Authors:Olha Bondar-Keleberda Pages: 24 - 33 Abstract: Type 2 diabetes mellitus (T2DM) is associated today with a non-infectious epidemic. Every year, the number of people suffering from this disease only increases. The comorbidity of pathology, namely gastroesophageal reflux disease (GERD) against the background of type 2 diabetes mellitus, is increasingly observed. Pathogenetic mechanisms of the progression of the latter in the combined course with type 2 DM are not sufficiently studied today, and data on the effect of adipokines on the morphological pattern of the esophagus in patients with type 2 DM are emerging. The aim of this study is to study changes in the esophageal mucosa depending on the concentration of ghrelin and leptin in patients with comorbid GERD on the background of type 2 diabetes. Materials and methods of the research. 120 patients were recruited for the study and divided into 3 groups and a control group. The 1st group – 60 patients with a combined course of GERD and type 2 DM, the 2nd group – 20 patients with GERD, and the 3rd group – 20 patients with isolated type 2 DM. The control group - 20 practically healthy people of the appropriate age. The levels of ghrelin and leptin were determined by enzyme-linked immunosorbent assay (ELISA) on a Labline-90 analyzer (Austria). Endoscopic examination of the upper parts of the gastrointestinal tract (GI) with targeted biopsy was performed with an esophagogastroduodenoscope with end optics "Olympus GIF Q 150-03" (manufactured by Olympus Europa SE & CO. KG, Japan). The degree of complexity and the presence of reflux esophagitis were determined according to the Los Angeles classification and grading system of esophagitis of the Japanese Society of Esophagitis (JSDE), modified in 1999 [1]. Results. Correlation analysis of the relationship between ghrelin and leptin indicators showed a reliable, inverse, medium strength dependence (r = -0.5531; p<0.05). Reliable maximum values of ghrelin were found in patients with non-erosive form of GERD, and minimum values of ghrelin were recorded in patients with reflux esophagitis stage C. When studying leptin indicators depending on the degree of esophagitis, the following data were obtained: the maximum values of leptin were found in patients with reflux - stage B esophagitis, and minimal - in patients with a non-erosive form of GERD. Regarding the reliability of the obtained data on leptin concentration, we did not find statistically significant differences in the studied groups (p>0.05). Conclusions. According to the results of the conducted research, we can say that changes in the concentration of ghrelin have an important diagnostic value in the focus of GERD against the background of type 2 diabetes. Decreased ghrelin levels have been associated with erosive forms of GERD in the setting of type 2 diabetes, which can lead to a significant deterioration in the patient's lifestyle. According to the data obtained during the study on the influence of leptin levels on changes in the mucous membrane of the esophagus, it was found that morphological changes in the esophagus did not depend on the concentration of leptin in the studied groups PubDate: 2023-12-28 DOI: 10.21303/2504-5679.2023.003276
Authors:Cassius Tumelo Makgabo Mathopa, Fumani Charles Makhandule, Mirza M. Z. U. Bhuiyan Pages: 34 - 38 Abstract: Spindle cell carcinoma of the breast is a rare breast malignancy, and it accounts for <1 % of breast neoplasms. Tumours are usually large, well-circumscribed, and cystic-containing lesions in the upper outer quadrant of the breast. The aim: The main objective of the case report is to highlight our experience with Spindle cell carcinoma of the breast. Result: A case presentation of a 58-year-old female who was referred from the peripheral hospital to our breast oncology clinic with a left breast mass rapidly growing for the past five months. The mass measured 23cm x 20 cm, palpable in all quadrants of the breast but more in the upper outer quadrant of the breast. Mammography and ultrasound showed a massive heterogeneous left breast solid mass involving the entire breast and all quadrants, with areas of cystic components and increased flow. There were no calcifications noted. She was assessed as BI-RAD 5. A core needle biopsy showed spindle cell carcinoma of the left breast. The patient was offered a modified radical mastectomy. Conclusion: Spindle cell carcinoma of the breast poses a diagnostic challenge due to the rarity of the disease; overlapping morphological features on histology and biomarkers specific to spindle cells have not been extensively studied PubDate: 2023-12-28 DOI: 10.21303/2504-5679.2023.003254
Authors:Mirza M. Z. U. Bhuiyan Abstract: Breast cancer remains the most common cancer in many parts of the world, particularly for women. In March 2015, a Breast Oncology clinic for breast cancer patients was established at Mankweng Hospital. Invasive ductal carcinoma is the most common (87 %) tumour found in Limpopo, and occasionally, another rare tumour of the breast is presented in the Breast Oncology clinic. The aim: The main objective is to share the experience of a rare tumour of the breast came across over the past 8 years since the establishment of the Breast Oncology clinic. Material and Method: Series of rare case reports of Breast tumours and literature review from the Mankweng Breast Oncology Clinic. Result: Rare tumour encountered in Breast Oncology clinic: adenomyoepithelioma, micro-papillary carcinoma of the breast, primary malignant melanoma of the breast, primary non-Hodgkin's lymphoma of the bilateral breast, advanced breast cancer in a case of Down's syndrome, primary neuroendocrine invasive breast carcinoma, sarcoma of the breast. Conclusions: Most of these rare cases are presented to the Breast Oncology clinic in the advanced stage. Breast cancer awareness campaign is highly important for women in Limpopo, particularly when attending primary health care for any other conditions. PubDate: 2023-07-31 DOI: 10.21303/2504-5679.2021.003058
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