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Introduction: Breast cancer is a complex disease characterised by abnormal cell growth in breast tissue. Trastuzumab is a targeted therapy that inhibits the HER-2 receptor and suppresses tumour growth. We aimed to determine if the clinical course of the disease could be predicted by early changes in serum levels of human epidermal growth factor receptor 2 (HER-2/neu) following trastuzumab-based therapy.

Material and methods: The study enrolled 120 women, divided into an experimental group (60 breast cancer patients receiving trastuzumab) and a control group (60 healthy women). Serum samples were collected before each weekly trastuzumab treatment. In addition, human breast cancer cell lines MCF-7 and AMJ13 were cultured in vitro and treated with trastuzumab. The study assessed cell viability using a cytotoxicity assay (methyl thiazolyl tetrazolium) and measured HER-2 protein levels. The half maximal inhibitory concentration (IC50) was determined to evaluate the effect of trastuzumab on breast cancer.

Results: The results showed that breast cancer patients had significantly lower serum levels of HER-2 compared to the control group. The cytotoxicity assay demonstrated that increasing trastuzumab concentration enhanced growth inhibition and cytotoxicity in the cell lines. There was a significant difference in IC50 between the MCF-7 and AMJ13 cell lines.

Conclusions: The study provides valuable insights into the effects of trastuzumab on serum HER-2 levels and breast cancer cell lines. These findings have implications for resource allocation and treatment decisions in breast cancer management. By understanding the impact of trastuzumab on HER-2 levels and tumour cells, healthcare professionals can make more informed decisions regarding therapy options for patients.

Introduction: Psoriasis is a chronic, non-infectious skin disease that affects people of all ages and has no sex preference, which is caused by environmental stressors involving skin cells, immunocytes, and several biologic signaling molecules. Psoriasis has been linked to psychological, metabolic, arthritic, and cardiovascular complications. Heat shock protein 70 (HSP70) is considered the most protective member of the HSP family. HSP70 can regulate protein homeostasis, minimize stress-induced denaturation and aggregation of intracellular proteins and operate as a protective factor in tissue damage. This study aimed to investigate the serum level of HSP70 in patients with psoriasis to assess whether there is an association of HSP70 with psoriasis and to assess the effects of age, gender, body mass index (BMI), waist circumference, and disease duration on the serum level of HSP70.

Material and methods: This was a case-control study which recruited 98 patients with psoriasis and 81 apparently healthy age- and sex-matched individuals as controls. Blood samples were collected via venipuncture (5 ml) to estimate the HSP70, random blood sugar, liver enzymes, lipid profile, and complete blood count.

Results: The results revealed that the level of HSP70 was significantly higher in psoriasis patients compared to the control group (p-value < 0.05). The level of HSP70 showed a significant association with gender, but a non-significant positive correlation with duration of psoriasis. The level of HSP70 showed a non-significant negative correlation with age, BMI and waist circumference.

Conclusions: The study suggested that HSP70 may have a potential role in the pathophysiology of psoriasis and may help to explain the mechanisms behind the development and treatment of psoriatic lesions with different severity.

Introduction: Breast cancer (BC) is the most frequent cancer in women and is a serious worldwide health issue. Phosphoglycerate dehydrogenase (PHGDH) is an enzyme that catalyses the first steps in the serine biosynthetic pathways downstream of glycolysis. Phosphoglycerate and glycine are produced by a series of enzymatic processes from the glycolysis intermediate 3-phosphoglycerate. The aim of the study was to indicate the levels of PHGDH and glycine in patients with breast cancer.

Material and methods: The study was performed from December 2022 to March 2023. The total number of samples was 135 samples - 65 samples were collected from women with breast cancer, and 70 samples were from healthy women as a control group. Blood samples (5 ml) were obtained from all study group members. The complete blood count (CBC) neutrophils/lymphocytes, and haemoglobin ratio analysis was done on a CBC haematology analyser (Sysmex, Japan). Serum PHGDH and glycine were measure by enzyme-linked immunosorbent assay.

Results: The study findings revealed a significant increase in the neutrophil/lymphocytes ratio and a decrease in PHGDH level in patients with BC compare to controls (p < 0.01), while the serum glycine level showed a significant increase in patients with BC compare to the control group (p < 0.01).

Conclusions: Reduced PHGDH level and high glycine concentration in patients with BC could act as a prognostic factor in cancer development.

Introduction: The aim was to assess the hemostatic impact of B-Lynch sutures following an open myomectomy for efficacy.

