Background: We evaluated the significance of the genes, defined as DRB1*04 or DRB1*01, in rheumatoid arthritis (RA) patients. We focused on the role of genetic and serologic markers to predict disease activity and destructive process of joints. Methods: Sixty patients with RA were examined. Radiographic changes were evaluated by (Larsen score) and disease activity was measured by disease activity score 28 (DAS28). The markers analyzed were: erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptides (anti-CCP2) and HLA-DRB1 alleles typed by PCR. Results: In this study, anti-CCP antibodies, CRP, RF and AKA were detected in 83.3%, 56.7%, 71.7% and 52% of patients respectively. HLA-DRB1*01 was found in 45% of patients and 35% of them had one or two HLA-DRB1*04 alleles. According to DRB1*04 subtypes, (DRB1* 0405) was present in of 80% them. For prediction of grade of activity, the independent predictors were anti- CCP (OR 19.6), and DRB1*04 positive allele (OR 5.1). The combination of DRB1*04 + anti-CCP antibodies gave increase in the specificity and positive predictive value to 92% and 90 respectively. As regards to the prediction of radiological joint damage, the independent predictors were HLADRB1* 04, HLA-DRB1*01, RF, and CRP > 18 (OR 5.5, 4.5, 2.5, 2.0 respectively). Conclusion: Our findings suggest that anti-CCP2 is superior to RF for the detection of RA and provided predictive information on joint destruction and disease activity. The presence of RA associated antibodies (ACCP or RF) and/or the SE genes are indicative for a poorer radiological outcome and higher grade of activity.

Background: We evaluated the significance of the genes, defined as DRB1*04 or DRB1*01, in rheumatoid arthritis (RA) patients. We focused on the role of genetic and serologic markers to predict disease activity and destructive process of joints. Methods: Sixty patients with RA were examined. Radiographic changes were evaluated by (Larsen score) and disease activity was measured by disease activity score 28 (DAS28). The markers analyzed were: erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptides (anti-CCP2) and HLA-DRB1 alleles typed by PCR. Results: In this study, anti-CCP antibodies, CRP, RF and AKA were detected in 83.3%, 56.7%, 71.7% and 52% of patients respectively. HLA-DRB1*01 was found in 45% of patients and 35% of them had one or two HLA-DRB1*04 alleles. According to DRB1*04 subtypes, (DRB1* 0405) was present in of 80% them. For prediction of grade of activity, the independent predictors were anti- CCP (OR 19.6), and DRB1*04 positive allele (OR 5.1). The combination of DRB1*04 + anti-CCP antibodies gave increase in the specificity and positive predictive value to 92% and 90 respectively. As regards to the prediction of radiological joint damage, the independent predictors were HLADRB1* 04, HLA-DRB1*01, RF, and CRP > 18 (OR 5.5, 4.5, 2.5, 2.0 respectively). Conclusion: Our findings suggest that anti-CCP2 is superior to RF for the detection of RA and provided predictive information on joint destruction and disease activity. The presence of RA associated antibodies (ACCP or RF) and/or the SE genes are indicative for a poorer radiological outcome and higher grade of activity.

Background: Accelerated hypofractionated approach is based on the radiobiologic model that a lower total dose delivered in fewer, larger fractions over a shorter period of time is at least as effective as the traditional longer schedule with increasing evidence of equivalent efficacy and toxicities from randomized trials comparing conventional radiotherapy schedules to different hypofractionated schedules. Patients and methods: 100 female patients having breast cancer after finishing their chemotherapy if indicated, randomized into two arms of accelerated hypofractionation; 39Gy/13 fractions (group A) and 42.4Gy/16 fractions (group B) both regimens given as 5 fractions per week. Results: The disease free survival was 93% and local recurrence was 1%. There were no statistically significant effects as regards recurrent rate in any studied factors. Radiation complications of patients, in terms of skin, subcutaneous, pulmonary, cardiac, ipsilateral arm lymphedema and brachial plexus toxicity, were assessed and graded in both group A and group B. There was significant increase of incidence of acute radiation dermatitis in patients receiving 39 Gy, as grade I and II reported in 82% and 46% for 39 Gy group and 42.4 Gy group respectively. In-addition, increased chronic subcutaneous fibrosis among patients with group A (28%) in comparison to group B (18%) that reach statistical significance. Type of surgery is the only factor that had significant effect on incidence of acute radiation dermatitis and chronic subcutaneous fibrosis. Conclusion: Our study concluded Equivalent efficacy of 39 Gy in 13 fractions and 42.4 in 16 fractions regarded local control and survival. 39 Gy in 13 fractions is not recommended for patients underwent BCS.

