ABSTRACT
Objective: To determine the accuracy of intraoperative radionuclide scintigraphy for detection of sentinel lymph node [SLN], using 99mTc-Nanocolloids, in patients with early breast carcinoma
Study Design: Cross sectional analytical study
Place and Duration of Study: Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi and department of Surgery, Pak Emirates Military Hospital, Rawalpindi, from Jul 2012 to Jun 2013
Patients and Methods: After fulfilling the inclusion and exclusion criteria and taking written informed consent, 67 patients of carcinoma breast were enrolled in the study. Each patient was injected with 37 MBq of 99mTc- Nanocolloids, via sub areolar, peri-tumoural route, pre-operatively. SLNs were identified using handheld gamma probe followed by excision biopsy. Patients, then, underwent modified radical mastectomy with dissection of axillary lymph nodes [ALN] and the samples were sent for histopathology
Results: Out of 67 patients, 28 to 77 years of age [mean +/- SD of 49.61 +/- 11.572 years], 17.9 percent [12] patients had T1tumour while 82.1 percent [55] had T2 tumour [mean +/- SD of 3.48 cm +/- 1.050 cm]. Histopathology revealed no metastasis in SLNs as well as ALN of 55.2 percent [37] patients while 40.3 percent [27] patients were positive for both. However, in 4.5 percent [3] patients SLNs were negative for metastasis with positive ALN. Diagnostic accuracy was calculated to be 95.5 percent, sensitivity 90 percent, false negative rate 4.5 percent and negative predictive value 92.5 percent
Conclusion: Intraoperative radionuclide scintigraphy, using 99mTc-Nanocolloids and handheld gamma probe is a reasonably accurate technique for localization of SLNs in early breast carcinoma
ABSTRACT
Objective: To evaluate the effectiveness and safety of treatment for proximal ureteral stones with pneumatic lithotripsy compared to holmium: yttrium-aluminum-garnet [HO: YAG] laser therapy
Study Design: Randomized control study
Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi from Sep 2014 to Mar 2015
Material and Methods: This randomized control trial was conducted at Armed Forces institute of Urology Rawalpindi. A total of 73 patients who underwent treatment between Sep 2014 and Mar 2015 were included in the study. Of the patients, 37 had pneumatic lithotripsy [PL group] and 36 had ureteroscopic HO: YAG laser lithotripsy [LL group] using rigid 8 Fr-ureteroscope for the fragmentation of the ureteric stones. Patients were evaluated for stone clearance after 3 weeks, with X-ray KUB, ultrasound and plan CT KUB [where indicated]. All the data were recorded in a proforma and analyzed in SPSS version 11
Results: There was a difference between the two groups according to overall stone clearance rate 83.8% for PL group vs. 86.5% for LL group. Proximal stone migration was seen in 16.2% of cases in PL group while in only 5.5% of cases in LL group. The overall complication rate was 35.1% in PL group while 30.5% in LL group. The mean procedure time was 28.8 +/- 4.5 minutes for PL group while it was 35.5 +/- 8.6 minutes for LL group
Conclusion: The pneumatic and holmium: yttrium-aluminum-garnet laser lithotripsy both are established choices for treatment of ureteral stone but in terms of stone clearance rate and decrease incidence of proximal stone migration HO: YAG lithotripsy is better than pneumatic lithotripsy
ABSTRACT
To explore the effects of electronic media polio immunization campaign on parents at cognitive [awareness/knowledge] and co-native [behavior/practice/implementation] levels in NWFP Pakistan. This descriptive analytical survey was conducted on a sample of 500 parents from 24 districts of North West Frontier Province [NWFP] of Pakistan. All the districts were divided into 3 groups and six districts from each group were selected. Data was collected through closed-ended questionnaire of multiple choices. Out of 468/500 responders, 70.6% and 48% agreed on that television and radio has a role in awareness about polio immunization campaign respectively. Higher education, high socio-economic status and well exposure to electronic media were significantly related with awareness about polio campaign. Around 95.6% of high socioeconomic status families, 95% of well educated and 91.6% of very/frequent exposures to electronic media had fully immunized their children as compared to 80.8% of low socioeconomic status families, 73.6% of illiterate parents and 69% of no exposure to electronic media. While 14.3% of low socioeconomic status families, 23% of illiterate parents, and 26.8% of never exposures to electronic media had not immunized their children at all as compared to 3.1% of high socioeconomic status families, 3.7% of graduate parents and 5.6% of very/frequent exposure to electronic media. Majority of parents are aware of polio campaign however their living standards, level of education and exposure to electronic media like TV and radio are the main factors affecting awareness knowledge and practice of polio campaign