Development of Curcumin loaded Nanostructured Lipid Carriers: Preparation, Characterization and In-vitro Evaluation of Anti-cancer Activity Against A-549 Human Lung Cancer Cell Line

Aims: The present study was aimed at preparing stable lyophilized curcumin loaded nanostructured lipid carriers (NLCs). The optimized lyophilized curcumin loaded NLCs were characterized and evaluated for various quality control parameters. Methodology: The optimized curcumin loaded NLCs were prepared by modified hot emulsification using compritol 888 ATO (CMPR), capmul MCM C8 EP (CAP) as solid and liquid lipids respectively. The combination of tween 80 (T80) and solutol HS 15 (SHS) were used as an emulsifier. The NLCs dispersion was lyophilized into powder form to improve the thermodynamic stability of the formulation. The lyophilized curcumin loaded NLCs were evaluated for particle size, size distribution, zeta potential, entrapment efficiency (EE), drug loading, assay, in-vitro drug release, crystallinity, thermal behavior and surface morphology studies. Results: The optimized lyophilized curcumin loaded NLCs have a mean particle size of 332.88 ± 5.9 nm with a size distribution of 0.350 ± 0.007, a zeta potential of 0.098 ± 0.019 mV with high entrapment of 97.64 ± 1.59% and drug loading of 2.50 ± 0.16%. The X-ray diffraction and endothermic peaks confirmed the maximum encapsulation of curcumin in lipid matrices. The particles were spherical with smooth surface morphology. In-vitro release studies showed sustained release for up to 24 h. The cytotoxicity against human lung cancer line A-549 for curcumin loaded NLCs was confirmed with positive control adriamycin (ADR). Conclusion: Curcumin loaded NLCs prepared had a nanosize particle distribution with maximum entrapment efficiency. Dispersion stability was increased by the lyophilization process. The solid lyophilized powder is reconstituted for oral delivery.

Pomegranate Seed Extract: A Strong Antioxidant against Benign Prostatic Hyperplasia Induced Oxidative Stress in Albino Wistar Rats

Aim: The aim of this study was to assess the antioxidant properties of ethanolic and aqueous extracts of Punica granatum (Pomegranate) seed in testosterone induced benign prostate hyperplastic albino Wistar rats. Study design: This study is an interventional study. Place and Duration of Study: The experimental aspect of this study was conducted at the animal house, Department of Pharmacology, University of Port Harcourt between April and September, 2019. Methodology: Seventy (70) adult albino male wistar rats were used for this study. They were divided into 12 groups of 5 rats each and fed with commercial rat diet and clean drinking water. Aqueous and ethanolic extracts of Punica granatum seed were prepared using the maceration method. Benign Prostate Hyperplasia was induced in rats after they submitted to bilateral orchiectomy by daily injections of testosterone propionate (TP) (4 mg/kg b.wt.sc). Rats were treated with 500 or 1500 mg/kg b.wt. of aqueous or ethanoI extracts of Punica granatum seed, dutasteride or in combination. Administration of extracts was done by gavage. Plasma total oxidant status (TOS), total antioxidant status (TAS), superoxide dismutase (SOD) activity, were analyzed using sandwich ELISA Kits by Shanghai Korain Biotech Co., Ltd, China, while oxidative stress indices (OSI) were calculated. Statistical analysis was done using SPSS version 22.0 of Windows Stat Pac and p values less than 0.05 were considered statistically significant. Results: The results showed that the mean TOS, TAS, SOD and OSI for the rats in the normal control group were 1.66±0.2U/ml, 2.71±0.25U/ml, 41.8±2.9pg/ml and 0.62±0.10 respectively. After BPH induction (group 2), the values were 3.25±0.5U/ml,1.17±0.14U/ml, 23.38±2.09 pg/ml and 2.81±0.60pg/ml respectively. There were significant decreases for TOS and OSI, and significant increases for TAS and SOD when the rats where treated with lower and higher doses of both aqueous and ethanolic extracts of Punica granatum and Dutasteride. Conclusion: In conclusion, both doses of Punica granatum seed for ethanolic and aqueous extracts individually and in combination and with dutasteride markedly reduced total oxidant status, oxidative stress indices and improved the activities of antioxidant parameters like superoxide dismutase and total antioxidant status.

