Articles

Breast cancer is the most common cancer in women and is a major public health problem. It is divided into several subtypes, including triple negatives. The general objective of our study is to establish the profile and the management of patients with triple negative breast cancer over a period of 2 years, operated in our department. During our study period, triple-negative breast cancers accounted for 10% of our population. The most affected age group ranges from 50 to 60. The majority of patients in our sample are pauciparous. In the group of patients who received hormone therapy, it was mainly HRT for 4 to 6 years. 96.77% of patients consulted a health worker within 3 months of the discovery of the signs. Adenopathies are frequently present at the time of diagnosis. 93.54% of the cases have an invasive ductal carcinoma. Triple negative cancers are essentially poorly differentiated. Triple-negative cancer has a high rate of cell renewal. In our study, neoadjuvant chemotherapy is mostly indicated for triple-negative breast cancers ≥ 30 mm at diagnosis and a delayed lumpectomy is then performed in 23.52% of the patients. For tumors of < 30 mm size, a lumpectomy is performed immediately in 76.47% of the patients, followed by adjuvant chemotherapy. Mastectomy was performed in 45.16% of patients; it was mainly indicated in front of a large tumor size associated with a small breast volume, then multifocal breast tumors. Breast reconstruction was performed in 21.42%. Radiation therapy is indicated in the majority of patients, postoperatively. In our population, 11 patients were proposed to have an oncogenetic survey; it was mainly indicated based on the Manchester criteria in front of a young age and a family history of cancer. There are two BRCA 1 mutations, one BRCA 2 mutation, and one case of absence of mutation. The therapeutic intake in case of a mutation is directed towards a prophylactic bilateral mastectomy and adnexectomy, proposed at the age of 40. Two patients had presented triple negative recurrences of their already treated breast cancer; first case PDL1 positive PD-L1 ≥ 1% treated with immunotherapy combined with chemotherapy (atezolizumab/abraxane) while the second and second PDL1 negative treated with chemotherapy alone. Despite their low frequency, triple negative breast cancers represent a subgroup marked by pejorative characteristics, a reserved prognosis, with limited treatment options.

Background: Proximal humerus fractures (PHFs) are common injuries particularly in older adults. Evidence-based protocols for PHF rehabilitation are lacking and physiotherapists use a variety of interventions. Purpose: To determine practice patterns and perceptions of physiotherapists who treat adults with PHF in Ontario, Canada. Method: A paper and pencil survey asking about respondent demographics and management of Neer Group 1 (minimally/nondisplaced) and complex (displaced 3- and 4-part) PHF was mailed to 875 randomly selected physiotherapists who were registered with the College of Physiotherapists of Ontario in 2013/2014 and working in practice areas likely to be accessed by adults with PHF. Results: The response rate was low (10%); 83 physiotherapists completed the survey - 80% had experience managing PHF. Respondents treated 1-5 individuals with PHF annually; more treated Neer Group 1 PHF (89%) than complex PHF (68%). Most individuals with PHF were older than 60 years (64%), female (76%) and accessed physiotherapy through a doctor’s referral (91%) more than 1 month post injury (33%). Main findings: Physiotherapists manage PHF using multi-component interventions and a minimum of 76% include the following elements: education and progression of passive, active assisted, active range of motion exercises and muscle retraining to build coordination and strength. Use of other elements was variable. The main factors influencing the treatment plan were the ability of the individual with PHF to comply, bone quality, and fracture type. Most respondents were unsure that there is sufficient PHF rehabilitation literature to guide treatment. Conclusions:This environmental scan is the first North American study to document practice patterns and attitudes of physiotherapists providing PHF rehabilitation. Elements used by physiotherapists in Ontario treating small numbers of individuals with Neer Group 1 or complex PHFs each year align well with the limited PHF rehabilitation literature available. Potential implications:Multi-disciplinary collaborations to design and conduct large, high quality, multi-centre prognostic studies and RCTs that evaluate the effectiveness of key aspects of non-surgical PHF rehabilitation in various patient groups are needed. Meanwhile, consensus guidelines should be developed in the context of region-specific physiotherapy service models to inform best practice in PHF rehabilitation management.

