Comparison of Her2/Neu Oncoprotein in Serum and Tissue Samples in Women with Breast Cancer.

BACKGROUND AND OBJECTIVES: Human Epidermal Growth Factor Receptor 2 (HER2/neu) is one of the most extensively studied proto-oncogens in breast cancer patients.  Accurate and timely assessment of the HER2/neu over expression is pivotal for the identification of breast cancer patients that could benefit from HER2-targeted therapy.  The present study was undertaken to investigate the diagnostic utility of serum HER2/neu testing by chemiluminescent immunoassay (CLIA) in breast cancer patients and compare it with the immunohistochemistry (IHC) method of HER2/neu expression. METHODS: Serum sample and tissue/paraffin block was collected from 52 patients with breast cancer before start of any anticancer regimen or hormonal therapy.  The tissue specimens were processed in Histopathology lab. Sections were immunostained with anti -estrogen receptor (ER) , anti -progesteron receptor (PR) and anti HER2/neu receptor  mouse monoclonal antibodies.) Serum HER2/neu was estimated using the chemiluminiscent immunoassay using 15ng/ml as the cut off. RESULTS: Out of 52 patients with breast cancer, serum HER2/neu was found elevated in 25(48.1%) patients and remaining 27(51.9%) showed normal serum HER2/neu concentrations. On IHC HER2/neu score was 3+ in 9(17.3%), 2+ in 10(19.2%), 1+ in 1(1.9%); while 32(61.5%) showed no HER2/neu expression.  31(59.6%) patients were ER positive and 28(53.8%) were PR positive. There was a significant correlation (P<0.001) of serum HER2 concentration with tissue expression of HER2/neu and Histological tumor grade. Serum HER2/neu levels showed a negative correlation with ER status (P=0.047) but no correlation with PR status. CONCLUSION: The result showed that the elevated serum HER2/neu was correlated with the IHC expression of HER2/neu in tissue and the histological grade of the tumor.  Findings suggest that post initial tissue diagnosis (IHC HER2/neu), serum HER2 assay may supplement subsequent tissue tests to monitor disease status and response to therapy.

Mean Serum Creatine Kinase among Organophosphate Poisoning Cases in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Major cases of poisoning are associated with organophosphates. Cholinergic effects and an intermediate phase seen with organophosphate poisoning may implicate myopathy. Creatine kinase is a marker of muscle tissue damage. This study aimed to find out the mean serum creatine kinase among organophosphate poisoning cases in a tertiary care centre. Methods: A descriptive cross-sectional study was carried out among organophosphate poisoning cases in a tertiary care hospital from 13 October 2017 to 30 March 2018. Ethical approval was taken from the Institutional Review Committee [Reference number: 117(6-11-E) 2/074/075]. Blood samples were assayed for serum acetylcholinesterase in the pharmacology laboratory and for serum creatine kinase and lactate dehydrogenase in the biochemistry laboratory. Low serum acetylcholinesterase was taken as the basis for the establishment of organophosphate poisoning. A convenience sampling technique was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 103 organophosphate poisoning cases, the mean serum creatine kinase was 931.35±446.60 IU/l (845.10-1017.60, 95% Confidence Interval). Conclusions: The mean serum creatine kinase level among organophosphate poisoning cases was higher than in other studies done in similar settings. Keywords: acetylcholinesterase; creatine kinase; organophosphate poisoning; rhabdomyolysis.

Dyslipidemia and Associated Cardiovascular Risk Factors among Young Nepalese University Students.

Introduction Cardiovascular diseases are one of the main causes of morbidity and mortality worldwide, atherosclerosis being the principal underlying cause of cardiovascular diseases. Early detection of dyslipidemia and long-term prevention of atherosclerosis by controlling risk factors should begin in young age. The purpose of this study was to assess dyslipidemia and associated cardiovascular risk factors among university students of Nepal. Methods A sample of 280 students aged 17-24 years, were selected randomly from Institute of Medicine, Tribhuvan University. An interview-based questionnaire was designed and information was collected on the basis of age, gender, smoking and alcohol consumption. Body mass index and waist-to-hip ratio of all participants were calculated. Fasting blood samples were collected from all participants and assayed for fasting serum total cholesterol, triglyceride, high-density lipoprotein and low-density lipoprotein. Results Overall, dyslipidemia was seen as hypercholesterolemia in 31 (11.1%), elevated low-density lipoprotein in 34 (12.1%), low high-density lipoprotein in 95 (33.9%) and hypertriglyceridemia in 39 (13.9%). Current smoking and binge drinking were significantly associated with hypercholesterolemia. Gender, binge drinking, and current smoking were found to be significantly associated with elevated low-density lipoprotein. All factors were significantly associated with hypertriglyceridemia. There was no statistically significant association between risk factors and the low high-density lipoprotein. Body mass index and waist-to-hip ratio were significantly higher in subjects with hypercholesterolemia, hypertriglyceridemia, and elevated low-density lipoprotein level. Conclusions The prevalence of dyslipidemia was high in young Nepalese university students. Screening the levels of lipids in youth, especially those at risk, and accurate follow-up of those with dyslipidemia can be done to reduce morbidity and mortality.