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Pediatric eye injuries in upper Egypt  [cached]
El-Sebaity DM,Soliman W,Soliman AMA,Fathalla AM
Clinical Ophthalmology , 2011,
Abstract: Dalia M El-Sebaity1, Wael Soliman1, Asmaa MA Soliman2, Ahmed M Fathalla11Department of Ophthalmology, Assiut University Hospital, Assiut, Egypt; 2Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut, EgyptPurpose: To analyze the patterns, causes, and outcome of pediatric ocular trauma at Assiut University Hospital in Upper Egypt (South of Egypt).Methods: All ocular trauma patients aged 16 years or younger admitted to the emergency unit of Ophthalmology Department of Assiut University between July 2009 and July 2010 were included in the study. The demographic data of all patients and characteristics of the injury events were determined. The initial visual acuity and final visual acuity after 3 months follow-up were recorded.Results: One hundred and fifty patients were included. The majority of injuries occurred in children aged 2–7 years (50.7%). There were 106 (70.7%) boys and 44 (29.3%) girls. The highest proportion of injuries occurred in the street (54.7%) followed by the home (32.7%). Open globe injuries accounted for 67.3% of injuries, closed globe for 30.7%, and chemical injuries for 2%. The most common causes were wood, stones, missiles, and glass. LogMar best corrected visual acuity at 3 months follow-up was: 0–1 in 13.3%; <1–1.3 in 27.3%; <1.3–perception of light (PL) in 56%; and no perception of light (NPL) in 3.3%.Conclusions: Pediatric ocular trauma among patients referred to our tertiary ophthalmology referral center in Upper Egypt over a period of 1 year was 3.7%. Of these, 67.3% of cases had open globe injury, 30.7% had closed injury, and only 2% had chemical injury. In Upper Egypt, socioeconomic and sociocultural status, family negligence, and lack of supervision are important factors in pediatric eye injuries, as 92% of children were without adult supervision when the ocular trauma occurred. Nearly 86.6% of children with ocular trauma end up legally blind. Modification of these environmental risk factors is needed to decrease pediatric ocular morbidity.Keywords: ocular trauma, pediatric, epidemiology
Pediatric eye injuries in upper Egypt
El-Sebaity DM, Soliman W, Soliman AMA, Fathalla AM
Clinical Ophthalmology , 2011, DOI: http://dx.doi.org/10.2147/OPTH.S24679
Abstract: iatric eye injuries in upper Egypt Original Research (2813) Total Article Views Authors: El-Sebaity DM, Soliman W, Soliman AMA, Fathalla AM Published Date September 2011 Volume 2011:5 Pages 1417 - 1423 DOI: http://dx.doi.org/10.2147/OPTH.S24679 Dalia M El-Sebaity1, Wael Soliman1, Asmaa MA Soliman2, Ahmed M Fathalla1 1Department of Ophthalmology, Assiut University Hospital, Assiut, Egypt; 2Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt Purpose: To analyze the patterns, causes, and outcome of pediatric ocular trauma at Assiut University Hospital in Upper Egypt (South of Egypt). Methods: All ocular trauma patients aged 16 years or younger admitted to the emergency unit of Ophthalmology Department of Assiut University between July 2009 and July 2010 were included in the study. The demographic data of all patients and characteristics of the injury events were determined. The initial visual acuity and final visual acuity after 3 months follow-up were recorded. Results: One hundred and fifty patients were included. The majority of injuries occurred in children aged 2–7 years (50.7%). There were 106 (70.7%) boys and 44 (29.3%) girls. The highest proportion of injuries occurred in the street (54.7%) followed by the home (32.7%). Open globe injuries accounted for 67.3% of injuries, closed globe for 30.7%, and chemical injuries for 2%. The most common causes were wood, stones, missiles, and glass. LogMar best corrected visual acuity at 3 months follow-up was: 0–1 in 13.3%; <1–1.3 in 27.3%; <1.3–perception of light (PL) in 56%; and no perception of light (NPL) in 3.3%. Conclusions: Pediatric ocular trauma among patients referred to our tertiary ophthalmology referral center in Upper Egypt over a period of 1 year was 3.7%. Of these, 67.3% of cases had open globe injury, 30.7% had closed injury, and only 2% had chemical injury. In Upper Egypt, socioeconomic and sociocultural status, family negligence, and lack of supervision are important factors in pediatric eye injuries, as 92% of children were without adult supervision when the ocular trauma occurred. Nearly 86.6% of children with ocular trauma end up legally blind. Modification of these environmental risk factors is needed to decrease pediatric ocular morbidity.