Introduction: Candidiasis is more frequent in human immunodeficiency virus (HIV)-infected patients and knowledge about the distribution and antifungal susceptibility of oral Candida species is important for effective management of candidiasis. Material and Methods: An oral rinses sample collected from hundred HIV-infected patients with and without clinical evidence of oral candidiasis in this study at the Infectious Department/Tripoli Medical Center, Libya. Species identified by standard phenotypic and conventional methods and in vitro susceptibility testing of the yeast isolates to antifungals were performed using the Disc diffusion method protocol as recommended by the Clinical Laboratory Scientific Institute. Results: Oral Candida colonization is detected in all patients with and without clinical syndromes, and Candida albicans were accounted for (74%), C. dubliniensis (11%) and C. glabrata (6%). A high proportion of Candida species (42%) showed decreased susceptibility to fluconazole. Among C., albicans more than 30% of isolate were resistant to most new azole antifungal including fluconazole, itraconazole, posoconazole and voriconazole. Conclusions: A significant number of oral Candida species particular Candida albicans exhibiting decreased susceptibility to fluconazole were isolated from colonized HIV-infected individual, given the high incidence and severity of fungal infections in HIV-infected individuals. The results of this study reinforce the importance of antifungal susceptibility testing, which contributes to the therapeutic strategies and highlights the need for continuous surveillance of Candida colonization in this population.

Anal melanoma is a rare and highly aggressive mucosal melanocytic malignancy. It is the third most common after melanomas of the skin and retina. The peak incidence in seen in the sixth and seventh decades. The clinical symptoms are pain, anal mass, bleeding per rectum, tenesmus or change in the bowel habits. It affects anal canal, rectum or both with a tendency to spread along submucosal planes. It is mostly beyond complete resection at the time of diagnosis and majority of patients die of metastasis. MR imaging significantly increases the diagnosis of anal melanoma in its early stages.

This review was conducted for the objective of assessing causes of COVID-19 pandemic impacts on life animals and dairy product processing industry of the world. Since its outbreak in Wuhan town of China, the newly emerged strains of corona virus COVID-19 causes incredible crisis both on life animal and its product especially dairy industry of the globe. During the outbreak of the virus, majority of the world people were stayed home to prevent the spread of the diseases. At that time, the wildlife found in the zoo were exposed to diseases and missed human attention, global wildlife trade was spotlighted and wildlife was running… wild. For the reason of COVID-19 pandemic, many schools and restaurants which received dairy product from dairy producers and cooperatives were shutdown. Due to schools and restaurant shutter, milk supply chain was disrupted. For this moment milk demand and supply was decreased, huge volume of milk was dumped, mode of milk trade was changed, market and farm prices was fluctuated, import- export route was interrupted and Farm workforce absenteeism were some of the challenges cases dairy industry crisis. Trade law modification, provision of financial assistance for dairy industry and farmers, and expansion of export route were the measures taken by concerned bodies to save dairy industry from corona virus crisis. Therefore, COVID-19 pandemic is the disaster diseases which causes social and economic crisis on dairy producers of the world. So, to save wildlife and dairy industry from corona virus crisis, global solidarity prevention is mandatory.

