized particles contain alcoholic and polyphenolic constituents, which are responsible for their capping and reduction. The HRTEM results revealed spherical shape of AgNPs with size ranging from 25 to 90 nm. The as-synthesized particles demonstrated excellent antibacterial properties against Gram positive and Gram-negative bacteria. The antioxidant applications of the particles were determined with 2,2-diphenyle-1-picrylhydrazyl (DPPH). Moreover, the photocatalytic application of the synthesized AgNPs was evaluated for brilliant green dye (BG). The results demonstrated high degradation of BG due to small size and well-dispersed nature of AgNPs. Degradation products of BG were identified to suggest degradation pathways. The eco-toxicity of the BG and constituents derived from the dye were studied with Ecological Structure Activity Relationship (ECOSAR) software

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication