Old disease, new targets--part-I, solid malignancies

Targeted agents are now an integral part of treatment regimens for some cancers. Trastuzumab is established in treatment of human epidermal receptor 2 (Her2) positive breast cancers, with improvements in both, the disease free and over all survival. Monoclonal antibody (MoAB) against vascular growth factor receptor (VEGF), bevacizumab and cetuximab a MoAB against epidermal growth factor receptor (EGFR) are establishing their role in a many cancers after making their mark in colorectal cancer. Sorafenib and sunitinib have success stories in renal carcinoma. The Sorafenib Hepatocellular Carcinoma Assessment Randomized Protocol (SHARP) trial has established sorafenib role in advanced hepatocellular carcinoma, while in gastrointestinal tumors; imatinib and sunitinib have proven role. At this point in time side effect profile of all these agents appears relatively safe however cost for developing countries remains an issue

Primary cutaneous B cell lymphoma--leg type (NEW EORTC--WHO classification), with nasal sinuses involvement

Primary Cutaneous lymphomas of B cell origin are rare, there remains a controversy in truly classifying these lymphomas and an updated EORTC classification divides them on the basis of their distinct histopthological grounds rather than on the basis of their anatomic location as in WHO classification, while the new WHO- EORTC joint classification maintains some characteristics of both systems, We report an elderly gentleman who primarily had a typical Leg dominant Cutaneous lymphoma of B cell origin uniquely with involvement of nasal Sinusues, bearing the Immunohistochemical staining features of Cutaneous lymphoma - Leg Type befitting the new joint WHO-EORTC classification of Cutaneous B cell Lymphoma

Lymphangiosarcoma of the arm presenting with lymphedema in a woman 16 years after mastectomy: a case report

Lymphangiosarcoma following breast cancer is a relatively rare entity, with around 300 cases so far reported worldwide. Affecting the long term survivors of breast cancer, lymphangiosarcoma (Stewart-Traves Syndrome) has a high mortality rate. Since lympedema following radical mastectomy or axillary clearance and radiotherapy seems to be the main predisposing factor, further research regarding modifications in the surgical technique of axillary nodes dissection as well as the development of new chemotherapeutic agents effective in lymphangiosarcoma are required

Splenic rupture, secondary to G-CSF use for chemotherapy induced neutropenia: a case report and review of literature

Introduction: Chemotherapy Induced neutropenia is a frequent and serious complication of cytotoxic cancer treatment. Granulocyte colony stimulating factors (G-CSF) are frequently used to counter neutropenia, attempt rapid recovery of Patients and allow for continuation of treatment without compromise on dose, especially in curative malignancies. Generally regarded as safe, G-CSF use has been very rarely reported to have resulted in serious side effects, such as, splenic rupture. Case Presentation: We are reporting a case of a twenty years old man, who was being treated for T cell acute lymphoblastic leukemia and received colony stimulating factors for treatment of severe neutropenia and suffered from splenic rupture, He was treated with splenectomy. Conclusion: Although extremely rare, splenic rupture can be a serious and sometimes life threatening complication of high dose colony stimulating factors therapy

The key roles of salicylic acid and sulfur in plant salinity stress tolerance

The salinization of agriculture soils over the globe has become one of the most devastating stresses and is significantly limiting cultivated land area, and crop productivity and quality. It is very imperative to explore both salinity tolerance in plants and insights into approaches (and underlying mechanisms) for effectively controlling salinity impacts. To this end, the role of phytohormone salicylic acid (SA) and plant nutrient sulfur (S) in promoting salinity tolerance has been researched in isolated studies, and SA–S interaction results have been little discussed. Given this, taking into account recent literature on SA, S and soil salinity, this paper aimed to (i) overview of the major impacts of soil salinity on plant health; (ii) highlight the significance of SA and S in improving plant salinity tolerance; (iii) discuss the role and underlying mechanism of SA, S and their interaction in the modulation of plant growth and development under salinity stress; and also to (iv) appraise the discussed literature and enlighten the major prospects

Determination of complication rate of PICC lines in oncological patients

OBJECTIVE: To determine the complication rate of (PICCs) peripherally inserted central catheters in cancer patients with a 1 year prospective cohort study. METHODS: All PICCs inserted in adult cancer patients in Radiology Department of The Aga Khan University Hospital were followed prospectively till removed or patient expired and pattern of complications noted. RESULTS: One hundred and fourty six PICCs were inserted over a period of 1 year and followed for a total of 3329 catheter-days; median placement, 14 days: range 3-218 days. Of these 67 (32.8%) PICCs were complicated and removed earlier, for a rate of 14.4/1000 PICC-days. Patients with haematologic malignancies were more likely to have complications as compared to those with solid tissue malignancies. CONCLUSIONS: Despite a significant complication rate, PICCs are a relatively safe and cost effective method of establishing central venous access

Efficacy of chemical and electrical cautery (Comparison) in management of Anterior Epistaxis

Objective: To compare the efficacy of chemical versus electrical cautery in the management of patients presenting with anterior epistaxis in terms of frequency of bleeding. Materials and Methods: Study Design = Randomized Control Trial (RCT) Study Setting = ENT Department Benazir Bhutto Hospital, Rawalpindi Duration = 6 months Sampling Technique = Consecutive (Non Probability) A Randomized Control Trial (RCT) of six months was done after the approval of the Ethical Committee. A total of 90 cases of anterior epistaxis were randomly divided into two groups: A (electrical cautery) and B (chemical cautery) using a random number trial with 45 in each group respectively. Informed consent was taken from all patients. Patients were explained about the procedure and its risk-benefit ratio. A detailed history was taken about epistaxis from patients presenting in an emergency. The site of bleeding was assessed. Pulse and blood pressure of patients were monitored. Patients were treated on an emergency basis. The nasal cavity was inspected with the help of a nasal speculum and suction of any blood clots was done. Bleeding points were identified and sprayed with lidocaine. The bleeding area was cauterized with a silver nitrate stick or electrical cautery for a few seconds. Antibiotic ointment was applied at the site of cautery to both groups. The patient was discharged on cessation of bleeding. A Performa was given to patients to fill 48 hours, 1 week, and 2 weeks after the procedure containing questions regarding relief of symptoms. Recurrent bleed was diagnosed on a history of separate bleed from nose post-procedure that was sudden in onset, with an identifiable bleeding point on inspection by speculum, total duration of all episodes in previous 24 hours less than 30 minutes. Results: A total of 90 cases (45 in each group) were taken. The mean age was calculated and found 34.42±8.70 in Group-A and 34.29+8.94 years for group B., The male patients were 32 (71.11%) in Group-A and 30 (66.67%) in Group-B while females were 13 (28.89%) in Group-A and 15 (33.33%) in Group-B, efficacy between chemical and electrical cautery in patients with reference to frequency of bleeding was 42 (93.33%) in Group-A and 35 (77.78%) in Group-B, the p value was calculated as 0.03 which shows a significant difference. <br>Conclusion: This study concluded that the efficacy of electrical cautery is significantly higher than chemical cautery in the management of epistaxis. However, some other trials on larger sample size are required to validate the findings of this study. &nbsp