Objectives: Smoking and weight of the human body were investigated as factors affecting the presence of E. coli harbouringcolibactin genes.Methods: A case control study was performed, including 50 patients with colorectal polyps and 50 healthy individuals.Smoking condition and body weight of those subjects were determined. Rectal swabs were collected from subjects forisolation of E. coli and the presence of clbA and clbP genes as the main colibactin genes was determined.Results: E. coli isolated from smoker patients with colorectal polyp, especially in males with neoplastic polyps, revealeda significantly higher content of colibactin genes, while these genes were found in one non-smoker female with neoplasticpolyps. Genes were also detected in three smoker healthy individuals and one non-smoker female.Colibactin genes were found more often in E. coli isolated from overweight and obese males with neoplasm. Fourhealthy individuals had also colibactin genes, two healthy obese females, and two males with overweight and obesecondition.Conclusion: Colibactin genes were frequently found in E. coli of smoking and heavy-weight patients with colorectalpolyps, especially in those with neoplastic polyps. The frequency of these genes in smokers and obese healthy individualswas raised.

Objectives: This retrospective study evaluated the prognostic significance of the ratio of C-reactive protein (CRP) toalbumin (Alb) in patients with biliary tract cancer (BTC).Methods: A total of 178 patients with newly diagnosed BTC, who had been treated in our departments between January2013 and September 2018, were enrolled in the study. All medical records were reviewed retrospectively. Patientswho showed clinical evidence of infection or other inflammatory conditions were excluded. We investigated the correlationbetween the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), CRP to Alb ratio (CAR)and the overall survival (OS) rates for BTC patients. Both univariate and multivariate analyses were performed to identifyclinicopathological variables associated with OS.Results: The optimal cutoff level for the CAR was 0.66. An elevated CAR was associated with low OS (p<0.001). In themultivariate analysis CAR, was independently associated with OS (HR 3.44, 95% CI: 2.05-5.79, p<0.001). Median OS forCAR ≤0.66 and CAR >0.66 were 22.0 months and 6.0 months, respectively. By contrast, NLR (p=0.12) and PLR (p=0.85)were not independently associated with OS.Conclusion: The CAR might be an independent prognostic marker for patients with BTC, and might have value comparablewith other established inflammation-based prognostic scores. The prognostic value of this novel inflammationbasedprognostic score needs to be verified in patients with other types of cancer.

Objectives: Bone surface is supplied with ample numbers of both sensory and sympathetic nerves, despite this a veryfew cases of Schwannoma had been reported to be originating from subperiosteal region. Our study aims at retrospectivelyanalysing patients presenting with vague pain around the knee joint with inconclusive radiological features inwhom subperiosteal Schwannoma was being considered as a differential diagnosis.Methods: Three patients presented with vague pain around knee joint to our OPD over a 10 years period. Two patientshad a painful mass around knee. Pain was temporarily relieved with NSAIDs. Two patients had lesion in proximal tibiaand one on distal femur. All patients were subjected to excisional biopsy and the results were analysed.Results: X ray was unremarkable in all three patients. Hypoechoic lesion was found on ultrasonography suspectedto be benign neoplastic lesion. Histopathology study of all excisional biopsy specimens confirmed the diagnosis ofschwannoma. All patients recovered uneventfully and had complete relief of pain post excision. There has not beenany incidence of recurrence.Conclusion: In patients with diffused pain around knee, subperiosteal schwannoma should be kept as one of the differentialdiagnosis. USG can help in diagnosis subperiostel schwannoma.

Objectives: Laryngeal cancer is the most common cancer in head and neck cancer group, of which it constitutes 75%.Squamous cell carcinoma (SCC) is the most common histological subtype. Systemic or local inflammation is a wellknown promotor for cancer development and progression. Systemic immune inflammation index (S II) has been reportedas an independent prognostic parameter in various cancers. We aimed to evaluate the capability of SII in predictingthe risk of recurrence in patients with operable laryngeal cancer.Methods: We retrospectively collected the data of 100 laryngeal SCC patients who underwent surgery between 2016and 2018. Neutrophil, lymphocyte, and platelet (Plt) counts were recorded. The SII was calculated as follows: SII= Neutrophilecounts *platelet counts/lymphocyte counts.Results: SI index was found to be an independent prognostic factor as affecting disease recurrence (p<0.05). We foundthat patients with SII >891 had a risk of disease recurrence of approximately three times more than patients with SII =<891.78 (HR: 3.06 (95% CI: 3.42-132.64).Conclusion: This was the first study to demonstrate that preoperative SI index is a simple and powerful independentpredictive index that predicts the risk of disease recurrence in patients with laryngeal cancer.

