Background Cancer in children is a potentially curable disease, particularly in developed countries. Conventional chemotherapy is essentially an integral part of treatment, either alone, or as a part of multimodality therapy including surgery & radiotherapy. How to deal with pain is an integral part of symptom management in pediatric cancer patients in general, with especially great importance in the context of palliative care in developing countries, in which curability lags behind that of developed countries. Proper recognition of underlying pathophysiology and various causes of pain are so essential for pain management, and for ameliorating suffering in the realm of holistic care for children with cancer. The aim of this study is to address and meticulously analyze the spectrum of pain characteristics in children with cancer at an institutional university cancer center to unravel pain profile in these patients as an experience for a developing country. Patients & Methods A hospital based, prospective study was conducted, involving pediatric cancer patients, who presented with pain due to cancer itself or its treatment in the period from 2013 Jul to 2015 Jan. Evaluation of patients' documented pain cycles for pain cause, type, and location & also for pain treatment characteristics was done. Results A total of 286 pain cycles was documented comprising 2216 treatment days (range 3-56 days). Disease-related pain was the most frequent cause of pain in our study. Oral mucosa was the most frequent site for treatment-related pain & strongly correlated with NHL diagnosis. Leukemia was strongly correlated with "the extremities" as a location of bone pain. Visceral pain was most often associated with lymphomas. Neuropathic pain was the least frequent type of pain, however, associated with higher initial pain intensity scores & longer pain cycle duration. Conclusions Children with cancer in the developing countries still have more disease-related pain than their counterparts in the developed countries. Pain experience in pediatric oncology may indirectly reflect presentations of childhood cancer, and could be a surrogate profile for tumor location, metastatic sites, the degree of treatment intensity, likewise the context of the disease state either at diagnosis, during treatment, or at progression.

Background: Anthracycline-induced cardiotoxicity in survivors of childhood cancer initially presenting as sub-clinical cardiac abnormalities that, if left undetected or untreated, can lead to clinical cardiac dysfunction. The present study aimed to evaluate the early myocardial changes that develop with anthracycline therapy. Material and Methods: In this prospective study the preanthracycline and 6-months postanthracycline echocardiographic and electrocardiographic parameters were analyzed for cardiac dysfunction. The demographic information, including age, sex, type of anthracycline, and cumulative dose, were recorded, as well. Results: In this study, 115 patients with childhood cancer, including 81 males (70.4%) and 34 females (29.6%) with the mean age of 11.1±3.8 years were enrolled. Their normal baseline and 6-months postanthracycline echocardiographic and electrocardiographic parameters were compared for myocardial changes. Doxorubicin alone was used in 91 (79%) patients while daunorubicin alone in 24 (21%). Only 16 children (14%) received a high dose of anthracycline (cumulative dose > 300 mg/m 2). QTc interval significantly prolonged 6-months after chemotherapy than the baseline readings (P0.001). There was a significant increase in the left ventricular dimensions, and all myocardial functional parameters were significantly deteriorated in children who received anthracycline (P0.001). The incidence of cardiac dysfunction found more in female patients (20/28; 71.4%). Myocardial dysfunction was significantly higher among children who received a high cumulative dose of doxorubicin (P0.001). Conclusion: The incidence of subclinical anthracycline-related cardiac dysfunction is high. Children treated with anthracycline require a long-term follow-up to identify and establish optimal prevention and management strategies that balance oncologic efficacy with long-term safety.

