Therapeutic effects of synbiotic on neonates with gestational age over 34 weeks admitted for jaundice.

BACKGROUND: Hyperbilirubinemia is a common problem in neonates. The aim of this study was to evaluate the effect of synbiotic in addition to routine phototherapy on the treatment of neonatal jaundice. METHOD: This double-blind clinical trial, was performed on 194, 3-14 days old neonates. Neonates were divided into intervention and placebo groups. The intervention group received 5 drops of oral synbiotic daily along with phototherapy and the placebo group underwent phototherapy plus a placebo. Gestational age, age, weight, sex, initial and daily bilirubin level, frequency of defecation, mode of delivery, and length of hospitalization were assessed. RESULTS: The rate of bilirubin reduction on the first day of admission was significantly higher in the intervention group (2.9±1.81 vs. 2.06±1.93, p = 0.002). The mean level of bilirubin on the second (9.8±1.92 vs. 10.88±2.26) and third days (8.06±1.54 vs. 9.86±1.7) was lower in the intervention group (p = 0.001). The proportion of discharged patients in the third and fourth days was higher in the intervention group compared to the control (65% vs. 41%, 99% vs. 86.5%, respectively, p = 0.001). However, the duration of hospitalization was shorter in the intervention group compared to the control (2.36±0.5 vs. 2.74±0.74, p = 0.001). CONCLUSION: Based on our results, daily treatment with 5 drops of synbiotic along with phototherapy can be a safe and effective modality in faster bilirubin reduction, decreasing the hospitalization period and phototherapy. Therefore, it seems that it can be used as an adjunct therapy for neonates with jaundice.

A case of sebaceous carcinoma arising in a benign cystic teratoma of the ovary and review of the literature.

OBJECTIVE: To present an extremely rare case of sebaceous carcinoma arising in a mature cystic teratoma of the ovary. CLINICAL PRESENTATION AND INTERVENTION: A 66-year-old woman presented with abdominal discomfort and a pelvic mass. Abdominal and pelvic ultrasound, as well as CT scan, revealed a 27 cm complex right pelvic mass, which was diagnosed histologically as a sebaceous carcinoma arising in a mature cystic teratoma. The patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy, peritoneal washings, appendicectomy and infracolic omentectomy. CONCLUSION: This case adds to the rare reports in the literature of sebaceous carcinoma occurring in a mature cystic teratoma. The clinical behaviour and optimal management of this entity are not well established. The patient has been well for 32 months following surgery with no evidence of recurrent disease clinically.

Is there any correlation between allergy and adenotonsillar tissue hypertrophy?

OBJECTIVES: Tonsil and adenoid are part of waldeyers ring; the basic function of which are antibody formation, which later react against a grat variety of antigens. The Adenotonsillectomy is the most common operation in small children but the exact reasons of adenotonsillar hypertrophy remains unknown, some researches have shown that allergy may be at risk factor for adenotonsillar hypertrophy. METHODS: Thorough one year two separated groups of children at the ENT and allergy ward of childrens hospital was enrolled in the study. The study group consisted of 117 children between 1 and 14 years old (with average of 6) who had adenotonsillar hypertrophy. The control group consisted of 100 children in the similar age that had not adenotonsillar hypertrophy. Both groups were examined for the incidence of allergic disease, results of skin prick test, serum IgE levels and close contact to smoke. RESULTS: In the study group 70.3% of children with adenotonsillar hypertrophy had positive skin prick test. But only 10% of children in control group had positive skin prick test. Increased serum total IgE level was confirmed in 48% of children with positive skin prick test in study group were in close contact with smoker parents. CONCLUSION: Allergy and sensitivity to different kinds of allergens are important risk factors for adenotonsillar hypertrophy in children. Allergy control may have role in reducing the rate of adenotonsillectomy in children suffering allergic reactions with adenotonsillar hypertrophy.

Comparison of three mathematical models for predicting the risk of additional axillary nodal metastases after positive sentinel lymph node biopsy in early breast cancer.

BACKGROUND: Women with breast cancer and a positive axillary sentinel lymph node (SLN) are recommended to undergo complete axillary lymph node dissection; however, further nodal disease is not always present. Mathematical models have been constructed to determine the risk of metastatic disease; three of these were evaluated independently. METHODS: Data from 108 women with breast cancer who had a positive SLN biopsy and completion axillary lymph node dissection were used. Measurements of additional parameters over those usually determined (such as size of SLN metastasis) were assessed under the supervision of two pathologists. These data were used to determine the predicted risk of non-SLN metastases using three mathematical models (from Memorial Sloan-Kettering Cancer Center (MSKCC), Cambridge University and Stanford University) and a comparison made with the observed findings. Analyses were made using the area under the receiver operating characteristic (ROC) curve (AUC). RESULTS: Some 53 (49.1 per cent) of 108 patients had a positive non-sentinel axillary lymph node metastasis. The AUC values were 0.63, 0.72 and 0.67 for the MSKCC, Cambridge and Stanford nomograms respectively. CONCLUSION: This independent comparison found no significant difference between the models, although the Cambridge model had the advantage of requiring fewer measurements with a more accurate predictive performance.