Docetaxel and cisplatin [DC] versus epirubicin, cisplatin and 5 fluorouracil [ECF] as systemic chemotherapy treatment for advanced gastric carcinoma [AGC]

Docetaxel and Cisplatin [DC] versus Epirubicin, Cisplatin and 5 fluorouracil [ECF] as Systemic Chemotherapy Treatment for Advanced Gastric Carcinoma [AGC]. Our study was performed to compare between DC and ECF combination chemotherapy as regard the clinical activity in terms of toxicity and response [primary objective] and the survival [secondary objective] trying to reach to a new effective and well tolerated regimen to improve the poor treatment results for palliative chemotherapy in advanced gastric cancer. Forty patients [pts] with AGC [unresectable and/or metastatic], bi-dimentionally measurable disease, performance status is >/= 70%, normal blood counts, hepatic and renal functions and no prior chemotherapy were randomized to receive DC [Docetaxel 75mg/m[2] dl and Cisplatin 75mg/m[2] dl] every 3w or ECF [Epirubicin 50mg/m[2] dl/3w and Cisplatin 60mg/m[2] dl/3w and 5 fluorouracil 200mg/m[2]/d continuous intravenous infusion for a total of 6 cycles for each regimen. The overall response was 45% for DC [n=9] [8 partial response + 1 complete response] and 30% for ECF [n=6] [all are partial responses]. Median time to progression was 7.0 months for DC and 5 months for ECF p=0.03. Median overall survival time was 10.5 months for DC and 8.5 months for ECF p=0.67. The most frequent G3 and 4 events per patient was neutropenia [DC=85%, ECF=30%]. Febrile neutropenia was recorded in 20% with DC versus 5% with ECF. Grade >/= 3 for other events with DC were anemia 15%, thrombocytopenia 10%, vomiting 10%, Diarrhea 10%, Stomatitis 0%, peripheral neuropathy 10% and lethargy 20% versus 5%, 5%, 20%, 20%, 10%, 0% and 5%, with ECF, respectively. There was no treatment related deaths. DC tends to be more effective in AGC with a higher response rate and better median time to progression and overall survival than ECF but with significantly higher neutropenia which was manageable. Use of primary prophylaxis with G-CSF is reasonably recommended

Histological study on the human gubernaculums in descended and undescended testis

The gubernaculum is a fibrous cord connecting the caudal pole of the testis with the scrotum. The regression of the extra-abdominal part of the gubernaculum in prenatal and early stage of postnatal life plays an integral role in testicular descent. Researchers claim that the undescended testis is a condition caused by failure of the gubernaculum to function, particularly in infants suffering from neuromuscular diseases and myopathies. To provide more information on the role of the gubernaculum in testicular descent, the structure of the gubernaculum was examined in cases of descended and undescended testis. The study was performed at both the light and electron microscopic levels. The gubernaculum biopsies were taken from 20 children with undescended testis, the control biopsies were obtained from 5 children [3 and 5 years old] who suffered from inguinal hernia but with descended testis. The specimens were prepared for light and electron microscopic examination. The histological examination revealed that the gubernaculum in 75% of undescended testis contained large amount of fat cells, a small amount of collagen fibers, and wide interstitial spaces, compared to the control group. The results suggest that the lack of testicular descent is probably caused by loss of retractibility of the gubernaculum

Doppler ultrasonogragshic evaluation of portal circulation in patients of portal hypertension treated by splenectomy, devascularization and oesophageal transection

The portal hypertension with bleeding oesophageal varicose is a major medical problem in Egypt, the risk of death from 10% to 40% in these patients due to massive secondary heamorrhage. Splenectomy, Devascularization and Oesophageal Transection is one of the most important lines was used to treatment of bleeding oesophageal varices in patients suffering from portal hypertension particularly after failure of upper gastrointestinal tract endoscopy. The doppler Ultrasonography is simple,non invasive investigation to determine the blood vessels diameter, direction of blood flow, blood volume and degree of vascular congestion. The portal circulation evaluated pre and post operative by doppler Ultrasonography in 50 patients [41 males and 9 females] suffering from portal hypertension and oesophageal varices [Child A or Child B] and treated by Splenectomy, Devascularization and Oesophageal Transection to determine the degree of correction of the hemodynamic state. The portal vein diameter decreased after the operation by 1.5 mm, cross sectional area by 0.42 cm while its flow velocity increased after the operation by 3.22 ' cm/sec Its flow volume increased after the operation by 49.2ml/min and its congestive index decreased after the operation by 0.07cm/sec.So the operation is effective in the treatment of portal hypertension and oesophageal varices as it improves liver blood flow and liver perfusion. It also eradicated oesophageal varices