A gastrointestinal Stromal Tumor of the Small Bowel Presenting as an Acute Peritonitis: A Case Report

Introduction: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract, GISTs of the small bowel presenting as an acute peritonitis are rare, which necessitates emergency surgery. Presentation of Case: A 44-year-old women presented with severe abdominal pain and nausea. Physical examination revealed a tenderness and muscular defense around the lower abdomen. Laboratory data showed an elevated white blood cell count and C-reactive protein level. An enhanced computed tomography (CT) scan showed a 8 × 10 cm cystic mass in the lower abdomen, which contained air. Emergency laparotomy showed a giant perforated tumor that arose from the ileum, the tumor and affected segment of ileum were resected. the tumor was diagnosed as GIST in low-risk category, and imatinib mesylate was initiated, The patiente had an uneventful postoperative course and remains well. Discussion and Conclusion: Such rare cases can be diagnosed and treated properly with careful clinical evaluation, Computed tomography (CT) is the gold standard for imaging that is used to characterize any abdominal mass. Surgical resection is still the first-line treatment for patients with primary localized and resectable small bowel GIST and adjuvant chemotherapy with imatinib mesylate is indicated in patients with high-risk small bowel GIST.

Anti-leukemogenic Efficacy of Aloe vera Gel on Benzene-induced Leukemia in Wistar Rats

Backgroud: The toxicity of benzene leading to leukemia induction has been well documented in animal model. Aloe vera is a succulent perennial evergreen flowering plant used traditionally in the treatment of jaundice and was found to have potent cytotoxic effect against HL60 human acute myeloid leukemia. The present study investigated the in vivo chemoprotective effects of Aloe vera gel on benzene-induced leukemia in rats. Methodology: Leukemia was induced in male Wistar rats of 80-90g weight by intravenously administered 0.2ml benzene solution alternate days for four weeks. Following induction, leukemic rats and normal baseline control rats were randomly assigned into four experimental groups of 6 animals each as follows: Group CTRL (control), normal baseline control rats; Group AVG (Aloe vera gel), normal baseline rats treated with Aloe vera gel (150 mg/kg) for 7 days, Group LKR (leukemic rats), untreated leukemic rats serving as leukemia control and Group LKR + AVG, leukemic rats treated with Aloe vera gel (150 mg/kg) for 7 days. Results: Leukemic rats showed altered hematology and morphological deformations such as anisocytosis, poikilocytosis and blast cells occurrence in peripheral blood. Also hypercellularity, severe dysplasia and significantly elevated micronucleated polychromatic erythrocyte were observed in marrow of leukemic rats. Moreover, benzene caused a significant elevation in plasma level of advanced oxidation protein products (AOPPs) with concomitant reduction in total sulfhydryl and arylesterase activity. However, treatment with Aloe vera gel restored blood hematology to near normal and mitigated the deformities in blood cell morphology induced by benzene. Aloe vera supplementation also effected a disappearance of dysplasia and diminution in the frequency of micronucleus in the bone marrow of treated leukemic rats. It also enhanced plasma antioxidant capability by restoring sulfhydryl content and arylesterase activity of the blood and abrogated the increase in plasma content of AOPPs. Conclusion: Overall, Aloe vera gel offered chemoprotective effect on Benzene-induced leukemia in rats.