Breast Cancer: Surgery at the South Egypt Cancer Institute  [PDF]
Ahmed A.S. Salem,Mohamed Abou Elmagd Salem,Hamza Abbass
Cancers , 2010, DOI: 10.3390/cancers2041771
Abstract: Breast cancer is the most frequent malignant tumor in women worldwide. In Egypt, it is the most common cancer among women, representing 18.9% of total cancer cases (35.1% in women and 2.2% in men) among the Egypt National Cancer Institute’s (NCI) series of 10,556 patients during the year 2001, with an age-adjusted rate of 49.6 per 100,000 people. In this study, the data of all breast cancer patients presented to the surgical department of the South Egypt cancer Institute (SECI) hospital during the period from Janurary 2001 to December 2008 were reviewed .We report the progress of the availability of breast cancer management and evaluation of the quality of care delivered to breast cancer patients. The total number of patients with a breast lump presented to the SECI during the study period was 1,463 patients (32 males and 1431 females); 616 patients from the total number were admitted at the surgical department .There was a decline in advanced cases. Since 2001, facilities for all lines of comprehensive management have been made accessible for all patients. We found that better management could lead to earlier presentation, and better overall outcome in breast cancer patients.The incidence is steadily increasing with a tendency for breast cancer to occur in younger age groups and with advanced stages.
Evolution of Pediatric Urology at Sindh Institute of Urology and Transplantation  [PDF]
Sajid Sultan
Frontiers in Pediatrics , 2014, DOI: 10.3389/fped.2014.00088
Abstract: Sindh Institute of Urology and Transplantation was started in 1972 as an eight bedded department of genitourinary surgery in a government hospital by its pioneer and present director Syed Adib ul Hassan Rizvi. Responding to the socioeconomic dynamics and the needs of the patient population the facility grew into the largest tertiary care Urology, Nephrology, and Transplant center of south Asia. One of the salient components has been the evolution of the Department of Pediatric Urology, which in itself has shown a tremendous growth into an internationally recognized center for pediatric urology services taking care of all aspects including center of excellence for pediatric stone disease. The guiding mission of this institute remains to provide free medical services at zero cost without any discrimination to all who come to its doorstep and matching with high standard of care without compromising their dignity and self-respect. This institute highlights the fact that lack of resources is no excuse and is a role model for developing countries, where national and international support, motivation, and cooperation can offer more advanced and better quality medical services to our children.
Systemic Analysis of Gene Expression Profiles Identifies ErbB3 as a Potential Drug Target in Pediatric Alveolar Rhabdomyosarcoma  [PDF]
Janne Nordberg, John Patrick Mpindi, Kristiina Iljin, Arto Tapio Pulliainen, Markku Kallajoki, Olli Kallioniemi, Klaus Elenius, Varpu Elenius
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0050819
Abstract: Pediatric sarcomas, including rhabdomyosarcomas, Ewing’s sarcoma, and osteosarcoma, are aggressive tumors with poor survival rates. To overcome problems associated with nonselectivity of the current therapeutic approaches, targeted therapeutics have been developed. Currently, an increasing number of such drugs are used for treating malignancies of adult patients but little is known about their effects in pediatric patients. We analyzed expression of 24 clinically approved target genes in a wide variety of pediatric normal and malignant tissues using a novel high-throughput systems biology approach. Analysis of the Genesapiens database of human transcriptomes demonstrated statistically significant up-regulation of VEGFC and EPHA2 in Ewing’s sarcoma, and ERBB3 in alveolar rhabdomyosarcomas. In silico data for ERBB3 was validated by demonstrating ErbB3 protein expression in pediatric rhabdomyosarcoma in vitro and in vivo. ERBB3 overexpression promoted whereas ERBB3-targeted siRNA suppressed rhabdomyosarcoma cell gowth, indicating a functional role for ErbB3 signaling in rhabdomyosarcoma. These data suggest that drugs targeting ErbB3, EphA2 or VEGF-C could be further tested as therapeutic targets for pediatric sarcomas.