Background: Anthracycline-induced cardiotoxicity in survivors of childhood cancer initially presenting as sub-clinical cardiac abnormalities that, if left undetected or untreated, can lead to clinical cardiac dysfunction. The present study aimed to evaluate the early myocardial changes that develop with anthracycline therapy. Material and Methods: In this prospective study the preanthracycline and 6-months postanthracycline echocardiographic and electrocardiographic parameters were analyzed for cardiac dysfunction. The demographic information, including age, sex, type of anthracycline, and cumulative dose, were recorded, as well. Results: In this study, 115 patients with childhood cancer, including 81 males (70.4%) and 34 females (29.6%) with the mean age of 11.1±3.8 years were enrolled. Their normal baseline and 6-months postanthracycline echocardiographic and electrocardiographic parameters were compared for myocardial changes. Doxorubicin alone was used in 91 (79%) patients while daunorubicin alone in 24 (21%). Only 16 children (14%) received a high dose of anthracycline (cumulative dose > 300 mg/m 2). QTc interval significantly prolonged 6-months after chemotherapy than the baseline readings (P0.001). There was a significant increase in the left ventricular dimensions, and all myocardial functional parameters were significantly deteriorated in children who received anthracycline (P0.001). The incidence of cardiac dysfunction found more in female patients (20/28; 71.4%). Myocardial dysfunction was significantly higher among children who received a high cumulative dose of doxorubicin (P0.001). Conclusion: The incidence of subclinical anthracycline-related cardiac dysfunction is high. Children treated with anthracycline require a long-term follow-up to identify and establish optimal prevention and management strategies that balance oncologic efficacy with long-term safety.

Background: Anthracycline-induced cardiotoxicity in survivors of childhood cancer initially presenting as sub-clinical cardiac abnormalities that, if left undetected or untreated, can lead to clinical cardiac dysfunction. The present study aimed to evaluate the early myocardial changes that develop with anthracycline therapy. Material and Methods: In this prospective study the preanthracycline and 6-months postanthracycline echocardiographic and electrocardiographic parameters were analyzed for cardiac dysfunction. The demographic information, including age, sex, type of anthracycline, and cumulative dose, were recorded, as well. Results: In this study, 115 patients with childhood cancer, including 81 males (70.4%) and 34 females (29.6%) with the mean age of 11.1±3.8 years were enrolled. Their normal baseline and 6-months postanthracycline echocardiographic and electrocardiographic parameters were compared for myocardial changes. Doxorubicin alone was used in 91 (79%) patients while daunorubicin alone in 24 (21%). Only 16 children (14%) received a high dose of anthracycline (cumulative dose > 300 mg/m 2). QTc interval significantly prolonged 6-months after chemotherapy than the baseline readings (P0.001). There was a significant increase in the left ventricular dimensions, and all myocardial functional parameters were significantly deteriorated in children who received anthracycline (P0.001). The incidence of cardiac dysfunction found more in female patients (20/28; 71.4%). Myocardial dysfunction was significantly higher among children who received a high cumulative dose of doxorubicin (P0.001). Conclusion: The incidence of subclinical anthracycline-related cardiac dysfunction is high. Children treated with anthracycline require a long-term follow-up to identify and establish optimal prevention and management strategies that balance oncologic efficacy with long-term safety.

Background: Anthracycline-induced cardiotoxicity in survivors of childhood cancer initially presenting as sub-clinical cardiac abnormalities that, if left undetected or untreated, can lead to clinical cardiac dysfunction. The present study aimed to evaluate the early myocardial changes that develop with anthracycline therapy. Material and Methods: In this prospective study the preanthracycline and 6-months postanthracycline echocardiographic and electrocardiographic parameters were analyzed for cardiac dysfunction. The demographic information, including age, sex, type of anthracycline, and cumulative dose, were recorded, as well. Results: In this study, 115 patients with childhood cancer, including 81 males (70.4%) and 34 females (29.6%) with the mean age of 11.1±3.8 years were enrolled. Their normal baseline and 6-months postanthracycline echocardiographic and electrocardiographic parameters were compared for myocardial changes. Doxorubicin alone was used in 91 (79%) patients while daunorubicin alone in 24 (21%). Only 16 children (14%) received a high dose of anthracycline (cumulative dose > 300 mg/m 2). QTc interval significantly prolonged 6-months after chemotherapy than the baseline readings (P0.001). There was a significant increase in the left ventricular dimensions, and all myocardial functional parameters were significantly deteriorated in children who received anthracycline (P0.001). The incidence of cardiac dysfunction found more in female patients (20/28; 71.4%). Myocardial dysfunction was significantly higher among children who received a high cumulative dose of doxorubicin (P0.001). Conclusion: The incidence of subclinical anthracycline-related cardiac dysfunction is high. Children treated with anthracycline require a long-term follow-up to identify and establish optimal prevention and management strategies that balance oncologic efficacy with long-term safety.