Objectives: Polyoxometalates (POMs), polyanionic metal clusters, have been well recognized for their anticancer activityin recent decades. Despite their potential anticancer activity, normal cell toxicity is one of the pressing issues thatprevent their further clinical applications. In this work, we synthesized a new bio-conjugate based on POM and biotin.We used biotin as a bio-molecule to control the cytotoxicity of POM on healthy cells and simultaneously increase thetoxicity on cancerous cells.Methods: We synthesized the biotin derivative of POM via an amidation between the two molecules of biotin andamine groups on polyoxomolybdate. We approved the final structure using different spectroscopic data. We studiedthe cytotoxicity activity in-vitro using MTT protocol. We chose breast carcinoma cells (MCF-7) and hepatocellular carcinomacells (HepG2) in comparison to the human umbilical vein endothelial cell (HUVEC).Results: Results showed that biotin could improve the anticancer activity of polyoxomoybdate (IC50; 0.082 mM) onMCF-7 and (IC50; 0.091 mM) on HepG2 cells. Furthermore, the biotin-polyoxomolybdate conjugate showed lower toxicityon healthy cells versus the parent polyoxomolybdate and the Cis-platin as an approved drug.Conclusion: Thus, we introduce promising novel POM bioconjugate, which can be further assessed in pre-clinical studies.

The recent catastrophic outbreak of a novel coronavirus (COVID-19), currently renamed as COVID-19; recalled us theearlier memories created by the Severe Acute Respiratory Syndrome Human coronavirus (SARS-CoV) from nearly twodecades ago. With the new advancements in earlier detection techniques for infections and better treatments; now weare better supported to deal this recent infestation of 2B coronavirus.

Pediatric limb salvage necessitates collaboration of multi-disciplinary team approach; members are orthopedic oncologist,pediatric oncologist, radiologist, pathologist, physiotherapist, and psychotherapist. Limb-salvage choices fall intotwo principal categories, biological reconstruction as well as endoprosthetic arthroplasty, each of which has functionaland technical concerns that are fundamental to determine the optimal management option. Limb-salvage surgery inpediatrics has unique challenges, with precise planning to assure the maintenance of limb-length equality with durableconstruction for long-term function into adulthood. Limb salvage can achieve satisfactory oncological and functionalresults and quality of life as compared with amputation. Improvements in biological reconstructive methods, aswell as endoprosthetic design, allow effective limb-salvage choices after oncological resections in pediatrics that areideally adjusted to the patient’s unique functional needs.

Corona virus causes respiratory infection including pneumonia, cold, sneezing and coughing while in animal it causesdiarrhea and upper respiratory diseases. Corona virus transmitted human to human or human to animal via airbornedroplets. Corona virus enters in human cell through membrane ACE-2 exopeptidase receptor. WHO and ECDC advisedto avoid public place and close contact to infected persons and pet animals. Firstly Corona virus (2019-nCoV) was isolatedfrom Wuhan market China at 7 Jan. 2020.

Coronaviruses (CoV) belong to the genus Coronavirus with its high mutation rate in the Coronaviridae.The objective of this review article was to have a preliminary opinion about the disease, the ways of treatment, andprevention in this early stage of COVID-19 outbreak.

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Adenoid cystic carcinoma (ACC) is a rare special subtype of breast cancer, accounting for approximately 0.1% of allbreast cancers. It is commonly seen in the salivary glands. The imaging findings of this rare tumor have not been welldescribed in the literature. Histologically, ACC is a triple negative tumor with basal-like breast features (tumors that aredevoid of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expressions, andexpress basal cell markers). For the most part, ACC is low-grade, that is how they have a good prognosis, whereas thereare a rare lymph node involvement and distant metastasis.In the current state of knowledge, Treatment is either simple mastectomy or lumpectomy with radiotherapy. There isno consensus on optimal treatment for patients with ACC. Otherwise, the role of chemotherapy and hormonal therapyremains controversial.Here, we report two cases occurred in female patients who presented with a palpable breast mass in the breast thatturned out to be an ACC of the breast.