Epidemiological Characteristics and Survival Studies of Rhabdomyosarcoma in East Egypt: A Five-Year Multicenter Study  [PDF]
M. A. Badr,Y. A. Al-Tonbary,A. K. Mansour,T. H. Hassan,M. R. Beshir,A. Darwish,R. A. El-Ashry
ISRN Oncology , 2012, DOI: 10.5402/2012/674523
Abstract: Background. Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children, it represents 5–8% of childhood malignancies. Aim of the Work. To evaluate the epidemiological characteristics and treatment outcome in two pediatric oncology centers. Patients and Method. A retrospective analysis was performed on 41 medical records of children with RMS during 6 years period. Results. The median age of patients was 6 years with 80.4% below 10 years. Head and neck was the most common primary site. Embryonal RMS was the most frequent histopathologic subtype. Stage IV was the most frequent stage. According to IRS postsurgical grouping classification, group 4 was the most frequent group. There was a significant relationship between histopathologic subtypes of tumor and metastasis, primary site of tumor and histopathologic subtype, age, metastasis, IRS presurgical stage and IRS postsurgical group and outcome. The overall survival rate was 56.9%?±?8.4 and the failure free survival rate was 68.3%?±?7.6. Conclusion. The epidemiological characteristics of our patients are quite near to the worldwide data, apart from the higher prevalence of stage IV and group 4 with most of the primary tumor site in the extremities. CWS2002 protocol of therapy had led to improvement in the curability of the disease. 1. Introduction Rhabdomyosarcoma (RMS) accounts for approximately 3.5% of the cases of cancer among children aged 0 to 14 years and 2% of the cases among adolescents and young adults aged 15 to 19 years [1]; The incidence is 4.5 per million children and 50% of cases are seen in the first decade of life [2]. Approximately, 65% of cases are diagnosed in children less than six years of age with remaining cases noted in the 10-to-18-year-old age group. There is a slight predilection for disease in males, with a male to female ratio of 1.3?:?1 [3]. Several distinct histologic groups have prognostic significance, including embryonal rhabdomyosarcoma (ERMS), which occurs in 55% of patients; the botryoid variant (5%); alveolar rhabdomyosarcoma (20%); undifferentiated sarcoma (UDS) in 20% of patients [4]. Distinctive features appear to cluster around the site of the primary tumor, the age at diagnosis, and the histologic subtype. Head and neck RMS are more common in younger children, with orbital tumors being characterized by embryonal histology in most of cases. Extremity tumors are more common in adolescents and are more likely to have an alveolar histologic subtype. Nearly 80% of genitourinary tract RMS are embryonal in nature [5]. The most common sites are the head and
Outcome of Rhabdomyosarcoma in First Year of Life: Children’s Cancer Hospital 57357 Egypt  [PDF]
Enas El Nadi,Emad A. H. Moussa,Wael Zekri,Hala Taha,Alaa Yones,Mohamed Saad Zaghloul,Madeeha El Wakeel,Rania M. Labib
Sarcoma , 2013, DOI: 10.1155/2013/439213
Abstract: Background. Rhabdomyosarcoma (RMS) is the most common soft-tissue sarcoma in children. Fifty percent of RMS cases occur in the first 10 years of life and less commonly in infants younger than one-year old. These infants require adapted multimodality treatment approaches. Patients and Methods. We analyzed patients’ characteristics, treatment modalities, and the outcome for RMS infants treated at Children’s Cancer Hospital Egypt (CCHE) between July 2007 and December 2010 and compared them to patients above one year treated on the same protocol. Results. Out of the 126 RMS treated during this period, 18 were below the age of one year. The male:?female ratio was 1.25?:?1. The median age at diagnosis was 0.7 ± 0.2 years. Most of the cases (27.8%) were presented in head and neck regions. The estimated 4-years failure-free survival and overall survival for infants were 49 ± 12% and 70 ± 12%, respectively. These failure-free survival rate and overall survival rate did not differ from those for older patients ( ). Conclusion. Infants with RMS are a unique group of RMS who needs special concerns in tailoring treatment in addition to concerns regarding toxicity and morbidity in infants. 