Delayed presentation of anorectal malformations in a tertiary care hospital in India

Objective: To study the clinical presentation, treatment, and outcome of Retinoblastoma (Rb) in a tertiary care hospital of Pakistan. Methods: A retrospective study was conducted in the Department of Pediatric Hematology Oncology, The Indus Hospital (TIH), Karachi from 1st June 2013 to 30th June 2017. Data including patients’ demography, clinical symptoms and duration, laterality, extent of the tumor, type of treatment, relapse, and final outcome were extracted and evaluated with respect to progression and survival. Results: A total of 93 patients were included; 34.4% were boys. The median age at presentation was 30 months. Leukocoria was the commonest symptom (61.3%), followed by proptosis (37.6%). Unilateral disease was seen in 59.1%, extraocular tumors in 43.5% and metastasis in 28.1%. Enucleation was performed on 46.2%, chemotherapy given to 80.6% and external beam radiation therapy to 29.3% patients. Conclusion: Delayed presentation, recurrent disease, extraocular disease and metastasis on presentation were factors affecting outcome in our cohort. Awareness about the early warning signs and symptoms in both public and health professionals for early recognition and timely management are mandatory to decrease morbidity and mortality. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1720 How to cite this:Zia N, Hamid A, Iftikhar S, Qadri MH, Jangda A, Khan MR. Retinoblastoma Presentation and Survival: A four-year analysis from a tertiary care hospital. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S61-S66. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1720 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Identifying the reasons for delayed presentation of Pakistani breast cancer patients at a tertiary care hospital

Cancer Management and Research ◽

10.2147/cmar.s180388 ◽

2019 ◽

Vol Volume 11 ◽

pp. 1087-1096 ◽

Cited By ~ 1

Author(s):

Faisal Gulzar ◽

Muhammad Shoaib Akhtar ◽

Rafshan Sadiq ◽

Sajid Bashir ◽

Sajida Jamil ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Delayed Presentation ◽

Breast Cancer Patients

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P0277PATIENTS WITH PYELONEPHRITIS PRESENTING ONLY WITH LOWER URINARY TRACT SYMPTOMS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0277 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Fazal Rehman ◽

Farrukh Umair

Keyword(s):

Socioeconomic Status ◽

Urinary Tract ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Upper Urinary Tract ◽

Flank Pain ◽

Care Hospital ◽

Delayed Presentation ◽

Western Population ◽

Urinary Tract Symptoms

Abstract Background and Aims The rate of acute pyelonephritis (APN) is assessed at almost 9– 11 cases for every 10,000 tenants. Its prevalence is more in developing countries and among those having low socioeconomic status. The demographics of the population in our region is different from the western population with multiple factors such as delayed presentation to hospital, varying socioeconomic status, malnutrition and lack of knowledge about basic treatment leads to increased morbidity and mortality as compared to western population. To the best our knowledge this will be the first study of its kind to describe the frequency of pyelonephritis without upper urinary tract symptoms in hospital setting. AIM To determine the frequency of pyelonephritis in patients presenting only with low urinary tract symptoms, at a tertiary care hospital, Karachi. Method Study is conducted at a tertiary care hospital charts and files were reviewed from 01-11-2018 to 28-02-2019 for all the patients having diagnosis of APN from medical record files. Results In our study total five hundred and twenty-one (n=521) patients were included (n=492 (94%) of the participants were suffering from pyelonephritis. Approximately, 22.8% of the patients showed absence of both flank pain and costo-vertebral tenderness but were diagnosed with pyelonephritis on the basis of CT/MRI as presented. While 27% of the patients reported both upper urinary tract symptoms and were also positive on CT-MRI. It is also witnessed that 24% and 16% of the patients either reported flank pain or costo-vertebral tenderness respectively. Insignificant association between gender, age, comorbid with pyelonephritis. While, the total leucocytes count was significantly related with CT/MRI. Conclusion Our study showed significant number of patients having pyelonephritis in the absence of any upper tract symptoms. Ignoring the diagnosis as serious can lead to under treatment, possibility of higher rate of re-admissions or poor selection of initial antibiotics. Whereas, other side of the spectrum haunts with higher investigation cost of imaging and broad spectrum use of antibiotic for every patient presenting with just urinary tract infection in Emergency department. A balance should be devised to equilibrate the balance between two extremes.

