Psychological traumatic events in the recent past and association with diagnosis of cancer

Emotional stress due to psychological trauma causes immune system dysfunction resulting in high risk of development of cancer. The study aimed to correlation psychological trauma in the past five years of cancer diagnosis. This study was a community based survey including cancer patients diagnosed with different cancers undergoing treatment or follow-up by using snowball sampling and questionnaire based technique. The study was conducted during a period of one year from December 2019 till December 2020. All recruited patients were requested for an interview. The results of the study showed a high rate of major psychological trauma among cancer patients. Sudden death of a close relative with and without trauma of natural disaster were high. The study conclude that risk of cancer development rises with major emotional trauma specially death of a close relative.

Validation of onco-assist survival prediction tool in stage I, II and IIIcolon cancer among Asian patients

Clinical calculators and predictors are now commonly used in clinical practice to predict most accurate clinical outcome and provide guidance for appropriate therapy. One of the most used calculator is Onco-assist. This study was conducted to compare onco-assist prediction of the patients diagnosed with colon cancer Stage I, II and III. Data was retrospectively collected from 88 patients of colon cancer diagnosed over the period of 11 years (2008 to 2018) and registered at Nuclear Institute of medicine and radiotherapy (NIMRA), Hospital, Jamshoro Sindh. These patients received primary surgical therapy without any neo-adjuvant systemic chemotherapy. Survival assessed on onco-assist prediction algorithm using the defined parameters and compared with the actual survival according to the grade of the tumour. The clinical calculator onco-assist incorporated seven variables: gender, age number of lymph nodes examined, number of tumor-involved lymph nodes, T = (1-4), grade (low / high), adjuvant chemo received (yes / no) if yes then only 5FU or 5FU plus Oxaliplatin based. Onco-assist predicted five-year survival rate in well differentiated tumours with and without chemotherapy as 84% and 80% respectively, in moderately differentiated tumour with and without chemotherapy as 78% and 76% respectively. For poorly differentiated tumours the predicted survival rate with and without chemotherapy was 73%. While actual achieved survival was 35%, 52% and 17% for well, moderately and poorly differentiated cancers. This clinical calculator onco-assist includes limited parameters and limited adjuvant therapy options thus the prediction of cancer survival following surgery in stage I –III colon cancer does not appear to accurately predict outcome in Asian population.

Familial traits of attached and unattached earlobe in human population of different age groups- A case study of district Nawabshah, Pakistan

This study aimed to evaluate frequency of attached earlobes (dominant) and unattached earlobes (recessive) traits in humans of different age groups. This study was conducted in the Department of Molecular Biology and Genetics of Shaheed Benazir Bhutto University, Shaheed Benazir Abad from September to October 2020. A total of 200 families with attached and unattached earlobes were included by using non-probability convenient sampling. Data was collected regarding attached and unattached earlobes of different people. The data was collected and analysed by using SPSS version 21.0. Results of the study suggested that unattached earlobes were dominant feature, and the attached earlobe feature appears to be recessive among all 200 families. We observed that the dominant feature of the unattached earlobe was more common in the 1 to 20 years’ age group, while the recessive feature of the attached earlobe was common in 31 to 45 years old age group. The study concluded that unattached earlobes can be observed in people of every age group and associated with family traits.

Hydroperitoneum: A complication of mini PCNL in pediatric age group? -A case report

Renal stones constitute 40% of renal disorders in Pakistan with silent stones constituting up to 3%. Nephrolithotomy and Pyelolithotomy were the only surgical options available for the treatment of large renal stones, with high rate of complications. Percutaneous nephrolithotomy (PCNL) has now become the mainstay of treatment for large renal stones over the past 30 years. Recent advances in equipment and technology has made PCNL the gold standard for this disease, resulting in removal of stones with shorter recovery time and decreased morbidity and mortality, and with few complications Case Discussion A boy aged 13 years, underwent mini PCNL for treatment of left side renal stone causing hydronephrosis, previously evaluated by KUB X-Rray and non contrast CT scan. His retrograde-percutanous access to the collecting system was done under fluoroscopic guidance. At the end of procedure, patient revealed taut and distended abdomen. Aspiration revealed presence of intraperitoneal fluid. Patient was effectively treated with immediate placement of abdominal drain with improvement of clinical presentation Conclusion Hydroperitoneum is a rare complication of conventional PCNL. Based on our experience and review of published literature, our case of hydroperitoneum after mini PCNL, is the first of its kind. A high degree of sensitivity and knowledge of this complication during PCNL in children would help identify and manage this complication in future. We recommend examination of abdomen post-PCNL in every child before he/she is brought out of anesthesia.

Assessment of pattern of refractive errors in infantile esotropia- A single-center cross-sectional study

This was a cross-sectional study conducted to explore the patterns of refractive errors found in infantile esotropia patients from newborns to the age of 15 years, attending the Pediatric clinic of Al-Ibrahim Eye Hospital, Karachi, Sindh, Pakistan. Data was collected on a pre-designed proforma. A total of 79 patients (total of 158 eyes) including 44 males (55%) and 36 females (45%) were recruited. All these patients had infantile esotropia. The study showed out of 79 patients (158 eyes), 89 eyes had hyperopia, 15 eyes had myopic astigmatism, 44 eyes had hyperopic astigmatism, while 4 eyes had mixed astigmatism, and 6 eyes had myopia. The hypermatropia was found to be the most commonly occurring refractive error in infantile esotropia resulting in inward eye deviation.