Background: Accelerated hypofractionated approach is based on the radiobiologic model that a lower total dose delivered in fewer, larger fractions over a shorter period of time is at least as effective as the traditional longer schedule with increasing evidence of equivalent efficacy and toxicities from randomized trials comparing conventional radiotherapy schedules to different hypofractionated schedules. Patients and methods: 100 female patients having breast cancer after finishing their chemotherapy if indicated, randomized into two arms of accelerated hypofractionation; 39Gy/13 fractions (group A) and 42.4Gy/16 fractions (group B) both regimens given as 5 fractions per week. Results: The disease free survival was 93% and local recurrence was 1%. There were no statistically significant effects as regards recurrent rate in any studied factors. Radiation complications of patients, in terms of skin, subcutaneous, pulmonary, cardiac, ipsilateral arm lymphedema and brachial plexus toxicity, were assessed and graded in both group A and group B. There was significant increase of incidence of acute radiation dermatitis in patients receiving 39 Gy, as grade I and II reported in 82% and 46% for 39 Gy group and 42.4 Gy group respectively. In-addition, increased chronic subcutaneous fibrosis among patients with group A (28%) in comparison to group B (18%) that reach statistical significance. Type of surgery is the only factor that had significant effect on incidence of acute radiation dermatitis and chronic subcutaneous fibrosis. Conclusion: Our study concluded Equivalent efficacy of 39 Gy in 13 fractions and 42.4 in 16 fractions regarded local control and survival. 39 Gy in 13 fractions is not recommended for patients underwent BCS.

Background: Accelerated hypofractionated approach is based on the radiobiologic model that a lower total dose delivered in fewer, larger fractions over a shorter period of time is at least as effective as the traditional longer schedule with increasing evidence of equivalent efficacy and toxicities from randomized trials comparing conventional radiotherapy schedules to different hypofractionated schedules. Patients and methods: 100 female patients having breast cancer after finishing their chemotherapy if indicated, randomized into two arms of accelerated hypofractionation; 39Gy/13 fractions (group A) and 42.4Gy/16 fractions (group B) both regimens given as 5 fractions per week. Results: The disease free survival was 93% and local recurrence was 1%. There were no statistically significant effects as regards recurrent rate in any studied factors. Radiation complications of patients, in terms of skin, subcutaneous, pulmonary, cardiac, ipsilateral arm lymphedema and brachial plexus toxicity, were assessed and graded in both group A and group B. There was significant increase of incidence of acute radiation dermatitis in patients receiving 39 Gy, as grade I and II reported in 82% and 46% for 39 Gy group and 42.4 Gy group respectively. In-addition, increased chronic subcutaneous fibrosis among patients with group A (28%) in comparison to group B (18%) that reach statistical significance. Type of surgery is the only factor that had significant effect on incidence of acute radiation dermatitis and chronic subcutaneous fibrosis. Conclusion: Our study concluded Equivalent efficacy of 39 Gy in 13 fractions and 42.4 in 16 fractions regarded local control and survival. 39 Gy in 13 fractions is not recommended for patients underwent BCS.

