Impending role of inflammatory markers and their specificity and sensitivity in breast cancer patients.

Cancer and related disorders are the most common cause of cancer-related mortality with the incidence of 1 in 9 among the pre-menopausal Pakistani females. among the most common ailments worldwide, indicating the importance of developing particular techniques that could help attenuate the effects of breast cancer and related outcomes. The primary aim of the current study was to review the role of inflammatory and stress markers in the development and progression of breast cancer. Four hundred ninety-eight (n = 498) patients with breast cancer and four hundred and ninety-eight (n = 498) age- and sex-matched controls were selected for this case‒control study. Serum samples were obtained, and the levels of stress and inflammatory markers, including Matrix metalloproteases (MMPs), Interleukins (ILs), Heat shock proteins (HSPs), Malondialdehyde (MDA), Nitric Oxide (NO), inducible Nitric Oxide Synthase (iNOS) and Tumour necrosis factor-alpha (TNF-α), were determined. Most (62%) patients had metastatic breast cancer (stage III or IV) with an adverse grade (65% with Grade III and 35% with Grade II). The present study showed that the levels of oxidants such as MDA, ILs, MMPs and HSPs were significantly greater, while the levels of antioxidants such as Superoxide Dismutase (SOD), Glutathione (GSH), Catalase (CAT), vitamin A, C and D were significantly lower in breast cancer patients than in controls, suggesting their diagnostic importance and role in the pathophysiology of breast cancer. Oxidants, including IL-1, HSP27 and MMP9, which are highly specific and sensitive, may be used to develop the pathophysiological pathways of metastatic breast cancer in these patients. These pathways include cell invasion, cell migration and epithelial-mesenchymal transition. Therefore, we concluded that an increase in growth factors, e.g., Vascular Endothelial Growth Factor (VEGF), Tumour Growth Factor-beta (TGF-ß) and B-cell lymphoma (Bcl2), under the influence of these variables plays a crucial role in the metastasis of breast cancer.

Changes in clinicomorphometrical findings, lipid profiles, hepatorenal indices and oxidant/antioxidant status as thermoregulatory adaptive mechanisms in poikilothermic Dabb lizard (Uromastyx aegyptia).

Wildlife has exposed to various environmental stressors. Reptiles (ectothermic) are highly susceptible to climatic changes due to their behaviour, physiology, and life history that were so heavily reliant on the ambient environmental temperature. The present work aims to monitor different biochemical and haematological indices of Dabb lizards (Uromastyx aegyptia) at various thermal gradients as well as their adaptation to oxidative stress. This has been reflected through assessment of their impact on some adaptive physiological traits i.e. thermoregulation, and muscle metabolic biomarkers, blood pictures and oxidant/antioxidant status. This experiment is carried out on non-hibernating adult male Dabb lizards (U. aegyptia; n = 24) of age of 18-24 months. These Dabb lizards are divided into four equal groups (n = 6 for each one) where they are exposed to different thermal treatments for one week as following; control group [Exposed to terrarium temperature 38-39 °C], low temperature exposed group [Exposed to 12-14 °C], Gp. C; moderate temperature exposed group [Exposed to 41-43 °C] and high temperature exposed group [Exposed to 43-45 °C]. Each independent group (n = 6) are kept at separated glass terraria. The investigated lizards are monitored for body temperature, morphometric measurements i.e. body weight (g) and total body length (cm; TBL), muscle biochemical analysis, haematological pictures indices and serum biochemical assays including mainly oxidant/antioxidants biomarkers throughout the current experiment. The results state that the thermoregulatory behaviour of Dabb varies with the increase of concentration of muscular metabolic enzymes. In low temperature exposed group, the increase in red blood corpuscles (RBCs), haemoglobin concentrations (Hb), white blood cell (WBC), serum antioxidant biomarkers and anaerobic Lactate dehydrogenase (LDH) enzyme are associated with a marked reduction in serum levels of total cholesterol (TC), triglycerides (TGs), total proteins (TPs), albumin, glucose and electrolytes. In moderate temperature exposed group, a significant elevation in serum values of TC, TGs, TPs, glucose, urea and uric acids levels are mentioned. In high temperature exposed Dabb group, a remarkable increase in blood values of RBCs, Hb, haematocrit value (HCT), WBC, T. chol., TGs, TPs, glucose, urea, uric acids, triiodothyronine (T3) and thyroxine (T4) levels are also observed. Moreover, significant increases in muscular anaerobic/aerobic metabolic enzymes as well as stimulation of antioxidant defence system have been reported. Different significant correlations have been stated between variably estimated laboratory indices in the investigated Dabb lizards under different thermal treatments. The study concludes that the Dabb lizards have a strong antioxidant defence system and undergo physiological thermoregulatory adaptive mechanisms, that involve biochemical and metabolic acclimatization as a response to environmental temperature changes that act as a protective mechanism against oxidative stress as well as maintained homeostatic responses and normal physiological functions.

