Microsatellite Instability in Near East Sebaceous Neoplasms: Toward Improved Prediction

Sebaceous neoplasms (SN) comprise a heterogeneous spectrum of tumors with different biological behaviors. In the Near-East Region (NER), microsatellite instability (MSI) in SN's development, and its correlation with the clinicopathologic features of tumors is not well elucidated. A cohort of 225 SN patients (40 benign SNs and 185 sebaceous carcinomas) from the NER was retrospectively reviewed. Clinical variables and available follow-up information were recorded. MSI proteins (MLH1, MSH2, MSH6, and PMS2) as well as P53, P16, EMA, CD8, and PDL-1 expressions were examined by immunohistochemistry. Detection of human papilloma virus was determined by polymerase chain reaction. Microscopic features such as mitotic count and tumor-infiltrating lymphocytes were documented. A minority of SNs from benign (n=2) or malignant (n=3) tumors in the NER exhibit MSI (2.2%). MSI is exclusively found in patients with extraocular lesions (back, n=5) and presented a poor outcome. Among these, PMS2 protein was mostly lost (average=80%, n=4). SN with MSI exhibited a significant increase in p53 expression, (average=62.10%, P=0.002). There was no significant correlation between MSI status and any of the following: PD-L1, CD8, p16, and human papilloma virus infection. Microscopically, SN with MSI show significantly higher mitotic count, cystic changes and increased tumor-infiltrating lymphocytes. MSI is rarely found in NER's SN. When detected, it is exclusively in extraocular SNs with minimal predicative microscopic features and worse outcome.

Child labour in Egypt. II. Impact of work environment on health

The studied population (1000 children and young workers and 250 controls) were interviewed for health complaints and subjected to extensive medical investigations. Health problems are more encountered among the workers than in the controls, which has been attributed to the impact of work on health and to the low socioeconomic background that compels the children to work, which may constitute a potential health problem from the start. The significant health problems include: a) Respiratory system complaints, attacks of cough, chronic bronchitis, bronchial asthma and reduction in FEV1.0/FVC; b) cardiovascular abnormalities including palpitations, sinus tachycardia, anemia, vertigo and syncope; c) gastrointestinal abnormalities including dyspepsia and parasitic infestations; d) neuropsychiatric complaints; and e) other health problems including urinary tract infections, backache, visual impairment, repair of hernia and nocturnal enuresis. The study has been concluded by recommending the use of primary health care approach to child labour, emphasizing the importance of pre-employment and periodical medical examinations for protecting this vulnerable group from work hazards, and expanding the efforts of family planning to reduce family size.

Child labour in Egypt. I. Occupational and socio-economic aspects

The present study comprised 1000 child and young workers in small and medium-size industries in Alexandria, as well as 250 control subjects. Almost all young workers work for more than 40 hours/week and suffer from fatigue. Workers' family needs rather than the lack of family care is the responsible factor for sending the child to work, and the economic problems seem to be the underlying factor for all other problems of child labour. Work improves labourers' socio-economic status and smoking habit, and provides a chance for their personal contacts and interactions, which are reflected on their level of intellectual capabilities; however, it has some impact on their food habits affecting their achievement of balanced diet; and no drug addiction exists among all the studied subjects. Noise and dust represent the main occupational exposures (84.4% and 55.8% respectively), followed by exposure to heat (25.3%), vapors and gases (10.4%) and biological materials (9.0%), and nearly 2/3 of the workers have combined exposures. Work injuries occurred to 18.4% of the workers and 7.4% had more than one injury during employment; however, nearly 1/3 of the injuries required absenteeism off work and/or hospitalization. The injuries have been typically related to industrial operations, occurring mostly to hands and fingers (80.4%), and are mainly attributed to lack of training (63.0%). The health services presented to the workers are very poor. The study has been concluded by recommending making the work safe, free from hazards, and ergonomically fit to children, providing educational and training services, covering young workers by social security, and revising legislation of child labour.