1. Introduction Rhabdomyosarcoma (RMS) is a heterogeneous group of malignant tumors that resemble morphology of developing skeletal muscle and is the most common soft-tissue sarcoma in children and adolescents [1]. It has a bimodal distribution pattern, the first peak occurring between 2 and 6 years and the second peak between 14 and 18 years of age [2, 3]. Approximately 5–10% of patients with RMS are diagnosed during the first year of life, and their clinical characteristics have been well documented. In the Intergroup Rhabdomyosarcoma Study (IRS)-IV protocol [4, 5], age less than 1 year emerged as an independent adverse prognostic factor in RMS [4, 6–8]. The failure-free survival was 55% in infants, 83% in children aged 1–9 years and 68% in patients over 10 years. The possible reasons for this outcome difference were not clearly identified. The management of RMS requires multimodality therapeutic approaches including surgery, chemotherapy, and radiotherapy. Patients aged less than 1 year are particularly problematic and required a tailored therapeutic approach. Studies suggest a less favorable outcome for patients aged less than 1 year [9, 10]. The well-known physiologic immaturity of various organs is responsible for the vulnerability of infants to acute and late effects of therapy, and the functional immaturity of the liver leads to a different metabolism of drugs in infants as
CLINICAL FEATURES AND CLINICAL OUTCOME OF ACUTE PROMYELOCYTIC LEUKEMIA PATIENTS TREATED AT CAIRO NATIONAL CANCER INSTITUTE IN EGYPT  [cached]
Ola Khorshid,Amira Diaa,Mohamed Abd El Moaty,Rafat Abd El Fatah
Mediterranean Journal of Hematology and Infectious Diseases , 2011, DOI: 10.4084/mjhid.2011.
Abstract: The current study reports the clinical features and treatment outcome of 67 patients with acute promyelocytic leukemia (APL) presented to National Cancer Institute (NCI-Cairo), in Egypt from January 2007 to January 2011. The median follow-up time was 36 months. All patients were treated with the simultaneous administration of all-trans retinoic acid (ATRA) and anthracyclin. The treatment protocol was modified due to resource limitations at the NCI-Cairo by replacing of idarubicin with doxorubicin in most of the cases and the inclusion of cytarbine during the consolidation phase only in pediatric patients. All patients who achieved molecular complete remission (CRm) after consolidation received two-year maintenance treatment with low dose chemotherapy composed of 6 mercaptopurine, methotrexate and intermittent ATRA courses. The median age at presentation was 29 years. There was a slight male predominance (53%). Bleeding was the most common presenting symptom (79%). Most patients had an intermediate risk Sanz score (49%) and 34% had a high risk score. All patients achieved molecular CR at end of consolidation therapy with a median duration of 100 days. The main therapeutic complications during the induction phase were febrile neutropenia (42%), bleeding (18%) and differentiation syndrome (11%). Five patients died at diagnosis due to bleeding, three died during induction chemotherapy due to febrile neutropenia (n=2) and bleeding (n=1) and one patient died during consolidation therapy due to febrile neutropenia. The 3-year OS was 89% and relapse rate was 3%. Adapting standard AIDA treatment protocols to limited resources by reducing dose-intensity during treatment consolidation, using ATRA in the consolidation phase and alternative anthracyclin (doxorubicin) may be a valid treatment option in developing countries. In spite of the increased incidence of high and intermediate risk score APL in our sample, we reported an acceptable CR rate, toxicity and OS.