Improvement of visual acuity in diabetic and nondiabetic patients after Nd:YAG laser capsulotomy.

PURPOSE: The aim of the study reported here was to compare the improvement of visual acuity (VA) of diabetic and nondiabetic patients after neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy. METHODS: In this prospective cohort study, 50 age- and sex-matched patients, comprising 25 nondiabetics and 25 diabetics (referred to as Group A and B, respectively), with posterior chamber poly(methyl methacrylate) non-foldable intraocular lens implants attending our clinic at Karachi for capsulotomy had pre- and postoperative measures of VA, posterior pole visibility, and grading of posterior capsular opacity as seen on slit-lamp examination. VA was recorded before and after performing standard capsulotomy. RESULTS: The postoperative (mean) VA in nondiabetics was 0.25, 0.23, and 0.21 logMAR as compared with 0.25, 0.25, and 0.24 logMAR in diabetics at 1 week, 1 month, and 6 months, respectively. P-values of 0.47, 0.47, and 0.24, respectively, were determined, which were not significant. Preoperative VA improvement was recorded in 92% of diabetics in Group B and 96% of nondiabetics in Group A. Two (8%) diabetic patients developed glaucoma and did not participate in the study further. CONCLUSION: Remarkable improvement in VA was achieved in both Group A and B, but the Group A nondiabetics showed more improvement in best-corrected VA after Nd:YAG laser capsulotomy.

Impact of movie-based simulation training, with or without conventional verbal demonstration on observed OSPE scores in medical undergraduates: a double control study.

BACKGROUND: Movie-based simulation training may be useful in delivering the preclinical observed OSPE curriculum, minimising the need of subjects/patients: however, a double-control trial needs to be performed and optimal timing and duration of training is yet to be defined. Likewise, gender-based response and students' feedback has to be assessed. The objective of this study was to compare the movie-based and traditional verbal demonstration teaching methodologies. METHODS: Second-year medical undergraduates (n = 90) of Avicenna Medical College were randomised to movie-based simulation training (group B, n = 30), traditional verbal training alone (group C, n=30), and a combination (group A, n = 30). The scores were marked by observers using a standardised key and were compared for performance at 2 observed OSPE stations. RESULTS: Group B and A performed significantly better than group C on station 1 and 2. Gender factor did not seem to influence the score. A total of 99% students reported that combination of the 2 teaching modes is the best option. They believed it offers more clear understanding with interest (61%), long term memory (21%), use of both senses; seeing & hearing (10%) & better focus of attention (3%). CONCLUSION: Even half an hour of movie-based simulation training with traditional instructor-based training may improve student performance significantly, and the students prefer a combination of the both.

Perceived stress, sources and severity of stress among medical undergraduates in a Pakistani medical school.

BACKGROUND: Recently there is a growing concern about stress during undergraduate medical training. However, studies about the same are lacking from Pakistani medical schools. The objectives of our study were to assess perceived stress, sources of stress and their severity and to assess the determinants of stressed cases. METHODS: A cross-sectional, questionnaire-based survey was carried out among undergraduate medical students of CMH Lahore Medical College, Pakistan during January to March 2009. Perceived stress was assessed using the perceived stress scale. A 33-item questionnaire was used to assess sources of stress and their severity. RESULTS: The overall response rate was 80.5% (161 out of 200 students). The overall mean perceived stress was 30.84 (SD = 7.01) and was significantly higher among female students. By logistic regression analysis, stressed cases were associated with occurrence of psychosocial (OR 5.01, 95% CI 2.44-10.29) and academic related stressors (OR 3.17 95% CI 1.52-6.68). The most common sources of stress were related to academic and psychosocial concerns. 'High parental expectations', 'frequency of examinations', 'vastness of academic curriculum', 'sleeping difficulties', 'worrying about the future', 'loneliness', 'becoming a doctor', 'performance in periodic examinations' were the most frequently and severely occurring sources of stress. There was a negative but insignificant correlation between perceived stress and academic performance (r = -0.099, p > 0.05). CONCLUSION: A higher level of perceived stress was reported by the students. The main stressors were related to academic and psychosocial domains. Further studies are required to test the association between stressed cases and gender, academic stressors and psychosocial stressors.