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Standing at the edge of mortality; Five-year audit of an emergency department of a tertiary care hospital in a low resource setup

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.3.3680 ◽

2021 ◽

Vol 37 (3) ◽

Author(s):

Sama Mukhtar ◽

Syed Ghazanfar Saleem ◽

Saima Ali ◽

Sarfraz Ahmed Khatri ◽

Anna Q Yaffee

Keyword(s):

Emergency Department ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Healthcare Sector ◽

Care Hospital ◽

Delayed Presentation ◽

Do Not Resuscitate ◽

Low Resource ◽

Coronary Syndrome ◽

Ed Visits

Background & Objective: Understanding the demographics of mortality and its burden in the emergency department of a tertiary care setup can lead to better planning and allocation of resources to streamline process flow. This can be achieved systematically through mortality audit that can identify the loopholes and areas of improvement. Our objective was to characterize the epidemiology of ED mortality in a tertiary care hospital of Karachi, Pakistan. Methods: A five-year retrospective chart review of 322 adult mortalities presenting between January l, 2014 – December 31, 2018 was conducted in the emergency department (ED) of The Indus Hospital (TIH), Karachi. All expiries in ED were included while those brought dead and with do not resuscitate order (DNAR) were excluded. Results: Mortality incidence of 0.076% (7.6/10,000 ED visits in five years) was reported. Amongst 507,759 adult ED visits, 322 mortalities were documented. Mean time lapse before presentation was 44±147 hours and mean length of stay before death was 3.4±2.8 hours. Acute coronary syndrome (ACS) was the predominant cause of death with 109 (33.8%) expiries. Significant association was reported between no history of prior care and high priority (P1) cases (p=0.013). Conclusions: This study identified the contributing factors to adverse outcome such as delayed presentation with systemic gaps in management and unknown disposition. The need to improve these factors at local and national level can lead to improvement in Pakistani healthcare sector. doi: https://doi.org/10.12669/pjms.37.3.3680 How to cite this:Mukhtar S, Saleem SG, Ali S, Khatri SA, Yaffee AQ. Standing at the edge of mortality; Five-year audit of an emergency department of a tertiary care hospital in a low resource setup. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3680 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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The HABITS AND REASONS OF DELAYED PRESENTATION OF PATIENTS WITH ORAL CANCER AT A TERTIARY CARE HOSPITAL OF A THIRD WORLD COUNTRY

Pakistan Journal of Public Health ◽

10.32413/pjph.v8i3.97 ◽

2018 ◽

Vol 8 (3) ◽

pp. 165-169

Author(s):

Zohra Saleem ◽

Syed Akbar Abbas ◽

Falak Nadeem ◽

Muhammad Mansoor Majeed

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Cancer ◽

Cell Carcinoma ◽

Squamous Cell ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Occurrence Rate ◽

Initial Symptom ◽

Care Hospital ◽

Delayed Presentation

Background: Oral cancer accounts for nearly one-fifth of all cancers in males and one-tenth in females globally. Squamous cell carcinoma accounts for 90% of the oral cancer. The occurrence rate of oral cancer is higher in Sri Lanka, Bangladesh, Pakistan and India. In South Asia oral cancer constitutes 25% of all new cancer reported among males. The estimated incidence of oral cancer in Pakistan is 14.7%. Methods: A cross sectional observational study was carried out at a tertiary care hospital in Karachi with a sample of 145 patients with pathological diagnosis of squamous cell carcinoma of oral cavity. Patients were characterized into early stage (I and II) and advanced stage (III and IV), according to AJCC classification of tumors (2010). Data entry and analysis was carried out on SPSS 19. Qualitative data was expressed in percentages and results were accessed by Chi squared test. Results: The mean age was recorded 47.87 ± 12.50 years. Males participants were 63.4% and 36.6% females were incorporated in our study. More than half came with the Stage IV. 35.2% of participants became aware of their initial symptom before 6 months before pursuing any doctor. 83% patients presented with noteworthy habit of Tobacco or Chalia chewing. Bulk of the participants stated that they would have presented before if they had knowledge about the disease. 85% thought that increasing awareness of oral cancer through media may decrease the time in seeking help from qualified doctor. Conclusion: The study concludes that most of the participants presented late to the professional because of lack of knowledge about signs and symptoms of oral malignancy.

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