EFFECTS OF CERVICAL MUSCLES STRENGTHENING WITH AND WITHOUT SHOULDER EXERCISES IN POST-MASTECTOMY PATIENTS WITH NECK PAIN

Background of the Study: To compare the effects of cervical muscles strengthening with and without shoulder exercises on post- mastectomy patients with neck pain. Methodology: It was a randomized clinical trial, conducted in physical therapy department of a clinical setting through Dynamometer. Sample size of 24 patients were taken. Non-probability convenience sampling technique was used. A written consent form was taken from patients meeting inclusion criteria and were randomly allocated. In one group, patients were treated with cervical Muscles strengthening with shoulder exercises. In other group, patients were treated with cervical Muscles strengthening alone. Treatment was given once a day for three weeks. Muscle strength was examined using dynamometer, Baseline data was taken before treatment on first day after inclusion in study and again on the last day after treatment. SPSS 25 was used to analyze the data. Results: Wilcoxon signed rank test was used to compare individuals within the group which showed significant results in both groups, p-value 0.000 (i.e. <0.001) for neck strength. Between groups comparison was done using Mann-Whitney U Test and it showed no significant changes for cervical extensors (p- value;0.143) , cervical side bending (right) (p-value; 0.315) and cervical side bending (left) (p-value; 0.853) strength differences, but however cervical flexors strength showed statistically significant results as p-value was 0.003. Conclusion: It was concluded that Cervical strengthening along with shoulder Rehabilitation can help improve the strength of cervical flexors. However, both the groups have equally resulted in improved cervical extensor, Side bending right and left strength.

Expression Patterns of P53 and Her2/Neu in Primary Ovarian Carcinomas

Background: Ovarian tumours are common neoplasms of the female genital tract and a leading cause of cancer mortality among women. There is paucity of local Kenyan data on the morphologic subtypes of ovarian tumours and the expression of select prognostic markers in ovarian carcinomas has not been previously investigated. The aim of this study was to determine the frequency and describe the patterns of p53 and HER2/neu expression in primary ovarian carcinomas and to describe the clinical and pathologic features of ovarian tumours diagnosed at the Pathology Laboratory of the Aga Khan University Hospital Nairobi. Methodology: A cross-sectional descriptive study was undertaken. Electronic histopathology reports of all ovarian tumours diagnosed over a three year period in the Histopathology department at the Aga Khan University Hospital Nairobi Laboratory were retrieved. Clinical and pathologic data were recorded. Haematoxylin-eosin stained slides of the ovarian carcinomas were reviewed and appropriate paraffin-embedded blocks selected and retrieved from the archives for immunohistochemistry. Additional paraffin blocks of primary ovarian carcinomas diagnosed consecutively over a 2 year period from the Aga Khan Hospital Kisumu, and the AICKijabeHospital were included in the study after review of haematoxylin-eosin stained slides. Sections were cut from all the selected ovarian carcinoma blocks and stained for HER2/neu and p53 using standard immunohistochemical techniques. The data were analyzed using SPSS version 17 and are presented in tables and charts. Results: Three-hundred and seventy-four ovarian tumours were diagnosed at Aga Khan University Hospital Nairobi during the study period. The median age for malignant tumours was 51.1 years. The most common benign tumour was mature cystic teratoma (44.3% 95%CI ±5.68%). The most common malignant tumour was serous carcinoma (44.7% 95%CI ±11.43%). Forty-three point three percent (95%CI 32.1-55.2%) of carcinomas were positive for p53 and 13.4% (95%CI 7.2-23.6%) were positive for HER2/neu. Serous carcinoma (61.1% 95%CI±15.9%) and adenocarcinoma, not otherwise specified (33.3% 95%CI ±11.3%) were more likely to be positive for p53. There was no association noted between the histologic grade or pathologic stage and positivity for p53. There was no association noted between staining for HER2/neu and histologic type, histologic grade or pathologic stage of carcinoma. Conclusion: The proportion of histologic subtypes of primary ovarian tumours that were diagnosed is similar that described in literature. There is no significant difference in the expression patterns of both p53 and HER2/neu from that described in literature.