Background: Breast cancer is the most common cancer in Indian women. The aim of this study was to assess the levels of red blood cell (RBC) superoxide dismutase (r-SOD), RBC catalase (r-CAT), RBC glutathione peroxidase (r-GPx) and the ferric reducing ability of plasma (FRAP) in advanced breast cancer patients post mastectomy before and after chemotherapy. Methods: Female breast cancer patients between 27 and 65 years of age who were admitted to the Department of Surgery of the All India Institute of Medical Sciences in New Delhi were enrolled in the study. This study included two arms: a control group of healthy age-matched females (n=20) and patients undergoing treatment with a combination of the anticancer drugs cyclophosphamide, doxorubicin, and 5-fluorouracil (CAF) (n=55), No treatment was given to the control group. The CAF group received CAF treatment at weeks 0, 3, and 6, then surgery at week 9 followed by CAF treatment at weeks 12, 15, and 18. A three-week drug-free interval was included between each cycle of drug treatment. Blood samples were collected from control subjects and from patients in the CAF group before administration of drugs at week zero to establish a baseline, again weeks 12 and 18, and once more at the end of the 26-week treatment. Blood samples collected from the control subjects and CAF patients were analysed to determine levels of the endogenous antioxidants, r-SOD, r-CAT, r-GPx, and FRAP. Results: Levels of r-SOD, r-CAT, r-GPx, and FRAP in CAF-treated patients at 12, 18, and 26 weeks were significantly decreased (P<0.001) in comparison to the baseline levels observed at week zero. Conclusion: The results from the present study show that a change in the enzyme antioxidant systems in patients after chemotherapy and mastectomy causes an overall decrease in antioxidant levels. Chemotherapeutic agents induce oxidative stress that damages many cellular targets.

Toxic leucoencephalopathy (TLE) is a rare neurological complication of heroin abuse. 'Chasing the dragon' is an inhalational mode of heroin abuse that originated in Southeast Asia. Intriguingly, no cases of TLE have been reported from this region, although the inhalational mode of heroin abuse is common. We herein report the case of a middle-aged man with a history of polysubstance abuse who presented with progressive neurological symptoms and progressed to an uncommunicative state. While the initial impression was that of iatrogenic parkinsonism, diffuse leucoencephalopathy with sparing of the cerebellum was noted on magnetic resonance imaging. In view of his history of inhalational heroin abuse close to the onset of the neurological symptoms, a diagnosis of TLE was made. No clinical improvement was noted with administration of a dopaminergic agent. This is the first known case of delayed TLE following heroin inhalation from Southeast Asia with the unusual feature of cerebellar sparing.
Administration, Inhalation ; Brain ; pathology ; Disease Progression ; Heroin ; administration & dosage ; Heroin Dependence ; complications ; Humans ; Leukoencephalopathies ; chemically induced ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nervous System Diseases ; chemically induced ; Singapore

Central pontine myelinolysis (CPM) is classically described as a demyelinating condition that results from the rapid correction of hyponatraemia. CPM has also been reported to arise from hyperglycaemia in association with concomitant acidosis, hypernatraemia and hyperosmolar syndrome. Herein, we report a rare presentation of CPM, which was purely secondary to hyperosmolar hyperglycaemia. The patient presented with ataxia and pseudobulbar affect, which evolved subacutely over a duration of two weeks. It is important to note that, in addition to acute changes in osmolality, a subacute shift secondary to hyperglycaemia may also lead to CPM.
Diagnosis, Differential ; Female ; Humans ; Hyperglycemia ; complications ; Magnetic Resonance Imaging ; Middle Aged ; Myelinolysis, Central Pontine ; diagnosis ; etiology ; Tomography, X-Ray Computed

An adenocarcinoma arising in a horseshoe kidney (HK) is rare. The case of a forty five-year-old male patient, presenting with a recurrent, painless hematuria, is reported. On investigation the patient was found to have a horseshoe kidney, with an adenocarcinoma in the left hemi-kidney, which was treated surgically, with a hemi-nephrectomy, of the involved part, being performed to excise the tumor. A brief review of the relevant literature is also presented.
Carcinoma, Renal Cell/*complications/pathology/surgery ; Human ; Kidney/*abnormalities/radiography ; Kidney Neoplasms/*complications/pathology/surgery ; Lymph Node Excision ; Male ; Middle Aged ; Nephrectomy/methods

PURPOSE: Both chronic periodontitis (CP) and iron deficiency anemia (IDA) induce oxidative stress in the body and cause an imbalance between reactive oxygen species and antioxidants, such as superoxide dismutase (SOD). This study explored the SOD enzyme activity of saliva and serum in CP patients with and without IDA and analyzed the impact of IDA on CP. METHODS: A total of 82 patients were divided into four groups: control group (CG, 22), periodontally healthy IDA patients (IDA-PH, 20), CP patients (CP, 20), and IDA patients with CP (IDA-CP, 20). After clinical measurements and samplings, serum and salivary SOD levels were determined using an SOD assay kit. RESULTS: IDA-CP patients exhibited a higher gingival index, bleeding on probing, probing pocket depth, and percentage (%) of sites with a clinical attachment loss (CAL) of > or =6 mm (P<0.008) than CP patients. The mean salivary and serum SOD levels were significantly lower in the IDA-PH, CP, and IDA-CP patients than in the CG group (P<0.008). A significant positive correlation between salivary and serum SOD activity was observed in IDA (P<0.05). Furthermore, serum and salivary SOD levels were significantly and negatively correlated with all periodontal parameters including the percentage of sites with CAL of 4-5 and > or =6 mm (P<0.05) except the significant correlation between salivary SOD activity and mean CAL and the percentage of sites with CAL of 4-5 mm (P>0.05) in these patients. CONCLUSIONS: Within the limits of this study, it may be suggested that IDA patients with chronic periodontitis have more periodontal breakdowns than patients with chronic periodontitis. Serum and salivary SOD activity levels were lower in the IDA-PH, CP and IDA-CP groups than in the CG. Iron deficiency anemia influenced the serum SOD activity but did not seem to affect the salivary SOD activity in these patients.
Anemia, Iron-Deficiency* ; Antioxidants ; Chronic Periodontitis* ; Cross-Sectional Studies* ; Hemorrhage ; Humans ; Iron* ; Oxidative Stress ; Periodontal Index ; Reactive Oxygen Species ; Saliva ; Superoxide Dismutase* ; Superoxides*