Background: Accelerated hypofractionated approach is based on the radiobiologic model that a lower total dose delivered in fewer, larger fractions over a shorter period of time is at least as effective as the traditional longer schedule with increasing evidence of equivalent efficacy and toxicities from randomized trials comparing conventional radiotherapy schedules to different hypofractionated schedules. Patients and methods: 100 female patients having breast cancer after finishing their chemotherapy if indicated, randomized into two arms of accelerated hypofractionation; 39Gy/13 fractions (group A) and 42.4Gy/16 fractions (group B) both regimens given as 5 fractions per week. Results: The disease free survival was 93% and local recurrence was 1%. There were no statistically significant effects as regards recurrent rate in any studied factors. Radiation complications of patients, in terms of skin, subcutaneous, pulmonary, cardiac, ipsilateral arm lymphedema and brachial plexus toxicity, were assessed and graded in both group A and group B. There was significant increase of incidence of acute radiation dermatitis in patients receiving 39 Gy, as grade I and II reported in 82% and 46% for 39 Gy group and 42.4 Gy group respectively. In-addition, increased chronic subcutaneous fibrosis among patients with group A (28%) in comparison to group B (18%) that reach statistical significance. Type of surgery is the only factor that had significant effect on incidence of acute radiation dermatitis and chronic subcutaneous fibrosis. Conclusion: Our study concluded Equivalent efficacy of 39 Gy in 13 fractions and 42.4 in 16 fractions regarded local control and survival. 39 Gy in 13 fractions is not recommended for patients underwent BCS.

Background: Accelerated hypofractionated approach is based on the radiobiologic model that a lower total dose delivered in fewer, larger fractions over a shorter period of time is at least as effective as the traditional longer schedule with increasing evidence of equivalent efficacy and toxicities from randomized trials comparing conventional radiotherapy schedules to different hypofractionated schedules. Patients and methods: 100 female patients having breast cancer after finishing their chemotherapy if indicated, randomized into two arms of accelerated hypofractionation; 39Gy/13 fractions (group A) and 42.4Gy/16 fractions (group B) both regimens given as 5 fractions per week. Results: The disease free survival was 93% and local recurrence was 1%. There were no statistically significant effects as regards recurrent rate in any studied factors. Radiation complications of patients, in terms of skin, subcutaneous, pulmonary, cardiac, ipsilateral arm lymphedema and brachial plexus toxicity, were assessed and graded in both group A and group B. There was significant increase of incidence of acute radiation dermatitis in patients receiving 39 Gy, as grade I and II reported in 82% and 46% for 39 Gy group and 42.4 Gy group respectively. In-addition, increased chronic subcutaneous fibrosis among patients with group A (28%) in comparison to group B (18%) that reach statistical significance. Type of surgery is the only factor that had significant effect on incidence of acute radiation dermatitis and chronic subcutaneous fibrosis. Conclusion: Our study concluded Equivalent efficacy of 39 Gy in 13 fractions and 42.4 in 16 fractions regarded local control and survival. 39 Gy in 13 fractions is not recommended for patients underwent BCS.

The aim of this study was to evaluate the effects of bacterial pneumonia and malnutrition on the frequency of micronuclei (MN) in peripheral blood of pediatric patients through flow cytometric analysis. The study was an analytical case-control study carried out on 35 malnourished children with bacterial pneumonia and 20 well-nourished children with bacterial pneumonia, in addition to 20 healthy children as controls. Complete physical examination including; anthropometric measurement, Chest roentgenograms were done for all cases. Assessment of MN was done by FACSCalibur flow cytometry. The frequency of micronucleated reticulocytes (MN-RETs) was higher both in the malnourished children with pneumonia and well-nourished children with pneumonia than the controls. Within the malnourished children with pneumonia, patients with kwashiorkor had more micronucleated mature erythrocytes (MN-RBCs) and MN-RETs than patients with marasmus. In conclusion: Pneumonia is associated with an increased frequency of MN and this increment is more pronounced in children with severe malnutrition especially kwashiorkor group.