Significance of Tumor Marker CA15-3 in Metastatic Breast Cancer

Secondary spread of cancer to bones is commonest and frequent phenomenon and enhances the need of special care for sufferers. Bone metastases mostly are the first complication of different variety of cancers which increase the need of care and expensive facilities. Blood dissemination is another common route, might be due to the venous drainage from visceral organs directly into the axial bones. CA 15-3 is a mucinous tumor markers derived from MUC1 gene, provides better guide line about the treatment, recurrence and prognosis. Aim: Aim of the study was to signify the role of tumor marker CA15-3 in metastatic breast cancer. Methods: Hundred females of breast cancer (any age) with different stages of breast cancer with and without bone metastasis were tested for their serum level of CA 15-3 (biomarker of breast cancer). Bone scan was done to check the secondary metastasis to bones. Intravenous dye Ttechnicium 99 MDP has been used. Serum levels of ca15-3 were measured with the help of Gama Counter with computerized system and IRMA kit (Immunoradiometric Assay) by IMMUNOTECH. Ultrasound of whole abdomen and X ray/CT scan were used to detect liver and pulmonary metastasis respectively. Results: Results indicate a high statistical significant relationship between bone metastasis and elevated levels of tumor marker CA 15-3 in breast cancer patients. Elevated levels of tumor marker CA 15-3 is strongly correlated with positive bone scan. An elevated level of tumor marker CA 15-3 is also correlated with positive pulmonary metastasis CA 15-3 is highly sensitive to detect bone metastasis and also sensitive to detect pulmonary metastasis. A lesser extent of high CA 15-3 serum levels is determinant of liver metastasis. Bone scan is essential tool to detect bone metastasis but need assistance of chemical biomarkers. Conclusions: CA 15-3 as a tumor marker proved a help full determinant of tumor burden in metastatic breast cancer. Its significance is more to detect bone metastasis than to pulmonary and then to liver metastasis. Future studies upon CA15-3 in association with imaging techniques and other organ related specific tumor markers to detect specific metastasis or overall body tumor burden will be blessing for patients and physicians

Impact of duration of antibiotic prophylaxis on rates of surgical site infection (SSI) in patients undergoing mastectomy without immediate reconstruction, comparing a single prophylactic dose versus continued antibiotic prophylaxis postoperatively: A multicentre, double-blinded randomised control trial protocol

Introduction: In breast surgeries, prophylactic antibiotics given before the surgical incision as per Joint Commission Surgical Care Improvement Project guidelines have been shown to decrease the rate of postoperative infections. There is, however, no clear consensus on postoperative antibiotic prophylaxis in patients undergoing mastectomy with indwelling drains. This trial protocol proposes to study the difference in rates of surgical site infection (SSI) with or without continuation of postoperative antibiotics in patients undergoing mastectomy without immediate reconstruction and with indwelling drains.Methods and analysis: In this multicentre, double-blinded clinical trial, all patients undergoing mastectomy (without immediate reconstruction) will receive a single prophylactic dose of preoperative antibiotics at induction of anaesthesia and will then get randomised to either continue antibiotic prophylaxis or a placebo postoperatively, for the duration of indwelling drains. The primary and secondary outcomes will be development of an SSI and antibiotic-associated adverse effects, respectively. Data will be collected through a standard questionnaire by wound assessors. Intention-to-treat analysis will be carried out using STATA V.12. For categorical variables, frequencies and percentages will be assessed by χ2 test/Fisher\u27s exact test as appropriate. The quantitative variables will be computed by their mean±SD or median (IQR) and will be assessed by independent t-test/Mann-Whitney test as appropriate. Unadjusted and adjusted relative risk with their 95% CI will be reported using Cox proportional regression. A p value of \u3c0.05 will be considered statistically significant.Ethics and dissemination: Ethical approval has been obtained from each site\u27s Ethical Review Board. The study background and procedure will be explained to the study participants and informed consent will be obtained. Participation in the study is voluntary. All data will be deidentified and kept confidential. The study findings will be published in scientific media and authorship guidelines of International Committee of Medical Journal Editors will be followed.Trial registration number: NCT04577846. (patient recruitment)

Perception of students and teachers regarding the attributes of an effective clinical teacher in dentistry: a cross-sectional analytical study

Objectives: To compare the perception of dental students and faculty members regarding the attributes of effective clinical teachers. Method: The cross-sectional study was conducted at the Dow University of Health Sciences, Karachi, from August 2021 to November 2021, and comprised third and final year dental students and associated clinical faculty members from in three dental colleges in the city. Data was collected using the modified version of a pre-validated questionnaire. Data was analysed using SPSS 25. Results: Of the 200 students approached, 169(84.5%) responded; 135(79.9%) females and 34(20.1%) males with mean age 21.78±1.099 years (range: 19-26 years). Of the 59 teachers approached, 49(83%) responded; 33(67.3%) females and 16(32.7%) males with mean age 31.59±5.041 years (range: 23-49 years). The students found record-keeping a tiresome task (42%), while teachers regarded it essential for clinical development. Unlike teachers, the students were unable to identify the relevance of clinical objectives and they also did not appreciate teachers’ involvement in clinical procedures. For other domains regarding personal traits, teaching methods and clinical skills, both groups had similar responses. Conclusion: There was generally a similarity of opinions among students and teachers regarding the essential qualities of effective dental clinical teaching. Key Words: Dental education, Clinical teaching, Competent clinical teacher