Medullary Thyroid Cancer: Case Series Reports and Literature Review

Background: Medullary thyroid carcinoma (MTC) is a rare neuro-endocrine tumor that arises from the C-cells of the thyroid. About 20- 25 % of MTC cases may be associated with hereditary syndromes like MEN 2A, MEN 2B and Familial MTC. The survival rate is related mainly to the age of the patient, stage of the disease and completion of the surgical resection. Methods: Retrospective review of 11 patients who were diagnosed with medullary thyroid cancer in our general surgery department during the period from 2011 to 2021. All patients had preoperative assessment including history taking, clinical examination, tumor marker (calcitonin and CEA), thyroid function testing, ultrasonography and FNAC. All patients underwent genetic assessment to exclude any underlying genetic mutation. Results: The mean age of diagnosis was 57.73 ± 16.45 years of age. Three patients were males and eight were females. All patients had total thyroidectomy, central and lateral neck dissection except one patient who had prophylactic thyroidectomy due to familial inherited RET mutation. Two patients had recurrence; both of them had high-stage tumor (T3 and T4) with multiple cervical lymph nodes metastasis. The sensitivity of serum calcitonin for the detection of MTC was about 98%. Patients, who had localized disease and underwent complete surgical resection, had good overall survival rates compared with patients with advanced disease. Conclusion: MTC represent a heterogeneous group of thyroid cancers. The overall survival is better than that of undifferentiated thyroid cancers. Complete resection of the thyroid tumor and any local or regional metastases provides the only cure for patients with MTC. Further researches are still needed to improve our understanding and management of MTC.

Narrative Literature Review on Risk Factors Involved in Lung Cancers, Breast Cancers, Brain Cancers, Gastrointestinal Cancers, Gynecologic Cancers, and Urogenital Cancers

In this study, we described the most critical risk factors for different malignancies including breast, prostate, lung, and colorectal carcinoma among others, with an emphasis on modifiable risk factors. We revised the literature review about risk factors involved in the genesis of cancer in various databases, including articles indexed in PUBMED, SCOPUS, PMC, and Google Scholar. Awareness of risk factors enables conscious decisions to be made in an effort to combat malignancies. Knowing risk factors is a mode of fighting malignancy. Diet, lifestyle, practises, and laboratory/clinical interventions were among risk factors of diverse malignancy. Diet, lifestyle, laboratory/clinical interventions all contribute to the genesis and prognosis in a variety of malignancies. We concluded that abstaining from risk factors can prevent the development of many malignancies in a century where this conundrum is raising disproportionately. By informing the public about modifiable risk factors cancer mortality rates can be reduced. It is treated here is to make the public aware of the modifiable risks of cancers.

Lenvatinib in Anaplastic Thyroid Carcinoma (ATC) in a Tertiary Caner Hospital- a Single Institute Experience

Anaplastic Thyroid Carcinoma (ATC) is an aggressive rare form of caner with limited treatment options and short survival. In view of initial case reports have shown some good clinical response with lenvatinib, we used the same in our institute. We are presenting a retrospective series of 4 cases between 2018-2021. It showed very promising results with 75% showing clinically meaningful regression of tumor. Hypertension is the most common side effect, which should be aggressively managed. We feel that, lenvatinib remains a safe and effective option to explore in patients with refractory anaplastic thyroid carcinoma.