Association of body weight on pulmonary function tests in young individuals (aged 18- 40 years)- A cross-sectional study

This was a prospective cross-sectional study conducted to evaluate association of waist, hip and thigh circumferences on respiratory parameters among young healthy adults. A total of 180 volunteers of different weight categories; including underweight, normal weight, over weight and obese people were recruited by using non-probability convenient sampling technique. Non-smoker males and females (non-pregnant), aged between 18-40 years with no pulmonary and cardiac disease were included in the study. Waist circumference, mid-thigh circumference, hip circumference and respiratory parameters were measured. The results showed a significant association between waist circumference with forced vital capacity (FVC) (r = 0.188, p = 0.011), average tidal volume (VT) (r = 0.160, p = 0.032), inspiratory reserve volume (IRV) (r = 0.388,p<0.001), vital capacity (VC) (r = 0.312, p<0.001), total lung capacity (TLC) (r = 0.385, p<0.001), and functional residual capacity (FRC) (r = 0.477, p<0.01), and a negative association with forced expiratory volume in 1 second (FEV1) (r = -0.148, p = 0.048) and FEV1/FVC ratio (r = -0.246, p<0.001). Significant association was not observed between waist circumference and expiratory reserve volume (ERV) (r = 0.071, p = 0.344). In the present study, increased waist, hip, and thigh circumferences were found to be negatively associated with FEV1 and FEV1/FVC ratio. Spirometry should be performed in obese and overweight young healthy adults even if they are asymptomatic, as early preventive measures can be taken to reduce the resulting morbidity.

Global burden of gynecological cancers

Gynecological cancers include malignant tumours arising from reproductive organs in women including ovaries, uterus, vagina vulva, and cervix. Cervical cancer is reported to be the most common cancer while the vagina is reported to have the lowest incidence all around the world. According to the World Health Organization report Asia has the highest rate of gynecological cancers followed by Africa, Europe, Latin America, North America, and the lowest rate is observed in Oceania. The rate was predicted to rise in the upcoming years. Thus appropriate strategies are needed to be adopted to control disease outcomes and adopt preventive strategies.

LIGATION OF INTERSPHINCTERIC FISTULA TRACT AS AN ALTERNATIVE TREATMENT FOR PERIANAL FISTULA AT TERTIARY CARE HOSPITAL

This study was aimed to evaluate clinical outcome of patients with perianal fistula operated with the ligation of intersphincteric fistula tract (LIFT) technique. The study was conducted at Department of Surgery, Liaquat University of Medical & Health Sciences, Jamshoro from July 2018 and August 2019. A total of 22 patients diagnosed with perianal fistula operated with the Ligation of Intersphincteric Fistula Tract (LIFT) technique were selected using non-probability consecutive sampling technique. Physical examination and magnetic resonance imaging (MRI) and/or endosonography (ES) were performed to make a confirmed diagnosis of fistula. They were classified according to Parks classification. All patients were subjected to intersphincteric fistulous tract ligation using the technique defined by Rojanasakul modified. There were 16 males and 6 females. Mean age was 42 years (range 23-68 years of age). Out of 22 patients, 17 patients had a history of perianal abscess drainage prior to surgery and an average preoperative symptom presentation was 2.2 years (range 0-10 years). Therapeutic success with first surgery was achieved in 77% and with a second surgery in 90%. None of this patients modified their preoperative Wexner. It was concluded that LIFT technique appears to be a convenient, reproducible, and effective surgical alternative. This provides an appropriate closing rate and without continence modification, Therefore indicated for complex cryptoglandular fistulas.

Impact of mandibular resection guidance prostheses on oral health related quality of life (OHRQoL) - A prospective study

This prospective study was aimed to measure the impact of mandibular resection guidance prostheses on oral health-related quality of life (OHRQol). A total of 35 patients with mandibulectomy defects were included. All the patients were rehabilitated with mandibular resection guidance prostheses respectively. These patients were subjected for assessment of OHRQol. The assessment was done by using OHIP-Edent-19 and a novel scale—maxillofacial prosthesis performance scale (MFPPS). The assessment was done on all the patients at two weeks and three months of prosthesis function. The scores of OHIP-Edent, and MFPPS for mandibular resection guidance prostheses after two weeks were 33.20and 18.74 respectively. The scores of OHIP-Edent and MFPPS for mandibular resection guidance prostheses prostheses at three months were 27.71and 15.20 respectively. These findings show significant improvements of prosthesis in terms of functional, physical, psychological and social parameters after long-term follow-up (3 months).

FACTORS AFFECTING UTILIZATION OF ANTENATAL CARE AMONG WOMEN ATTENDING PRIVATE SECTOR OUTPATIENT DEPARTMENT

This study aimed to evaluate the factors influencing women to avail antenatal care among women attending outpatient department (OPD), of private sector hospitals in Hyderabad. This was an interview-based survey conducted during a period of six months (from1stJuly 2019 to 31st December 2019) at OPD of private sector Hospital in Hyderabad. All the pregnant women and their female companions attending the antenatal OPD were included. Those women who regretted being part of the study were excluded. Participants of the study were interviewed regarding the knowledge and factors affecting utilization of antenatal care among women attending OPD as defined in a pre-set questionnaire. All the data was recorded in self-made proforma and analyzed by using SPSS version 20. A total of 500 pregnant women were interviewed regarding awareness of antenatal care. The study participants were grouped according to their age, 3% were 15-20 years of age, 30.9% were 21-30 years of age, 34.5% were 31-40 years of age and 31.5% were more than 41 years of age. Out of those who did not avail antenatal care, 8.5% were not allowed due to family restrictions, 47.3% reported ignorance, 9.7% lived far away from the facility, 24.2% could not afford it and 10.3% had other reasons of not availing antenatal care. The study concluded that the main reason for not utilizing antenatal care was ignorance by the women as well as their family members; affordability was also an important factors in a considerable number of participants.