Background: Anthracycline-induced cardiotoxicity in survivors of childhood cancer initially presenting as sub-clinical cardiac abnormalities that, if left undetected or untreated, can lead to clinical cardiac dysfunction. The present study aimed to evaluate the early myocardial changes that develop with anthracycline therapy. Material and Methods: In this prospective study the preanthracycline and 6-months postanthracycline echocardiographic and electrocardiographic parameters were analyzed for cardiac dysfunction. The demographic information, including age, sex, type of anthracycline, and cumulative dose, were recorded, as well. Results: In this study, 115 patients with childhood cancer, including 81 males (70.4%) and 34 females (29.6%) with the mean age of 11.1±3.8 years were enrolled. Their normal baseline and 6-months postanthracycline echocardiographic and electrocardiographic parameters were compared for myocardial changes. Doxorubicin alone was used in 91 (79%) patients while daunorubicin alone in 24 (21%). Only 16 children (14%) received a high dose of anthracycline (cumulative dose > 300 mg/m 2). QTc interval significantly prolonged 6-months after chemotherapy than the baseline readings (P0.001). There was a significant increase in the left ventricular dimensions, and all myocardial functional parameters were significantly deteriorated in children who received anthracycline (P0.001). The incidence of cardiac dysfunction found more in female patients (20/28; 71.4%). Myocardial dysfunction was significantly higher among children who received a high cumulative dose of doxorubicin (P0.001). Conclusion: The incidence of subclinical anthracycline-related cardiac dysfunction is high. Children treated with anthracycline require a long-term follow-up to identify and establish optimal prevention and management strategies that balance oncologic efficacy with long-term safety.

Background: Anthracycline-induced cardiotoxicity in survivors of childhood cancer initially presenting as sub-clinical cardiac abnormalities that, if left undetected or untreated, can lead to clinical cardiac dysfunction. The present study aimed to evaluate the early myocardial changes that develop with anthracycline therapy. Material and Methods: In this prospective study the preanthracycline and 6-months postanthracycline echocardiographic and electrocardiographic parameters were analyzed for cardiac dysfunction. The demographic information, including age, sex, type of anthracycline, and cumulative dose, were recorded, as well. Results: In this study, 115 patients with childhood cancer, including 81 males (70.4%) and 34 females (29.6%) with the mean age of 11.1±3.8 years were enrolled. Their normal baseline and 6-months postanthracycline echocardiographic and electrocardiographic parameters were compared for myocardial changes. Doxorubicin alone was used in 91 (79%) patients while daunorubicin alone in 24 (21%). Only 16 children (14%) received a high dose of anthracycline (cumulative dose > 300 mg/m 2). QTc interval significantly prolonged 6-months after chemotherapy than the baseline readings (P0.001). There was a significant increase in the left ventricular dimensions, and all myocardial functional parameters were significantly deteriorated in children who received anthracycline (P0.001). The incidence of cardiac dysfunction found more in female patients (20/28; 71.4%). Myocardial dysfunction was significantly higher among children who received a high cumulative dose of doxorubicin (P0.001). Conclusion: The incidence of subclinical anthracycline-related cardiac dysfunction is high. Children treated with anthracycline require a long-term follow-up to identify and establish optimal prevention and management strategies that balance oncologic efficacy with long-term safety.

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Due to the importance of arginase enzyme in different malignant disorders, the purpose of the present study was to determine and compare the arginase activity in cancerous cells and their normal and benign counterparts. The tissue arginase activity level was evaluated in 30 females with breast cancer, in 6 females with benign breast disease and in 9 healthy control subjects. The arginase activity levels were significantly increased in malignant breast tissues in comparison to healthy ones, while the difference did not reach the level of significance

Due to the importance of arginase enzyme in different malignant disorders, the purpose of the present study was to determine and compare the arginase activity in cancerous cells and their normal and benign counterparts. The tissue arginase activity level was evaluated in 30 females with breast cancer, in 6 females with benign breast disease and in 9 healthy control subjects. The arginase activity levels were significantly increased in malignant breast tissues in comparison to healthy ones, while the difference did not reach the level of significance