Analysis of Patients Undergoing Splenectomy for Spleen Masses

Aims: Spleen masses, which are discovered on imaging studies, usually create difficulty in diagnosis and treatment. Except for lymphomas involving the spleen, primary and secondary neoplasms are rare and discovered by chance. This study analyses a series of splenectomies in a surgical clinic to evaluate the management of incidentally diagnosed splenic masses. Study Design: This retrospective study included patients operated for spleen masses between 2010 and 2021. Patients with a history of lymphoproliferative disease and splenectomy performed as part of a larger resection were excluded. Methodology: The patients were divided into three groups, i.e. cystic, benign and malignant, based on the results of pathological examinations. The groups were compared in terms of age, gender, tumor size, and previous history of malignancy. Results: Splenectomy was performed in 512 patients in 11 years, 62 of whom had solid and cystic lesions detected on imaging. Thirty-five patients (56,5%) were female and the median age was 40 years (range: 18-80 years). Forty-four patients (71%) had distinct symptoms. Radiological evaluations of all the patients were made. Diagnostic biopsy could not be performed in any of the patients. The final pathological examination showed cysts in 38 patients (61,3%), benign lesions in nine patients (14,5%) and malignant lesions in 15 patients (24,2%). Out of 15 patients with malignant lesions, one patient had Hodgkin’s lymphoma, four patients had diffuse large B cell lymphoma and ten patients had metastatic tumors. There was a significant difference in age between the groups and the malignant group was older (p = 0.017). The size of the lesions also significantly differed and the malignant lesions had a significantly smaller diameter (p = 0.014). A significantly higher rate of the malignant group had a previous history of cancer (p˂0,001). Conclusion: Spleen neoplasms are masses that are difficult to diagnose. Most of them are asymptomatic and are found after splenectomies by coincidence. Splenectomy can be utilized as both a diagnostic and curative method. It should be kept in mind that the lesions detected in the spleen in patients with a history of malignancy can be metastatic.

Immunohistochemical Characterization of Genes Expressed in Leiomyoma using Ki67 and P53 in Patient Attending Niger Delta University Teaching Hospital

Objectives: This study aimed to investigate the expressions of p53 and ki67 genes in the characterization of leiomyomas. Materials: Fifty (50) Paraffin embedded tissue blocks were selected from the department of Histopathology, Niger Delta University Teaching Hospital, Okolobri from January 2011 to August 2019. The histological characterization and morphological evaluation were defined using the routine Hematoxylin and Eosin staining method. Immunostaining was done for p53 and ki67 using the manufacturers antibodies. Results: A direct correlation between age and the expression of the p53 gene was also made in this study. It was observed that in patients within the ages of 50-59 and 60-69, there was markedly no expression of the p53 gene whereas in patients within the ages of 20-29, there was still some level of expression (20%) and ages 30-39 (80%) and finally 40-49 (10%). There was no expression (0.0%) of Ki-67 in uterine leiomyomas across all age groups. Conclusion; This study therefore has suggested that based on the percentage of expression, it can rightly be inferred that the p53 gene is a good indicator in the immune-histochemical characterization of leiomyomas as it has good sensitivity and good prognosis as opposed to Ki67.

Fibrous Dysplasia: A Retrospective Review of Histologically Diagnosed Cases in a Tertiary Health Care Centre in Nigeria

Aims: This study aims to document the age, sex and site distribution of fibrous dysplasia in our tertiary health care facility in order to compare our findings with published literature. Study Design: This is a hospital-based retrospective and descriptive study extending from 1st January 2005 to 31st December 2019. Place and Duration of Study: Department of Histopathology, Jos University Teaching Hospital, Jos, Plateau State in North-Central Nigeria between 1st January 2005 to 31st December 2019. Materials and Methods: Materials consisted of Archival slides, paraffin wax tissue blocks, surgical pathology register and case files of all cases of fibrous dysplasia diagnosed histologically during the period of review. The age, sex and site affected by the tumour were documented for each case using both electronic and hard copy records. The histology slides were examined to confirm the diagnosis. A total of 165 primary bone tumours (103 benign and 63 malignant) were recorded during the period of review, of which 28 were fibrous dysplasia. Results: There were 28 cases of fibrous dysplasia which represented 17% of the primary bone tumours and 27% of the benign bone tumours. A half (50%) of the cases occurred in the second decade and 82.1% of cases were diagnosed in craniofacial bones. There was no sex bias in diagnosis. Conclusion: Fibrous dysplasia is a relatively common bone tumour in our environment. The sex distribution, age at diagnosis, and bones affected is in keeping with findings by authors from other parts of the world.