Material and methods: In this prospective clinical research, performed in Alazhar university hospitals (Al-Hussain, Damietta, Assiut) and Minia University Maternity Hospital, 250 women scheduled for open myomectomy between January 2021 and January 2023 had multiple fibroid uteri with uterine sizes corresponding to 12-22 weeks. There were two groups of women. Group I (125) underwent standard open myomectomy surgery, whereas Group II (125) underwent normal open laparotomy surgery followed by B-Lynch sutures. Certain inclusion and exclusion criteria were applied to every patient. We recorded vital data, length of the procedure, complications (bleeding during the procedure, bleeding from multiple bites, bladder injury, fever, wound infection), complete blood count before and after surgery, need for blood transfusion, postoperative vital data, time until ambulation, passing flatus, and ability to eat and drink, as well as the amount of blood lost during and after the procedure.

Results: There was no statistically significant difference between the two groups in age, parity, weight, number of fibroids, or uterine size as measured by ultrasonography. Between groups I and II, there was a significant difference in the average intraoperative blood loss (Group I lost 562.6 ml, whereas Group II lost 411.3 ml) as well as the mean blood loss following surgery (205 ±82 ml in Group I and 117 ±41 ml in Group II). No significant difference was observed in the mean length of hospital stay between groups I and II (2 ±0.3 days and 2 ±0.6 days, respectively).

Conclusions: Using a B-Lynch suture can help minimize blood loss during and after an open myomectomy. Therefore, if the uterus is large and has a lot of fibroids, it is recommended to be done frequently.

Hysterectomy is a common surgical procedure performed to remove the uterus. This is considered as a clean-contaminated surgical procedure. It is a safe procedure, but major and minor complications can occur, including vault hematoma and vault cellulitis, which are specific to the surgical site. Vault hematoma is the accumulation of blood within the vaginal vault, while vault cellulitis is an infection of the vaginal vault or the surgical cuff following a hysterectomy. Vault hematoma may be caused by trauma during surgery, improper hemostasis or infection. Smaller hematomas may resolve with conservative management, but larger vault hematomas and infected hematomas may need surgical drainage and antibiotic coverage. Vault cellulitis typically occurs due to the introduction of bacteria into the surgical site which may occur due to inappropriate postoperative care and contaminated materials. The patient may present with pelvic pain and fever. Broad-spectrum antibiotics are typically prescribed to treat the infection. While both these complications are relatively rare and appear to be mild, healthcare providers should be vigilant in recognizing and managing them promptly to prevent adverse outcomes. Prophylactic antibiotics should be administered before the surgery to reduce the risk of infection. Care should be taken to minimize tissue trauma, ensure proper hemostasis, and maintain strict aseptic techniques during surgery.

Introduction: Breast carcinoma is a heterogeneous disease, characterised by diverse clinical behaviour. The aim of this study was to assess how cleaved caspase-3 and Ki-67 index, evaluated on diagnostic biopsy, are related to response to neoadjuvant chemotherapy in the context of molecular subtype, post-treatment tumour, N category, and grade.

Material and methods: A retrospective analysis was carried out among 110 breast cancer patients. Ki-67 levels and caspase-3 expression on diagnostic biopsy were explored regarding their relation to tumour grade and molecular subtype, ypT, ypN categories, and T and N categories according to Sataloff tumour response evaluation.

Results: A statistically significant relationship was found between Ki-67 levels and tumour grade K-W = 24.2932, p < 0.0001; molecular subtype K-W = 28.5439, p < 0.00000967538; size and invasion of the primary tumour after neoadjuvant chemotherapy K-W = 11.7944, p < 0.0377169; caspase-3 expression after neoadjuvant therapy, evaluated according to the Sataloff classification χ² = 5.97, df = 1, p = 0.0145.

Discussion: No significant difference was found between Ki-67 expression in patients with pathological complete response, compared to those with partial and no response, a statistically significant difference in cases with different molecular subtype, histology grade, and tumour stage after neoadjuvant therapy. Cleaved caspase-3-positive breast cancer cases are often better responders to neoadjuvant therapy, but with no significant correlation to molecular subtype, high-grade categories, or tumour stage.

Conclusions: The caspase-3 and Ki-67 index on diagnostic biopsy are related to post-neoadjuvant treatment prognostic factors (ypT stage, grade), proving them useful for prediction of treatment response to neoadjuvant therapy and further patient management.

Introduction: Urinary tract infection (UTI) is a prevalent infection among the elderly population, often culminating in more severe and life-threatening complications. The prevalence of diabetes among elderly individuals is markedly on the rise, with UTI emerging as the most prevalent infectious ailment in this diabetic cohort. This study aims to ascertain the influence of theory-based education on promoting UTI prevention behaviours among elderly diabetic women.

Material and methods: In this experimental study, 100 elderly women with diabetes who sought care at comprehensive health service centres in Miandoab City between January and May 2022 were assessed. Multistage random sampling was employed, and an educational intervention was designed according to the health belief model (HBM) constructs. Data collected before and one month after the educational intervention were analysed with a validated and reliable researcher-designed questionnaire.

