Using single injection percaruncular peribulbar local anaesthesia for phacoemulsification in patients with axial myopia is an effective technique.

Introduc tion: Docetaxe l, Cisplatin and 5-Fluorouracil (DPF) became the standard i nduc tion c hemotherapy in advanced Head and Neck Cancer (HNC) but associated with high toxicity rate. Se veral studies reported higher response rates with better tolerability when chemotherapy dose is calculated based on Pharmacokinetics (PK) versus conventional Body Surface Area (BSA). Patien ts an d Me thods: Thirty nine patients with stage III and IV HNC who received induction DPF were inc luded in the study. Dose of cycle 1 was BSA-based then Docetaxel and 5-FU doses were PK-adjusted starting from cycle 2 whereas Cisplatin dose was BSA-based throughout the study. Results: After median follow up period of 14 months the median overall survival (OS) and progression free survival (PFS) were 15.1 and 10.6 months respectively. Twenty nine patients were available for response assessment. Seven patients (24.1%) achieved complete response while partial response encountered in 19 patients (65.5%) with and Overall response rate of 89.6%. Both treatment related side effects and mortality significantly decreased after the application of PK dose adjustments (p-value 0.007 and 0.01 respectively). Conclusi on: PK-guided dose adjustments of 5-FU and Docetaxel in D PF regimen can significantly decrease the treatment related side effects and mortality without compromising the tumor response rate. A randomized clinical trial is needed to compare the PK-guided dose adjustment with the standard BSA based protocol.

This is a retrospective study of 142 stone-formers admitted during 1981 to a general surgical unit of a district hospital. The majority were adult non-Kuwaiti males. Contrary to expectations it was the manual workers from lower economical social strata who were commonly afflicted. The possible reasons for this are discussed. There were no specific biochemical defects in the patients' sera but of 22 patients whose 24-hour urines were examined, half had some abnormality. The majority of IVPs showed some anatomical abnormalities. Calculi were passed spontaneously in nearly half of the patients.

Objective: To determine the possible therapeutic gain of using three-dimensional conformal radiotherapy (3D-CRT) as a treatment option for portal vein tumor thrombus (PVTT) in patients with hepatocellular carcinoma (HCC) and to evaluate the tolerance and toxicity of using such treatment. Materials and methods: Sixty two patients were enrolled in this prospective study between June 2013 and August 2015. The clinical target volume (CTV) was the PVTT and the prescribed dose was 50 Gy/25 fractions. The median follow-up time was 7.4 months. Results: The thrombus crude response rate was 40.4% and the only significant prognostic factor for response was the thrombus size. Responders had significant better survival compared to non-responders with a median survival of 12.5 and 8 months respectively (P < 0.0001). The radiation toxicity profile was satisfactory. Conclusions: The results of this study suggest that radiotherapy should be considered as a safe treatment option for HCC patients with PVTT. It is effective not only for PVTT local control but also for survival, although prospective randomized trials are needed to confirm these results.

Despite the continuous evolution in different treatment modalities for head and neck cancer (HNC), severe side effects of medications remain a challenge. Chemotherapy (CTH)-induced toxicities may lead to alterations in the treatment plan in the form of dose reduction, treatment delay or even discontinuation of treatment. Many efforts were done to overcome the impact of CTH-induced toxicity on HNC treatment. One of the explored strategies is the pharmacokinetic (PK)-based dosing of CTH. A literature search for trials investigating PK-based CTH dosing in HNC from 1988 to 2018 was performed. Few clinical studies including one randomized clinical trial were identified. The limited evidence obtained from these studies shows that PK-based CTH dosing in HNC results in significantly less toxicities with no detrimental impact on treatment outcome. The current evidence is not enough to recommend the routine use of PK-based CTH dosing in HNC. However, the promising results call for future studies.