Ewing Sarcoma of long bones is a rare entity in elderly patients. The prognosis and appropriate treatment in this subgroup of patients is not clearly defined. We report a case of 78 years old male treated with surgery followed by adjuvantradiation and had excellent disease control without systemic therapy.

The Internet is a widely accessible interactive medium. Statistics show significant growing Internet usage in the UnitedStates (US) from 2005 to 2018. In the most recently reported year, over 300 million internet users accessed the web fromthe US, and worldwide 3.17 billion. Undoubtedly the Internet has become an essential educational, recreational andcommunication tool; however, its excessive use may lead to negative impacts on individual psychological well-being,family relationships, emotional stability, and daily life functions. This phenomenon is defined as Internet Addiction (IA)or Problematic Internet Use and is considered to be a type of behavioral addiction. IA is an emergent disorder whichposes a serious clinical threat. Surveys in the US and Europe have suggested the prevalence rate of IA between 1.5%-8.2%; some have suggested that 1 in 8 Americans suffer from IA. The figures are even higher in countries like in Koreaand Taiwan, where the prevalence of IA has been reported to be greater than 31%. The principal objective of this paperis to explore the association of Cyber Disorders, e.g. Internet Addiction and psychiatric co-morbidities like mood disorders, substance abuse, ADHD, anxiety, social phobia, exemplified by this case report of bipolar disorder.

Optimal management of early coronary bypass graft failure in patients with ST-elevation myocardial infarction (STEMI)is unclear. The data regarding the treatment of left anterior descending artery (LAD) stenosis located distally to its anastomosis with the left internal mammary artery (LIMA) or at the site of anastomosis are insufficient. Presented here is adescription of the management of a case of severe stenosis at the site of LAD-LIMA anastomosis with STEMI.

We present a case of a 25 years old woman who presented to the gynaecological oncology unit before pregnancy witha histological and clinical diagnosis of cervical squamous cell carcinoma stage 1B1. She desired fertility and hencean elective admission for vaginal trachelectomy (for fertility sparring) was planned. She fell pregnant whilst awaitingsurgery and opted to continue with the pregnancy after counselling. She received neoadjuvant chemotherapy and wasdelivered at 36 weeks and a caesarean radical hysterectomy and pelvic lymphadenectomy was done. There is no disease recurrence after 2 years of follow up. This case highlights the challenges of prolonged waiting periods for surgeryin our setting as well as the presentation of a rare histopathology of clear cell carcinoma. Clear cell adenocarcinoma ofthe cervix is associated with exposure to diethylstilboestrol (DES) in utero.

Objectives: Studies investigating associations between common polymorphisms in phase II metabolic enzymes COMTand SULT1A1 and the risk of various cancer types have revealed inconsistent and controversial results, with no attentionturned to date to the most common adult leukemia type, i.e., chronic lymphocytic leukemia.Methods: In this small case-control study with 47 cases and 50 controls, the role of two functional polymorphisms,Val158Met in COMT gene and Arg213His in SULT1A1 gene affecting the activity level of respective enzymes, was studied on the susceptibility to chronic lymphocytic leukemia in an Estonian cohort.Results: Although statistically non-significant (p>0.05), the suggestive reduction in disease risk observed with lowactivity enzyme variants could indicate the involvement of O-methylation and sulfation of various endogenous andexogenous substances in the process of leukemogenesis. The odds ratio (OR) for Met158Met genotype of COMT was0.60 with 95% confidence interval (95% CI) 0.20-1.82 compared to the wild type Val158Val genotype and the OR forHis213His genotype of SULT1A1 was 0.58 with 95% CI 0.20-1.71 compared to the wild type Arg213Arg genotype.Conclusion: Further large-scale studies are highly needed to confirm or disprove the findings of the present study anddetermine genetic risk factors for chronic lymphocytic leukemia.