Over the last few years, antimicrobial shampoo therapy has been increasingly used to treat skin infections in order to reduce systemic use of antibiotics. This study was aimed to compare the In vitro bactericidal effect of a black currant oil based shampoo (S1) to a chlorhexidine 4% shampoo (S2) against methicillin-sensitive Staphylococcus pseudintermedius (MSSP), methicillin-resistant Staphylococcus pseudintermedius (MRSP), Staphylococcus aureus (SA), Escherichia coli (EC) and Pseudomonas aeruginosa (PA) isolates. A collection of 50 bacterial strains from skin swabs of dogs with superficial recurrent pyoderma was selected: 10 MSSP, 10 MRSP, 10 SA, 10 EC and 10 PA. The two shampoos were blindly tested in duplicate with a microdilution plate method, with scalar concentrations from 1:2 to 1: 256. The MBC was performed for each dilution. A linear regression was used to detect a statistically significance between the two shampoos. All isolates were completely killed at 1:2 up to 1:16 dilution of the two antiseptic products. At the 1:32 dilution the first bacterial growths were observed, in particular for 2 and 4 strains of MRSP by S1 and S2 respectively. The first lethal dilution for SA was at 1:64 for S1/S2 and only for S2 against SP. No significant difference was observed between the two shampoos according to the results of linear regression significant for: i) MRSP, PA and EC (p < 0.05); ii) MSSP and SA (p < 0.1). This study showed that both black currant oil based shampoo and chlorhexidine 4% shampoo have a similar In vitro bactericidal activity.

The study was conducted in Ilu and Waliso districs of South West Shoa Zone to investigate the perception of dairy cattle producers on oestrus synchronization and mass artificial insemination services. A total of 122 respondents (38 from Ilu and 84 from Waliso districts) owning at least one lactating cow and participated in synchronization program were randomly selected and interviewed individually by using semi- structured questionnaire. Both primary and secondary data were used to generate reliable information on the intended topic. All collected data were analyzed using SPSS statistical package version 20 and the output was presented by descriptive statistics such as percentage and mean values in inform of graphs. Most of the respondents (67.15%) indicated that their satisfaction level towards synchronization and mass artificial insemination was low. Only few of them reported being satisfied as (medium-13.45%, good - 12.35% and very good - 7.05%). This might be because of shortage of feed, silent heat, poor performance of the inseminator and low awareness of farmers on the technology. From the study it was also noted that the overall percentage (26.22%) of calving rate to oestrus synchronization and mass artificial insemination was low. This might be due to heat detection problem (36%); A.I technician efficiency (29.25%), absence of A.I technician (23.9%) and distance of A.I center (10.25%). Therefore, the skill and knowledge based training should be given for both the farmers and implementers to enhance perception and adoption of the technology.

Background: Telerehabilitation has been identified as an effective treatment that promotes exercise rehabilitation in individuals with multiple sclerosis (MS). Social support is recognised as a core element of such interventions. However further research is needed to consider the role and value of different social support domains. Aim: Review available literature to assess and synthesise the use and value of social support within telerehabilitation interventions for individuals with MS. Method: A narrative synthesis was conducted. A systematic search of included articles was conducted. Electronic databases were searched from inception to January 2017. Other search methods were undertaken. Evaluation and synthesis of included articles utilised risk of bias assessment and a 4-stage synthesis process. Main Results: A total of fourteen studies, involving 718 participants (505 female, 213 male; aggregated mean age 47.6 years) with MS, were included. Esteem support was the most frequently reported method of social support, followed by informational, emotional and tangible. It would appear social support can be beneficial in assisting participants to adhere to treatment interventions. Visual feedback may be directly beneficial to improve impaired balance in individuals with MS. A model for future interventions is provided. Conclusions: Social support appears to increase the adherence of participants with MS to telerehabilitation interventions. Unique findings provide an indication for the direction and content of future interventions. Further research is necessary to ascertain the optimal types and frequencies of social support delivery and its effect on health outcomes for participants with MS.

Bone metastases in cancer patients are highly painful and decrease the quality of life for these group of population. Covid-19 pandemia is a global challenging issue that mostly affect the patients with immune suppression or having comorbid diseases older than 65 years old. The palliation and management of bone metastases varies from single dose to several fractionation. The main goal of this article is to decide that short or long term fit for the cancer patients with bone metastasis in the Covid-19 era. We reviewed the topic about the short course and long term radiotherapy in the patients with painful bone metastases via novel literature.

Nasopalatine duct cyst is the most common non-odontogenic cyst. It develops in the midline of the anterior maxilla. It is usually asymptomatic and sometimes it can be overlooked or misdiagnosed. We present 10 patients who applied to Istanbul University Faculty of Dentistry, Department of Oral and Maxillofacial Surgery.