Evaluation of oxidative stress and nitric oxide levels in patients with oral cavity cancer

OBJECTIVE: The aim of this study was to evaluate the magnitude of oxidative stress and levels of nitric oxide in patients with oral cavity cancer by analyzing the levels of lipid peroxidation products, antioxidants and nitric oxide products. METHODS: This prospective study was conducted on 15 patients with biopsy proven squamous cell cancer of the oral cavity with clinical stage III/IV and an equal number of age and sex matched healthy subjects. The levels of lipid peroxidation products, antioxidants and nitric oxide products were determined by colorimetric methods. RESULTS: Lipid peroxidation products like lipid hydroperoxide (LHP) and malondialdehyde (MDA) and nitric oxide products like nitrite (NO(2)(-)), nitrate (NO(3)(-)) and total nitrite (TNO(2)(-)) were significantly elevated, whereas enzymatic and non-enzymatic antioxidants were significantly lowered in oral cavity cancer patients when compared to normal healthy subjects. CONCLUSIONS: Enhanced lipid peroxidation with concomitant decrease in antioxidants is indicative of oxidative stress that provides evidence of the relationship between lipid peroxidation and oral cavity cancer. Increased nitric oxide production represents a general mechanism in its pathogenesis.     

Digestive parasitism in Sousse area. Results of a 16 years retrospective study

To report the prevalence and type of intestinal parasites together with their kinetics in Sousse region. Our retrospective study concern data from the examination of 56,268 stool samples and 7552 tape tests, performed in the laboratory of parasitology of F. Hached Sousse hospital from 1st January 1987 up to 31 December 2002. We observed an overall parasite prevalence of 31.5%. Most common parasites were protozoa, Giardia lamblia, Dientamoeba fragilis and Blastocystis hominis being the most frequently encountered. Helminths consisted mainly of Enterobias vermicularis (35.86% positive tape tests) and Hymenolepis nanus. The kinetics data analysis showed an important decrease in the prevalence of Giardia lamblia, the other feco-oral transmitted flagellates and Hymenolepis nanus. In contrast, Dientamoeba fragilis and Blastocystis hominis prevalences increased. The prevalence of the amoeba showed a slight decrease. Intestinal parasites remain quite common in Sousse region, even though their epidemiological patterns are changing. Factors inducing these changes need to be investigated in order to plan efficient control measures.     

Mortality of urban and rural young children with cerebral palsy in Bangladesh

Bangladesh has a high child mortality rate. However, little is known about the outcome for young children who have cerebral palsy (CP). Ninety-two children with CP with a mean age of 3 years 3 months at entry into the study were followed for up to 3 years as part of an intervention study. Eight children died: two of 49 (4%) from an urban area and six of 43 (14%) from a rural area. Extrinsic factors such as infections and drug reactions preceded all the deaths, but those who died were mostly severely malnourished and among the more severely disabled of the total group. Eighty-nine percent of rural children in the study were from low-income families. Intervention programmes for severely disabled children in developing countries must include primary health care and feeding programmes as well as rehabilitation services to address both the needs of the child and empowerment of the mother and the family.     

Prevention of thalassaemia and haemoglobinopathies in remote and isolated communities--the Maldives experience

The Maldives comprises 1192 islands covering a land mass that amounts to under 1% of the total geographical territory of the country. The population of 280,000 is dispersed across 200 isolated communities, with an average of 1000 people per community. Recent progress in health terms include a reduction in the infant mortality rate from 62 in 1992 to 14 in 2003, and 95% coverage in child immunization. In 1992, SHE a non-governmental organization established that the beta-thalassaemia prevalence rate was 18.1% (1 in 5) and on the basis of the result, launched a nationwide awareness and population screening programme, visiting each island in the Maldives every 5 years and targeting 12-35-year-olds. Screening of 100 cord blood samples indicated a 28% incidence of alpha-thalassaemia. Screening results highlighted significantly high incidence of more than one haemoglobinopathy on individual islands. This is of particular importance given the norm of intra-island marriages. Specific mutation analysis showed that three mutations accounted for more than 95% of the thalassaemia genes, ensuring a high detection rate and cost effectiveness of a prenatal diagnosis programme. Outcomes of the screening programme include screening of more than 25% of the target population; the establishment of a Government National Thalassaemia Centre; inclusion of thalassaemia into the school curriculum; the legal requirement for screening prior to marriage; legalization of prenatal diagnosis and medical termination of pregnancy; and the commencement of prenatal diagnostic services. The programme successes include effective advocacy, resource mobilization, motivation for screening, voluntary blood donation, and thalassaemia becoming a household word in the country.     

Management of Hirschsprung’s disease: a comparison of Soave’s and Duhamel’s pull-through methods

The aim of this study was to compare the safety and benefits of Soaves and Duhamels pull-through procedures for the management of Hirschsprungs disease (HD). The patients consisted of 33 boys (85%) and six girls (15%), a ratio of 5.5:1. Their ages ranged from 1 day to 8 years. Rectal biopsy was performed to confirm the diagnosis of HD. Twenty-five patients (64%) underwent Soaves pull-through, and 13 patients (33%) underwent Duhamels pull-through. Twenty children (80%) out of the 25 undergoing Soaves pull-through recovered uneventfully, compared with 11 out of the 13 (84%) undergoing Duhamels pull-through. The complications following Soaves procedure included strictures in two patients (8%), enterocolitis in another two (8%), and anastomotic leakage in one (4%). Additional operations were required in two patients (8%). The complications following Duhamels procedure included stricture in one patient (7.6%) and enterocolitis in another (7.6%). An additional operation was required in one patient (7.6%). The rate of constipation was 16% after the Soaves pull-through compared with 15% after the Duhamels pull-through. There was no significant difference between the two procedures in postoperative surgical morbidity or in long-term risk of enterocolitis. In the light of present findings, both procedures appear comparable in terms of efficiency and associated complications.     

Case control study of novel prognostic markers and disease outcome in pregnancy/lactation-associated breast carcinoma

A case control study of pregnancy/lactation associated breast carcinoma (PAC) was conducted on 24 test cases with two controls per case, matching age, tumor grade, tumor size and axillary lymph nodes status. During seven years of this study, 6% of all patients with breast cancer had PAC. In this study, 67% of the test cases showed positive axillary lymph nodes compared to 49% in our series of 315 cases of non-pregnancy/non-lactating women with breast carcinoma (p < 0.05). The expression of nine prognostic markers, i.e. ER, PR, p53, C-erbB-2, EGFR, Cathepsin-D, PCNA, DNA ploidy and S-phase fraction, were studied by immunohistochemistry and flow cytometry. Hormone receptor status showed a statistically significant difference between the two groups, i.e. 29% immunoreactivity in test cases compared to 58% in controls with a p value of 0.007. Among p53, C-erbB-2, EGFR and Cathepsin-D in the test group, only EGFR showed a significant correlation, i.e. 33% immunoreactivity in test cases and 19% immunoreactivity in controls (p < 0.05). Higher PCNA positivity was seen in the test group compared to controls, i.e. 35% in test patients and 28% in controls (p < 0.05). Metastasis to bone and liver was a common feature of test patients as compared to controls (p < 0.05). After a median follow-up of 72 months, there was no significant difference in the overall survival (OS) of test cases and controls as 54% deaths were recorded in test patients and 44% in controls at the end of this study (p > 0.05). In summary, in spite of some significant differences in the expression of few prognostic markers, i.e. ER/PR, EGFR, PCNA and metastatic potential, there was no significant difference in the OS of PAC vs. control group if compared stage for stage.