Low Prevalence of TP53 Mutations and MDM2 Amplifications in Pediatric Rhabdomyosarcoma  [PDF]
Simona Ognjanovic,Ghyslaine Martel,Carlos Manivel,Magali Olivier,Erica Langer,Pierre Hainaut
Sarcoma , 2012, DOI: 10.1155/2012/492086
Abstract: The tumor suppressor gene TP53 is the most commonly mutated gene in human cancer. The reported prevalence of mutations in rhabdomyosarcoma (RMS) varies widely, with recent larger studies suggesting that TP53 mutations in pediatric RMS may be extremely rare. Overexpression of MDM2 also attenuates p53 function. We have performed TP53 mutation/MDM2 amplification analyses in the largest series analyzed thus far, including DNA isolated from 37 alveolar and 38 embryonal RMS tumor samples obtained from the Cooperative Human Tissue Network (CHTN). Available samples were frozen tumor tissues ( ) and histopathology slides. TP53 mutations in exons 4–9 were analyzed by direct sequencing in all samples, and MDM2 amplification analysis was performed by differential PCR on a subset of 22 samples. We found only one sample (1/75, 1.3%) carrying a TP53 mutation at codon 259 (p.D259Y) and no MDM2 amplification. Two SNPs in the TP53 pathway, associated with accelerated tumor onset in germline TP53 mutation carriers, (TP53 SNP72 (rs no. 1042522) and MDM2 SNP309 (rs no. 2279744)), were not found to confer earlier tumor onset. In conclusion, we confirm the extremely low prevalence of TP53 mutations/MDM2 amplifications in pediatric RMS (1.33% and 0%, respectively). The possible inactivation of p53 function by other mechanisms thus remains to be elucidated. 1. Introduction Rhabdomyosarcoma (RMS) is the most common type of soft tissue sarcoma diagnosed in children under the age of 15 years contributing to approximately 4% of all childhood malignancies [1]. Two major subtypes, embryonal (ERMS) and alveolar rhabdomyosarcoma (ARMS), together comprise 80% of all rhabdomyosarcoma [2]. The predominant subtype is ERMS which is characterized by earlier age of onset and better survival compared to ARMS (70% versus 50%, resp.) [2, 3]. While ERMS is characterized by frequent loss of imprinting on chromosome 11p15, a region containing a number of imprinted genes, including IGF2, 80% of ARMS present with translocations, most frequently involving PAX 3 or 7 and FOXO gene rearrangements [4, 5]. Young age of onset, a number of identified predisposing syndromes, and paucity of environmental and lifestyle risk factors all contribute to the widely accepted view that genetic aberrations may play an important role in RMS development [3, 5]. However, the etiology of RMS remains largely unknown primarily due to its rarity and diagnostic diversity [2]. TP53 is the most commonly mutated gene in human cancer; however, the prevalence of TP53 mutations varies greatly by cancer type [6]. This tumor
Clinical Characteristics and the Prognosis of Childhood Rhabdomyosarcoma in 60 Patients Treated at a Single Institute
Farzad Company,Mohammad Pedram,Nazila Rezaei
Acta Medica Iranica , 2011,
Abstract: Rhabdomyosarcoma (RMS) is the most frequent soft tissue sarcoma in children. The aim of study was to retrospectively review the treatment results of childhood rhabdomyosarcoma and identify prognostic factors. 60 children with rhabdomyosarcoma treated between 1996 and 2002 in Shafa Hospital were reviewed. The data were analyzed for clinico-epidemiological factors. Age, gender, race, histology type, primary site, tumor size and intergroup rhabdomyosarcoma study (IRS) group were evaluated. The primary site of involvement was orbit in 6 cases (10%) head and neck nonparameningial in 12 cases (20%), parameningial region in 12 cases (20%). The histological findings were as follows: 12 cases (72.5%) for embryonal, 6 cases (10%) for alveolar and 11 cases (17. 5%) for botryoid type. With respect to the IRS III (15%) were group II, 32 (52.5%) were group III and 24 cases (40%) were group IV. The 5-year survival rate was 47.9%. Primary tumor site (P=0.0003), and histology (P=0.05) were associated significantly with survival after recurrence. Among the variables, age, gender, regional lymph node involvement, and IRS group did not affect 5-year survival but the type and time of recurrence (P=0.0002), and its relation with therapy (P=0.0001) were associated with survival. This study showed that overall survival for rhabdomyosarcoma is dependent on histological subtype, primary site, disease group, duration of disease before treatment. The outcome for infant with RMS is less satisfactory than older children and the patients aged 1-9 years had the best 5 year survival.
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