Results: The participants had a mean age of 62.30 ±7.63 years. There was significant disparity between the experimental and control groups concerning the mean scores for knowledge, HBM constructs, and behaviour, with adjustments made for baseline differences. In essence, the intervention had significant affects, resulting in heightened levels of knowledge, improvements in HBM constructs, and more favourable behavioural changes. The effect size was moderate for perceived benefits and severity, while it was large for other variables (p < 0.05).

Conclusions: The research findings validate the effectiveness of an intervention grounded in HBM for fostering UTI prevention behaviours among elderly diabetic women. Consequently, such an approach is recommended for enhancing the overall health of elderly diabetic women.

Introduction: The aim of the present study was to investigate the association between some risk factors and endometrial pathologies determined by transvaginal sonography (TVS), as well as the diagnostic predictive values of serum oestradiol (E2) levels, subcutaneous adipose tissue (SAT) thickness, endometrium thickness (ET), and the ratio of ET to uterine wall full thickness (UWT) in differential diagnosis of malignant, precancerous, and benign pathologies of endometrium in patients with postmenopausal bleeding (PMB) or with asymptomatic increased endometrial thickness.

Material and methods: The study was conducted with 211 women who applied to the hospital with complaints of PMB or ET of 5 mm or more in their routine controls. Venous blood samples were taken for complete blood count and the measurement of E2 levels. Patients also underwent TVS; ET, UWT, and the ratio of ET to UWT were measured.

Results: Menopausal age and body mass index averages were significantly higher in atypical hyperplasia and endometrial cancer (EC) groups. Endometrial thickness and endometrial thickness/uterine wall full thickness ratio measured by TVS were significantly higher in all precancerous pathologies and EC. Subcutaneous adipose tissue thickness was significantly higher in all precancerous pathologies and EC. Oestradiol levels were higher in the atypical hyperplasia and EC groups.

Conclusions: Postmenopausal bleeding is a common symptom of EC, but in some cases this disease may occur asymptomatically. Measurement of the endometrium thickness, and the ratio of endometrium thickness/uterine wall full thickness and SAT thickness by sonography has a high predictive value for this disease.

Introduction: Polycystic ovary syndrome (PCOS) is a complex hormonal condition associated with psychological, reproductive, and metabolic features. Low-grade inflammation is a recognised factor causing metabolic and reproductive disorders in PCOS, which is why anti-inflammation approaches in PCOS treatment, especially during the COVID pandemic, are considered. A promising therapeutic option is osteopathic manipulative treatment (OMT), which activates the cholinergic anti-inflammatory pathway and can inhibit proinflammatory cytokines, such as TNF, IL-1β, and TNF-β. In our paper we analysed the influence of OMT in women with PCOS.

Material and methods: Seventy-three patients, aged 29-46 years, with a history of reproductive failure, who underwent a physiotherapeutic treatment were evaluated. Six months after the end of a physiotherapy session, a follow-up questionnaire was performed.

Results: The results show that most women (83.6%) were satisfied with the therapeutic process, and that the sessions met the patient's expectations. Reducing the level of anxiety related to infertility treatment and pregnancy was declared by 60 (82.2%) women, an improvement in well-being was declared by 72 (97.3%) (p = 0.04), and increasing awareness of the body after physiotherapy sessions was declared by 70 (95.9%) women.

Conclusions: The physiotherapeutic sessions improved infertility treatment, enhanced quality of life, and had a positive effect on overall health in PCOS women.

Introduction: Cervical cancer (CC) is a leading cause of mortality in women around the world, with the highest incidence rate still being in developing countries. The most common aetiological factor is infection with high-risk human papilloma virus viral strains. Oxidative stress through generation of reactive oxygen species leads to lipid peroxidation and DNA damage. Studies show that reactive lipid electrophiles such as 4-hydroxynonenal (4-HNE) produced in the process play an important role in cancer signalling pathways and are a good biomarker for oxidative stress. We aim to investigate the prognostic role of 4-HNE as a biomarker for oxidative stress in patients in early and advanced stages of CC measured by immunohistochemistry.

Material and methods: This is a retrospective study of 69 patients treated at our Department of Oncogynaecology. Paraffin embedded tumour tissues were immunohistochemically tested for the levels of expression of 4-HNE. The results for H-score, Allred score, and combined score were investigated for association with tumour size, lymph node status, andInternational Federation of Gynaecology and Obstetrics stage.

Results: 4-hydroxynonenal showed higher expression in more advanced stages of CC and in cases with involved lymph nodes. Tumour size was not associated with the levels of 4-HNE.

Conclusions: To best of our knowledge, this is the first study to use immunohistochemistry to examine the expression of 4-HNE as a prognostic factor in CC. The 3 score systems showed similar results. The pattern of 4-HNE histological appearance is dependent on the histological origin of cancer and is not universal.