A role for human cytomegalovirus (HCMV) in the pathogenesis of glioblastoma multiforme (GBM) was proposed more than a decade ago and has since generated a considerable debate as a possible therapeutic target. We investigate the presence of HCMV in the specimens of patients with GBM treated in our centre. This is a retrospective cohort study to investigate the presence of HCMV by routine immunohistochemical stains and polymerase chain reaction (PCR)-based molecular analysis on formalin-fixed-paraffin-embedded tissue of all patients with GBM treated in our hospital in 2009-2013 (5 years). The evaluation of positivity by immunohistochemistry (IHC) was semi-quantitative. The molecular analysis was performed by extracting the tumour DNA from representative paraffin-embedded tissue blocks and amplified for detection by a sensitive real time PCR (RT-PCR) CMV assay. During the study period, we treated 45 patients with GBM; however, adequate pathology tissue materials were available only for 32 patients. All the pathology material was reviewed and the diagnosis was confirmed. All the cases were found to be negative for CMV expression by our IHC and RT-PCR CMV assay. Our study has shown no expression of CMV in GBM. Our results were similar to other recent reports that concluded insufficient evidence to recommend routine testing for CMV in GBM or treatment as an add-on therapy.

e12009 Background: Oncotype-DX assay recurrence score (ODX-RS) cut-off values have recently changed in response to the results of the TAILOR-X trial. We aim to explore decisions for ACT based on physicians’ clinical assessment and on evolving ODX-RS. Methods: Patients who underwent ODX testing after curative surgical resection of estrogen receptor positive (ER+), Her2 non-over-expressed (Her2-) and lymph node negative (LN-) BC were included. Patients with micro-metastases to LNs were excluded. Data was collected retrospectively from the electronic records. Management of these patients was guided by the results of the old ODX-RS-1 (<18, 18-30 & ≥31) risk grouping. For the purpose of this study, treatment decisions were also assumed according to TAILOR-X results (ODX-RS-2). Decisions of 3 medical oncologists on ACT were solicited by blinding them to the RS values to investigate inter-physicians discrepancy and concordance with ODXA RS-1&2. Results: Sixty six consecutive patients fulfilled the inclusion criteria. Median age was 50.5 (range: 21-73) years. There was one male patient and 37 out of 65 females (56.9%) were pre-menopausal. Median tumor size was 21.5 (range: 10-55) mm and the grade were I, II and III in 6 (9.1%), 46 (69.7%) and 41 (21.2%) patients respectively. The 3 oncologists’ had discrepancies about ACT recommendations in 29 (44%) patients. Based on majority opinion (≥2 oncologists), ACT would have been recommended to 22/41 (53.7%) and 24/46 (52.2%) patients with low risk tumors according to ODXA RS-1 and ODXA RS-2 respectively. Similar number of patients (n=12) would have received ACT regardless of ODXA RS cut-off value (table). Conclusions: Decisions on ACT for patients with ER+/Her2-/LN- early BC should be guided by ODX-RS to prevent overtreatment and discrepancies in management. Broadly, ODXA RS-1 and ODXA RS-2 seem to guide ACT decisions in similar proportions of patients. Nevertheless minor differences exist and need to be studied in larger cohorts. [Table: see text]

Background: Obesity and overweight are usually considered as poor prognostic factors in early breast cancer. Body mass index (BMI) is a significant predictive factor for lower pathologic complete response (pCR) rates after neo-adjuvant systemic therapy (NST). The relationship between obesity and breast cancer prognosis varies according to patient and tumor characteristics such as menopausal status and tumor subtype, respectively. Patients and Methods: Between March 2010 and October 2013, 80 patients with early breast cancer who had received standard NST from KFSH Saudi Arabia were included in this study. For statistical analysis, the study participants were categorized into two groups based on their BMI, as normal (BMI < 25 kg/m 2) and obese groups (BMI ≥ 25 kg/m 2). pCR was defined as non-invasive cancer in the breast/axillary tissue. Results: The median age of our patients was 48 (range, 38-68) years. Invasive ductal carcinoma (IDC) subtype was identified in 93.8% of the cases. Additionally, 26 (32.5%) and 33 (41.25%) patients were diagnosed with stage II and stage IIIA breast cancer, respectively. Lymphovascular invasion was detected in 32.5%, whereas intermediate and high-grade malignancy were found in 61.25% and 32.5% of the patients, respectively. Forty-four patients (55%) were obese. pCR was achieved in 56 patients (70%), and the comparison between patients with and without pCR revealed that those in the former group had significantly lower tumor grades. Significantly, lower relapse and mortality rates were distinguished in patients who achieved pCR than in those who did not. Additionally, comparison between normal and obese patients revealed that a high number of patients in both groups were post-menopausal (p = 0.001). However, survival analysis indicated the absence of significant differences in disease-free survival between the two groups based on BMI (p = 0.19). Conversely, patients with normal BMI had significantly better overall survival than obese patients (p = 0.029), with a higher mortality rate noted in the obese group (16.7% vs 2.3%, p = 0.037). Conclusions: In the present study, 58.3% of patients that failed to achieve pCR had BMI above the normal level; they moreover had higher relapse rates and lower survival compared with normal BMI patients. This finding needs to be verified through further prospective studies to determine if BMI is a risk factor for breast cancer.

Background: scaphoid waist fractures can be fixed percutaneously as opposed to being cast-immobilized Evaluation of the results of patients with stable waist scaphoid fractures following percutaneous fixation with a Herbert screw or cast immobilisation. Methods: A total of 30 patients, age from 19 to 60, were included in this prospective study at the orthopaedic department's hand and microsurgery unit at Sohag University Hospital. The extent of mobility, the strength of the grasp, the ability to return to work, and the radiological assessment were checked. Results: Follow up were 12 months. Patients who received volar percutaneous fixation experienced an earlier union than those who had conservative treatment with a cast. Conclusion: An earlier time to union, a rapid return to daily activities, and an earlier wrist motion recovery were all made possible by percutaneous treatment of acute stable waist scaphoid fractures. Compared to the operative group, the conservative group has a greater nonunion rate.

The medicolegal report written by physicians must prove the relationship between an injury and an alleged prohibited act. This affects the judges' opinions in criminal cases. This cross-sectional study aims to assess the awareness of resident doctors at Sohag University Hospital about the medicolegal reporting of injuries compared to grade-five medical students. The participants were asked to fill out an online questionnaire that included pictures of seven types of wounds to identify the medical, Arabic term of the wound, causative instrument, legal classification, and expected healing time. One hundred twenty-nine respondents (85 students and 44 residents) were included in this study. The students' group showed significantly higher results compared to the residents' group in three questions: causative instrument of a stab wound, medical term of the lacerated wound, legal type of fracture (p-value: 0.022, 0.026 and 0.007 respectively) While residents' group had better results regards causative instrument of contusion, medical term and recovery time for the fracture (p-value: 0.041, 0.019 and 0.037 respectively). The total score of correct answers for each participant in both groups showed a homogeneous distribution with a mean+ SD of 26.5±3.6 in the students' group and 25.8±3.7 in the residents' group. There was no statistically significant difference between both groups regarding total score (p-value:0.321). In conclusion, although both students and the residents' group had a comparable level of knowledge, this level does not reflect the expected experience among the resident's group. It is recommended to hold frequent workshops to enhance the physicians' medicolegal reporting of injuries.