Electronystagmography profile in unilateral profound sensorineural hearing loss

Forty two patients with profound sensorineural hearing loss for more than 5 years were examined by electronystagmography [ENG] to evaluate their vestibular function. Their age range was 20 - 45 years. They had no complaint of imbalance and on examination there was no spontaneous nystagmus, no nystagmus on gaze or positional tests and they showed normal saccadic, smooth pursuit and optokinetic test results. Bithermal caloric test showed weaker response recorded from either ear of the study group when referenced to the normal subjects; however, fixation suppression index was normal. There was no significant unilateral weakness of the ear with hearing loss compared to the normal ear of the same subjects. These findings could be attributed to one of the compensation mechanisms, which suppress the normal ear and stimulate the affected ear

Auditory cognition - heart beats physiological axis

Electrocardiogram [ECG] tracings were recorded from normal 28 male subjects in response to an attentive auditory task. Data regarding the changes in ECG that occur on listening to the rare tone bursts were calculated and compared with those on listening to frequent tone bursts. P wave showed longer duration and lower amplitude, in response to rare stimuli, indicating longer, but weaker atrial contraction. QRS complex and P-R interval did not show significant differences between the listening of the two types of stimuli. T wave showed shorter duration and lower amplitude on listening to rare stimuli indicating faster and less ventricular relaxation. The present work denoted that not only passive hearing, but also the active listening had changes in the cardiac cycle

Pharmacological interactions between ondansetron, an antiemetic drug, and some neuromuscular blockers, succinyl-choline, mivacurium and atracurium

This study was designed to evaluate the effect of the antiemetic ondansetron [5-hydroxytryptamine subtype 3 receptor antagonist] on the onset, potency and recovery rate of succinylcholine, mivacurium and atracurium induced neuromuscular blocking effect both in vitro and in vivo experiments. The study showed that ondansetron should be administered cautiously to the patients using the muscle relaxants [succinylcholine, mivacurium and atracurium] to protect against its initial depolarizing effect and the possible interference with the potency and the rate of recovery of muscle relaxation during surgical procedures

Hearing profile in asthmatic children

An audiological assessment was performed on 23 asthmatic children divided into three groups [mild, moderate and severe] according to the severity of asthma. None of the children had a sensorineural hearing loss and 14 children had a bilateral or unilateral conductive hearing loss. The results supported the opinion that children with high risk factors as asthma should be continuously followed up by systematic and selective hearing screening, which are necessary for planning preventive and curative programs

Antibiotics prescribing in Ramadi city, Iraq

A total of 4000 prescriptions dispensed by general practitioners [G.P's] and different specialists were collected from different pharmacies in Ramadi City, Al-Anbar Governorate. A simple random sampling with replacement was adopted to calcu late the average percentage of antibiotics [A.B.] used. Of the sample 40.8% were found to contain A.B. units. Cephalosporin and Tetracycline were prescribed more frequently by G.P's than specialists, whereas Rifampicin and Amoxycillin were prescribed more frequently by specialists than G.P's Combinations of A.B. used by G.P's was 19%, while for specialists was 13%. Antibiotics use was noticed to be maximized at the start of each of the two main seasons

Hearing loss and individual susceptibility in recurrent meningitis

Bacterial meningitis infection is one of the most common causes of acquired deafness. The purpose of this paper is to study the post-meningitic hearing profile especially in recurrent episodes of meningitis. The study involved 83 subjects just discharged from fever hospital. All patients were submitted to full E.N.T examination, audiological evaluation including pure tone audiometery speech audiometery, immittance-metery and brain stem audiometery, C.S.F analysis for sugar, protein and culture for type of pathogen was done. Pneumococcal meningitis was reported to have recurrent attacks and showed a higher incidence of hearing loss than other causative organisms. The study showed that recurrence of meningitis did not show higher risk of hearing loss. It is suggested that individual susceptibility may be responsible for the recurrence of infection