Objectives: Hepatitis C virus (HCV) infection is one of the major causes of hepatocellular carcinoma (HCC) in Egypt.Recently, genetic polymorphisms of DEPDC5 and MICA have been reported to correlate with the progression of HCC inhepatitis C patients. The aim of this study was to determine the relationship between DEPDC5 (rs1012068) T/G, MICA(rs2596542) C/T and the risk of HCC development in patients with HCV infection.Methods: One hundred HCV infected patients suffering from HCC and one hundred healthy controls were enrolled inthe current study. Single nucleotide polymorphisms (SNPs) have been studied for DEPDC5 and MICA using real-time PCR.Results: Out of the two genes polymorphisms analyzed, the DEPDC5 and MICA variants were significantly related tothe development of HCC (p<0.0001). Only the DEPDC5 variants showed a high (p<0.0001) significant difference inpatients with cirrhosis. Moreover, the DEPDC5 variants were significantly correlated with low platelets count (p<0.045).Conclusion: DEPDC5 (rs1012068) and MICA (rs2596542) could be a valuable indicator in diagnosing the progressionof liver disease to HCC risk related Hepatitis C Virus patients in Egypt.

Objectives: It is well known that Asians have an increased prevalence of CAD. This study investigated the associationbetween the prevalence of “premature” CAD (i.e. CAD in men < 40 and women < 50) and ethnicity, with a focus on Asianethnicity.Methods: Our study included 1,386 young adults who underwent coronary CT angiography (CCTA) at a single institution. Ethnicity and other demographic variables were recorded. For all plaques identified on CCTA, the blood vesseland segment affected was recorded. Plaques were characterized as calcified, non-calcified, or mixed, and the degree ofstenosis was assessed based on the CAD-RADS reporting system.Results: The prevalence of premature CAD was over twice as high among Asians (p=0.003, 33.3%, 19.0%-47.6%) (Mean,95% C.I.) compared to Whites (16.0%, 13.1%-18.8%), Blacks (12.4%, 8.5%-16.2%), and Latinos (12.3%, 9.2%-15.4%). Themajority of plaques among all ethnic groups were non-calcified plaques identified in the proximal segment of the LAD.There was no relationship between ethnicity and plaque type (p=0.617) or location (p=0.788).Conclusion: Asians are not only at an increased likelihood of developing CAD, but the atherosclerotic disease process begins at an earlier age compared with patients of other ethnicities. Atherosclerotic plaque characteristics aresimilar among all ethnicities.

Objectives: Acute lymphoblastic leukemia (ALL) occurs due to the defective maturation of lymphoid cells and lack ofdifferentiation. The present study was aimed to determine the prevalence of P190 BCR-ABL1 transcript in ALL patientand their relation with age, gender, and ethnicity in Iranian population.Methods: This cross-sectional research was done on 50 children with ALL including 28 (56%) males and 22 (44%) females. The presence of P190 BCR-ABL1 transcript was assessed by Nested-PCR technique.Results: From 50 ALL patients, P190 BCR-ABL1 transcript with e1-a2 fusion gene was positive in 2 (4%) cases, one patient (50%) male, and one female (50%) with <5 years old age range and Arab ethnicity.Conclusion: It seems that P190 BCR-ABL1 transcript prevalence and its relations with diagnosis and prognosis, age andethnicity of ALL patients, need a higher population of the patients to better achievement in this field.

Objectives: To screen and treat women in a low-resource area of the Amazon basin in Peru for cervical cancer using ahand-held digital colposcope and compare the colposcopic impressions and histologic diagnoses.Methods: Descriptive study of 250 Peruvian women who presented for visualization with acetic acid (VIA) screening inthe Amazon basin during October 2017. Screening was performed using a digital handheld colposcope system, withbiopsies collected and analyzed for those who were thought to have cervical dysplasia on colposcopic impression. Theprimary outcome was the congruence between colposcopic impression and pathologic diagnosis on cervical biopsy.Results: 250 women were screened. 30 women screened positive during colposcopy. Of the 20 women who weresuspected of having low-grade dysplasia, 15 had CIN 1 and 5 were negative for dysplasia (75% congruent, CIN1). Ofthe 6 women suspected of having high-grade dysplasia, 1 had cervicitis, 2 had CIN2, and 3 had CIN3 (83.3% congruent,CIN2-3). Of the 4 women suspected of having invasive carcinoma, 3 had invasive cancer and one had severe cervicitis(75% congruent, cervical carcinoma).Conclusion: Digital colposcopy can optimize cervical cancer screening in low resource settings, as it can yield a relatively high congruence between colposcopic impressions and histologic diagnosis.